2001-Sun Sep 24 17:25:03 EDT 2017
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Not to be morbid, but have you ever noticed that some of your former pets have chosen interesting times to get sick and die, like shortly after their best buddy passes, a week into your long-planned European vacation or in the middle of a move?
It’s almost as if they were feeling hopeless, depressed and unwilling to continue living. If that’s your sense of the situation, I have to agree that our pets are absolutely willing and able to decide when it’s time to move on to the great beyond.
We all know people who have done the same thing: For example, husbands who've shortly followed their wives of 60 years into the beyond and vice versa. This well-understood phenomenon is probably why it’s easy for most of us to believe that some pets also seem to make up their own minds about dying.
I’ve observed this interesting occurrence in my experiences with the deathly ill –– mostly in the case of cats, but with some canines, too. In many of these instances, it’s frighteningly predictable that pets with a certain personality and attitude will prevail, while others with a bleaker outlook will succumb.
It also happens with humans, like cancer patients who don’t have the stomach for the tedium and the insecurity of long-term therapy simply (and understandably) call it a life. Or trauma sufferers who barely survive their ordeals only to awaken long enough to utter their goodbyes.
I’m not saying that there’s a one-to-one relationship between losing the will to live and dying. Obviously, there are plenty of humans and animals who really want to live and struggle mightily to survive, but they can’t get beyond the limitations of their injuries or illnesses. Alternatively, there are those who really want to check out –– but modern medicine somehow finds a way to keep them alive.
I got to thinking about this subject last week when one of my less sociable feline patients presented with a mass on her lower forelimb. Despite my best efforts to identify its origins in order to initiate therapy before it progressed, the thing blew up and Honey's leg was huge! Within 24 hours, the limb had doubled in size and become unsustainably painful.
Unfortunately, the biopsy hadn’t made its way back in time to help me decide a definitive course of action. Adding insult to injury, the laboratory thumbed its nose at my request for a faster turnaround. The oncologist I’d consulted urged patience, but my patient didn’t seem like she was willing to wait. She looked like she wanted nothing better than to die –– immediately.
Just so you know, cats are especially good at dying on command –– their own, that is. Give them enough reason to stress out and they can get themselves into that mindset with astonishing alacrity, which is why I ultimately decided to take the leg off ASAP. In fact, within two hours of realizing this cat was trying to check out on me, I took the kind of crazy step of forcing her hand: I gave her a bolus of opiates and operated on her.
I know it sounds kind of cruel to knowingly thwart an animal’s obvious psychological and physiological desires, but here’s the issue: If you can alter perception of the event quickly enough, you can sometimes buy yourself a lot of time. Hence why speed is of the essence with pets who have a glass-half-empty approach to life and death.
After all, given half the chance, these pets will die with or without our fancy vet care and even our most heartfelt ministrations. If we’re quick about it, sometimes we can manage to get to the finish line before they do. In these cases, however, understanding our patients’ personalities and anticipating their psychosomatic tendencies is more than half the battle.
So what’s a vet to do in the face of such mind-body resistance to treatment? Should she press on in spite of her patient’s fervent reluctance? Or should she always err on the side of caution and press on based on the hardest kind of data available, knowing that pets can be difficult to read, which makes veterinary outcomes so uncertain?
The latter is clearly my approach to the problem, but that doesn’t mean that Honey’s attitude toward life doesn’t color my view of her condition and my recommendations to her owners. Sure, I think her personality and less-than-sunny disposition make her a poor candidate for any kind of serious surgery, but she’s nonetheless reacting positively to our efforts.
Why do I think that’s the case? Probably because we never gave Honey a chance to exert her opinion. And also because, sometimes, the act of forcing treatment on someone (human or animal) has a way of working out for everyone in the end.
The hard part: knowing which patient needs to be pushed — and which one I should let go.
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