Woulud you exhaust medical resources for your pet?

[Rapunzel]

I think I see your perspective a bit, Annie. My mom and I just recently had a conversation on this regarding her brother's years of chemo. He ended up in the hospital a few weeks ago almost dead - not from the cancer but from the treatment of the cancer. If his cancer wasn't going to kill him his "cure" sure would!

So, he kept going through this cycle of remissions and every time it was getting worse. The chemotherapy was working just enough to keep him from dying while his oncologist was insisting to him and his wife he could be "cured". My mom had a hard time talking to them about the reality of the situation. They did not make any funeral plans in advance - none - because the oncologist drilled it into them that he would "beat" this. My aunt has very bad multiple sclerosis and he had been taking care of her. They made NO arrangements for her care. Why? Because his oncologist insisted he would outlive her (she's definitely got a good decade in her I think). Soooooo, he lived on for many months in agony from the chemotherapy that would fix him. He died a couple of weeks ago.

I don't have a problem with chemotherapy. Definitely not. It does work for a number of people. But, my uncle really wasn't given realistic expectations considering his condition (baaad - two different types of cancer at once with one of them being leukemia). In the end, when it looked like it would be a matter of days, my mom called my cousin (her brother's son) and had him make sure my uncle was getting good pain management. She instructed him on what to say to his care providers. I'm not sure if he understood what she was telling him (in fact, I doubt he understood or he probably wouldn't have said it) but she basically instructed him to tell the nurses to keep upping the morphine - indefinitely until the pain stopped - period. His organs were all shutting down anyway one at a time. Such a painful way to die.

Incidentally, my mom has developed this anger towards oncologists lately. It's purely emotional. Heaven knows she'd go to one in a heartbeat if she was found to have breast cancer! But, I see the complications to the issue and I soooo do not envy oncologists their job!

So, I do have a problem with someone finding out "Oh, I have breast cancer" and immediately running out to figure out how to off themselves. But, I have no problem in easing the pain of a person who is in incredible suffering. And, if that pain management hastens that person's already immediately impending death I'm OK with that. I have a problem with euthenasia - but not with pain management if that makes sense. (And, yes, I'm OK with medical marijuana - but that's a tangent and the gonja ain't gonna kill you ).

Well, we've completely taken this thread away from the animals now!

Jennifer

[DCJenn]

I remember crying hysterically at the pharmacy (conveniently) located across from the vet telling Rick, "OK, I can do one injection, but the minute he goes to two per day, that's it." right. but remember, I had a sick relationship with the Fat Bastard.

My parents kept our family cat alive way too long with sub-I fluids (on the dryer) and various other treatments, my brother just put their 12 yo pointer to sleep after unsuccesful cancer treatment and our friends who adopted right before we did had a 6 yo dog that they finally removed from cancer treatment after he was more miserable with treatment. Cancer is a horrible way to go. My FIL basically was begging us to do the same for him and unfortunately we couldn't.

jenn

First, I have to make a plug for the diabetic pet, well a diabetic dog. I've heard cats with diabetes are difficult to manage and oozing diarrhea? No quality of life there.

Our dog has had diabetes for over and year and now that I am in the swing of things, it is no big deal. I give him 2 insulin shots per day -- that costs me around $30 per month. He does need different food but the price difference between that and the other stuff I fed him is small. I don't have to monitor his blood sugar -- I'm hoping we can get to a twice per year schedule. It did take us a while to get the right dosing but I think we have it figured out (different amounts for the am and pm is the trick!). Within a few weeks of getting insulin, he was back to his happy go-lucky self and I think it is safe to say that he has a very good quality of life. So.....for anyone out there that learns their dog is diabetic -- it might not be so bad!

Incidentally, my mom has developed this anger towards oncologists lately. It's purely emotional. Heaven knows she'd go to one in a heartbeat if she was found to have breast cancer! But, I see the complications to the issue and I soooo do not envy oncologists their job!

That sums it up for me. I've been pretty disillusioned after seeing everything that my FIL went through.

I've now re-written and erased this more times than I can keep track of. It is frustrating when it feels easier (though not easy) to provide a pet a more dignified death than it is for a parent.

[Michele]

So here's another opinion....and I KNOW my opinion is biased...

One of my best friends in vet school had an old dog...about a 9 yo boxer. This boxer had had most of the "boxer" diseases, boxer cardiomyopathy, boxer corneal ulcers, boxer gingival hyperplasia...and I think a few more...she started having intermittent vomiting and diarrhea and after much of my urgance, we ended up diagnosing her with an intussuception most likely secondary to intestinal cancer. We checked her lungs for evidence of metastasis, didn't see any and my friend made the decision to spend >$2000 for surgery and post op care...Honey the boxer stayed in the ICU for a few days due to her heart disease making sure she was ok to go home...shen went home and recovered from the surgery (several feet of intestines were removed)...and Honey had a great two weeks...until she started having seizures...we assumed it was a metastatic lesion that started growing faster after the primary tumor was removed and she elected euthanasia after the second seizure. My friend wouldn't have traded those last two weeks for anything. Honey was back to acting like a puppy and it gave them a chance to say goodbye.

Another story, a 7yo German Shepard who bloated (gastric dilation and volvulus). Presented with a high lactate level (usually means a poorer prognosis), we went to surgery, derotated the stomach and the dog looked great...didn't even have to remove the spleen or any part of the stomach...recovered in ICU and then 1 day later started bleeding from the incision...he was slipping into DIC (a very serious clotting/bleeding problem)...after $4000 worth of plasma transfusions/intensive management he went home and is doing great.

A 2 year old Rhodesian Ridgeback presented for anemia and weakness...the day before thanksgiving of 2003, I diagnosed her with a high stage lymphoma...cancer. She was given chemotherapy and she responded beautifully and went into remission. I don't know how she is doing now because they didn't ahve a lot of money so they went back to their regular vet for the follow up treatments, but I know she made it through the Christmas season with her family and was much happier than when she originally presented to us.


Some argue the "old" dog, ie. who knows how much longer...some argue that cancer is just devestating...I can respect each of those opinions...and I wouldn't tell anyone they were wrong for making a decision that involved finances, or gross out factor...or emotional turmoil....ultimately, you must do what is best for your family and situation as it stands at the time you have to make the decision...like Jenn said about "before children."

On the cancer note....
I think what we do in vet med with cancer is different than what goes on in the human side...we only *hope* to achieve remission and cure...usually we strive for quality of life...reducing tumor burden to relieve clinical signs, so that we can buy a few more months to a year or even more of a happy pet. Yes some cancers don't respond to our treatments, but many do, even if it's just for a few months. The quality of the life for the patient is always our number one goal...not the cure...in human med we wouldn't be allowed to let a cancer go without trying, hard, really hard...some "rights" group would be all over it....or a grieving family member who was lost in their pain.

I greatly respect the power I have to control death. I've never euthanized an animal and not felt completely terrible doing it...nor I have I ever thought that it was the wrong thing to do. Haivng watched people and animals die "naturally" I am very thankful that I am allowed to spare final suffering in some patients.

Very well put Michele!

[Rapunzel]

Very insightful, Michelle.

Jennifer

Thanks, Michelle!

I would add to that list the $2,000 or so my parents spent on rattlesnake anti-venom after our dog was bit. It took a few more doses than they expected and at a couple of hundred dollars per dose it adds up. Truly, it brought her back from the brink of death and I can't imagine letting her die that way -- or stopping after a few doses of anti-venom.

I realized I missed the orginal question before. The age of my pet and what is thought to be wrong would probably determine whether I exhaust all options. So far the diabetes treatment has been well worth it as was the denimectomy surgery (dog ate a leg of jeans). But that is small potatoes...

[Vishenka69]

As Fira is our only baby at the moment, I would spend any money necessary for her treatment. Although if it came to quality of life issues, I would have to think twice. A few years back, she swallowed some string and I had to take her to a vet ER. I didn't even blink at spending $150 for the vet to tell me it'll come out naturally the next day (it did).

These days there's even pet medical insurance, so I guess that's always an option.

As for the people and the euthinasia issue, I'm still on the fence for that. I think it really depends on a case by case situation.