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Pet Loss and Bereavement
Dr. Lorri Greene
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Monday, April 28, 2008; 12:00 PM
A transcript follows.
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Dr. Lorri Greene: Good afternoon. It is a pleasure and an honor to particpate in this online forum. I willl answer as many questions as possible during this hour. Hopefully, my answers will help some of you get through the difficulties facing pet guardianship.
Lorri
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Joe Heim: Hello everyone and thanks for joining us for this chat. I'll try to answer any questions you have about the article on pet health care and Dr. Greene will take on specific questions you may have about how to deal with your pet's illnesses and deciding whether to euthanize a pet.
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washingtonpost.com: Pets, Vets and Debts ( Sunday Source, April 27)
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Lumberton, N.J.:
One option you didn't note in your article is that if you're faced with a sudden one-off incident or illness (car accident, poisoning, pancreatitis, whatever) and money is difficult, some vets will let you pay in installments. (This is particularly true if you have a relationship with your vet). In any case, it can't hurt to ask if installments are a possibility. Installments aren't really helpful in dealing with expensive chronic illnesses, but at least it's an option for shorter-term problems.
I have also, a couple of times, told my vet that I was having financial problems and asked whether a set of tests was really necessary or if there was a less expensive option than the one being offered. My vet's always been very good about working with me to keep my cat as healthy as possible within whatever constraints I was facing at the time.
washingtonpost.com: Pets, Vets and Debts ( Sunday Source, April 27)
Joe Heim: You're right, a lot of vets do let you pay in installments and will work with you to find the right arrangement. Still, many of the pet owners I spoke with were stunned about the cost of treatment. Many simply weren't prepared financially for the bills.
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Washington, D.C.: My girlfriend has 3 cats and a dog, of which, two of the animals are medically challenging. Her vet bills are now higher than her take home income. However, she made a lifelong commitment to the well being of her animals.
When is enough enough?
Joe Heim: Well, I guess that every pet owner is going to answer that differently. What some owners think is the best treatment for their animals other owners view as outrageous and far too expensive.
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Orlando, Fla.: How do you know when the right time to decide to euthanize is? Have two senior dogs with lots of problems...some good days, some bad days...lately mostly bad days. However, both still eat (though less than usual) and wag their tails and seem excited to see me. It's difficult to make the decision when they still look happy sometimes...help
Dr. Lorri Greene: It is always difficult for a caring pet guardian to make the decsion to euthanzie a pet. Euthansia, in Greek, means "painless death". However, this does not make it painless for us. And, it is not an easy choice. For me, I belive that the quality of life is more important the quantity and that is what I use for my guide. If my pet has more bad days than good, I would probaby consider euthanasia.
Dogs do not live as long as humans, therefore, I do take that into consideration as well. It has also been said that your dog will let you know. Perhaps that will also help in making your decision. I hope that helps with a very difficult situaiton.
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Cardiff, Calif.: Why has pet health care become so expensive in recent years?
Joe Heim: I think there are a lot of different factors. Medical treatment and tests that were once only available to humans are now being offered for pets. And that includes very expensive things such as complicated surgeries, chemotherapy and a host of medications. Owners are also willing to spend more for their animals than they have in the past and with more options available to them, the costs can really skyrocket.
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OK: I am waiting biopsy results for our miniature dachshund. If the news is bad, how do I talk to my 4 and 6-year-old when it is time to say goodbye to him? I am planning on waiting until closer to the end to talk to them.
Dr. Lorri Greene: The age of the child is important in what to tell your child. Your children are 4 and 6. At this stage in their psychological development they don't fully understand the concept of death as being final. What I usually suggest to parents is to say someting like "You know the toy you had that was broken and we couldn't fix it? That is what happened to our dachshund (sorry I don't know your pet's name). We took him to the doctor and the doctor could not fix him. Therefore, he won't be here to play with anymore." If you have some sort of spiritual belif system, you might let your child know where you belive your pet may have gone. I truly hope this helps a bit and I hope the news is good.
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Re: Kidney Disease Reader Response: We always thought my now-10-year old beagle was just extremely lazy, but it turned out his lethargy and lack of interest in food was due to kidney disease. The vet gave him a few months to live and prescribed frequent IV infusions and meds (basically to provide a comfortable end). We then took our beagle to an alternative medicine vet, who prescribed a natural homemade diet, lots of enzymes and vitamins, and IV infusions. Four months later, our beagle is like a puppy again! We honestly haven't seen him with so much energy and such a big appetite in years. I'm not usually an alternative medicine person, and the vet is really expensive, but it's definitely worth looking into for some of these diseases where traditional vets tend to take the "make them confortable for their last few months" approach.
Joe Heim: Glad to hear your dog is doing well. I've heard from a lot of readers who are big proponents of alternative treatments for their pets. It's definitely a growing field.
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Washington, D.C.: A few months ago I had to take my lovely, sick kitty to a local vet to be put to sleep. In the examining room, the doctor told me that if I agreed to allow tissue samples to be taken from her, the cost of the euthanasia and cremation would be covered by a research organization. At the time, I was so completely flustered and upset that I refused permission to do so. In retrospect, I wonder if I did the right thing. Can you please shed some light on the proposal I received? What would it have entailed exactly? What research might be involved? Thank you very much.
Joe Heim: Hmm, I haven't heard of this before. Perhaps some other readers know more. I'll track it down after the chat and see what I can find. Feel free to email me heimj@washpost.com and I'll get back to you.
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Fairfax, Va.: We recently lost our friend and companion, Bertha. She was 16. A growth on her liver finally took her.
Having said thet, I can attest to the fact that it's easier to discuss final plans for a pet than it is to experience it. We are still sad.
For what it's worth, there are two lovely, sweet, happy books out there by Cynthia Rylant about our departed friends and their adventures in heaven. They are sold as children's books, but are wonderful for grown-ups, too. One book is titled "Cat Heaven," the other is "Dog Heaven."
Joe Heim: Thanks. Good to know.
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Raleigh, N.C.: A couple of years ago, I lost a dog that "disappeared" from my property. I believe he was stolen, and I searched and followed up on all leads for months and months on end. I think about him every single day. There are so many horrible scenarios as to what might have happened -- did he end up in a laboratory, "bait" for pit bull fighters, etc. (both a possibility in the area where I live). I see many resources onlilne for dealing with the loss of a pet due to illness or accident, but nothing really, about coping with a pet that otherwise goes missing. People think and treat you like you're just plain crazy and pathetic for feeling this way, but there's no denying it, and the not-knowing-what-happened means there will never be any closure. Are there any such resources? Thank you.
Dr. Lorri Greene: This is a terribly difficult situation for pet guardians. It is somewhat the same as families feel when their loved one is Missing In Action during wartime. It is hard to put closure on this, as they don't know what happened to the person. He or she could still be alive is often the thought that goes through their minds.
In fact it is so common that I devoted a whole chapter in my book: SAYING GOOD-BYE TO THE PET YOU LOVE (New Harbinger, 2002) to it. I call the Chapter: Horrible Images, Terrible Thoughts. It deals with , what we call is psychology, Post-traumatic Stress Disorder. You may want to look at the book, or learn more about this disorder, to see if it fits your situation. Unfortunately, it is common and you are not "crazy ot pathetic" in feeling this way. I have seen hundreds of people over the years with the same situation. Please know that there are resources out there. You can also log onto my website at: www.petbereavement.com for more information. Hopefully this helps a bit.
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Silver Spring, Md.: In your opinions, what percentage of veterinarians will lead a (human) client on in terms of unrealistic expectations on a pet's prognosis, versus explaining the reality of that pet's prognosis? In other words, how many vets will suck a client dry if they know that client will do everything short of put a lien on their home, for a beloved pet? Whether you like it or not, this is a common complain among pet owners.
Joe Heim: Honestly I think there are very few vets who would do this. Obviously, in every profession there are some practitioners who aren't ethical, but I don't think vets are any more likely to be unethical. If you don't trust your vet you should seek out one that you do trust. Ask other owners about their experiences and get recommendations.
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Chantilly, Va.: A piece of advice that is often given to owners of exotics that I don't see given to cat and dog owners is to have at least $1,000 in the bank for each pet that is earmarked only for emergency vet bills, and be prepared to spend it. Putting 10-15 dollars a month aside for your pet will give you this amount in less than a year. You can add or subtract from that amount to set what you would consider a reasonable amount for emergency bills (I would consult your vet's office to determine what kind of emergency services your pet might need someday and how much they cost)
As a ferret owner, I have discovered that taking this advice has helped me greatly in making decisions on how to approach treatment for common diseases (i.e. surgery vs. medication for adrenal gland disease) on top of quality of life facet.
Joe Heim: Thanks for the suggestion. Unless I'm misreading something, I think you probably meant to say putting aside $100-$150 a month. Easier for some people to do than others.
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Arlington, Va.: Shocked at the cost of care is an understatement! My cat's three-week stay at the hospital last fall cost the equivalent of a decent car (or a year of college). Further into debt we went... It is really a shame that the costs are so astronomical. At a time when you should be worrying about the welfare of your non-human dependent, instead you are put into a position of worrying about the finances. Every bad test result is a double blow.
Ultimately, we were influenced by the hospice care our human relatives had received. We got our cat out of the hospital as soon as he stabilized and took him home and loved him for another two months until he was ready to go. Yes, it was a lot of work, and yes, it was heart wrenching.
I don't regret the treatment we pursued; we did the best we could. Providing excellent end-of-life care to someone you love is an honor.
Joe Heim: Thanks for sharing this.
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Washington, D.C.: Do you think people are getting too emotionally attached to their pets? Witness people who treat pets as surrogate children and who associate human emotions, feelings, and thought processes to animals.
Dr. Lorri Greene: An excellent question. I believe that as society has become more urbanized we may have lost some of the connections our ancestors had with animals. It is not as common to see a dog hearding cattle, or a cat chasing a mouse for food, as it was in the past. If one lives in rural area, perhaps they do not understand the Human-Animal Bond in the same way as people living in urbanized areas. Animals are living now, more than ever, with humans in their homes. For many, they have become part of the family. Some say they are like their children. jack Lemmon once said about his dog, Chloe, "She is like a child but a child with a great sense of humor."
Many people are spending less time with people. Therefore, their companion animal has also become more important. As I am typing this, my therapy cat, Kali, is sitting on my lap. She is purring and is quite content. There are studies that have indicated that petting a friendly animal not only lowers a human's blood pressure, but also lowers ours. She is certainly proving that to me as I write.
However, you do raise an important point. As pets become more like family members, we tend to attribute human qualities to them. It is important, expecially toward end of life decisions, to remember that they do think and process information differently than human beings. They do not, as best we know, think of death, therfore are not afraid of it.
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Mom to Three Cats: If we make a commitment to take care of another living being, don't we have to honor that "til death do we part"? If I had a human child (or parent, for that matter) who was chronically ill, I don't think getting them put down would be an option. Why should an animal be different? We CHOSE to acquire an animal -- with that comes the good and bad. Do I get to turn a kid over to the foster care system because s/he has behavioral issues or wets the bed at age 8?
Joe Heim: Thanks for writing. I think that not all pet owners feel that their pets are the equal of humans or that they necessarily deserve the same care. Many do, of course, and are willing to do as much (and spend as much) for their cat or dog's health care as they would for a child.
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Chalk Hill, Pa.: Last March we had to put our 15 year old poodle to sleep. We took him to a vet I didn't know because he offered cremation. The vet came in and never said a word to us. just put the dog on the table. I was holding jessie face in my hands when the vet put the needle in Jessie's back leg. Jessie started screaming out in pain and he bit my hand. My husband said "This is wrong it's supposed to be painless" then the vet shoved Jessie's dead body across the table and said "take your dog and get out of here" It's been over a year and I can't get over the ugliness of Jessie's death. I promised him he would just go to sleep, instead I hear his yell and see his limp body being shoved and he didn't deserve this,I feel that I let him down. I wake in the middle of the night thinking about this event, it haunts me constantly. For this reason I will never own another dog and have to go through this again. God bless our little Jessie James.
Joe Heim: That sounds like a pretty awful story. I'm sorry you had to go through that. If you haven't done so already, you might want to let your local veterinary board know about this incident.
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Encinitas, Calif.: I had to put my beloved cat Sophie to sleep in early January. For me, the hardest part was knowing that I was the one responsible for determining when and how she would die. Even though it was the logical and merciful thing to do, I still have a very hard time forgiving myself for my actions.
My question is, and I am desperate to know how you help your pet owners overcome this guilt?
Dr. Lorri Greene: Guilt is very common and can be very persistent in the grieving process. In its simplest definition, guilt is a thought triggered by a past event. It is a very normal response to the perception that somehow we have filed our companion animals. These thoughts of guilt often evoke feelings of remorse, shame, anxiet, anger and sadness, to mention a few. We ask ourselves questions like, "Why did I do what I did"?, Why couldn't I have done more?,"If only I had the money i could have saved my pet."
Very few people feel that they euthanized at just the right time. Unfortuantely, our pets usually do not live as long as we do, so most of us will go through the grief of losing a pet at some point in our lives. I think you did the right thing.
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Berryville, Va: In regards to telling you children about (future) the loss of a pet. There are many good children's books to help them with understanding, and grieving. Also it may be a good idea for each child to make a memory book of the pet's life.
This is a difficult time for everyone in the family and I think it is okay for your kids to know how the loss affects you.
Joe Heim: Thanks for the suggestion.
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Charlottesville, Va.: My consideration is whether my pet will be able to get back to something resembling a 'regular' life.
I had a cat with FIV and three legs (prior to my adopting him) only a few teeth (somotitis because of the FIV) and he had a tumor in his ear. I took him down to Va. Tech and they did a full ear canal ablation on him. He was miserable right after the surgery, but it eliminated the chronic ear infections (the tumor was benign but it was trapping dirt and gunk between the tumor and the eardrum causing infections.) It cost over $3,000, but a few weeks after the surgery he was fine and lived another 5 years.
I've also had to put down a cat with lymphoma and a dog with kidney failure. I didn't want to prolong their suffering and there was no good treatment that would make them better.
The good part of all this is that my sister is a vet and has come to me to put my animals down at home. It's something that she also does for her clients who request it. To not have to make the last thing in the animal's life a trip to the vets (always stressful) is one last thing I feel I can give them.
Joe Heim: I've heard from a number of readers that they had vets who agreed to come to their home to put their pets down> I'm not sure if there's an extra fee for this, but the people I spoke with said that it made a big difference to them.
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Denver, Colo.: When we had to put our Eskie to sleep (after trying some surgery and a week in the hospital to see if it would solve the problems), the hospital was great about putting us in a room as soon as we got there, and bringing all the paperwork to us ahead of time. Then they brought our dog in to us to spend as much time with as we wanted, and gave us the choice to be there with her as they euthenized. It was the hardest thing I've ever had to do, and the hospital's practices were so compassionate -- it made a huge difference.
Joe Heim: Clearly the way that a hospital or a vet handles euthanasia can make a big difference to how the owner feels about the entire experience.
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Attached to pets: I have never understand people who think there's something wrong with people who love their pets "excessively." As long as you are caring for and loving another living creature, how is that wrong for the world? I'm more wary of people who feel that you can and should set emotional limits on how attached to your are to the living things (and you could include children in this) under your care.
Dr. Lorri Greene: I agree. What doe s"excessive" mean anywa? If you love another living being, hwta does it harm anyone, unless it takes away from your, or your families, quaity of life?
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Vienna, Va.: Which vets/people did you interview for your story? The average cost for owning and maintaining a pet using a vet's services on an annual basis is generally around $400 plus in the Washington Metro area. Just getting an annual teeth cleaning is usually between $150 to $250 depending on whether or not bloodwork is done prior to the cleaning (usually done on older dogs above the age of eight). I don't know any vets that will anesthesize an animal for routine procedures such as teeth cleaning, especially if the animal is considered senior (see above), without testing their blood. Then, if you keep your pet on Interceptor or other heartworm preventives that usually runs around $60.00 a year, and Frontline (for fleas and ticks)or Advantix or whatever brand is used is about $80.00 per year. As you can see, I am way above the amount quoted in your news article AND I've just scratched the surface.
Dr. Lorri Greene: Veternary medicine has indeed gone up in price. This has happened for many reasons. For one, the cost of doing business is higher. There is also more technology available than there was even 20 years ago, so there are more options for pet owners. I believe that a good veterinarian will explain all options to the pet guardian, including the option to euthanize. it is important to ask good questions, just as it is good medicine for them to answer. Some questions to ask may be: Is htere a reaosnable cance for comfort or a cure; How mch extra time am I buying my pet; What will the quality of life be if I spend this money on my pet; Do I have the financial, emotional and physical resources to do what is required of me.
Veterinarians in urban areas may charge more, as they have higher overhead costs. However, it depends on oyu what services you want to consider for your pet. They present all, however, you don't have to accpet all. You may also get another opinion if you think it is a good idea.
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Alexandria, Va.: When my last pet got sick very suddenly, we took him in to the vet around 1:00 p.m. on a Sunday afternoon. We said we would spend $500, no questions asked on treatment, but if it added up to more, please call.
Well, they did call, and said they wanted to do this test and that treatment, and finally called at around 7:00 saying our dog was on life support and come immediately. Final tally: $1,500 for 6 hours, no hope of cure, dog died when they removed the life support breathing tube after we got there. Apparently it was a cancer that had suddenly burst.
At what point should the vet logically have told us "your dog is now unconscious," (he was alert and awake when we took him in), "is not likely to regain consciousness; come now as more treatment is futile." I have the feeling they were more "experimenting" than "treating," and I regret more unnecessarily keeping his body going when there was no hope than I do the money -- although the money was not inconsequential, either. Should it be the vet who says "no more" or the owner? How can a non-medically-trained owner feel confident of making that decision when the vet wants to keep doing more?
Dr. Lorri Greene: I belive that it should be up to the owner to say "no more'. However, I also belive that a good veterinarian should offer input on helping you make that decision. He or she should keep you infomred, if the pet is hospitalized.
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Ohio: I agree we treat our pets like family, they are. My home is shared with one small dog.
He is 14 pounds of fun, companionship and comfort. He is always glad to see me and there are days I feel guilty not taking him to work with me. (He went nearly his whole first year, is now 3 1/2). I would be shattered if something happened to him. He is not my first pet, I have had many in my 70 plus years, but he is here now and I am blessed to have him.
Dr. Lorri Greene: So many people share your thoughts and feelings. i am glad there are [people like you out there. These creatures give us unconditional love, make us laugh at there antics and in general add to our quality of life. I am glad there are people like you out there.
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Fairfax, Va.: I need to prepare for the day, in the near future, when we put our old, beloved dog to sleep. I'm worried about how my wife, who found the dog thirteen years ago (long before she found me) and nursed her back to health, will cope. I know I'll be grieving as well and may not be thinking so straight, so I want to have a couple things planned to help with the grieving process. Any suggestions?
Dr. Lorri Greene: I always suggest that people have some kind of memorial service for their pets. If you think of funerals, they are not for the person that has died, but for the living to help put closure on the death. Sometimes people have their pets creamated and spread the ashed in the pets favorite place. Others keep them in their homes. There is a process of grief, and most people will go through that if they love their pet. Just being there for the other person and listening will help both your wife and yourself. i also suggest never say to someone that you know how they feel. Instead just tell them how sorry you are for their loss. Sometimes the death of a pet makes a couple stronger just being with each other to cry and comfort one another.
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Northern Va.: Concerning the right time to euthanize a pet, Dr. Greene wrote that "It has also been said that your dog will let you know." That was exactly my experience with my 15-year-old mutt. He declined rapidly in the last year or so of his life. I know that people close to me were wondering what we were waiting for. However, he still wanted to walk every day and had a fine appetite. Then one day he just did not want to get up. He was in tremendous pain -- it was obvious the time had come. I feel like that is the last gift that he gave me. He let me know that the time had come.
Joe Heim: Thanks for sharing this.
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Washington, D.C.: Treating an animal can be a really difficult decision. My sister had one cat who, through expensive treatment, could be totally cured -- and he was young. Her other cat, she was told, was dying from heart disease ($5,000 later), and he's now totally fine. It's so hard as a pet owner to say no when something is treatable yet very expensive. And then you have no idea if the vet really knows what they are doing -- to go through a battery of tests and treatments only to have the pet recover on his own is very draining (emotionally and financially). I've had some great vets but I have to say sometimes you really feel like the cash register is ringing unless you're firm with them.
Dr. Lorri Greene: This can be true. Being firm is the key. Let your veterinarian know what you can and cannot afford. Remember there are so many more new treatments out there, most veterinarians feel that they need to offer all of these services. You have to decide what you can afford.
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Alexandria, Va.: A few years ago I had to euthanize my dog due to cancer that had progressed so she no longer had a good life. Since then I have become the guardian of two great dogs who are 6 and 3. I find myself constantly worrying about when the day will come when they can no longer be with me, either due to them passing away naturally or me having to face that awful decision again due to sickness. I worry and think about this at least once a week because I can't imagine how sad I will be when they are gone and also because of how hard it was with my first dog to make that decision. Is this normal to worry this much? How do I stop worrying this much?
Dr. Lorri Greene: I understand that this must be difficult. However, in your case, perhaps you can just live one day at a time with your pets. Enjoy each day as if it were your last with them. I suggest we all do this, whether it be with our pets or ourselves. Perhaps you heard of the shark attack here in San Diego last Friday. The man that died was a friend of mine. He was a retired veterinarian as well. Obviously no amount of worrying about when he would die, by either himself or his family, could have prepared them for what happened. My friend died in the water doing what he loved. A sad as we all are, we are happy his last day on this planet was doing what he loved. So enjoy your pets.
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Grants Pass, Ore.: Dear Dr. Greene:
Thank you for your book. It has helped me a lot. I have a question? How can I help others when they have to go thru this decision?
Dr. Lorri Greene: You can help others by just being there for them to talk to. Don't judge or offer platitudes, such as "It was his time, or "I know how you feel." No one knows how another feels.You might want to send a sympathy card and ask if there is anything you can do for them.
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North Carolina: Just an anecdote...When my son was 5 years old we were faced with putting one of our dogs down. We told him the night before that she was probably going to "dog heaven." He seemed to understand. A week later I picked up her ashes and when I came home he asked me what it was. I hadn't had much time to think about it, so I said, "This is where Freddy is now." His eyes got huge and he said, "THAT's heaven?" It did give us time to have an interesting conversation...
Joe Heim: Great story. Who knew Heaven was so small?
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Vienna, Va.: We have a 19-year-old part Siamese cat that in its old age is driving us crazy. It was always a talker -- now she's deaf and meows loudly constantly, especially at, oh say 4:30 a.m. Is there anything we can do with her? My good feelings for this old cat have deteriorated.
Dr. Lorri Greene: As cats get older, they sometimes get a little dementia. Tis happened to one of my cats. Ask your veterinarian if there is any kind of medication that might calm her down a bit.
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San Diego, Calif.: What good answer can you give to somebody when you have a sick cat and he says: "Why are you spending all this money on JUST a cat?"
When you are grieving about the loss of a pet, what is the best short reply to give to somebody who says:"It is ONLY a cat. I don't understand"?
Dr. Lorri Greene: If someone asks you that question, it is not probably someone that understands the bond that you have with your cat. Perhaps the best way to respond is tell them that this is a choice you have made. Perhaps it might not be their choice, but it is yours and you hope that they respect that.
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Bethesda, Md.: What plans should we make in case WE die and leave our pets behind?
Dr. Lorri Greene: Great question. Many local Humane Society's can help you draw up some form of document that will give power of attorney to someone to take care of your pet should you die before your pet.
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San Diego, Calif.: For Dr. Greene:
How do you deal with the guilt of euthanizing a pet because you can't afford the treatment?
Dr. Lorri Greene: Guilt is very common among almost all pet guardians, especially when it involves euthanasia. Remember that you did the very best for your pet while he or she was with you, and it is not always possible to afford all types of veterinary care. I have a chapter in my book that might help you, as it is a very long answer. My book, entitled, SAYING GOOD-BYE TO THE PET YOU LOVE (New Harbinger, 2002), has an entire chapter devoted to this. You can log onto my website at www.petbereavement.com for more information.
I also want to take this opportunity to thank the Washington Post for bringing this important topic to the forefront. It has been a pleasure answering as many questions as I could for you. I realize I didn't answer all of them, so if you would like further information, please feel free to e-mail me at: lgreene98@aol.com. I will do my best to get back to you in a timely manner. Thanks again to Joe Heim and all of the staff at the Washington Post.
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Joe Heim: Thanks everyone for your questions. I'm sorry that we weren't able to answer all of them. Clearly there's a lot of interest in this subject.
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washingtonpost.com: Pet Bereavement
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