Sunday, April 25, 2010

4/25/2010 Euthanasia Part III: Making the Decision

 Vet tip of the Day: When is it the right time for euthanasia?

In this final entry concerning the difficult topic of euthanasia, I would like to share with you my views as a veterinarian on the hardest part of the decision for euthanasia: when is the appropriate time?

First and foremost, I respect the right of a horse's owner to use their own judgement in deciding what they believe is best for their horse.  Horses legally are considered property, they do not have legal rights.  There are governing bodies in every state to respond to situations of animal cruelty to protect horses from abuse situations, but elective euthanasia is not considered abuse. I do not agree with every decision for euthansia, and I have refused to perform euthansia in rare cases.  However, the vast majority of owners who come to the decision to end their horse's life do so after careful and painful deliberation, and are acting in the best interest of their cherished animal.

I am frequently asked by clients to help them in making the decision to end a horse's life.  Usually this is in the case of geriatric horses, or chronically lame horses.  I would love to be able to tell you that it is always clear to me when a horse is suffering inhumanely, but it isn't.  The question of quality of life is engulfed in a huge grey cloud. Two things that I offer as factors to consider when you are trying to determine the quality of a debilitated or geriatric horse's life are: 1) progressive weight loss in the face of an excellent plane of nutrition and 2) prolonged periods of recumbency (lying down) to the point that pressure points such as hips develop non-healing sores, and the horse has pronounced difficulty rising.

The subject of euthanasia for practical reasons is really problematic.  Horses live a long time and they are very expensive to care for.  As horses age they typically require more calories and special dietary considerations, as well as nutritional supplements and sometimes medication (such as pergolide for Cushings horses, or anti-inflammtories for musculoskeletal problems) which increase the cost of upkeep for an animal that may no longer be rideable.  I stick very firmly to my respect for each horse owner's individual right to make decisions for such horses.

On the other end of the spectrum are owners who simply do not believe in euthanasia, and feel very strongly that all living beings should die a natural death.  Again, I respect this perspective, as long as the owner is able to provide adequate nursing care and pain medication to support their horse through the process of dying.  I always remember a foal I treated back at the University of Georgia when I was a resident.  The owner had lost a son to a long battle with cancer and absolutely would not consider euthanasia an option for this foal.  The foal suffered from neonatal septicemia, a bacterial infection that circulated throughout the body, seeding infections in multiple sites.  The foal had bacterial endocarditis (a vegetative bacterial growth on a heart valve), pneumonia, an infected umbilical cord, and an infection of the growth plate adjacent to one of the hind fetlock joints.  The bacteria responsible for all these infections was resistant to virtually every antibiotic available.  Statistically the foal's chance of survival was way below 10%, he was extremely lame, had dramatically reduced exercise capacity due to his enlarged heart and leaky mitral valve, as well as the severe pnuemonia.

Despite my repeated explanations of the foal's condition and poor quality of life, the owner refused to consider euthanasia, and instructed me to continue treating the foal, regardless of cost or prognosis.  Well guess what?  That foal lived to race as a 3 year old - he only raced once, and not very well, but he managed to overcome his heart infection, and although he never was sound, he was retired after his one race and lived out his life in a beautiful pasture. It is not our place to judge the decisions of others regarding their horses, unless cruelty or neglect are evident.

So when is it appropriate to choose euthanasia for your horse?  Only you can make that decision.  Listen to your veterinarian's assessment of your horse's condition and prognosis, then search your heart and mind and make your decision based on your own personal ethical code.  It is never easy, and it never gets easier, but it is part of the responsibility of horse ownership. 

I believe that education is the key to evolution. 
I believe that animals are the key to compassion.
I believe the learning never stops.

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