A few weeks ago, I was in Thailand lecturing at an Asian veterinary conference. Being that I was going to be out of the country for almost two weeks, I was paranoid about how JP, my 12-year-old pit bull with a brain tumor, would do. As my luck would have it, JP developed severe cluster seizures (multiple seizures within a 24-hour period) and aspiration pneumonia while I was away. This made for one really panicked veterinarian, who was sitting helplessly over 8,000 miles away.
Thankfully, I had a phenomenal pet-sitter and a JP "dream team" (which consisted of veterinarians, veterinary technicians, and JP supporters) who knew exactly what to do. I had left them my neurotic, four-page, pet-sitting note (and that’s not including the printed out directions to four local emergency clinics nearby), my living will directives, and my clear explanation of what I’d like medically done.
We had pre-set up Skype and an international texting and phone plan (which was ridiculously expensive, but said company will remain unnamed!), and planned for worst-case scenario situations. As a result, the JP dream team was able to proceed with ease. (I, on the other hand, didn’t fare quite as elegantly or gracefully, as I was frantically sprinting around southern Thailand beaches looking for Internet cafes to Skype with them).
Most pet owners may not go into this amount of detailed planning when leaving their four-legged friends for a few days. But they should. I’m often shocked that most pet owners aren’t aware that they can set up a living will for their pets. I’m a huge advocate of this, for 2-legged and 4-legged creatures alike.
During my residency, I saw pet owners subject their pets to way too much, regardless of what we as veterinarians recommend. This often included invasive, painful surgery (despite end-stage disease) or ventilator/respirator therapy, despite the terrible prognosis (Just because you have money, doesn’t mean you should necessarily do the procedure, by the way … but that’s a whole other blog!).
As a veterinarian, I’ve been put in the difficult position where I have to balance a pet’s quality of life with the pet owner’s emotional, mental, and financial decisions. Thankfully, I can keep the pets pain free with potent pain medication in the process, but it’s frustrating to see pets subjected to so much, and resources wasted in the process. (For example, it often takes at least two veterinarians and a barrage of veterinary nurses to maintain a pet on a ventilator under constant sedation and monitoring.)
Since then, I made the decision to get a living will for both myself and my pets. I didn’t want those same heroics performed on me — I’d rather go peacefully, without being a financial, emotional, or physical drain on my loved ones. In fact, I’m quite medically specific on my living will: if I have more than 75 percent of my body covered in burns, have a Glasgow Coma Score of less than 8 (meaning I won’t be able to read, write, or recover well), or have to be on a ventilator for greater than 2 weeks, shut me down, baby!
Living wills should include a detailed list of resuscitation orders, including the following:
- If you want CPR performed on your pet
- If you want your pet intubated (where a breathing tube in placed) or placed on a ventilator/respirator under anesthesia
- If you want a temporary feeding tube placed (to supply calories)
- If you want your pet to receive certain life-saving drugs (e.g., epinephrine, dopamine, etc.), blood transfusions, or emergency surgeries
My pets’ living wills are very specific, and saved in the electronic medical record at the veterinary hospital, so everyone knows where that information is. Likewise, I’ve known several responsible doggy daycares or pet-sitting places that offer something similar, providing detailed contracts with emergency contact information, credit card information, and veterinary contact. In fact, if they don’t ask you for this information, avoid them!
By creating a living will, your veterinarian, family, and pet-sitter will be able to respect your wishes and know what to do in the extreme condition that they can’t get in touch with you during an emergency. Make sure your pet-sitter or family members know what you want done, how much money you are willing to spend (as it’ll be a few thou’), and if you are going to leave a credit card number or reimburse them for their help. Be sure to clarify how invasively you are willing to go, thereby authorizing them to approve emergency surgery.
While creating a living will for your pet sounds corny (or neurotic) to some, it may save your pet’s life.
Dr. Justine Lee