Much of what we do in veterinary practice involves ethics. When we consider whether something is ethical or not, we are primarily looking at what is in the best interests of the animal; this can sometimes have grey areas. Is it better for an animal to undergo painful, lengthy surgery in order to live longer? Or is it better to end suffering now and recommend euthanasia? What are the owner’s wishes and what are their finances like? Can the animal’s temperament withstand lots of invasive treatment?
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These are the sorts of dilemmas that vets up and down the country help guide owners through on a regular basis.
What is ‘heroic treatment’?
Heroic treatment can be defined as ‘treatment or remedies of a severe character, suited to a desperate case’. The term is often used to describe major and drastic surgical procedures or perhaps a very intensive course of medical treatment such as chemotherapy.
An example of this could include a dog with a malignant tumour in its mouth or jaw that requires a total mandibulectomy (removal of a large part of the lower jaw) to reduce the risk of further tumour spread. In some cases, depending on the tumour type, this radical procedure may only by the dog a few extra months before the cancer returns with long term survival rates poor. Meanwhile, the dog will have undergone surgical removal of part of his face, leading to eating issues, drooling and tongue problems; as well as the pain of the surgery and recovery itself.
Of course, in some situations, we don’t know for sure whether our dog will be one of the lucky ones. And whether his surgery will be curative, or whether they sadly succumb to the disease despite our best efforts. This is one of the issues that can make it tricky when deciding whether to go for heroic treatment or not.
How do I know if the treatment is in the best interests of my pet?
While we can’t always predict the outcome of a radical procedure or surgery your vet should be able to help guide you by looking at some average statistics. A procedure that carries an 80% chance of long-term success, whilst no guarantee, should give you more confidence to proceed than a procedure with only a 10% chance.
You also need to consider how your pet will be after the treatment. If your pet is left unable to do the things that he loves doing (like swimming or running) or there is a high chance he will be left in ongoing pain, then you must think about who you are really doing it for. Is it for your pet, or is it for you, perhaps because you can’t face saying goodbye yet?
Your pet’s temperament may also play a large part in this. Nervous, easily stressed or highly aggressive animals are unlikely to be good candidates for major surgery; as well as the post op care that is required afterwards. Even chemotherapy may require regular trips to the vets, blood samples and intravenous drips; which only works if your pet is amenable to being handled.
When is it time to say goodbye?
Euthanasia is described as an act to end or prevent suffering. But when and how do we know that time has come?
At the front of your mind should be your pet. Are they still enjoying life and able to do the things that they like doing? Is any form of heroic treatment going to change this? If not, then their quality of life comes into question.
Dogs live in the moment; they don’t look forward to the future in the same way that we do. So, when considering any form of major surgery or treatment, try and see things from your pet’s perspective. Would they want to go through painful procedures, rehabilitation, and multiple vet trips to only extend their life by a few months?
However, if the evidence points towards a more positive outcome, then you may decide it’s worth trying. Be led by your vet or ask for a referral to a specialist if you want to discuss the pros and cons in more detail.
Sadly, for some though, finances may mean that there is no other option but euthanasia. Not every owner has the money to spend on heroic treatment options, and certainly, euthanasia is kindest in this situation. Discuss your thoughts with your vet.
Conclusion
There is no clear-cut answer when deciding whether to go for a heroic treatment option or not. It will come down to the circumstances that surround the individual case which includes the chances of the treatment being worthwhile. For example, will it significantly extend your pet’s life? Will your pet have a good quality of life afterwards?), your pet’s temperament and your own finances. Speak to your vet for help and guidance. And be prepared to at least consider euthanasia as an option if your pet’s quality of life is suffering.
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