The Pain of Making the Euthanasia Decision

It can be traumatic whether it’s the first time you’ve had to decide when your dog’s life will end or you’ve experienced this many times.

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In the past few days, I’ve exchanged dozens of texts and phone calls and one FaceTime session with a long-time friend regarding his dog Leroy. Stephen and his partner adopted Leroy from my local shelter in September 2011—and in the 13½ years since, we’ve probably exchanged hundreds of texts and emails and phone calls about the happy, clever little dog.

Leroy was the first dog Stephen had ever owned, and was the first dog his partner had owned as an adult, and they often had questions about the joyful, willful little mixed-breed dog! As Stephen’s long-time friend and adoption facilitator (I selected Leroy, who was then an estimated 7 to 9 months old, as a good candidate for my friends following a disastrous adoption failure from another shelter), I was asked for advice regarding Leroy’s diet, training and behavior, boarding/pet sitting, and, starting in Leroy’s middle age, advice about his health issues.

Sometimes even a long lived dog doesn't live long enough.
Stephen and his partner made a sizeable donation to my local shelter after adopting Leroy. At the time, a pet supply store chain in their area would have a giant poster made with your dog’s photo when you showed proof of a donation of a certain size to a shelter. Their donation enabled Leroy’s poster to be made and hung in one of the stores—as well as another giant poster for my dog, Otto! Photo by Mark Rogers, for Petfood Express.

Leroy had some intermittent lameness, which eventually resolved with a costly but effective spinal surgery; in the past two years, he started having urinary tract issues, which were eventually traced to cancerous tumors. Stephen and Scott spent a small fortune on chemotherapy and surgery, with the hopes of giving the little dog an estimated four to six more months to live; he made it 15 months before his kidneys failed. Despite having to wear an incontinence garment indoors in the past few months, until just a week ago, Leroy still enjoyed his meals, going for walks with his owners, rolling in the grass at the park, greeting his many friends in dog-friendly stores in his neighborhood, and living his sweet comfortable life with his owners.

But in the past few days, his health took a sudden nosedive. At the veterinary ER, he was put on IV fluids for two days in an attempt to improve suddenly off-the-charts-bad lab results indicating that his kidneys had more or less quit functioning; those values didn’t budge even with rehydration therapy. He stopped eating. Stephen and his partner made the decision to bring Leroy home and make the call to a veterinarian who would euthanize Leroy after they had one more day to spend with him.

I spoke to Stephen several times during Leroy’s last day. Stephen stayed home from work and spent every minute watching the little dog and working to keep him comfortable. He administered subcutaneous fluids, which, in combination with an anti-nausea medication, made Leroy feel good enough to eat some chicken and some baby food. But Leroy mostly slept.

Stephen had second thoughts about having a vet come to euthanize Leroy; with another day or two on IV fluids, might his kidney function improve enough to give him another couple of days or weeks? One of the vets who saw him on his last day at the emergency clinic thought it might. Stephen wanted to know what I thought.

I told him that the decision absolutely sucked, it was awful, and no one could tell him what was the right thing to do. That it’s our responsibility to do our best to make the decision that would spare our friends the most pain, without robbing them of the potential for more good days, and that it’s impossibly difficult to know if you’ve made that calculation accurately. That no matter what, we are likely to feel like we didn’t make the right decision. I shared with him that I am haunted by the idea that I had my beloved Otto euthanized too early, when perhaps he had another good day or two in him; but one of my best friends is haunted by the idea that she had her dog euthanized too late, and the dog had a painful last day and a traumatic last hour. You just have to do what you think is best for your dog.

Stephen asked me to observe Leroy, and we switched our call to a FaceTime video. I teared up when I looked at Leroy’s darling foxy little face, now with a distinguished grey muzzle. His cloudy eyes were open as he lay there; he looked exhausted, near death. But then suddenly he sat up and licked some baby food out of a jar that Stephen offered him, and then walked over to one of his other dog beds and emphatically rearranged the fleece blanket in the bed to his liking before curling up to go back to sleep. It was easy to see that he didn’t feel good, and yet he was still himself.

I told Stephen, “We should be so lucky, to have such a nice last day. He’s home, not in the hospital. You’re home, and Scott will be home soon. Leroy is failing, but given the help from all his meds, he’s not in agony—but that pain is barely being held at bay. If you ask me, it’s time—but you have to make the decision.”

Stephen and his partner kept the appointment with the housecall veterinarian; Leroy passed easily and peacefully. But my friends are still in shock at Leroy’s sudden decline and that they didn’t have more time to weigh the euthanasia decision. I am doing my best to offer them some comfort—but I also know that living with doubts about whether or not you made the right call is par for the course.

Does you ever feel like you did exactly the right thing at the exact right time? How do you cope if you feel you didn’t handle things perfectly?

21 COMMENTS

  1. I have a 12 1/2 year old Eskimo who was just diagnosed with splenic cancer. It is devastating but I am focused on good research and working day to day to help her maintain her quality of life. I recommend this book, The Dog Cancer Survival Guide by Dressler and Ettinger. It is really helpful!

  2. Every day I wonder if I could have done more, then I remind myself how selfish it may have been to keep trying to give him one more day. When looked so lovingly at me I knew, He was ready to go, I just wasn’t ready to let him.

  3. I’ve had to make that decision more than I’d like. Most of the decisions have been clear. My beloved Mercy was on the edge of a massive heart attack; Lark, at over 14, had osteosarcoma that took her out in 6 weeks; Magi (like the 3 wise men) battled lymphoma for a year and had a GREAT last day then crashed within a 2 hour span. The one that haunts me still is my sweet True. She had pulmonary hypertension. At 15 years old she began having syncope episodes. It went from 1 ever week or so to multiple times a day. I worked with a hospice vet tech and he guided me through some exercises to make the decision. The day I decided to do it she had already had 3 and it wasn’t even noon. However, when the vet got to the house, she walked around the room and greeted him and the vet tech, wagging her tail. I about collapsed. I know, cognitively, that had I halted it, she would have gone on to have multiple more that afternoon. The episodes frightened her, she wasn’t eating (a Labrador that doesn’t eat…), and couldn’t do the things she once enjoyed that made her life a quality life. I still cry over her. Well, I cry over them all – cats and dogs alike.

  4. Years ago when talking with a Veterinarian friend about this subject, she offers me some advice that I still cherish. Better a day too early than a day too late. As much as it hurts to agonize over this decision, my dog’s comfort is far more important than my wishes to have just that little bit of extra time with them if it means they are in pain.

    • I love that “better a day too early than a day too late”. I had to make the decision for each of our three greyhounds who died a year apart. It’s hard but now we have raised a 9 year old English lab from 7 weeks……..she’s got major health problems that showed up by year one but I read and do my very best by her. Hubby calls her our $20,000 lab but we’re great full we have the funds to care for her and that we are the lucky ones who chose her

    • Ginger – that is the advice we follow with ours dogs. Of course, it will be different for everyone, but on the whole, we think it makes sense. We have had regrets every time we’ve had to make that decision, but how can anyone not, considering what is at stake?

      We also want to do what’s best for the dog and not what is better for us. Is having another day, or two or three, with our dog better for us, or better for the dog? No matter what anyone decides, I would encourage them to look at the decision to euthanize from your dog’s perspective.

      Someone told me a long time ago that the only thing that is wrong about dogs is that they don’t live long enough.

  5. We have been through this difficult with 3 dogs and 2 cats. While all decisions, and the process itself are heartbreaking, each pet is a different experience, because your relationship with each is different. My wise veterinarian and friend once told me this: our dogs love us, and trust us fully. So that wherever we lead them, they follow us with that trust. And they therefore sense in you the kindness in whatever happens, because they trust you that much. Her words gave me the strength to have our last dog euthanized, with no regrets, and perhaps only a bit of second guessing, though I still cried for weeks.

  6. I put my 14 1/2 year old down the last day of January and my 15 year old 3 days ago.
    It was an absolutely heart wrenching decision. I am grateful that they had such long lives
    especially with major health issues. I chose to do it at home and would not change it for a bit.
    Both of my dogs had them most peaceful and loving send off.
    I am grateful I could spare them a panic filled emergency in a hospital setting where maybe I could be with them or not. Agree 100% with the other comment about better to be too early than too late.
    My heart is broken and empty as I miss them more than I ever though possible.
    I too, have no regrets.

  7. Hardest decision ever. I felt so badly about keeping one dog alive, that I cancelled 3 dates for euthanasia. He was a neutered male, had been diagnosed with mammary cancer, at Cornell, at 10 1/2. Chemo wasn’t done routinely back then. He developed secondary opportunistic infections and was on antibiotics 3 times daily. There were no masses, just teats that would fill with blood. I kept him alive for 3 more years.
    The day before his last day, endorphins kicked in and he was perky. The next day he was worse. The vet said that his gums and tongue were pale, and that he likely would have passed naturally within hours. I’ve often regretted being selfish and not knowing when to let go. I’ve had many dogs and cats since. When the have no return to quality of life, I make that tough decision. I’m on dogs #13, 14 and 15 now. All of my animals have been strays and rescues. There is a small apple grove next to my house, where everyone’s ashes go, including mine some day.

  8. I have had to make the decision for 7 dogs so far. I brought my first dog back from the near dead three times before my vet looked at me and I knew a fourth would be too many — each time the reprieve had gotten shorter. It is never easy; it is always heartbreaking, whether you have a dog for 7 weeks (hemangiosarcoma in a newly adopted dog) or 14 years. But I am fully in the camp of better one day too soon than one day too long. My grief is nothing compared to the pain they might be feeling, often without understanding why.

  9. At the beginning of the pandemic in 2019, our beloved 4-year-old Springer Spaniel was diagnosed with lymphoma. After a rocky start on chemotherapy, she was back to our happy Noelle for 16 months. Then suddenly in August 2020 it returned with a vengeance and she was no longer happy. In desperation, I asked the emergency vet at the cancer clinic what she would do if Noelle were her fur baby. She told me that she would give her palliative care, take her home, spend the next day doing all of her favorite things then bring her back. That’s what we did; the vet’s honesty made the decision a little easier. Since it was at the height of the pandemic, she was euthanized on a picnic table under a tent in the vet’s parking lot. It was so hard but we didn’t want her to suffer. We were grateful to give her 20% more life and give us more time with a truly special family member. We grieve still.

  10. I’ve spent a lot of hours agonizing over this decision for my pets. In most cases, I felt afterwards that I’d waited a little too long. I put them through one or more procedures or surgeries that did not help prolong their life. In not one case did I feel afterwards that I’d ‘jumped the gun’.

    While the vet can offer their recommendation, they don’t know your pet like you do. And, no matter how knowledgeable they are, they don’t have the connection with them that you do.

    I found an at-home euthanasia vet service when I faced this with my last dog. It was as good an experience as it could be. Buddy was relaxed, in his bed, eating his favorite treats, and surrounded by the people he loved. He never felt a thing. I’ll never have it done in a scary place again.

  11. I had someone give me wise counsel several years ago — at the point in time that the decision to euthanize or not is about your feelings, not the pet’s well-being, comfort and dignity, you, as the responsible human, need to consider very strongly letting them go.

    That was 2 cats and 4 dogs ago – including Sampson, my Great Pyrenees, who I had to let go in September 2023. He was THAT dog – the once in a lifetime buddy who I will never get over. The night before I took him, 15 neighbors who loved him came by to tell him goodbye. He had impacted their lives as well.

    Hardest thing I ever did – but he deserved a quality of life and dignity that was no longer possible for him. Because I loved him so, I let him go.

  12. We are facing that decision in the near future. Our collie boy has multiple health issues. So far, the good days are outweighing the bad ones, but that will change soon. A wise friend (and animal communicator) once told us that we “do not put our beloved pets down, we release their spirits back to God (the universe/whatever your high power is). That has changed my outlook on it!! It is still the toughest decision ever!!

  13. This is a tough event to deal with. Sometimes my dogs have been clear in letting me know it was time.The hardest in many ways was one of my foster “fails” . A Wheaton, he had been in a puppy mill for 7 years until freedom. He had so much to learn… but 2 years ago he developed a mass in his mouth… notified it was oral melanoma. I had choices, none good, but scans told me there was tumor in his lungs. I chose to keep him comfortable and have together time… One Saturday he had significant breathing problems, so I made the call. And was in shock because I wasn’t really ready.
    The following Thursday I was driving on the road, looked up in the sky and saw a rectangular cloud…. Odd, I thought. Then I looked again, and there was more cloud… and it was clear that it was my Fin, lounging… saying he was ok, lounging around (something he loved to do). I still cry about him being gone, but was able to take a picture of the cloud and that helps.
    Listen to your pet….. be with them at the end…..and be alert for the various messages they send to us…….

  14. My Lab/Golden, Saffy, was the official Best Dog Ever. Even people that didn’t like dogs, loved her. She didn’t have a fatal disease but at 14-1/2, she could no longer walk. She would eat and drink if I brought food and water to her and she was wasting away. She was deaf, and unable to go outside on her own. She had always been a clean dog, and she got distressed when she peed on herself. She had no quality of life, so we finally make the decision to let her go. It was one of the worst days of my life. I told our vet that I was worried I could have given her more time. He said, that would have been for me, not for her and it was better to be a little too soon than a little too late.

  15. As difficult as the decision is, a wise person once said to me that: “it’s better to do it a week too soon than a day too late.” We can give our pets a gift that we can’t give to people. Save them from unnecessary suffering and pain. I dread the decision that I’m going to have to make shortly for my 12+ year old disabled Golden, but I’m going to do what’s best for her.

  16. I am a R.N. My professionalism gives me the privilege of actively listening to patients and families as they navigate difficult decisions. It is my role to provide them with the information and tools so that they are equipped to make their own decisions . It is never my role to steer them towards or make a decision for them, even if Im asked to do so.You , as well, are looked upon and respected as a professional. I am extremely disappointed in your telling your friends “It’s time “.You are in a role to listen with an empathetic ear and provide information, not guide a decision, especially regarding euthanasia. As a personal example , I have a 14 plus year old pitbull mix . About 8 months ago, he suddenly stopped eating . The Vet. Appointment revealed he has chronic kidney disease . I was told he could live perhaps 2 months, or two years . Another words, she was unsure. .As the owners of the dog you described, we too are very motivated to keep Pinkie going, so long as he’s not in pain and he’s still getting joy in life , albeit , he sleeps more. We give him SubCu fluids at home , and medications and are constantly readjusting his treatment to fit his needs . I personally believe you crossed the line .

  17. I so appreciate these questions! Just my take.

    I have experienced both. In some cases, I felt I did the right thing for the right animal at the right time. With some animals I feel like I would not do it the same way at the same time. Unfortunately, there’s no way to do a double-blind study to see how things would go, no model to plug variables into. Each time is the first time and the only time.

    Some things that have impacted my decisions:
    Do I have enough money?
    Do I have enough knowledge, time and energy to give appropriate care?
    What is my own relationship with pain and am I projecting that onto my animal?
    How is my stability with respect to uncertainty?
    Can I get support (logistically and availability) to manage things if I get in over my head or panic or things take an unexpected path, etc?

    Add to that the projections from well-intentioned others who feel or are certain that they know the right thing to do and it can become a confusing, stressful ocean to navigate while I am also feeling the pain of loss/anticipatory loss.

    I try to remember to ask the vet team “what will it look like if we don’t do that (course of treatment, euthanasia, etc.)? What will a natural death at home look like?”

    From my experience it might not actually go the way expected, because each animal is unique, their people are unique, and their relationship is unique. The relationship can influence how things go, and again, we don’t get to have a double-blind study.

    When I end up second guessing, I remind myself that if I had decided differently, I still would not know for certain how things would have turned out if we had gone down a different path. I am left with the totally maddening fork-in-the-road reality that I will never know.