5 Questions to Ask Before Saying ‘Yes’ to Expensive Surgery
By Dr. Karen Becker and comments by Diane Weinmann
Some of the most difficult decisions we make as pet parents involve the treatment and ongoing care of an animal companion who is seriously ill or incapacitated.
Veterinary medicine is evolving in terms of new treatments, but just because a treatment is available doesn’t mean it’s appropriate in every situation. In fact, sometimes, refusing treatment is actually the best decision a person can make for their pet’s quality of life.
Asking the Right Questions
Receiving the news that a dog or cat is seriously ill or injured is extremely upsetting for most pet parents, but it’s important to keep your wits about you so that you can formulate the right questions to ask your veterinarian.
At a minimum, you need to know what’s wrong with your pet, the extent of the illness or injury, what treatment options are available and associated costs, and the best-case and worst-case scenarios for each type of treatment.
Armed with this information, I recommend you take a day or two to think things over and write down any additional questions or concerns that arise. This is also a good time to consider a second opinion, perhaps with a specialist such as a veterinary cardiologist, oncologist, or surgeon, depending on what’s wrong with your pet. Questions to ask yourself as you contemplate your pet’s treatment options:
- What is in the overall best interests of my pet? This is a gut check to ensure it’s your pet’s interests and not your own that remain your primary focus.
- How difficult will treatment be for my pet? If, for example, your cat is stressed out by car rides and veterinary visits, a course of treatment that requires lots of both will add to her discomfort and anxiety.
- Will the recommended tests and treatments change my pet’s outcome? Unfortunately, sometimes “doing everything possible” in terms of diagnostic tests and treatments delivers no benefit whatsoever beyond helping pet parents feel they “did everything possible.”
- Will the treatment offer my pet an improved quality of life? This is arguably the most important consideration.
- What can I realistically afford in terms of financial and time commitments?
Preparation is priceless. I recommend establishing treatment boundaries before you find yourself in a situation in which your emotions are running high and you’re more apt to make decisions you may later regret. Some of the situations below are extremely difficult to contemplate, but whenever possible, it’s best to do so with a clear head. Things to consider:
- How will I pay for my pet’s treatment? You can find information on pet health insurance, other options to pay for pet care, and preventive care tips in my article One of the Most Neglected Aspects of Pet Ownership.
- How far will I go with treatment for my pet? Generally speaking, it makes little sense to put an elderly pet through a course of treatment (e.g., an amputation, back surgery, or removal of a major organ) that probably won’t improve and may even detract from his quality of life.
- How many invasive procedures will I allow my pet to undergo? Set an “invasiveness tolerance level” for your animal based on your own feelings and beliefs — your wise inner voice. For example, an ultrasound is a three-dimensional image taken with an external device that is entirely non-invasive but could be stressful for your pet.
Exploratory surgery, on the other hand, is the definition of invasive. Your pet will be put under general anesthesia, opened up, and her internal organs explored. If you’re unwilling to put your pet under the knife but you’re okay with an ultrasound, write it down so you know in advance how you feel about invasive procedures.
- How far will I let my pet be pushed? This involves assessing your pet’s individual stress tolerance level. If you must pack your elderly housecat off to an emergency clinic with dozens of barking dogs, bright lights, odd smells and strange people, it can be overwhelmingly stressful for her.
In such a case, you may decide not to put her through certain procedures — even if they’re warranted and you’d prefer they be done — because you know she’ll very likely have an emotional meltdown simply from the stress of the situation. Identify your pet’s stress threshold and make a decision ahead of time not to go beyond it.
- How do I feel about resuscitation and other end-stage issues? If your beloved pet slips into a coma at an emergency animal hospital, do you want the staff to perform CPR, or are you prepared let him go? If you want your pet saved at all costs, will you be able to manage a critically ill animal, perhaps on life support?
- How do I feel about euthanasia? Sort out your thoughts and feelings about euthanasia. Think about whether you agree in principle with it. If you must euthanize your pet, would you want it done at home? Which family members would be involved? How about your children, if you have any, and other pets?
- How do you want your pet’s remains handled upon death? Do you want to take her home for burial? Would you like her cremated and the ashes returned to you? Or would you prefer to leave the remains at the clinic for disposal? Try to give the situation some thought before the time arrives. Only you know what’s best for your pet, and for you and your family.
Taking Care of Yourself While You Care for Your Pet
Sharing your life with a pet brings immeasurable amounts of joy and unconditional love, but when your pet becomes ill, caring for him can take a toll on your mental health. Researchers assessed what they called “caregiver burden” in 238 owners of a dog or a cat.
It’s well known that caregivers of human patients facing a chronic or terminal illness experience heightened levels of stress, depression and anxiety, so the researchers set out to determine if the same held true for pet caregivers.
As you might suspect, the answer is yes. Compared to owners of healthy animals, the results showed greater burden, stress and symptoms of depression and anxiety, as well as poorer quality of life, in owners of pets with chronic or terminal disease.1 In turn, the feeling of higher burden was linked to reduced psychosocial functioning.
It’s important to remember that you can’t care for your pet unless you care for yourself first. Practice positive self-care, from eating right to getting enough sleep, and reach out for support when you need it.
For many, the emotional toll is the hardest part of caring for a sick pet, which is why expressing your thoughts and feelings is crucial.
You needn’t keep your emotions bottled up; what you’re feeling — perhaps failure, frustration, inadequacy or guilt — is valid and by sharing your thoughts — in a journal, with a friend or in a support group — you can ultimately move past them and let them go. The International Association for Animal Hospice and Palliative Care (IAAHPC) states:2
“We encourage you to reach out to like-minded individuals in your community and online who have experienced similar situations, and ‘get it.’ Look to your local animal shelters, veterinary association, and pet funeral homes for pet loss support groups. Human hospice programs in your community offer grief and bereavement services to the public (interview them for their views on pet hospice first).”
In addition, if you’re feeling overwhelmed with decisions and information regarding your pet’s illness, ask for explanations from your veterinarian, and realize that you don’t have to shoulder the burden alone. If you need a moment to regroup, ask a close friend or family member to care for your pet so you can focus on stress relief.
“[T]he ability to think clearly will directly affect how effective you can be in your care for your animal companion,” IAAHPC notes. “Respite, or some time away from caregiving, can be important to your continued well-being.”
Despite the stress and, oftentimes, uncertainty, there can be great solace in being there for your pet when he needs you most. Sometimes, if you’re feeling anxious or overwhelmed the best thing you can do is to simply sit and be with your pet in the present moment.
As an alternative, consulting with an animal communicator, like Diane Weinmann, to obtain the wishes of your pet, along with signs that they will display if they are ready to transition into spirit and if they want assistance with that journey can also take the uncertainty of the situation away.
Take some deep breaths, practice mindfulness or meditation, and your calmness will likely be felt by your pet as well.