The Dog Cancer Survival Guide (88 page)

Apocaps has also helped several dogs in my practice feel better in their final days.

Your vet or oncologist will be helpful in coming up with a pain management strategy that works for your dog. Keep in mind that combined medications might be more effective than single agents.

Even dogs with limited mobility can enjoy fresh air and sunshine, massages, petting, going for a drive, or gentle play sessions with favorite toys. Acupuncture has a good record for providing some pain relief and nausea management, and a session or series of sessions might really help. Do anything you can to fill your dog’s life with connection, warm feelings and closeness.

To help yourself prepare for your dog’s passing, it might be helpful to do one or two of the exercises from
Chapter 2
. Pledge of Thanks and Life Story can be especially meaningful at this time.

Some guardians struggle with guilty feelings. One way to help cope is to take some time to apologize to your dog for everything you feel you could have done better in his life. Although it may sound sentimental, expressing your regrets to your dog directly, out loud, can help you feel you’ve really apologized from the heart. Dogs have a way of letting us know they forgive us for even our deepest faults, and that can be healing.

Even if you don’t feel guilty, this exercise can be helpful during this time of transition to say your last words.

Spending quality time with your dog in her last days can be moving. It can also be exhausting and sad and just plain hard. It is normal to feel lots of different emotions and have many stressful thoughts during this time. Be kind and compassionate toward yourself, so that you can stay focused and help your dog.

Sometimes dogs die naturally, in their sleep, at home. Most guardians, however, come to realize that what is best for their dog is to put her to sleep. If you are contemplating euthanasia, this section is for you.

Sometimes euthanasia is suggested during a vet appointment, or after an overnight stay, but very often you can schedule the appointment in advance. Schedule the appointment for a time when the vet is not likely to be terribly busy or rushed. The receptionist will probably ask you how you would like your dog’s remains to be handled, after death. You will have the choice of taking them home with you or leaving them with your vet for burial or cremation.

To prepare yourself, it is helpful to remember that you may see healthy pets in the waiting room. I also recommend asking a family member or friend to come with you. Even if you don’t want them present during the procedure, you may need their help getting home. Having a loving presence with you at a time like this can ease the suffering a little.

Some guardians do not want to be present for the euthanasia. There is nothing wrong with this, however, the majority of people do not regret being with their dogs in their last moments. If you are worried that you will be too emotional, remember that the vet and her staff have probably seen many people react to the death of their beloved dogs, and it’s unlikely they will judge you. If you are having trouble deciding, it may help to imagine yourself a year from now, looking back at this time, and ask yourself from that vantage point, whether you will regret being present or regret being absent.

Some guardians feed a “last supper” immediately before the euthanasia appointment. Although I understand this impulse, a very full stomach can sometimes cause nausea or vomiting, particularly if a sedative is given prior to the euthanasia solution. For this reason, try to schedule that delicious meal at least two hours before the appointment.

“If and when it comes time to help them cross the bridge, they will let you know and they will, in their own way, convey their appreciation to you for a life well lived.”

- Jill Stout, Medford, Oregon

Euthanasia is a very simple procedure, with a profound impact on everyone involved. There are several things for you to know.

The euthanasia drugs must be administered directly into a vein, so it is important that your dog doesn’t move around during this final procedure. To ensure that your dog is both extremely comfortable and calm, many vets use a sedative before actually injecting the euthanasia solution. Depending upon the circumstances, it may be possible for you to hold your dog or cradle him while this happens. Once the dog is sedated, the vet finds a vein, usually in the foreleg, and slips a very fine needle into it. He slowly injects the euthanasia solution into the blood. This solution is, most commonly, an overdose of a rapid-acting barbiturate. According to what we know of humans who received drugs like this, there is no pain.

Six to twelve seconds after the injection is complete, the dog usually takes a deep breath, relaxes, and then quietly passes away. Your dog may release his bowels and bladder during this time. There may still be some involuntary movements or a few more breaths taken before death occurs. However, most guardians are surprised by how quick and painless euthanasia is. Vocalization is very rare.

Most vets will give you a few moments alone with your dog after she has passed, which many guardians appreciate. At my practice we also take an impression of the dog’s paw in clay and give it to the guardian as a memento. Some guardians collect a little fur as a keepsake.

If you have opted to bring your dog home, you can bring a casket or box with you or your vet will have a box or a blanket ready.

If you are leaving your dog’s body, the staff will probably wait until after you leave to handle the remains. If you choose cremation, it can take a few days or longer to get the body to the crematorium. Make sure to ask your vet how long it will take to get your dog’s ashes, and any other questions you have about this process. One question I get a lot is “how do I know whether those are my dog’s ashes?” Most crematoriums are very sensitive and careful about making sure that the ashes delivered belong to the right guardian. If you have any questions about the process, be sure to ask them.

The journey home may be a tough one for you, so if someone else can drive, that might be best. Everyone handles euthanasia differently, and we often can’t predict our own responses ahead of time. It can be normal to cry, laugh, scream, feel numb or have any other emotional response.

Sometimes guardians want to have the euthanasia performed at home, and some vets do perform this service. While home euthanasia can be less stressful than going to the clinic, there are things to consider. Some house call veterinarians do not have support staff, which means that you may have to take on the task of restraining your dog, cleaning up soiled blankets and linens, and handling your dog’s body after the vet leaves. Depending upon your emotional state, this may be difficult, especially if your dog is less compliant on his home turf. Make sure you ask if your vet will bring an assistant, and whether they can bring the remains to the crematorium for you. Keep in mind there may be extra fees for after-hours or in-home visits, transportation, or assistants.

I am not a psychiatrist or a therapist; however, as a veterinarian and a dog lover, I am all too familiar with loss. I would like to offer a few words about the grieving process, which may help you as you face the death of your own beloved dog. Loss of any kind results in grieving of some kind, and no one is exempt. We all experience our grief in our own ways, and it is hard to predict exactly how.

Most of us feel sad. This is completely natural and expected, and you need to accept it. Give yourself permission to feel your own sadness – it’s a way of honoring your love for your dog, and it’s not a sign of weakness or mental instability. If you are like me and many other guardians, you consider your dog to be a family member, and you have experienced a genuine loss. Let yourself feel it.

Grief can manifest in many ways. For example, some people feel physical pain like a stomachache or a headache, while others feel terrible emotional sadness. Some people cry continuously, while others grow quiet and reserved. Some sleep all day, while others stay up all night.

Some guardians may hear a sound that reminds them of their dogs’ running through the house or even catch a glimpse of something out of the corner of their eye that registers as their dogs. Sometimes a scent or a visual reminder will trigger a memory so vivid that it feels unbearably intense. This is a lot more typical than you might think, and it’s not a sign that you are crazy.

Sometimes the sadness is terrible at night, when the house is quiet. Other times it is worse during work hours, or when you’re doing an everyday chore. Sadness, anger and upset feelings are normal and natural. Feeling them as they come up is important for the grieving process. Trust yourself.

It is not uncommon to struggle with the loss and have a really hard time. You may even need the help of a professional to get through the grief, and if you do, there is no shame in getting it. For many guardians, our dogs are true family members, and we take our grieving seriously. Counselors, psychologists and psychiatrists help people dealing with emotional hardships of all kinds, and this certainly qualifies. Friends, family members, online support groups and spiritual leaders can provide help, too.

As time passes, those intense grieving sessions usually shorten, become fewer and farther apart. Things will start to feel normal again, and you will stop thinking about your dog as much as you did at first. This is normal, too. It’s not a betrayal of your dog – it’s just what happens as we heal from grief.

If you successfully grieve (as awkward as that sounds) and really feel your feelings as they arise, without holding on or wallowing in them, your feelings of grief will diminish. Most people never stop missing their dogs, and yet, you may find that if you think about her, a few months down the road, you feel mostly all right.