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Defining β€œQuality of Life”
by Moira Anderson Allen, M.Ed.

Whenever one considers the painful choice of euthanasia, one is always advised to take theΒ Β pet’s β€œquality of life” into account. But what is β€œquality of life”? How can you determineΒ Β whether a pet is still experiencing a good quality of life β€” or whether its level of suffering is noΒ Β longer acceptable? That decision is individual to every pet, and every owner. Following,Β Β however, are some factors to consider when attempting to assess a pet’s quality of life:Β Β 

Mobility
An older pet often loses mobility. A dog may no longer be able to climb stairs or hop into a car;Β Β a cat may lose the ability to jump onto a bed or chair. At this stage, however, your pet may stillΒ Β be healthy and happy, and you can easily make accommodations for its reduced ability. If,Β Β however, your pet can barely move, that’s another matter. Can your pet get to its feet withoutΒ Β assistance? Can it sit or lie down without collapsing? Can it walk? Can it handle basic functions,Β Β such as squatting on a litterbox? Does it whimper or growl if you attempt to move it? I’ve seenΒ Β dogs so crippled with hip dysplasia that they literally had to drag their immobilized hindquartersΒ Β across the floor; this hardly represents the β€œquality of life” I want for my pets.Β Β 

Appetite/Eating AbilityΒ 
Is your pet able to eat? Can it consume enough food (or digest that food) to remain properlyΒ Β nourished? Does it regurgitate immediately after eating? Is it unable to chew, or does it haveΒ Β difficulty swallowing? Does it enjoy eating, or do you have to coax every bite past its lips? A petΒ Β that is unable to eat or gain sufficient nourishment from its food is on a slow road to starvation.Β Β 

BreathingΒ 
A number of illnesses, including cancer, can affect the lungs. When a condition causes the lungsΒ Β to fill with fluid or foreign matter (such as cancer cells), a pet quickly loses its ability to breatheΒ Β easily or comfortably. You’ll notice that your pet may seem to be panting, or that it is laboringΒ Β to breathe; often, you’ll see its stomach or flanks β€œpumping” as it can no longer breathe withΒ Β just the chest muscles. It may also experience wheezing attacks. If such symptoms occur, ask forΒ Β a chest x-ray to determine the condition of the lungs. If the problem is due to an allergy,Β Β infection, or asthma, medication may help; if it is due to fluids that are the result of cancer or aΒ Β heart condition, however, little can be done.Β Β 

DiscomfortΒ 
It can be difficult to determine whether a pet is in pain, as animals instinctively mask discomfortΒ Β as much as possible. You can pick up clues, however, by watching its posture and expression.Β Β Does your pet’s face appear furrowed or β€œworried”, rather than relaxed and happy? Does it sitΒ 

hunched or β€œhunkered” and tense, rather than relaxing and lying down? Lack of mobility canΒ Β also be a sign of pain.Β Β 

Another indication of pain is β€œdenning.” An animal in pain will seek a safe place where it won’tΒ Β be disturbed by other animals. If your pet has forsaken its usual territories or sleeping places forΒ Β the back of the closet or a spot under the bed, this may be a sign that it is pain or distress andΒ Β feels vulnerable. A more obvious indication of pain is a pet’s reaction to touch. If your petΒ Β responds to touch by flinching away, hissing, snarling, or even snapping, this is a clear indicationΒ Β of pain. Sometimes this can indicate a localized pain; if the pet doesn’t want to be touched atΒ Β all, however, it may indicate a broader discomfort.Β Β 

IncontinenceΒ 
Many pet owners feel terribly guilty over the natural annoyance they feel when a pet becomesΒ Β incontinent. They feel they should be more loving, more patient. Incontinence, however, canΒ Β also be stressful for the pet. As a basic survival mechanism, animals learn not to β€œmess whereΒ Β they sleep” (for the smell would draw attention to the location of one’s den). When an animalΒ Β can no longer control when or where it urinates or defecates, you can be sure it is not happyΒ Β with the situation.Β Β 

Mental CapacityΒ 
Older pets occasionally develop signs of diminished mental capacity. They may seem to β€œforget”  things, such as where a toy is located or what a command means. Such a pet may becomeΒ Β confused by its surroundings, and this confusion can develop into fear. (In some cases, thisΒ Β β€œconfusion” may be the result of hearing or vision loss, to which both you AND your pet canΒ Β often adapt.)Β Β 

HappinessΒ 
Determining whether your pet is β€œenjoying” life is certainly a subjective decision. However, ifΒ Β you have been a keen observer of your pet’s behavior and attitude during its lifetime, you areΒ Β likely to be able to determine when it no longer seems β€œhappy.” You’ll know when it no longerΒ Β seems to take any pleasure from its food, its toys, its surroundings β€” and most of all, fromΒ Β contact with you and the rest of its family. Most pets are tremendously easy to please; when itΒ Β no longer becomes possibly to raise a purr or a tail-wag, you can be fairly certain that your petΒ Β is receiving little joy from life.Β Β 

Response to TreatmentΒ 
When a pet becomes ill, our natural response is to provide whatever treatment we can. ThisΒ Β may mean tests, medications, even surgery. But drugs have side effects, repeated trips to theΒ Β vet cause emotional distress, and more invasive treatments take a physical toll. Eventually, weΒ Β may conclude that our efforts to treat a pet’s illness are more stressful to the pet than theΒ Β condition itself β€” and that our efforts to save a pet’s life are actually diminishing, rather thanΒ Β enhancing, the quality of that life.Β 

Making a DecisionΒ 
Assessing a pet’s quality of life is an ongoing process, not a one-time decision. Initially, we’reΒ Β likely to attempt to compensate for the problems we see. Pain medication may relieve a pet’sΒ Β discomfort and improve its mobility. A change in diet may improve a pet’s appetite or provideΒ Β better nutrition. We may resolve that we’re willing to clean up after a pet and carry it whereverΒ Β it needs to go, for as long as necessary. But eventually such measures will cease to be effective.Β Β The process of assessing β€œquality of life” is really a question of determining (and deciding) whenΒ Β that point has been reached β€” and what you intend to do next. It is often tempting, at thisΒ Β point, to postpone a decision still longer by deciding to β€œlet nature take its course.” BeforeΒ Β choosing that course of action (or inaction), however, it’s important to understand that, as aΒ Β pet owner, you have been thwarting the β€œcourse of nature” from the beginning. By ensuringΒ Β that your pet has food and shelter and is protected from predators, you have alreadyΒ Β guaranteed that nature will not take its course. By providing medical treatment, you haveΒ Β prolonged the life of your pet far beyond what it could have expected if left to β€œnature.” InΒ Β nature, an animal that becomes too ill to obtain food or protect itself will perish quickly, thoughΒ Β not necessarily comfortably.Β Β 

Nor does nature necessarily offer an β€œeasy” death even if you choose to let it β€œtake its course”  in the comfort of your home. An animal that cannot breathe easily, cannot eat or digest foodΒ Β properly, cannot control its bodily functions, and can scarcely move or enjoy human contactΒ Β because of pain, is hardly dying β€œcomfortably.” This is really what the β€œquality of life” issue is allΒ Β about.Β Β 

By usurping nature’s role throughout the life of our pets, we must sometimes also accept itsΒ Β role in determining (and bringing about) the death of a pet. To accept this, we may also have toΒ Β accept that, in some cases, the quality of life we’re really trying to protect is our own: ThatΒ Β we’re allowing our pet to suffer out of a desire to avoid the anguish we know that we willΒ Β experience when it dies. And that, ultimately, is the most unselfish act of love we can offer: ToΒ Β end a pet’s suffering, we must choose to accept our own.Β Β 

Copyright Β© 2001 by Moira AllenΒ Β 

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