4 Ways to Know When It's Time to Say Goodbye -- Cone of Shame with Dr. Andy Roark

hey guys hardest question that get as a veterinarian is when people asked how do I know when it's time to put my dog to sleep and they usually asked me with tears in their eyes and it's an emotional conversation and it's a hard conversation what I wanted to do today is tell you what I tell these people and just walk you through what I believe in hopes that if you are having these thoughts and having these questions this might be of comfort and it might help you come to your own decision on when is the right time to use an eyes a pet a couple of days ago I was putting an old dog to sleep in its owners were there and it was this really nice couple and the man looks at me at one point and said I bet this is the hardest part of your job and I just kind of smiled at him I'm just you know we were having a good a good conversation I want to be supportive of them the truth is it is probably not really in most cases when we come to the end of the life euthanasia is a gift and a blessing for dogs that are suffering or in pain and so I don't see this as a terrible thing sometimes I honestly believe in a lot of cases honestly I believe that this is the kindest thing that we can do and I just want to say that up front as far as the hardest part of being a veterinarian from me anyway the hardest part is telling people that the pet that they love has got a terminal illness or is suffering or will be leaving this world and you see the emotions on their face and and it's just it breaks my heart and it's a hard thing for me to do but it's an important thing for me to do I remember the first time that I had to tell someone that I had to tell someone your dog is going to die I'm worried about your dog's suffering and being in pain it was there was this guy he was a middle-aged guy and he came in with his two children the first time and he was great and his dog was an eight-year-old Rottweiler and the dog's name was stone and I liked stone but stone did not like me he just he didn't he didn't he didn't want to be at the vet clinic and I get it the owner brought stone in because he was limping and that's when the guy thought hey this might be a problem and stone not a fan not a fan of mine and when I pressed into his shoulder that was the end of the opportunities for us to be friends he would he was done with me he was really painful in that shoulder and so I took some x-rays and I had to tell this this guy and and and his kids and I was very gentle and how and how I talk to the children of course but you know one-on-one conversation with with the man I said listen your dog has osteosarcoma in his shoulder and osteosarcoma is a terrible terrible illness is a bone cancer it is hard to treat they're kind of limited options there are things that we can do but they're not easy things and it's painful bone cancer really hurts and he you know for a couple of reasons we were not able to to do surgery amputate this dogs like we knew we were not going to do chemotherapy or radiation like that's a decision that we'd come to and that's just where we were and so together he and I decided that we were going to do everything we could to keep stone comfortable and to practice palliative care and he said to me I don't want stone to suffer when it is time I want him to pass from this world because I do not want him to hurt and I said I agree with you I am with you and we will make that happen and he said to me how do I know when we're at that point when it is time for stone to cross the Rainbow Bridge and that was the first time anyone ever asked me that question and since then I have tried again and again to get better and better at answering it I got four ways that I look at this I'm gonna lay enough for you every pet illness and situation are different okay what your dog is experienced is different from any other dog so just know that going in just because your mom felt differently when it was her dog or your neighbor did something differently when their pet had this certain disease or condition that doesn't matter okay this situation for you is special and so every pet every situation is unique here's what I want you to do if this is a medical condition there's an illness that your pet has get as much information as you can about that illness right learn what you can about the disease process is this progressive does it tend to move quickly is it painful is it uncomfortable what can you expect in the future because that knowledge is power and that will help you see into your crystal ball what's coming in the future and that will empower your decision so know that your pet and your situation are special understand what is gonna happen as best you can because that will help you make this decision and the last thing that I say to people that's a huge help I believe is don't be afraid to get perspective from an outside person get someone who knows you and knows what you what you care about and sort of how you feel about things that knows your relationship with your pet and see what they think because they will not be as deeply emotionally involved as you are and we all know that sometimes having that perspective that's a step away they can have more clarity they can help us see things in a way that we can't see it when we're really in this decision so don't be afraid to get an outside perspective from someone that you trust and who knows you and who knows your relationship with your pet pets live in the moment one of the most wonderful things about our dog is that they are fully involved in the present they don't think about what the past and how things used to be and they don't worry about the future they are just here in the present I think about my dog is this old Vizsla and he was with me for years and years and every time I came home he just celebrated just through his own one dog parade and it didn't matter that I'd come home a thousand or five thousand times before the fact that I am home right now that meant the world to him because he was fully invested in this present moment that's one of the things to remember about the world of the dog when our pets suffer their point of view is on the present they don't think about the great days in the past they don't worry or ponder the future all they know is how they feel right now that's their perspective and that's what matters so the question is how is your dog right now ask yourself important questions sometimes articulating or writing down your thoughts can make everything so much more clear when you go back and read them some of the questions that tend to help people that I work with are things like why do I think it might be time to euthanize what are my fears and my concerns about euthanizing whose interests beside my own am i taking into account while I'm making this decision what are the fears and the concerns that the people around me have what are they saying or what are they worried about just so I have it in my mind and the last thing is am I making this decision because it's what's best for my dog or am I making a decision because it's what's best for me and those are questions that I put to people just to get them thinking and there's no right or wrong answer but walking yourself through those questions can provide a lot of clarity and the last thing I like to think about is try to measure quality of life quality of life is just simply how good is life right now and that is hard to figure out sometimes when we're dealing with dogs that they can't talk and they can't tell us how they feel there's four different techniques that I like to use to help me get an idea of what is this dog's quality of life in a walk you through the first approach that a lot of veterinarians take in assessing quality of life is called the five good things and so the way it works is this take a piece of paper and write the five things that your dog loves to do more than anything else his or her favorite five activities in the world pay close attention to whether or not your dog is doing these things the scale that looks like this in some ways if your dog stops doing one of the five favourite things that's a big deal if your dog stops doing three out of her five favorite things we've lost a good amount of quality of life and it may not be worth going on at this point a lot of vets say three out of five that's when they start to really think about euthanasia the second approach is good days versus bad days and this is really simple a lot of times I have pets that have good days and bad days and people say I don't know how will I know when it's time and one of the things that can help is to visually look at how many good days and bad days are we having because that gets lost in our mind sometimes so go to the calendar get a paper calendar the old school paper calendar put check marks big check marks on the days that we had a good day and put x marks on the days that we had a bad day and if you're looking and your dog is having more bad days than good days again that is a big indicator for a poor quality of life the third technique that I like a lot is from a doctor that I have great respect for her name is dr. Allison Villalobos and she has what's called the HH h HH mm scale so five H's and two M's okay the HS stand for hurt hunger hydration hygiene and happiness okay hygiene is the ability to keep themselves clean the M stands for mobility and more as in more good days and bad days which is what we just talked about so five H's are two M's dr. villa-lobos recommends writing down these seven things and then give your dog a score on a scale of one to ten where one is they have absolutely no quality of life in this area and ten is they have perfect 100 quality of life they doing this completely and they are happy doing it score your dog on those seven things for dr. Villalobos if the majority of those categories are scored as a 5 or higher then going on and continuing supportive care is acceptable if that's how you feel we should go however if it's less than that this dog is probably suffering and and needs to be put to sleep if you want to learn more about this scale there's a link right here and I'll put it down in the comments for you as well and the last technique that I like for looking at quality of life is a pet Hospice Journal if this is something that you're wrestling with having it down in writing and saying everyday how was your pets behavior how did they feel how do their appetite how well are they sleeping and just making some notes about those types of things that can really help you track over time and see if there's a trend and see how quickly our condition is progressing or to see if we're losing quality of life as the days and weeks go by there is a fantastic online Pet hospice journal that's totally free it's at Pet hospice journal dot-com it also has an integrated quality of life scale so take a look at that or feel free to go the old-fashioned way and just keep a written log guys just so you know stone didn't suffer when the time came and he was obviously painful and we couldn't control that pain his owner made the right decision and he crossed the Rainbow Bridge in the arms of his family he was remembered with dignity he was remembered as the strong protector of those children and he was remembered with love I remember his owner for being a strong person and making the right decision when it came time I hope that you and I and everyone else will have that strength to make that hard decision because our dogs deserve it and we want to protect them the most important thing in life is koala of life it's not about quantity and getting the most days possible gang take care of yourselves if you're watching this episode because you recently made this decision and you're second-guessing yourself or you're wondering if you did the right thing I want you to know that those questions are totally normal the fact that you've watched this whole video and thought about all of these things that says a world about how seriously you took this decision I am sure you made the right choice also if you are thinking about this going forward I'll tell you one last thing I put my own dog to sleep he was almost 16 years old it was last year at the end of the year and I wrestled with that decision so much and now I had the same thoughts that I hear all from pet owners all the time I have never had a pet owner come back to me and say I wish I had waited longer to make this decision I never once I have had lots of pet owners and I think I probably am one who say I wish that I had put my dog to sleep sooner because as I look back I don't think he had quality of life at the end of the year I don't think he was happy thanks for watching this episode I really hope that it will be useful for you and for others in the future if you have a story about your dog crossing the Rainbow Bridge feel free to put it in the comments and share sometimes it feels really good to share I promise I'll read what you write this stuff is important and so let's be supportive of each other if you think that this is a video that would help someone that you know please share it with them help me get the word out and let's support people as best we can because this is a terrible experience to go through but it's something that every dog lover must go through I hate to say it but guys this is the cost of admission when we let the dogs into our heart we know that they're going to pass away from us and so let's be supportive of each other and just do our best when that day comes all right take care of yourself bye bye

Channel: Cone Of Shame

Views: 191,752

Keywords: cone of shame, pets, cats, cat, dog, dogs, kitten, puppy, pet, vet, veterinary medicine, andy roark, doctor, veterinarian, euthanize, quality of life, pet euthanasia, put pet to sleep, cat euthanasia, dog euthanasia, calgary, when is it time to put pet to sleep, when is it time to euthanize my dog, when is it time to euthanize my cat, cat euthanasia at home, dog euthanasia video, dog euthanasia documentary, pet passed away, dogs quality of life, cats quality of life, rainbow bridge

Id: m4Nc51G9qPU

Length: 15min 31sec (931 seconds)

Published: Tue Apr 10 2018