How do I know when it is time to say goodbye?

This is always a very difficult question.  The choice of euthanasia is a difficult one, but can also be one of the kindest desicions we make for our furry little friends.  "How do you know when it is time?" is a question that I hear on a daily basis in my job.   The veterinarian and the staff can assist you in making an objective assessment of the patient, but it ultimatley comes down to you.  Your endpoint is going to be different from your neighbours and your friends.  So how do we make this objective assessment?

Dr. Alice Villalobos, the veterinarian who started Pawspice, a quality of life program for terminal pets, has published a scoring system for life quality called The HHHHHMM scale. The letters stand for: Hurt, Hunger, Hydration, Hygiene, Happiness, Mobility, and More Good Days than Bad.

Quality of Life Scale: The HHHHHMM Scale
Pet caregivers can use this Quality of Life Scale to determine the success of pawspice care. Score patients using a scale of 1 to 10.  (Where 10 is a healthy animal)
Score	Criterion
1-10	HURT - Adequate pain control, including breathing ability, is first and foremost on the scale. Is the pet's pain successfully managed? Is oxygen necessary?
1-10	HUNGER - Is the pet eating enough? Does hand feeding help? Does the patient require a feeding tube?
1-10	HYDRATION - Is the patient dehydrated? For patients not drinking enough, use subcutaneous fluids once or twice daily to supplement fluid intake.
1-10	HYGIENE - The patient should be brushed and cleaned, particularly after elimination. Avoid pressure sores and keep all wounds clean.
1-10	HAPPINESS - Does the pet express joy and interest? Is the pet responsive to things around him or her (family, toys, etc.)? Is the pet depressed, lonely, anxious, bored or afraid? Can the pet's bed be close to the family activities and not be isolated?
1-10	MOBILITY - Can the patient get up without assistance? Does the pet need human or mechanical help (e.g., a cart)? Does the pet feel like going for a walk? Is the pet having seizures or stumbling? (Some caregivers feel euthanasia is preferable to amputation, yet an animal who has limited mobility but is still alert and responsive can have a good quality of life as long as caregivers are committed to helping the pet.)
1-10	MORE GOOD DAYS THAN BAD - When bad days outnumber good days, quality of life might be compromised. When a healthy human-animal bond is no longer possible, the caregiver must be made aware the end is near. The decision needs to be made if the pet is suffering. If death comes peacefully and painlessly, that is okay.
*TOTAL	*A total over 35 points represents acceptable life quality

Adapted by Villalobos, A.E., Quality of Life Scale Helps Make Final Call, VPN, 09/2004, for Canine and Feline Geriatric Oncology Honoring the Human-Animal Bond, by Blackwell Publishing, Table 10.1, released 2006.

How is euthanasia performed?
Euthanasia is performed using an overdose of an anesthetic drug.  This drug is injected into the vein, so it is necessary to place an IV catheter.  We will carefully do this with the least amount of stress possible for you and your beloved pet.  Should the patient stress or struggle the Veterinarian may give a sedative.  Once you are ready, the veterinarian will inject the drug through the IVport.  This overdose will stop her heart quickly.  The veterinarian will confirm that there is no heart beat using a stethoscope.  You are always welcome to hold her in your arms during the final moments if you wish.  After the procedure you may stay as long as you wish to say your final goodbye.

If you prefer, this service can be done at your house, or in your pet's favorite place under the apple tree. Please call to discuss this with a staff member.

What happens after the procedure?
You have 3 options for your pet's aftercare.  You can have her cremated, either privately or in a group. A private cremation means that he will go in alone and her ashes will be returned to you in a beautiful urn. You may also choose to bury her on your property. Please ensure the grave is deep enough to prevent other animals from digging her up.

For more information about cremation please visit Until We Meet Again Pet Memorial Center

If you are considering euthanasia, discuss your pet's condition with your veterinarian.