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(US DE) When do you say, 'It's time'? August 19, 2005 11:14 PM

 
 
Owners of sick, aging pets agonize over the decision to end an animal's sufferingBY CHRISTOPHER YASIEJKO / The News Journal08/19/2005

Ben was a Great Dane, the adopted son of a proud Karole Brownson.

Each night, before he climbed the stairs and went to bed, he would stand on his hind legs and lean much of his 190 pounds on her shoulders. His meaty white paws dangling off Brownson, Ben sometimes would steal a kiss before lumbering away.

First in Newark, then in New Castle, the homes of Brownson, 55, and her partner Iris Berman, 53, were filled with decorations that made clear their love for dogs. To this day, lawn ornaments poke up from the mulch and declare, through images and words crafted in wood, that theirs is a home centered around their dogs.

There was Ben, who inspired Brownson to clip "Marmaduke" comics, and there was Zach, a black labrador who when playing fetch favored a certain toy football.

Earlier this year, Ben, 8 1/2, got sick. His veterinarian, Charlotte Fagraeus of Animal Haven Veterinary Center in Bear, tested for cancer. Negative. She tested for irritable bowel syndrome. Negative. She tested for Addison's disease.

Positive.

Brownson and Berman knew they'd have to make a decision: Do we let nature take its course? Or could euthanasia prevent suffering?

It's a decision Delaware residents face each year.

Today's decision is easier in some ways. Medical advances can keep pets alive and comfortable longer. The process of euthanization itself is more dignified, increasingly allowing owners to oversedate their pets at home, in their arms, in a family setting.

"See, the animal is really a member of the

family," says Booker Outland, a 73-year-old retired veterinarian who ran the Bridgeville Animal Hospital. "Perhaps it may sound trivial, but it is actually true. There's no difference between a kid being a precious member of the family and an animal who's a precious member of the family."

For Brownson and Berman, Ben's disease, in which the adrenal gland's hormone production is insufficient, initially causes vague symptoms -- vomiting, lethargy, a depleted appetite -- but can cause heart problems, shock and death.

Brownson didn't want Ben to suffer. She had to make a decision. Euthanasia, once treatment became futile, was the likely end. She knew this.

"Probably the hardest decision," she says, "was knowing when to say, 'It's time.' "

Many veterinarians, including Fagraeus, tell clients to look for signs that their pets no longer have the will to behave in ways befitting their personalities -- big eaters, for example, lose appetites, and playful dogs or cats don't respond to the usual cues.

To fight Ben's Addison's, Brownson injected him once with cortisone. Before the next scheduled injection 25 days later, Ben grew ill. He weakened. His back paws began curling under him.

"Do you have any doubt in your mind that this is the right time?" Brownson asked Fagraeus.

"None at all," she said.

On March 3, Fagraeus visited Brownson and Berman's home. Brownson held Ben in her arms. She told him he was a good boy. And his doctor of more than seven years gently injected into Ben's body an overdose of anesthetic. He drifted out of consciousness, and he died in peace.

"People in general, including doctors, run from death," Brownson says. "And I promised myself from my early teenage years that I would never let anyone I know die alone. Because I don't want to die alone."

Any reputable veterinary clinic will allow the owner to be present when a pet is euthanized. Many veterinarians will come to the homes of their patients for the last moments. If the owner can't summon the emotional strength to hold the animal, a technician usually will provide that final comfort in the office.

A retired nurse, Brownson chose to have Ben euthanized at home for a reason: "I don't believe in taking a dog or cat to a place that makes them nervous and having that be their last memories."

On June 8, after 16-year-old Zach's neurological problems had worsened to the point that he would fall, Brownson and Berman had Fagraeus visit their home again. Three months after they quietly bid farewell to Ben, they did the same for Zach.

A precious family member

Although animal euthanasia isn't universally accepted, it's long been considered a humane alternative to the drawn-out death that comes of terminal illnesses.

However, area veterinarians say it's not as necessary today because of medical advances.

Booker Outland of Bridgeville Animal Hospital retired two years ago after 37 years of veterinary practice. During the final 10 years of his career, he says, euthanasia decisions became less frequent. He attributes that decline to better drugs, more specialists and organ transplants for pets.

But the emotional process, Outland says, hasn't changed.

"From the very beginning," he says, "the rule was no pain and suffering. Even though we have an improvement in the drugs, making it easier to achieve that, it would always be our priority."

Fagraeus echoed that sentiment. During her 11-year career, she says, the percentage of those who opt to euthanize has held steady. (She speaks anecdotally, since she's worked at more than one clinic and since the latest numbers are separated according to animals' weights and other factors.)

The overall number may

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 August 19, 2005 11:15 PM

The overall number may have risen with the population of cats and dogs. However, no one tracks the numbers of pets who are euthanized each year, say spokesmen for the American Veterinary Medical Association and the American Humane Society.

The quality of the euthanasia experience, though, has improved.

"The animal-human bond has grown so much," Fagraeus says, "people would be more likely to take the pet to us rather than taking them to the SPCA or letting them die after an illness at home."

Ultimately, she notes, improved methods of diagnosis won't preclude a decision about cancer or an end-stage disease. But the quality of euthanasia is more dignified. People are more likely to be with the animals during the process, sedation is more common, and home euthanizations allow pets to die in a more comfortable setting.

Simba's last battle

Empathy was evident in early July at the Animal Haven Veterinary Center. Nancy Brady, the Bear practice's other veterinarian, had come in on a Tuesday (usually a day off) to meet Joanne Senn, a client now living in Vineland, N.J., and whose cats she'd treated during the Senns' six years in Newark.

Atop a stainless steel table in a small examination room, 12-year-old Simba rested on a peach-colored towel. His coat was a deep black, satiny to the touch. His belly was shaven, along with two wristband-sized patches on his front legs.

He looked like he was napping. Leaning on the left side of his face, he used his paws as a pillow. His golden eyes were hidden -- the right one was infected, crust and goo sealing it shut; the left one simply was tired. A curious noise now and then tapped his instinctual energy, and his left eyelid would pop open. Just as quickly, it closed.

Around his neck were layers of white and blue gauze. They hugged him like a turtleneck and secured a small orange tube. When its cap was removed, food and medication passed through to Simba's esophagus.

The bottom third of his tail softly swayed.

"His heart sounds strong," Brady said. "But I'm worried about how much fluid he's carrying.

"The fact that he put up something of a fuss back there" -- she said Simba had growled as she extracted blood with a syringe -- "means he still has some spunk in him."

"He's just started purring within the last couple days," Senn said. She stroked his back.

Simba already had been tested with X-rays and ultrasounds. He'd seen an oncologist and a cardiologist. Before this visit, he was on six medications. Senn would grind the pills into powder and send it into the feeding tube.

"And I know she might not be able to save him," Senn said, and she clenched her lips.

Brady completed the thought: "But we're going to try everything we can."

They met each Tuesday for the next month, tracking Simba's condition. He didn't seem to be in pain. Good news meant he'd gained a bit of weight or had played with a string that hung from the couch. But his improvements weren't remarkable. On Simba's latest visit, Brady noticed his kidneys had deteriorated.

Senn had decided to delay euthanization until Simba showed signs of suffering. She was willing to let him go before she was ready, but not before he was ready.

On Aug. 3, Simba died. He vomited, inhaled some, and he died of aspiration. "George and I were both with him, which I am so grateful for. We buried him in our yard. It's not that we've never lost a pet, but we've never lost one this close."

Simba's death meant she didn't have to decide when it was time, she says.

"God, to do that," Senn says of euthanizing Simba, "it's like pulling the plug on a child when they're sick."

Playing God?

Ginger Young, a paddock judge at Dover Downs and Harrington Raceway, had a 33-year-old horse named Prissy who, after mediocre careers as a racehorse and a brood mare, had become more a pet than anything else. During a stormy night earlier this year, Prissy lay down in her stall. For four hours, she struggled to stand. She couldn't.

And Young had to make a choice. "I hate to play the role of God," she says, "but at that point, not to euthanize her would have been for me. I think we could've gotten her up, but I knew in my heart that at 33 it would've happened again."

Contact Christopher Yasiejko at 324-2778 or cyasiejko@delawareonline.com.

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