Economic Euthanasia

[kitty613]

Since I’m the official Debbie Downer of the group lately, I’m going to take the title in stride and ask your thoughts on a disturbing trend in veterinary medicine- economic euthanasia. Here’s a quote from an article that explains the issue perfectly (better than I could).

Many pet owners cite financial difficulties as the reason for euthanizing their pet. However, in some cases, pet owners want to put the animal down rather than spend money on proper pet care and "they're not willing to make the change in their lifestyle to accommodate their pet's behaviors.". Though many of these pets suffer from serious, difficult to treat injuries or terminal illnesses, a steadily increasing number of these pet euthanasias are being performed on pets whose owners cannot financially afford simple treatment of their pet.
An even more disturbing trend which is becoming more commonly encountered are those pet owners who elect to take a sick or injured pet home to die without treatment. Again, many of these pet owners cite financial difficulties as the reason behind their decision. Unfortunately, in these situations, it is usually the pet who suffers the most with no pain control and little hope.

As future vets, how do we handle requests for euthanizing animals, for let’s say a broken leg or a urinary issue simply because the owner can’t afford the necessary treatment? Or how do we handle the fact that many pet owners will take home their pets without treatment? What a catch-22! Have you personally encountered situations like those described above? Is it very common? What a horrible moral dilemma that vets face every day. Your thoughts on the issue?


PS: My next thread is definitely going to be more upbeat...

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[camcam]

That is how my Tonic died I didn't have the money to get him to a vet let alone be medically ethathanized so I had to watch him die on my living room floor.

It's a lot harder on the owners then the vets doing it.

 

[StealthDog]

I practice in an area that's been pretty hard hit by the recession, so I have a lot of clients (especially on emergency) who can barely afford the exam fee, much less diagnostics or treatment. As sad as it is to euthanize pets with treatable conditions, something like a fractured leg can easily cost $1200-$1500 to amputate or $2000-$3000 to repair. If I know my client has financial constraints, we work through payment options (CareCredit, possibly a payment plan if they're a long-term client) and pare down the estimate as much as possible without compromising the pet's health... But it's not hard to euthanize when the pet is in pain and the owner simply can't afford treatment. As much as I'd love all my owners to have an emergency fund or pet insurance, that just isn't realistic to expect 🙁

If owners want to take their pets home without treatment and they are sick or injured, I have them sign an Against Medical Advice form and follow up with them the next day. I have no qualms about calling Animal Control to check in on patients that I think are suffering due to lack of medical treatment.

It can be incredibly emotionally draining to have multiple financial hardship cases in a row, but you just have to help who you can help and be able to take some comfort in the knowledge that euthanasia is better than untreated pain and suffering.

 

[kaydubs]

i'm out

 

[kitty613]

kitty-I don't know what's going on in your life to have you so glum, but try and turn it around (as much as that's in your control). I know what it's like to be depressed (and more...) but you have to be happy about the small things. Like being alive!

Yeah, I guess I have the blues. Sorry to get everyone down. I've been pessimistic lately...maybe it's the winter blues 🙁 You're right though...I need some positive energy!!! Thanks kaydubs! 🙂

 

[light10]

Well, where do you draw the line? How much expense should someone be able to bear? How much of a long, painful recovery is worth it if in the end the animal returns to a high quality of life? Both of those questions are going to have very different probabilities depending on the situation. I think all pet owners will have a different place they draw the line when faced with a medical emergency.

For instance, if my older, retired mare had a colic that needed surgery, I've already (in a rational non-panicked setting) made the decision I'd put her down. She goes absolutely flipping crazy on stall rest, so recovery would be really hard on her (and everyone who has to work with her), and its hard to justify spending $8-10,000+ on an older horse that can no longer work when I'd have borrow the money to do it.

When I saw the title, I thought this would be about vets being asked to put down otherwise healthy animals because the owner can no longer care/pay for them. This has come up increasingly in the horse world as the economy took a nosedive - someone has a retired horse that isn't able to work any more, that person loses their job and is in danger of losing their house and can no longer pay board. Is it OK to euthanize? Or, horse can no longer do any work but owner really wants to ride. Owner can only afford one horse and asks vet to euthanize newly retired horse. Is that ok? Is it better than the alternative of selling horse at auction?

 

[sumstorm]

I will do everything in my power to save life. If someone insists that they want the animal euthanized, I will give them the options that I can to avoid euthanization. I would be willing to hospice the animal myself (if I can - I'm not totally naive about costs, trust me). But, the owner makes the final decision. Unfortunately.

This statement I cannot agree with. I cannot. I am a pet owner and watched many of my animals suffer but, I want to be a vet so I can make sure (on my watch) that no one ever has to go through that helplessness of watching a beloved animal, a member of my family, die.

Could you elaborate, I'm a bit confused. Are you saying that if you have an owner come in with a neoplasia that might be saved with chemo and radiation and they can't afford chem/rad you will pay for that out of pocket? Or if it is a late stage neoplasia and the animal is suffering and the family wants to euth you will push to provide the hospice care yourself?

I'm asking because it sounds like you see death as failure, and helping provide a peaceful death is failing your patient. I'm not criticizing your enthusiasm, just trying to understand how you will manage that in practice.

For myself, my approach to economic (and convenience) euthanasia is born out of seeing much worse deaths occur when folks are desperate. I will do my best to make the options viable for clients, but I will not take responsibility for the majority of my patient's in terms of financial concerns. I do hope to have a non-profit developed on the side to assist in those costs (and I have experience in non-profit management) but I will push for that to be extremly selective (ie if a client has cable television but no savings to care for your pet, that is an issue with their priorities) because I want any help I provide to be a stop-gap measure that is an exception in their lives (rather than a repetitive experience where they don't value what they do have.)

I hope to be able to point them to various rescues and non-profits that can help, and to have connections within those organizations to check that the client has pursued those options. But if worse comes to worse and funds or capability to care for the animal are lacking, I will euthanize, even if that has to be free.

However, I have a broader range of what I think an animal can go home with and recieve pallative care and survive. They may never be fully functional again, but if the family is devoted and accepting of that, it is possible to send a pet home with a leg that is splinted rather than surgically set (with proper pain manaagement) and allow scar tissue to immobilize the fracture. Far less than ideal, but for a beloved pet it is worth it. I'd rather euthanize a salvagable pet than have it abandoned, gassed, shot, drowned, or otherwise suffer. I am also not above explaining to an owner that the pet must be kept on pain relieving meds until death if they want to wait for death, and if they refuse, explaining that I will report them for abuse. At the same time, I am not willing to refuse treatment, including euth, because unless I am willing to take 100% of the responsibility for that pet myself.

 

[chickenlittle]

I have performed a substantial number of economic euthanasias, living in a pretty poor area (median household income < $40k). Like StealthDog, I always try to offer more affordable treatments.... but the truth of the matter is that some diseases are expensive to treat and people can't afford it. I really struggled with economic euthanasias when I first graduated from veterinary school, but have come to the conclusion that it's better to euthanize a pet for financial reasons than to have it suffer without treatment. I've realized that unless I (personally) am willing to pay for the patient's treatment out of my own pocket, I really can't force the owners to do so... and therefore it comes down to what is best for the pet.

I did have one "economic euthanasia" that REALLY upset me, though... and made me start to question anyone who claims they can't afford treament. I diagnosed a cat with diabetes a few years ago; the cat looked great on physical exam, but had been drinking excessively and urinating outside the litterbox. We ran bloodwork, diagnosed diabetes, and I had a LONG talk with the owner about treatment, ways to control costs, etc etc. The owner thought about it for several days, then tearfully told me that she and her spouse could not afford treatment and the wanted to have the cat euthanized "before she started to suffer." I euthanized the cat (reluctantly).... and what is the next thing they brought to our clinic? THREE NEW KITTENS!! And what did they present those kittens to our clinic for? Not just a spay... oh, no - they got all three DECLAWED!! Okay, if you can afford elective surgery on three kittens, you could have treated the diabetic... you just didn't want to treat her 😡 I was angry for a good while over that one. I actually went out of my way to avoid seeing that client for the remainder of time that I worked at that clinic - other docs that I worked with did the surgeries and all of their other vet visits.

 

[chickenlittle]

I am also not above explaining to an owner that the pet must be kept on pain relieving meds until death if they want to wait for death, and if they refuse, explaining that I will report them for abuse.

If this is an important issue for you, make sure to ask about it during job interviews. I have not yet had a job where my employer permitted me to make abuse reports. In my first three jobs, it likely would have meant termination... or at least put my employment status on shaky ground. I had conversations with all three employers on that subject (some of those conversations in reference to specific cases, some were more 'hypothetical' discussions) - all three stated that if word got out that we reported abuse cases, our patient load would drop and therefore I was not permitted to report. In my current job (with a corporation) I am supposed to report abuse to my regional management and they apparently will follow up with their own determination of whether or not to report, but I am still not permitted to directly place a call to Animal Services.

Just something you (and others) may want to consider when you graduate and start job-hunting, if this is something you feel strongly about.

 

[sumstorm]

you just didn't want to treat her 😡 I was angry for a good while over that one. I actually went out of my way to avoid seeing that client for the remainder of time that I worked at that clinic - other docs that I worked with did the surgeries and all of their other vet visits.

I definitly understand this sentiment, but some folks really are inept and can't handle their own pets to treat them (I don't just mean doing the monitoring or giving insulin, I'm referring to even keeping track of the cat.) I have seen this a lot as an animal trainer. I know my parents treated a diabetic dog for years, but if their current cat became diabetic, they wouldn't treat it because they can't consistently track it down. Sometimes folks also have personal experiences that color thier impresion of what a disease does to their pets. IE I have met war veterans that are extremly freaked about amputations because their war buddies have suffered from amputations, and I know a couple of diabetics that had horrid experiences with their own disease that didn't want their cat to ever suffer any of hte experiences they had. I only mention that because sometimes we can see it from someone else's perspective and it makes things a bit more tolerable (and/or lets us address the fears/concerns)...but I would have avoided those folks too.

 

[sunshinevet]

kitty-I don't know what's going on in your life to have you so glum, but try and turn it around (as much as that's in your control). I know what it's like to be depressed (and more...) but you have to be happy about the small things. Like being alive! It's good you're seriously considering issues, but the vet profession isn't all doom and gloom. Why else would so many people stick with it? It's medicine- it's about saving lives.


Euthanization is a sad reality of the profession. It will vary with each individual.. I can only speak on how I will handle this situation when it arises (no matter what area I go into, it will): I will do everything in my power to save life. If someone insists that they want the animal euthanized, I will give them the options that I can to avoid euthanization. I would be willing to hospice the animal myself (if I can - I'm not totally naive about costs, trust me). But, the owner makes the final decision. Unfortunately.


This statement I cannot agree with. I cannot. I am a pet owner and watched many of my animals suffer but, I want to be a vet so I can make sure (on my watch) that no one ever has to go through that helplessness of watching a beloved animal, a member of my family, die. I don't care if I come off as overzealous but honestly, I want to save life. Every life that I can touch. I want to save the world. Seriously. And with my drive and personal motivation, I will. (End rant)

You do realise that every living thing dies, right...??? Like, no matter what you do...?

Euthanasia is an amazing gift our profession has, one that human medicine lacks to their detriment. We have the ability to take away pain when we can no longer relieve it - to end suffering when we can no longer treat it. In my opinion, there is no greater gift, no greater act of love and loyalty that an owner can give, than giving their pet a painless end when the time comes.

In the case of a suffering and dying pet, I think it shows a lack of respect for the human animal bond not to euthanaise upon request. Reaching that decision is not one that loving pet owners do lightly, and it is part of the greiving process. By refusing to euthanaise because "you find it too sad" or something I would find pretty insulting - you didnt love that pet, they did! Its their choice, its their emotional rollercoaster. It shouldnt be yours.

As for economical euthanasia - its not the evil that its made out to be. Almost all euthanasia ends up being because of economics - yes, we usually could spend literally thousands of dollars on almost every case trying to keep the animal alive, but most of the time it would be futile and unfair to both owner and pet. Yes, there are times where otherwise healthy animals with broken limbs etc get euth'd, and these are sad, but I dont know about you - if my cat suddenly needed a $5000 surgery, I wouldnt just have that money lying around. Most people dont. And so some of them reach the hard and emotional desicion to euth. I'm lucky i live in a vet clinic, I'm lucky ive always worked at vet clinics. Yay for hefty staff discounts. The rest of the population isnt that lucky.

And yes, there are some cases where people dont want to spend 2c on their animals. But these are generally few and far between - because they dont tend to take their animals to vet clinics in the first place.

 

[sumstorm]

If this is an important issue for you, make sure to ask about it during job interviews. I have not yet had a job where my employer permitted me to make abuse reports.

Thanks for the advice. I have a couple job offers (with contracts) upon graduation already. fortunatly, I came to vet med from a different career, and my reputation for being honest and convincing folks about things like this was already established before those offers were made. I have actually helped vets with this as a trainer and the head of a non-profit. It amazes me how tense most vets get during the discussion with a client, then everyone is on the defensive, and that is bad for business as well. I also have, in my pre-contractual negotiations, made it clear that I won't do an unnecessary euth on a new client, or a found patient, and I won't work in a place that doesn't scan new patients for microchips and confirm ownership. In half a dozen years of dealing with this stuff, I've made 2 reports, and in both cases, I did it with the client in the room, and handed the phone over to them. strangely, both times when they realized it would be considered cruelty by an official, they worked with us to provide a minimum standard of care. I did approach it as 'you do understand that this is a minimal level of care, and we want to make sure that you don't face any legal consequences for your actions.' which comes across better than 'do this or else'

 

[chickenlittle]

I am completely envious that you have been able to find practices that will allow you to uphold those standards... and hope you don't meet with any surprises once you take those jobs. Can I ask what part of the country those job offers are in? Maybe it's a regional thing.

 

[bunnity]

I would talk to the owner about options, and make sure we had exhausted all community resources (pet food banks, low cost clinics) help from family members, or rehoming if that were a realistic possibility (I've spent enough time in shelters to know that it's usually not). If none of those were possible I would support the decision to euthanize the pet. There are many fates worse than death, and many deaths worse than euthanasia. I've seen enough of both that I would much prefer to have an animal's peaceful death on my conscience than have them starve or be put on the street or go to a shelter.

 

[cowgirla]

I would talk to the owner about options, and make sure we had exhausted all community resources (pet food banks, low cost clinics) help from family members, or rehoming if that were a realistic possibility (I've spent enough time in shelters to know that it's usually not). If none of those were possible I would support the decision to euthanize the pet. There are many fates worse than death, and many deaths worse than euthanasia. I've seen enough of both that I would much prefer to have an animal's peaceful death on my conscience than have them starve or be put on the street or go to a shelter.

👍👍

 

[DVMDream]

I have seen multiple cases of pets euthanized for treatable conditions due to financial constraints. I have seen multiple parvo puppies euthanized because there is no money to treat and the puppy is in poor condition, recently there was a 2 year old blocked male cat that the owner could not afford treatment or surgery that we euthanized (this poor thing was in so much pain and the owner's were so grateful that we let them put the euthanasia on payment plan so they could relieve their family member from the pain), I have seen a newly diagnosed 3 year old diabetic dog with pancreatitis euthanized because the owner could not afford the extensive treatment. It is hard to see treatable conditions end in euthanasia, but where do you draw the line? Can you accept only $50 as a down payment on treatments that will cost over $1,000 and hope that person holds true to their word to pay you? And how many times do you do that and for who do you do that for?

In the end, it is better for a peaceful ending rather than the pet suffering at home with no pain meds and no treatment, which is cruelty.
I have also had to call animal control on somebody because they refused to do anything for their puppy with parvo and even when we offered courtesy euthansia for this puppy that was very sick the owner became offended that we would even mention that. She would not let us euthanize the puppy and she would not do any treatments. She told us she was taking the puppy home and "God will keep the puppy safe and pain-free." So then I had to tell her that what she is doing is considered animal cruelty and we will have to have an animal control officer come over to check on the puppy to be sure that she has given some type of treatment to keep the puppy from suffering. Her response, "He is not suffering." 😡

It is hard, but you can only do so much in these cases. You try your best and just remember that in the end, the pet is no longer in pain.

And you remember the good stories: Lady brings in young pitbull puppy that she received from her neighbor because her neighbor was not properly caring for the puppy. This puppy has a severly broken leg that is healing improperly. The new owner of the puppy (only had pet 5 minutes) pays over $1500 for a leg amputation without blinking an eye to give this puppy the life it deserves. 😀

 

[StartingoverVet]

I would talk to the owner about options, and make sure we had exhausted all community resources (pet food banks, low cost clinics) help from family members, or rehoming if that were a realistic possibility (I've spent enough time in shelters to know that it's usually not). If none of those were possible I would support the decision to euthanize the pet. There are many fates worse than death, and many deaths worse than euthanasia. I've seen enough of both that I would much prefer to have an animal's peaceful death on my conscience than have them starve or be put on the street or go to a shelter.

👍

I find that people, who like bunnity, have spent a decent amount of time in a shelter have an easier time understanding this kind of rationale than someone whose main experience is as a pet owner. Reality does "suck" and we oftentimes have to choose the least disagreeable option.

I certainly hope I will at least work somewhere that would do an occasional euthanasia for free rather than allow an at-home euthanasia, no treatment, or abandonment to occur.

 

[Robdude]

If I buy a car for $2,000 and find out there is something horribly wrong with it and the repair bill would be many, many times as much; rather than pay 20k to get my junker running; I'd probably just take 2k and buy a new car.

I feel the same way about my pet. Don't get me wrong, my dog is awesome. But if there was some unexpected bill that was many times more the cost of a new dog I'd probably not pay it. Another dog would be awesome too.

The same goes for myself.

Just because we can treat a medical condition, I don't believe we always should.

 

[Cautionary Tail]

If this is an important issue for you, make sure to ask about it during job interviews. I have not yet had a job where my employer permitted me to make abuse reports. In my first three jobs, it likely would have meant termination... or at least put my employment status on shaky ground.

Very true. We experienced one flagrant case of abuse at the last practice I worked in. (There had been two deaths, we knew that there were a large number of dogs and a few cats on the property that were at risk, and there was a severely disabled elderly individual involved who may have been receiving improper care as well. The abuse wasn't intentional, but the owner was in way over their head and needed major assistance.) My boss would not allow us to report because the owner in question was our highest paying client, and s/he did not want to lose his/her business. (Trying to keep things vague here.) Fortunately, a neighbor filed a report soon after, and I didn't end up having to jeopardize my employment. Definitely impacted my job satisfaction, though.

I'm not a busybody by any stretch of the imagination, but sometimes, reporting is a necessary evil. Ethically, I couldn't have let that one slide. Yes, finances are important... but so is being able to wake up in the morning and live with yourself.

My concern would be how to broach this subject with potential employers without giving off the impression that you're a report-happy troublemaker.

 

[StartingoverVet]

If I buy a car for $2,000 and find out there is something horribly wrong with it and the repair bill would be many, many times as much; rather than pay 20k to get my junker running; I'd probably just take 2k and buy a new car.

I feel the same way about my pet. Don't get me wrong, my dog is awesome. But if there was some unexpected bill that was many times more the cost of a new dog I'd probably not pay it. Another dog would be awesome too.

The same goes for myself.

Just because we can treat a medical condition, I don't believe we always should.

Ah, to live in a disposable society where it is easier to just get a new one than take care of the valuable things we already have.

This why I think pets should cost more and people shouldn't be allowed to own one if they can't afford to reasonably take care of it.

 

[Whyevernot55]

If this is an important issue for you, make sure to ask about it during job interviews. I have not yet had a job where my employer permitted me to make abuse reports. In my first three jobs, it likely would have meant termination... or at least put my employment status on shaky ground..

Really? I must be extremely fortunate - I work in a place where the doctors are happy to report abuse cases - we actually have one dr going to court next month to follow up on one, a pet whose leg was broken by one of the owners and who couldn't afford to treat.

My boss is also against convenience euth's. As a vet, you are always going to have to decide what YOU can live with - I think there is an awful lot of gray when it comes to "acceptable" circumstances.

 

[KiaKia]

I feel the same way about my pet. Don't get me wrong, my dog is awesome. But if there was some unexpected bill that was many times more the cost of a new dog I'd probably not pay it. Another dog would be awesome too.

You know a lot of people get their dogs for 0$, right? Even if you buy a dog from a breeder, using your logic, it's better not to have a pet at all because, even if the dog never gets sick, it costs more to feed it than the price of the dog itself.

Better argument, plz.

 

[Robdude]

Ah, to live in a disposable society where it is easier to just get a new one than take care of the valuable things we already have.

This why I think pets should cost more and people shouldn't be allowed to own one if they can't afford to reasonably take care of it.

I think they key word we are looking at is 'reasonable'.

I think we both agree that, at some point, a vet bill to treat a condition becomes unreasonable. Would you spend 100k to treat your 10 year old dog? What about 10k? What about 1k?

If you are Bill Gates, 100k might not seem like a big deal. If you are a single mother of two and your daughter needs braces and you can't imagine how you will pay the electricity bill this month - 1k might seem unreasonable.

From a bigger-picture perspective, there are plenty of unwanted and uncared for pets. Using fictional numbers, let's say that the annual cost for caring for a healthy dog is $1,000 and the annual cost for caring for a sick dog is $10,000. Is it more humane to spend 10k to give one dog a happy environment or is it more humane to give 10 healthy dogs a happy environment and put down the sick dog, as sad as that is?

 

[Robdude]

You know a lot of people get their dogs for 0$, right? Even if you buy a dog from a breeder, using your logic, it's better not to have a pet at all because, even if the dog never gets sick, it costs more to feed it than the price of the dog itself.

Better argument, plz.

Better understanding, plz.

 

[sumstorm]

I am completely envious that you have been able to find practices that will allow you to uphold those standards... and hope you don't meet with any surprises once you take those jobs. Can I ask what part of the country those job offers are in? Maybe it's a regional thing.

NE - Massachusetts and NH.

I can say that there are huge regional variations from working in animal fields in over a half dozen states.

 

[pennyonthefloor]

I think they key word we are looking at is 'reasonable'.

I think we both agree that, at some point, a vet bill to treat a condition becomes unreasonable. Would you spend 100k to treat your 10 year old dog? What about 10k? What about 1k?

If you are Bill Gates, 100k might not seem like a big deal. If you are a single mother of two and your daughter needs braces and you can't imagine how you will pay the electricity bill this month - 1k might seem unreasonable.

From a bigger-picture perspective, there are plenty of unwanted and uncared for pets. Using fictional numbers, let's say that the annual cost for caring for a healthy dog is $1,000 and the annual cost for caring for a sick dog is $10,000. Is it more humane to spend 10k to give one dog a happy environment or is it more humane to give 10 healthy dogs a happy environment and put down the sick dog, as sad as that is?

I get your view… I really do… because this is the same perspective that I share and it is making the work that I do with a foster organization so extremely difficult to back sometimes. There’s a dollar limit that my dog has when it comes to medical bills (and this will still hold true when I get my DVM... the amount just may increase). From work with shelter medicine and in a great deal of spay/neuter clinics, I see the sheer volume of unwanted animals that exist and I cannot rationalize spending a ton of money on my dog (or any dog or cat, for that matter).
We have, at any given time, 30-50 foster dogs ‘in the system’. All of these dogs come from rural shelters, hoarding cases… pretty bad situations that their next step (if we don’t intervene) is euthanasia. Sad. Really sad. I’m not saying every dog doesn’t deserve a chance, but really, being a non-profit and trying to keep an organization afloat—you can’t save everyone. With our organization, I have a HUGE problem with pulling dogs out of shelters that have horrendous medical issues or behavior issues that are going to exhaust our resources (whether it be tying up a foster family that has to hold on to a certain dog for their entire life because they have behavior issues or some medical treatment that is financially exhausting). I get it that everyone likes the ‘pity adoptions’…. Spending money on a dog or cat that they can baby because they have x y or z wrong with them—making people feel more important. Great. When I see that, as an organization, we have spent thousands of dollars on ONE dog, I can’t help but get angry because we could have better utilized those resources to save x amount of dogs, or offer our sterilization services to x amount of people to help prevent the problem we are putting a bandage on.
*steps off soapbox*
That being said, I don’t know if other areas are starting to jump on this bandwagon, but in Columbus, we have a pet pantry. Similar to that of what organizations do for people—but people can come and pick up pet food if they are having economic issues. May be a small impact overall, but it at least cuts down on the amount of people that cannot pay to feed their animals and *hopefully* cuts down on the amount of euthanasias or animals surrendered to shelters... (Medical issues are a whole ‘nother can o worms)
Sorry if some of this was off on a tangent… felt it kind of related to the topic at hand… if nothing else it may spark some interesting discussion…

 

[KiaKia]

Better understanding, plz.

Sorry, sneaking on here at work so I didn't get a chance to expand and decided on snarky. I understand the need for euthenasia, and all that you said in your further posts, but the original statement/argument was lame -- not the idea, but the presentation.

Medical care and food will cost more than the average dog, it's part of the package. If you buy a pet for $100, and a few years down the line the pet suddenly needs a surgery that costs 1000$ you don't have, then yeah, euth seems to be the only option (beyond trying to get it a new home etc).

Sure, dogs are "replacable" but the "I'll just get a new one" statement rubbed me the worng way not because of the disposability factor, but because the new pet will again be a money drain. I'm now in danger of stepping onto the "poor people shouldn't have pets" slippery slope, which I disagree with.

I was also imagining a non-geriatric pet.

 

[l2vet]

Several people have said similar things, but here's how I see it.

The hospital I work at is the highest-powered place in 60 miles for emergency medicine. We get a lot of non-client emergencies. A lot, a LOT of them have financial constraints--I'd say probably at least 90%. Many people can tell you over the phone, "Do whatever you need to do" and then say 10 hours later when they get the $1k bill "can we put him down." I have heard clients threaten our vets that they will take the dog out in the parking lot and shoot it (live in a rural area) if we don't euthanize it (often a broken leg, other treatable condition), or that they'll just "take it home and let it die." That happens way, way more than I'd like. There are many more clients who, through ignorance, have allowed their animal's health condition to go from not 100% but acceptable (tartar on teeth that might be controlled with brushing or dental chews) to horrific (slab fractures in nearly every large tooth, missing many of small ones, abcessed and rotting teeth, etc), and can't afford the huge vet bill they'd build up to treat it (and don't qualify for a credit line) but probably could have afforded the month to month cost to treat the issue before it got that bad.

I would much, much rather see a dog or cat slip away into oblivion quietly on my table than have it starve to death from not being able to eat (no teeth or horribly painful teeth), be shot out back or at home, or be left to die in the garage or shed out back. Furthermore, I cannot continually offer free care to those who cannot pay. I wish with all my heart that I could, but veterinary practices cost money to run, and I have to eat (and maybe I will have a family, etc and so forth). If the practice goes bankrupt, who's going to treat those animals then? Who's going to do their best to make sure preventative medicine is practiced so that you don't end up with dogs with mouthfuls of abcessed, rotting, fractured teeth, dogs 30# overweight in CHF and huge, swollen, arthritic joins, or whole litters of backyard-bred pups with severe parvo and parasites? Who's going to make sure that the "guard" dog brought in for broken bones doesn't have to be "taken out back and shot"? 99% of vets that I've seen are wonderful people who know medicine and know animals, but there are quacks/apathetic jerks out there. Do you want to go out of business and risk sending an animal to one of"those" doctors? Or worse yet, risk it having no veterinary care at all?

 

[chickenlittle]

NE - Massachusetts and NH.

I can say that there are huge regional variations from working in animal fields in over a half dozen states.

Gotcha... that makes a lot more sense. My area is a major source of the "Dixie Dogs" that are shipped to rescue groups in the Northeast. TOTALLY different regional attitudes!!! 🙂

 

[Robdude]

Sorry, sneaking on here at work so I didn't get a chance to expand and decided on snarky. I understand the need for euthenasia, and all that you said in your further posts, but the original statement/argument was lame -- not the idea, but the presentation.

Medical care and food will cost more than the average dog, it's part of the package. If you buy a pet for $100, and a few years down the line the pet suddenly needs a surgery that costs 1000$ you don't have, then yeah, euth seems to be the only option (beyond trying to get it a new home etc).

Sure, dogs are "replacable" but the "I'll just get a new one" statement rubbed me the worng way not because of the disposability factor, but because the new pet will again be a money drain. I'm now in danger of stepping onto the "poor people shouldn't have pets" slippery slope, which I disagree with.

I was also imagining a non-geriatric pet.

Fair enough 🙂

Looking back my post really did sound more 'trollish' or offensive than I meant it to. Most of the online forums I go to are pretty brutal compared to hear, I'm just used to being abrasive. Sorry!

 

[OnceBitten]

As future vets, how do we handle requests for euthanizing animals, for let’s say a broken leg or a urinary issue simply because the owner can’t afford the necessary treatment? Or how do we handle the fact that many pet owners will take home their pets without treatment? What a catch-22! Have you personally encountered situations like those described above? Is it very common? What a horrible moral dilemma that vets face every day. Your thoughts on the issue?

We see this a lot more often than I would like here, and I am sure that the problem is much worse in non-VMTH, more rural clinics. Personally, I have no problem euthanizing an animal that is suffering when an owner can't afford treatment, although I will still be saddened by it. I think I will struggle with clients who have a non-critical issue, perhaps a 12 year old cat going into renal failure or a dog on his third foreign body removal, who believe they won't be able to afford to treat and are unwilling to adopt out the animal, but I do think it's better than allowing them to suffer. I'll just have to take it case by case and wade through the gray area to the best of my ethical abilities.

As for owners opting to take their animals home without treatment at all, we see that a lot, as well. One case that we had last year haunts me still. It was a lovely, young adult dog with a rifle-induced open femur fracture. Instead of opting for a $60 euthanasia, the owners opted for $60 worth of a morphine injection and took the dog home to die. It was incredibly upsetting to me, particularly since they gave the veterinarian on staff the impression that they were just going to shoot it. What a waste. I have seen many similar cases since that one, and, while I am becoming less and less surprised by it, it still sucks, and I feel a little bit helpless when it comes to making the situation better.

 

[kitty613]

I would much, much rather see a dog or cat slip away into oblivion quietly on my table than have it starve to death from not being able to eat (no teeth or horribly painful teeth), be shot out back or at home, or be left to die in the garage or shed out back.

This reminds me of an article I read recently, which is what made me post this thread. I didn't want to post the link originally because I thought the story might be too upsetting to some; however since this issue was brought up, I'd thought I'd post it.
PS: After reading the article, I seriously began to rationalize how euthanizing a 'healthy' animal is better than the alternative. If you're for the faint of heart, move on to the next post. If not, take a look. DISCLAIMER!

"Awhile back a client brought in a dog with a broken leg that could have been easily fixed for a cost. The owner thought it was ridiculously expensive and said, "How much to kill it?" I told him that I would not euthanize an otherwise healthy dog. I offered to adopt the dog, fix it at my cost, and find it a home.
He said no to my offer, then rudely stated he would take it somewhere else. He walked out without paying. I stepped into the receptionist's office to explain what happened, mumbling under my breath, when all of a sudden we were all jolted by a bone-piercing crack of thunder.
I ran outside to see what happened, only to find the dog shot through the head in the back of the man's truck. Its red eyes were bulging out, staring up, as if looking at the owner for the last time. Its mouth was agape, the near side of its head concaved, and the opposite side of his head was splattered like trunk paint across the bed of his pick-up truck.
The former owner looked up, grinning, with a smoking gun in hand and said "I told you it was too much."

You can read the whole article, "Euthanisia: Can We Say No?" by Dr. Doug Mader at http://www.cliniciansbrief.com/blogs/7724/euthanasia-can-we-say-no

 

[chickenlittle]

That is exactly why I'm *not* typically against economic euthanasias. I live in an area where many people shoot their animals instead of paying for euthanasia... I even once had a guy with a very sick kitten ask me "why should I pay you to kill it when you said it'll die on its own without treatment?" In some of those situations, I have offered to euthanize for free. I would have been willing to pay the euthanasia fee myself if my employers didn't support my actions, but so far the two employers where I was presented with that scenario have agreed to no-charge euthanasia if the client was willing to take the pet home for burial.

 

[l2vet]

This reminds me of an article I read recently, which is what made me post this thread. I didn't want to post the link originally because I thought the story might be too upsetting to some; however since this issue was brought up, I'd thought I'd post it.

I am sad to say that, while that's definitely the minority of owners that would shoot it right there in the parking lot, that I'm not surprised that happened at all.

We've had quite a few owners take their dogs home after coming in Saturday evening and calling to say that their dog has died. That always makes me sick inside; it's without pain medication, they may have been terribly dehydrated or hungry, and I can say that I'm sure 99% of these animals' deaths are nowhere near as "good" as euthanasia.

 

[sumstorm]

I think I will struggle with clients who have a non-critical issue, perhaps a 12 year old cat going into renal failure or a dog on his third foreign body removal, who believe they won't be able to afford to treat and are unwilling to adopt out the animal, but I do think it's better than allowing them to suffer.

Out of curiosity, do you know many people who would adopt a cat going into renal failure? or a dog that ingests that many thing that it isn't suppose to?

I only ask because I'd have a hard time placing those animals.

 

[sumstorm]

Gotcha... that makes a lot more sense. My area is a major source of the "Dixie Dogs" that are shipped to rescue groups in the Northeast. TOTALLY different regional attitudes!!! 🙂

Yeah, it makes a HUGE difference! I've lived in IN, IL, PA, NY, NJ, MA, LA, SC, & NC, and the variations are huge!

 

[l2vet]

Out of curiosity, do you know many people who would adopt a cat going into renal failure? or a dog that ingests that many thing that it isn't suppose to?

I only ask because I'd have a hard time placing those animals.

Well the former is definitely (in my opinion) NOT an adoptable case. There's a difference between someone being willing to properly manage to condition when they already own the animal and asking someone to take on that responsibility, both financial and emotional, when they have no bond with the animal. In the dog's case, with careful supervision that issue could be managed. You'd just need to be up-front with potential adopters that the dog has a pica for X or has been known to ingest foreign bodies, and that they need to be very willing to supervise him closely.

 

[spicykimchi]

If I may ask, why is euthanasia by gun considered unethical? I thought if an animal was shot in the head, it would be dead before it ever knew what happened? And I thought vets sometimes euthanized horses by gun, horses whose circulatory system was too impaired to distribute the euthanasia drug around.

 

[sumstorm]

If I may ask, why is euthanasia by gun considered unethical? I thought if an animal was shot in the head, it would be dead before it ever knew what happened? And I thought vets sometimes euthanized horses by gun, horses whose circulatory system was too impaired to distribute the euthanasia drug around.

Euthanasia by gun is acceptable in some circumstances, preferably by individuals who actually know what they are doing both in handling a firearm appropriatly and in handling an animal appropriatly. In the parking lot of a non-conscenting business is not appropriate.

I have seen dogs shot in the head by police officers for 'euthanasia' that survived for 48 hours...and most folks don't really understand immobiliaztion and appropriate distances.

 

[l2vet]

If I may ask, why is euthanasia by gun considered unethical? I thought if an animal was shot in the head, it would be dead before it ever knew what happened? And I thought vets sometimes euthanized horses by gun, horses whose circulatory system was too impaired to distribute the euthanasia drug around.

Yes, gunshot is an acceptable way to euthanize horses and other large animal species but the AVMA prefers the penetrating captive bolt gun due to safety issues. It is also the policy of the AVMA that gunshots the heart or neck are not acceptable euthanasia methods because they do not cause instant loss of consciousness.

For use of a gunshot to the head as a method of euthanasia in captive animals, the firearm should be aimed so that the projective enters the brain, causing instant loss of consciousness. This must take into account differences in brain position and skull conformation between species, as well as the energy requirement for skull bone and sinus penetration.

In other words, it takes a considerable knowledge of anatomy and skill to truly be able to humanely euthanize by gunshot. Most laypeople do not have this knowledge. There are plenty of farmers out there for whom gunshot is a routine euthanasia practice on their farm, and while I would prefer a drug method, I would trust them to at least perform it humanely. I have also heard of LA vets performing euthanasia by gunshot for those who do not feel comfortable doing it themselves, but cannot afford the dose of euthanasia solution (or it is not economically feasible). However they're still in the minority. Most people have little or no idea (or care) how to properly euthanize by gunshot--and it's not the preferred method of euthanasia, even if you ARE doing it properly.

 

[kaydubs]

Removed. per me.

 

[Chinola]

I work at a high kill shelter. We took in 36,000 animals last year (dogs and cats). 20,000 of those animals were euthanized which is approximately 56%. We euthanize animals most frequently because of lack of space. We get a lot of animals in from the street either brought in by animal control officers or good Samaritans but we also get a lot of animals through owner surrenders. On the form that the owners have to fill out relinquishing their ownership of the animal they also have to write why they are surrendering their pet. The #1 reason is "cost".

So while these owners aren't opting to take their pet to the vet for the economic convenience euthanasia they are essentially doing the same thing when they surrender the animal with us. Granted the animals have a slightly higher chance. But if it's a cat that isn't a specific breed or a dog that isn't a puppy, the animal's chance isn't very high that it's going to make it out alive.

I used to have a much harder time with convenience euthanasias but after working at this shelter I've come to terms with it. I see animals die every day simply because no one wants them. They could be beautiful and healthy but we run out of space.

 

[DVMDream]

I have walked into the exam room of a dog who had a very simple, treatable, cureable and relatively inexpensive condition and the owner's first words before I was able to even introduce myself: "If this can't be fixed for a reasonable price, I have a bullet for the dog that will work just as well." It is sad, very sad. Especially since they claimed that they loved the dog but they just could not afford to spend too much money on him. It is a sad reality, but some people have a limit. I have had a client tell me before, "people before pets and I have to feed my family this month." It is a hard reality and pill to swallow, but I will sit down with owners and go through every possible treatment, costs, possible care credit or payment plans; what the owner decides to do in the end is up to them. I agree that it is often sad when people see pets as disposable, but society in general sees humans as a higher priority than animals (that probably will not change in a long time, if ever and I say in general because there are some people out there who put their pets as a higher priority than even themselves.)

 

[OnceBitten]

Out of curiosity, do you know many people who would adopt a cat going into renal failure? or a dog that ingests that many thing that it isn't suppose to?

I only ask because I'd have a hard time placing those animals.

I don't, and especially not in vet school where we're all in a massive amount of debt and generally responsible enough not to put ourselves in more by taking on a new pet with extensive medical issues. I always think it's worth a shot to try adopting them out, though. It may still end in euthanasia, but I would at least feel like I explored every option before giving up on an animal that might still have a wonderful few years of life left in them.

 

[lareinesoleil]

I don't, and especially not in vet school where we're all in a massive amount of debt and generally responsible enough not to put ourselves in more by taking on a new pet with extensive medical issues. I always think it's worth a shot to try adopting them out, though. It may still end in euthanasia, but I would at least feel like I explored every option before giving up on an animal that might still have a wonderful few years of life left in them.

Especially if it's a non-dangerous behavior issue - some people have a lot more time/tolerance to train an animal than others do.

 

[squirrelsrule]

This is an issue I have struggled with in wildlife rehabilitation. Not exactly economic euthanasia, but just dealing with euthanizing saveable animals. There will always be more wildlife coming in than I can take on. At the center where I volunteer they euthanize all eyes closed babies that do not go home with a volunteer. For the last 3 years I have been the only volunteer taking babies home. The center takes in over 2000 animals a year, usually with at least 200-300 of those being eyes closed babies. I can handle 100-150 animals a year, so obviously that is not all of them. I have struggled with it and pushed my limits several times, but in the end, I am coming to terms with the fact that I can't save them all. I have set limits for myself and will say no.

In the end, the reason for the limit is economical. I could take more if I didn't work, but if I didn't work, how would I afford any of them. I think we all need to realize that we will be doing amazing work as vets, but we have limits, we can't save them all, we can't make people fork over thousands for their animal, all we can do is our best and if that means euthanizing a "saveable" animal, then that is far from the worst thing that could happen.

It is incredibly sad when people come in and opt to euthanize because they truly can't afford treatment, but these people usually have animals that have a chronic issue that will be expensive and in the end they are really only buying time with their sick pet. It is sad, but we all have to draw the line sometime.

The ones that really make me mad are the people who get pets and then say they can't afford to take them to the vets for vaccines or if they get a minor illness. That is just being irresponsible and it makes me really mad. If they can't afford to properly care for their pet, why in the world did they get it!

 

[kitty613]

The ones that really make me mad are the people who get pets and then say they can't afford to take them to the vets for vaccines or if they get a minor illness. That is just being irresponsible and it makes me really mad. If they can't afford to properly care for their pet, why in the world did they get it!

👍

 

[168135]

I have a question that's kind of off topic...

Is Care Credit an American thing? Is there an equivalent in Canada? All of the clinics I volunteered at require full payment upon discharge. Just wondering if this is the norm here. Some vets may waiver certain payments based on the their history with that client (I've seen it done with friends and friends of friends), but they're not allowed to run up a tab and make payments.

 

[Chinola]

I have a question that's kind of off topic...

Is Care Credit an American thing? Is there an equivalent in Canada? All of the clinics I volunteered at require full payment upon discharge. Just wondering if this is the norm here. Some vets may waiver certain payments based on the their history with that client (I've seen it done with friends and friends of friends), but they're not allowed to run up a tab and make payments.

Care Credit is sort of like a credit card that the owners can apply for. It's available in many different areas of human medicine too such as at dentists. You have a certain amount of time to pay off your bill without interest. The amount of time you have to pay it depends on how much the bill is (more money spent, more time to pay it off). However if you go over your allotted "grace period" the interest rates are pretty high. Unfortunately in my experience the owners that need it the most are the same owners that don't have a high enough credit score to get the card. The vet office gets paid in full by Care Credit (just like if it was a Visa/Amex/Mastercard). The only difference is that the owner has more time to pay off the charge.

 

[lareinesoleil]

Care Credit is sort of like a credit card that the owners can apply for. It's available in many different areas of human medicine too such as at dentists. You have a certain amount of time to pay off your bill without interest. The amount of time you have to pay it depends on how much the bill is (more money spent, more time to pay it off). However if you go over your allotted "grace period" the interest rates are pretty high. Unfortunately in my experience the owners that need it the most are the same owners that don't have a high enough credit score to get the card. The vet office gets paid in full by Care Credit (just like if it was a Visa/Amex/Mastercard). The only difference is that the owner has more time to pay off the charge.

Also, while it's true that not everyone does qualify, I *think* it's still easier to get than a "normal" credit card - you just might not get a very high limit. And you can get an instant decision, 24 hours a day, and start using it right away.