How Do You Make Medical Decisions for Your Dog?
One of the hardest things about having a companion animal is the responsibility of making medical decisions for them. When our human friends are sick, we can give advice, but ultimately the decision about whether and how to treat an illness is made by the person who’s going to be treated. One of the hardest things I’ve ever had to do is make decisions about whether and when to treat my dogs for serious illnesses. How do I give them a voice, a say in what happens to them? How do I know what is best? According to my beloved Gunny, one of the hardest things about being a dog is not having control over your life, including what is done to your body in a medical setting. That makes a lot of sense to me.
When there are several different options before you, how do you go about making the decision that is right for your dog? Here are some things that I consider when having to make medical decisions:
What do I have to decide first or right now?
I want to make as few decisions as possible while I am in a state of shock/stress and before I have all the facts. For example, if you learn that your dog has a cancerous tumor that can be surgically removed and chemotherapy after surgery is recommended, you don’t have to decide all of that in the first moment. If your dog is nauseated and not eating because of that tumor, the only decision you probably have to make that day is whether and how to treat the nausea. Next, you have to decide whether to do surgery: what are the risks of doing it vs not doing it, how long is the recovery, and how difficult/painful will the surgery be for your dog? In some cases, your dog is in pain WITHOUT surgery and it doesn’t seem right to ask them to live in pain. In other cases, maybe your dog isn’t showing signs or symptoms, but you know that surgery is the best chance to avoid pain and suffering later. Every situation is unique. But in general, my advice is to make decisions one at a time, giving yourself time for reflection, more knowledge, and the experience of seeing how well your dog handles each treatment decision before making the next one.
How does my dog handle being at the vet and being touched/treated?
Some dogs are terrified of going to the vet with good reason. If your dog is in that category, you need to discuss it with your vet long before there is a serious illness so that you can find ways to make him more comfortable in that environment or switch vets. These days, vets don’t “take a dog to the back” for minor things like blood draws, and participate in programs like Dr. Marty Becker’s “Fear Free” initiative. Some procedures require your dog to be taken to another room to be tested/treated. Does your dog go willingly? Does he shake with fear? Does he come out of the experience agitated? You need to factor all this in when deciding whether to embark on a treatment plan that will require your dog to have frequent vet visits.
What does my dog value?
In some ways, this is the easiest of the questions to answer. You know if your dog loves to retrieve and play like a nut, or if she is at an age where a short walk around the block is enough and she just wants to cuddle with you on the couch. It sometimes depends on age, and sometimes it’s personality. If you have a 3 year old dog who gets incredible pleasure from running and playing, it might be really unfair NOT to do surgery on a ruptured knee ligament and ask her to give up that activity forever and tolerate pain. If a 12 year old sedentary dog has the same injury, it might be unfair to ask her to go through the surgery and recovery when she is still going to mostly just want to lay on the couch and snuggle.
Vets are incredibly busy. They can give you their best advice about the medical risks and benefits of a procedure or course of action, but you are the one who knows your dog and has the responsibility of looking out for their best interest. There is most always something that you CAN do. The challenge is figuring out what you SHOULD do. Pause, take the time you need, talk to your dog about it, and try to figure out based on what you know about your dog, what you believe THEY would want. Maybe they don’t want to be treated. Maybe they would be happier just living out their days without medical intervention even if such intervention could extend their life. THERE IS NOTHING WRONG WITH THAT! Or, maybe, like Gunny, they want to live and fight for their life and take big risks for big rewards. Just asking the question “WHAT WOULD MY DOG CHOOSE?” is a big step in honoring your dog’s desires and making the best decision on his/her behalf. For example, I stopped chemotherapy for one of my dogs when I saw him shaking in the car as we approached the vet office parking lot. That was all I needed to know. He died a few weeks later, but I couldn’t ask him to endure fear so that I could keep him with me for a longer time.
When you look at these situations through your dog’s eyes – what they value, what they can tolerate – it actually makes the decision easier. You owe it to your dog to listen to him when he shows you how he feels about medical treatment, and to act on that information in a way consistent with what he wants. YOU might be willing to do anything to keep your beloved friend with you as long as possible. But that is not the decision before you.