Endings and Grievings
Life endings are a subject most of us would prefer not to think about. We'd all like it best if our beloved pets would go quietly in their sleep at about age 100 (human years!). Unfortunately, not many of them do that. In our practice, we see many animals at the end of their lives. Many come here when they've been diagnosed with something like kidney failure or cancer. Others have been coming here for many years for acupuncture of general care and simply reach the end of their journey on this plane. A frequent question is "How will I know when it’s time?" There’s no easy answer. Nothing about endings is easy. You will know. Although each animal is different, each owner is different and each situation is different, there are a few generalities that can be made.
It's a good idea to be aware of what constitutes Quality of Life for your pet so that you’re not asking yourself that question at a time of confusion and uncertainty, which end of life often is. Make a list. The list may change over time, just as it would for human from infancy to old age. On the list will be the basics like vital organs functioning properly, the ability to eat and drink without assistance, to process food and eliminate, to walk, run, or climb stairs. Loss of these important abilities may or may not mean it's time for the enc. We've seen cats and dogs who for one reason or another cannot urinate and/or defecate on their own or cannot control those functions, but with the trained assistance of their owner or the help of pet diapers or medication can still lead happy lives. We've seen a cat with a liver problem who needed a feeding tube for a while. We've seen others who cannot walk on their own but are very happy in a pet wheelchair. Eyesight and hearing are functions sometimes lost to older dogs and cats, but most of them can function quite well in spite of the loss. These are the obvious items on the list. The owner’s ability to cope, practically, emotionally and financially, with such issues is also an important consideration.
The less obvious items are those particular things that make your pet happy. Going for a walk or a ride in the car may be very important to your dog, or being able to get up on the bed or into that special chair. Your cat may live for that worn out catnip mouse. Does he or she greet you at the door every night? Is there a special game you play? Observer and identify what activities are important to your pet. Add them to your list.
As you cross off the items your pet can no longer achieve or enjoy, you know you’re getting closer to time to let go. In some cases there is very little doubt about the time, especially if a tumor bleeds out or causes lungs to fill with fluid or cuts off circulation to a vital organ. A fatal disease can take the decision out of the owner’s hands. Often, however, our companions decline slowly or just plain get old and we wonder – should we euthanize? When?
Stacy's Renee was a 14 year old Golden Retriever, a lovely old lady. As often happens with the elderly ones, she gave Stacey a few scares. She had pneumonia several times. One day Stacey came home to find Renee curled up in front of the kitchen door so that Stacey couldn't open it. She thought the end had come, but once she managed to get inside, she found that Renee had just been sleeping very soundly. Each morning she would look Renee over, think "Is this the day?" The day came when the answer was "No"” in the morning but by afternoon the time had come. Sometimes you can plan a couple days ahead; other times it has to be Now. Stacey has three other Goldens, Tanner, Kylee and Bouncer. She still misses Renee.
Mouse was 17, and Bill and I had her since she was a foundling kitten. That’s a good old age for a cat. Once day she decided not to eat any more. Quality of Life for her involved going an a tear from one end of the house to the other, once in the morning and once at 10 p.m. On the dot. She stopped doing that as well. An ultra sound indicated that she probably had lymphoma. At that age, we didn't want to put her through any surgery or chemo or radiation. She declined over the next two weeks. We had the opportunity to spend some quality time with her, hold her and tell her how much we loved her. Although she did continue to eat a little, she grew steadily weaker until it was time to help her make the transition. She died in November, and for practical reasons we waited until after the Christmas tree came down to get another cat, rather that deal with that issue right away. We still had Freep at home. We still miss Mouse.
Fearless Freep had quite a long Quality of Life list. Every other item involved some form of food. Also on his list were bird watching; sunbathing on the screened porch; being with his true love Gracie; and trying to make kittens with his teddy bear, Lester, which he did every day of his life from about one year old until his last few days. In the end, none of these things mattered. He couldn't keep any food down, and the tumor in his chest kept filling his lungs with fluid. Can't eat, can't breathe – other considerations no longer matter. We euthanized him, and I was able to hold him while he passed. It was a very sad time, but a very intimate and precious moment. It was some time before I was ready to bring another cat home to keep Gracie company. We still miss Freeep.
Gracie's passing was different. Dr. Kathy found the abdominal mass in the morning and sent us directly to the surgeon. By noon, I was giving permission to euthanize her on the operating table. Her tumor was gotten off the blood supply to her liver, and she would have been in constant pain. Waking her up just to say goodbye would have been cruel. She was my little angel, and she left a big hole in my heart. I was surprised to find that I wanted another cat right away, but had to wait almost four months to get the right companion for Sam. We still miss Gracie.
Bob (Big Orange Boy) was our hospital cat. He showed up as a stray, moved himself in, and let us stay as long as we'd feed him well! He developed a fibrosarcoma between the shoulder blades. With herbals and a fresh food diet he did well for a year or so, while the tumor continued to grow. Eventually it was surgically removed, but he soon developed more tumors. He grew thinner and weaker, but still loved sleeping in his sunny window and interacting with his people. Then came a day when he was coughing and falling over, and it was time to help him go. Bob purred until his very last breath. We all still miss Bob, including some clients who were very fond of him.
There's a very helpful book on our reading list, Blessing the Bridge: What Animals Teach Us About Death, Dying and Beyond, by Rita M. Reynolds. Reynolds has had many rescued animals of various species, and many at any given time. This has given her a great deal of experience with end times, and she recounts many touching stories. She recommends talking to the animal, and especially asking him or her to let you know when they’re ready to go and whether they would like some help (euthanasia). They do understand more than we usually think they do, and they have ways of letting us know – ways we don't understand. Sometimes it’s a look in their eyes. Sometimes you just suddenly know. They have a direct route to our hearts, after all.
You can't assume your vet will tell you when it's time. While your vet can help you make the decision, the decision must be yours and not theirs. Before you make the call for euthanasia, you need to know what you want done afterwards. Do you have a place for burial in your yard? Or do you want cremation? If so, do you want the ashes returned to you? There is a significant cost difference. The alternative is a communal cremation or burial. Some practices require payment at the time of the visit. We prefer to do euthanasia at the end of the day when there won’t be more patients coming in so we can take as much time as necessary, and to bill later so owners don’t have to worry about the money at such an emotional time. We also supply tissues and hugs as needed.
Each pet is unique in life and unique in death. Grieving has been different for Bill and me in each loss. For us there is no question: There will always be another cat. Two is the right number for us. However, I hear many people say "Never again – no more animals. It's just too hard." It is hard. I've reached a point where I welcome the pain as part of the way I honor the life and love that have been shared with me, the blessing and the curse. Bill accepts the pain but is not ready to welcome it. We both take comfort in knowing we’ve done everything we can to make the transition as peaceful as possible.
I take tons of photos of our cats, and I find it very therapeutic to go through my stacks of photos and assemble a scrapbook for each one. I know other people who can’t bear to look at the photos after the loved one is gone. Writing about the pet can be helpful, as well as holding a small ceremony of some sort. The Concord Monitor will actually publish a pet obituary. One family who lost three dogs in one year sent out star shaped candles to several friends and asked them to burn the candles in remembrance of the dogs.
There are grief counselors who will do individual or group counseling for pet loss. There are also books and websites to help you through this difficult time. After Freep died and I had cried myself to sleep every night for over a month, I visited my naturopath for a cranial-sacral treatment, which helped me to integrate my feelings and let go. Talking with other pet owners can also be helpful. Often people express their grief to friends who are not pet lovers and are told, "Get over it – it's only a dog/cat!" Aside from the insensitivity, anyone who would say such a thing has clearly never had the privilege of living with such a wonderful creature.
Keep in mind that the guilt factor always creeps in. What if I did…? Should I have done more…? Was it too soon? After each of my losses, I’ve had to keep reminding myself of why all the choices were made the way they were. It’s a natural part of the grieving process – one on which we must not dwell but remind ourselves that we did what was best at the time.
And never say never. In the difficult time after the death of a pet it may be too much to imagine ever giving that much of ourselves to another animal. But a few weeks, months or years down the line another special soul may come along and steal your heart again.
— Judi Wishart