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Defining โ€œQuality of Lifeโ€
by Moira Anderson Allen, M.Ed.

Whenever one considers the painful choice of euthanasia, one is always advised to take theย ย petโ€™s โ€œquality of lifeโ€ into account. But what is โ€œquality of lifeโ€? How can you determineย ย whether a pet is still experiencing a good quality of life โ€” or whether its level of suffering is noย ย longer acceptable? That decision is individual to every pet, and every owner. Following,ย ย however, are some factors to consider when attempting to assess a petโ€™s quality of life:ย ย 

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

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

Breathingย 
A number of illnesses, including cancer, can affect the lungs. When a condition causes the lungsย ย to fill with fluid or foreign matter (such as cancer cells), a pet quickly loses its ability to breatheย ย easily or comfortably. Youโ€™ll notice that your pet may seem to be panting, or that it is laboringย ย to breathe; often, youโ€™ll see its stomach or flanks โ€œpumpingโ€ as it can no longer breathe withย ย just the chest muscles. It may also experience wheezing attacks. If such symptoms occur, ask forย ย a chest x-ray to determine the condition of the lungs. If the problem is due to an allergy,ย ย infection, or asthma, medication may help; if it is due to fluids that are the result of cancer or aย ย heart condition, however, little can be done.ย ย 

Discomfortย 
It can be difficult to determine whether a pet is in pain, as animals instinctively mask discomfortย ย as much as possible. You can pick up clues, however, by watching its posture and expression.ย ย Does your petโ€™s face appear furrowed or โ€œworriedโ€, rather than relaxed and happy? Does it sitย 

hunched or โ€œhunkeredโ€ and tense, rather than relaxing and lying down? Lack of mobility canย ย also be a sign of pain.ย ย 

Another indication of pain is โ€œdenning.โ€ An animal in pain will seek a safe place where it wonโ€™tย ย be disturbed by other animals. If your pet has forsaken its usual territories or sleeping places forย ย the back of the closet or a spot under the bed, this may be a sign that it is pain or distress andย ย feels vulnerable. A more obvious indication of pain is a petโ€™s reaction to touch. If your petย ย responds to touch by flinching away, hissing, snarling, or even snapping, this is a clear indicationย ย of pain. Sometimes this can indicate a localized pain; if the pet doesnโ€™t want to be touched atย ย all, however, it may indicate a broader discomfort.ย ย 

Incontinenceย 
Many pet owners feel terribly guilty over the natural annoyance they feel when a pet becomesย ย incontinent. They feel they should be more loving, more patient. Incontinence, however, canย ย also be stressful for the pet. As a basic survival mechanism, animals learn not to โ€œmess whereย ย they sleepโ€ (for the smell would draw attention to the location of oneโ€™s den). When an animalย ย can no longer control when or where it urinates or defecates, you can be sure it is not happyย ย with the situation.ย ย 

Mental Capacityย 
Older pets occasionally develop signs of diminished mental capacity. They may seem to โ€œforgetโ€ย ย things, such as where a toy is located or what a command means. Such a pet may becomeย ย confused by its surroundings, and this confusion can develop into fear. (In some cases, thisย ย โ€œconfusionโ€ may be the result of hearing or vision loss, to which both you AND your pet canย ย often adapt.)ย ย 

Happinessย 
Determining whether your pet is โ€œenjoyingโ€ life is certainly a subjective decision. However, ifย ย you have been a keen observer of your petโ€™s behavior and attitude during its lifetime, you areย ย likely to be able to determine when it no longer seems โ€œhappy.โ€ Youโ€™ll know when it no longerย ย seems to take any pleasure from its food, its toys, its surroundings โ€” and most of all, fromย ย contact with you and the rest of its family. Most pets are tremendously easy to please; when itย ย no longer becomes possibly to raise a purr or a tail-wag, you can be fairly certain that your petย ย is receiving little joy from life.ย ย 

Response to Treatmentย 
When a pet becomes ill, our natural response is to provide whatever treatment we can. Thisย ย may mean tests, medications, even surgery. But drugs have side effects, repeated trips to theย ย vet cause emotional distress, and more invasive treatments take a physical toll. Eventually, weย ย may conclude that our efforts to treat a petโ€™s illness are more stressful to the pet than theย ย condition itself โ€” and that our efforts to save a petโ€™s life are actually diminishing, rather thanย ย enhancing, the quality of that life.ย 

Making a Decisionย 
Assessing a petโ€™s quality of life is an ongoing process, not a one-time decision. Initially, weโ€™reย ย likely to attempt to compensate for the problems we see. Pain medication may relieve a petโ€™sย ย discomfort and improve its mobility. A change in diet may improve a petโ€™s appetite or provideย ย better nutrition. We may resolve that weโ€™re willing to clean up after a pet and carry it whereverย ย it needs to go, for as long as necessary. But eventually such measures will cease to be effective.ย ย The process of assessing โ€œquality of lifeโ€ is really a question of determining (and deciding) whenย ย that point has been reached โ€” and what you intend to do next. It is often tempting, at thisย ย point, to postpone a decision still longer by deciding to โ€œlet nature take its course.โ€ Beforeย ย choosing that course of action (or inaction), however, itโ€™s important to understand that, as aย ย pet owner, you have been thwarting the โ€œcourse of natureโ€ from the beginning. By ensuringย ย that your pet has food and shelter and is protected from predators, you have alreadyย ย guaranteed that nature will not take its course. By providing medical treatment, you haveย ย prolonged the life of your pet far beyond what it could have expected if left to โ€œnature.โ€ Inย ย nature, an animal that becomes too ill to obtain food or protect itself will perish quickly, thoughย ย not necessarily comfortably.ย ย 

Nor does nature necessarily offer an โ€œeasyโ€ death even if you choose to let it โ€œtake its courseโ€ย ย in the comfort of your home. An animal that cannot breathe easily, cannot eat or digest foodย ย properly, cannot control its bodily functions, and can scarcely move or enjoy human contactย ย because of pain, is hardly dying โ€œcomfortably.โ€ This is really what the โ€œquality of lifeโ€ issue is allย ย about.ย ย 

By usurping natureโ€™s role throughout the life of our pets, we must sometimes also accept itsย ย role in determining (and bringing about) the death of a pet. To accept this, we may also have toย ย accept that, in some cases, the quality of life weโ€™re really trying to protect is our own: Thatย ย weโ€™re allowing our pet to suffer out of a desire to avoid the anguish we know that we willย ย experience when it dies. And that, ultimately, is the most unselfish act of love we can offer: Toย ย end a petโ€™s suffering, we must choose to accept our own.ย ย 

Copyright ยฉ 2001 by Moira Allenย ย 

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