IN SICKNESS AND IN HEALTH
JERRY KLEIN,
DVM
42
At the Very End
L
tions they’d arrived with at the hospital were being shattered.
ast October, three people were needed to get Yo-Yo, a
Our advancements in veterinary medicine seem to parallel
14-year-old spayed Akita, out of an SUV in the emerour advances in human medicine. Technology and change in
gency vet hospital’s packed parking lot at 11 p.m. And
expectations have somewhat altered my own thoughts on
one person narrowly missed being bitten on the arm. “Yo-Yo
managing things like cancer. People these days don’t just
is never friendly,” Mr. Letterman told them. That night, after
want to know that their dog is dying of cancer; they want
her 7 p.m. supper, Yo-Yo was restless and pacing. About one
to know what type of cancer and treatment options such as
hour before, she started retching and howling. Mr. Letterman,
surgery and chemotherapy, even if it may mean a short-term
a 70-something-year-old man, needed to get his two young
gain. Hope springs eternal.
neighbors to help him get her into the truck.
These days, fewer people seem to take the option of
Once at the hospital and on the examining table, it was obvihumane euthanasia when presented with a guarded to poor
ous Yo-Yo was in dire straits: She was pale, panting heavily and
prognosis. I find it especially true of first-time dog and cat ownhad a rapid heart rate. Her belly was tight and tympanic (felt like
ers. They will go to every option available to the very end. It
a drum), she was bloated, and her stomach had twisted. Now,
may be because this is what they think
you and I know that an average Akita
is expected of them, or maybe they try
doesn’t live past 14, if they’re lucky. But
to model their choices based on what
not Mr. Letterman! In trying to get him
I learned early on
know about human medicine.
to consider life-quality issues, we menthat people deal with theyBecause
of the nature of our
tioned her advanced age, the seriousness
and express grief in
hospital, we see a huge number of
of her condition on presentation (lactate,
really, really sick animals, some acutely
a measure of perfusion, was nearly the
very different ways.
(trauma, bloat, internal bleeding) and a
highest we’d observed) and the high cost
lot of chronically ill ones that use our
of getting the surgeon in to perform Gasspecialty services. These include ongoing cardiac patients,
tric Dilation Volvulus (GDV) surgery (about $4,000, if no complidogs or cats with brain tumors or uncontrollable seizures,
cations). Nope, that didn’t stop Mr. Letterman.
long-standing infiltrative bowel disease, lymphoma, chronic
Once in surgery, the surgeon discovered that half of Yo-Yo’s
pancreatitis, chronic obstructive pulmonary disease, etc.
stomach was necrotic, or dead, and he called Mr. Letterman
Ironically, though we are credited for saving thousands of
with the bad news, expecting him to say, “Let her go.” Well,
lives, the vast majority of the handwritten thank you cards we
Mr. Letterman wanted him to continue. So off came half of
receive acknowledge the kindness and care bestowed on the
Yo-Yo’s stomach. On recovery, Yo-Yo had the expected abfamily and the pet during the process of handling the euthanormal cardiac rhythms, but then she developed something
nasia of their loved one.
called DIC, disseminated intravascular coagulopathy, nickHelping guide people through the process of electing
named “death is coming.” But once a pet owner has started
euthanasia for their pets is challenging. It is a combination of
going down the road of treatment, they usually feel the need
science and art, brain and heart. You use your medical knowto continue that journey (if they can afford it). Several plasma
ledge and diagnostics to get the diagnosis, and then present
transfusions later, and after 10 days of hospitalization (oh, did
the results to your client.
I mention Yo-Yo bit one of our veterinary technicians?), Yo-Yo
slowly walked out of the hospital on her own.
Mr. Letterman brought us loads of cookies and chocolates
Dealing With Grief
at Christmastime.
I learned early on that people deal with and express grief in
very different ways, and you can’t always judge what you see.
About 30 years ago, I had a night where early in the evening,
When Suggesting Euthanasia
a woman brought in her dying 14-week-old kitten, previously
When I first started working emergency, one of my biggest condiagnosed with Feline Leukemia Virus, and was inconsolable
cerns was how I was going to be perceived by people whom
when it passed. Her level of emotion bordered on hysteria,
I’d just met, and then telling them their dog or cat was gravely
and she stayed in the exam room wailing for more than two
ill. “Who are you?” I thought they would say, in challenge of
hours. We were afraid for her safety on her way home. And
me telling them their beloved Snickers or Toby was probably
she had adopted that poor little kitten just one month before.
not going to make it another two hours, let alone through the
About three hours later, a nice man in his 80s brought in his
night. I didn’t know either them or their pet, and here I was,
some stranger, telling them that all their hopes and expectaCONTINUED ON PAGE 46
DOGSinREVIEW.com