When Do I Euthanize My Pet With Cancer?
by Dr. Kari Trotsky
Peaceful Endings for Pets
When your pet is diagnosed with cancer, it can be devastating news. Not only does cancer come in all different shapes and forms affecting different areas such as skin, organs, bones, or nerves, some can be aggressive either spread throughout the body (metastasis), or remain locally, causing its own destructive tissue damage. The main questions that need to be answered are:
- Where is it?
- What is it (biopsy often needed)?
- Is there any evidence of spread (metastasis) throughout the body?
- What are the treatment options (whether you pursue them or not)?
- What is the prognosis?
Once these questions are answered, only then you can make informed decisions.
If your pet is really old, you may not want to even pursue getting a biopsy, and that’s understandable. Those decisions are personal, and as long as you don’t plan on treating it (meaning trying to get rid of the cancerous cells whether it be through surgery, chemotherapy, or radiation), and know that future outcomes can be unpredictable since we won’t know how the cancer will act (will it be aggressive, will it travel to the lungs, will it cause anemia, etc) then going forward with hospice care is fine. Hospice in this situation would mean treating every symptom within reason (especially pain control) to make the pet as comfortable as possible until the time to euthanize comes.
So, whether you decide not to pursue a biopsy, or if you have pursued full treatment options, but now the end is near anyway, there are a few things that may help you know when it’s time to euthanize your pet.
First, are the symptoms. If your pet has rapid weight loss, is weak, starts to eat less, has vomiting or diarrhea, then it may be time to euthanize. At the first start of, say, vomiting, it’s ok if you get an anti-emetic injection and subcutaneous fluids from your vet to see if it’s an ailment unrelated to the current cancer and will respond to conservative treatment. But barring that, if it’s now going on 2-3 days, waiting any longer will only prolong your pet’s suffering. If your pet is wasting away, feeling so ill that he or she doesn’t want to eat or drink, feels nauseous, or is too weak to go outside or to the litter box to eliminate, then you need to make that ultimate decision.
Next, your pet may have location specific problems, but any issue with the heart and lungs should not be prolonged! If your pet has labored breathing, or an increased respiratory rate at rest, or fluid build-up in the lungs, these conditions all feel horrible and the pet can go downhill very rapidly. With these conditions, the pet either feels like he is suffocating, or that he is drowning in his own fluids. Your pet cannot keep this up for very long. The body will get tired, your pet won’t get much sleep because of the positions he has to maintain in order to breathe, and delaying euthanasia is not advisable. These pets can also be a little tricky to euthanize because as the sedative (before the final euthanasia injection) starts to take effect, it will depress the respiratory and cardiac centers causing the breathing and heart rate to slow. When this happens, the pet can have trouble breathing. I’ve dealt with this situation many times, and if the pet’s breathing is hampered in any way, it is best to step in sooner than expected and euthanize the pet instead of waiting for the full effect of the sedative to take place.
Another consideration beyond the heart and lungs are other locations in the body. If your pet has a brain tumor, he may not know where he is or who you are. He may act uncharacteristically aggressive and the risk of biting a human could be high. He may go blind or walk into walls. If your pet has an abdominal mass, there may be a risk of that tumor rupturing and bleeding and, thereby, causing internal hemorrhage. This can happen at any time and can be rapid. Or, maybe your pet has a large external tumor. These can start to decay on the inside, progress to an open wound, and cause infection, bleeding and pain. Also, another location could be bone cancer. Often these progress to pathologic fractures (the destruction and lysis of the bone causes the bone to fracture) which cause a lot of pain. These can often spread to the lungs where your pet can have labored breathing (see above), or require so much pain medicine for the pet to be comfortable, that high doses are needed and heavy sedation can occur. Pets shouldn’t be maintained on medications that constantly keep them sedated, so euthanasia will be needed, even though, mentally, your pet may still be very sharp.
This was just a brief overview of the many different sequelae cancer in pets can cause. I’ve dealt with all of these over the course of my 17 years in practice, so if you have any questions, I can certainly help.
Linda and I want to thank you for so many things. First of all it’s your informative web site that clearly explains not only what the euthanasia procedure involves but specific signs that help one decide whether or not to consider it. Obviously our beloved black lab Harley was a candidate after the spleen and liver diagnosis of untreatable cancer. Then you returned our initial phone call immediately and gave us a couple of timeframe options. Before you even arrived we were able to make the proper preparations due again to your comprehensive web site. You explained exactly what was going to happen before you even began and you made our Harley completely relaxed with you so he didn’t even have the slightest bit of anxiety and he didn’t even know that you had given him the first shot (the sedative). When the first shot was not totally effective you gave in a second to make sure he would feel absolutely no pain when the final shot to stop his heart would be administered but surprise surprise, our Harley refused to cooperate and still wasn’t completely under showing minor signs of responsiveness to stimuli so a third sedative shot was administered until he was finally ready to be put to sleep which was not even noticeable. That kind of care and compassion is rarely seen these days.. Since we wanted Harley cremated you laid out several options for us making the entire procedure comforting for both our Harley and us, we can’t thank you enough. May God bless you.
Good to find an expert who knows what She’s talking about!
I know in human medicine steroids are contriversial. Do you recommend them with cancer in dogs? They decrease inflammation but speed up cancer growth. Thank you, Chelsa Shepard
It really depends on the particular cancer and pet. For instance, if someone opts to not treat with full chemotherapy for their pet with lymphoma, steroids can extend the pet’s life with a good quality for a short time.
I am absolutely broken-hearted about making this decision. My dog has hemangiosarcoma which has spread to his heart and major organs (I’m guessing lungs also). It was detected more than 3 months ago and he was not able to be treated due to age, tumour growth and serious anemia. He’s surely in pain right? He’s so submissive that it’s really hard to tell. He’s slower, more ‘noisy’ with his old man noises and looks dreadful but I really fear I am putting him to sleep too early.
It’s really difficult to tell without seeing him. But, the fact that you say he looks dreadful makes me lean towards it may be time. So sorry you’re facing this.
Our boy just had his biopsy come back as a Gastric adenocarcinoma with metastasis to gastric lymph node. From the research I’ve done this is pretty aggressive and not a very good prognosis. We are having to force feed him a liquid diet every day just to try and get him to make it to our oncology appointment next week. I feel it is time because in my eyes he is obviously suffering but my wife is determined to try and make him better. Any thoughts Dr?
Sorry, I didn’t respond sooner. With urgent questions, it is best to contact me directly. I’m not sure what has transpired since you wrote this, but I suspect he couldn’t recover from this. It may be your wife needed to know she tried every avenue before saying it is time.
May I send you a recent medical record for you to review?
All vets recommended for euthanasia because a large cell, lymphoma is incurable and difficult cancer in the long run.
My cat had anemia but he seems eat good and poops every day.
I just cannot decide when is time.
I just want to have a right time. Not too soon or not too late.
Let me know if I need to compensate your time to review.
We only review records when we are working directly with a pet.
We just had to put our German Shepherd to sleep after a terrible diagnosis of a tumor near base of her heart or spleen and I feel incredibly guilty about doing this. The vet could not tell exactly but saw on a sonogram (and xrays)she had a mass. Because of this mass, her heart was very enlarged (fluid around her heart), the vet said the biggest she’s ever seen. Her liver was enlarged, her liver counts were high, she also had fluid in her abdominal cavity. She began eating not as well and panting more in July. Then when August rolled around she would not touch her dog food. She would sometimes eat cooked food but very little for a 91-pound dog. This went on for 3 weeks. She began panting more and more as she was awake and mouth open, and upon sleep/rest her breathing was labored, respirations were fast. Her belly/mid-section also look like it was getting bigger. The vets said she was in pain and advised us to put her down. She would also moan when getting up or laying down. But not all the time, she would not whimper or whine all the time, just upon rising and laying down. We were stunned and devastated at the news and the fact our vet called her “a ticking time bomb.” and they advised us to put her down that same day. We didn’t take their advice that day, but we took her home, loved on her, made a stepping stone and told her over and over how much we loved her. She would continue to get up and go outside and sniff around, but not much else. We felt her respiration/labored breathing was getting worse, so we made the appointment to let her go nearly a week and a few days after we found out. We talked to the vet at length before we made the decision and we went through with it. It kills me because she was still walking around and alert despite her troubles. I am wracked with guilt over what we decided- it doesn’t feel right. I know she was terminal, but did we rob her of a few days, a few weeks, a month (s)? She was nearly 12 years old and seemed in fairly good shape until this devastating news. I just don’t know if we did the right thing and I am agonizing over it. I loved her so very much, as did my family and it was the toughest decision we’ve ever had to make. I hope she forgives us. I don’t think she realized how sick she was. 🙁
I’m so sorry for your loss. You absolutely did the right thing at the right time. She couldn’t breathe well and her future would be dying from lack of air. That is not a pleasant way to pass. Instead of letting her go through that, you let her go peacefully, when you weren’t rushing to the ER while she suffered. Instead I’m sure she passed peacefully with her favorite people. Pets don’t always make noise when they are in pain. They just deal with it. If you have a sore knee, you don’t say ouch every few seconds when walking. You adjust your gait.
She doesn’t have to forgive you because she trusted you would make decisions for her out of love and you did. Grieve her and miss her but please let go of any guilt. She was in your life to enrich it. She would not want you remembering her with guilt and pain. She’d want you to remember all the fun times playing and simply being around her family.
My 12 year old cat was diagnosed with Lymphoma a year ago and we started prednisone that lasted 9 months. (3 month shots) His chronic diarrhea and ravenous appetite along with 4 lbs of weight loss lead me to believe it might be time to let him go but he’s very alert and doesn’t seem to be in pain. I don’t want him to suffer in any way but don’t want to euthanize to soon either. Any suggestions?
I’m sorry you’re going through this. Ask your veterinarian if the medication can be adjusted. Maybe giving more or adding another could help symptoms short term.
If he’s not keeping weight on and is ravenous, he’s likely not getting any nutrition absorbed and is wasting away. He eats, but it doesn’t satisfy him. That may not be a pleasant feeling. Eventually, his organs will start to shut down.
If nothing else can be done, it may be better to schedule euthanasia where everyone who wants to be there is present, he’s not acutely suffering, and it can be a beautiful celebration of his life.
This may be a situation where you take it day by day and discuss it with others. You know him best.
Thank you so much for taking the time to respond. Greatly appreciated! I will follow-up with my vet regarding possible symptom relief.