Defining "Quality of Life"
by Moira Anderson Allen, M.Ed.
Whenever one considers the painful choice of euthanasia, one is always advised to take the
pet's "quality of life" into account. But what is "quality of life"? How can you determine whether a
pet is still experiencing a good quality of life -- or whether its level of
suffering is no longer acceptable? That decision is individual to every pet,
and every owner. Following, however, are some factors to consider when
attempting to assess a pet's quality of life:
An older pet often loses mobility. A dog may no longer be able to climb stairs or hop into a car;
a cat may lose the ability to jump onto a bed or chair. At this stage, however, your pet may still
be healthy and happy, and you can easily make accommodations for its reduced ability.
If, however, your pet can barely move, that's another matter. Can your pet get to its feet without
assistance? Can it sit or lie down without collapsing? Can it walk? Can it handle basic functions,
such as squatting on a litterbox? Does it whimper or growl if you attempt to move it?
I've seen dogs so crippled with hip dysplasia that they literally had to drag
their immobilized hindquarters across the floor; this hardly represents the
"quality of life" I want for my pets.
Is your pet able to eat? Can it consume enough food (or digest that
food) to remain properly nourished? Does it regurgitate immediately after
eating? Is it unable to chew, or does it have difficulty swallowing? Does it
enjoy eating, or do you have to coax every bite past its lips? A pet that is
unable to eat or gain sufficient nourishment from its food is on a slow road to
A number of illnesses, including cancer, can affect the lungs. When a condition causes the
lungs to fill with fluid or foreign matter (such as cancer cells), a pet quickly loses
its ability to breathe easily or comfortably. You'll notice that your pet may
seem to be panting, or that it is laboring to breathe; often, you'll see its
stomach or flanks "pumping" as it can no longer breathe with just the chest
muscles. It may also experience wheezing attacks. If such symptoms occur, ask
for a chest x-ray to determine the condition of the lungs. If the problem is
due to an allergy, infection, or asthma, medication may help; if it is due to
fluids that are the result of cancer or a heart condition, however, little can
It can be difficult to determine whether a pet is in pain, as animals instinctively mask
discomfort as much as possible. You can pick up clues, however, by watching its posture and
expression. Does your pet's face appear furrowed or "worried", rather than
relaxed and happy? Does it sit hunched or "hunkered" and tense, rather than
relaxing and lying down? Lack of mobility can also be a sign of pain.
Another indication of pain is "denning." An animal in pain will
seek a safe place where it won't be disturbed by other animals. If your pet has
forsaken its usual territories or sleeping places for the back of the closet or
a spot under the bed, this may be a sign that it is pain or distress and feels
A more obvious indication of pain is a pet's reaction to
touch. If your pet responds to touch by flinching away, hissing, snarling, or
even snapping, this is a clear indication of pain. Sometimes this can indicate
a localized pain; if the pet doesn't want to be touched at all, however, it may
indicate a broader discomfort.
Many pet owners feel terribly guilty over the natural annoyance they feel when a pet
becomes incontinent. They feel they should be more loving, more patient.
Incontinence, however, can also be stressful for the pet. As a basic survival
mechanism, animals learn not to "mess where they sleep" (for the smell would
draw attention to the location of one's den). When an animal can no longer
control when or where it urinates or defecates, you can be sure it is not happy
with the situation.
Older pets occasionally develop signs of diminished mental capacity. They may seem to
"forget" things, such as where a toy is located or what a command means. Such a
pet may become confused by its surroundings, and this confusion can develop
into fear. (In some cases, this "confusion" may be the result of hearing or
vision loss, to which both you AND your pet can often adapt.)
Determining whether your pet is "enjoying" life is certainly a subjective decision. However,
if you have been a keen observer of your pet's behavior and attitude during its lifetime, you are
likely to be able to determine when it no longer seems "happy." You'll know
when it no longer seems to take any pleasure from its food, its toys, its
surroundings -- and most of all, from contact with you and the rest of its
family. Most pets are tremendously easy to please; when it no longer becomes
possibly to raise a purr or a tail-wag, you can be fairly certain that your pet
is receiving little joy from life.
Making a Decision:
Assessing a pet's quality of life is an ongoing process, not a one-time decision.
Initially, we're likely to attempt to compensate for the problems we see. Pain medication
may relieve a pet's discomfort and improve its mobility. A change in diet may improve a pet's
appetite or provide better nutrition. We may resolve that we're willing to
clean up after a pet and carry it wherever it needs to go, for as long as
necessary. But eventually such measures will cease to be effective. The process
of assessing "quality of life" is really a question of determining (and
deciding) when that point has been reached -- and what you intend to do next.
It is often tempting, at this point, to postpone a decision
still longer by deciding to "let nature take its course." Before choosing that
course of action (or inaction), however, it's important to understand that, as
a pet owner, you have been thwarting the "course of nature" from the beginning.
By ensuring that your pet has food and shelter and is protected from predators,
you have already guaranteed that nature will not take its course. By providing
medical treatment, you have prolonged the life of your pet far beyond what it
could have expected if left to "nature." In nature, an animal that becomes too
ill to obtain food or protect itself will perish quickly, though not necessarily comfortably.
Nor does nature necessarily offer an "easy" death even if you choose to let it "take its course"
in the comfort of your home. An animal that cannot breathe easily, cannot eat or digest food properly,
cannot control its bodily functions, and can scarcely move or enjoy human
contact because of pain, is hardly dying "comfortably."
This is really what the "quality of life" issue is all about. By usurping nature's role
throughout the life of our pets, we must sometimes also accept its role in
determining (and bringing about) the death of a pet. To accept this, we may
also have to accept that, in some cases, the quality of life we're really
trying to protect is our own: That we're allowing our pet to suffer out of a
desire to avoid the anguish we know that we will experience when it dies. And
that, ultimately, is the most unselfish act of love we can offer: To end a
pet's suffering, we must choose to accept our own.
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