As more Americans share their beds with their dogs, they are becoming less willing to accept the verdict of the veterinarian who says, "I've done all I can" when pets become terminally ill. There are owners "so caught up in their animal's pain, suffering, and the potential loss of that animal that they're losing sight of what is a reasonable thing to do," says doctor Nicholas Trout, a veterinarian surgeon at Boston's Angell Animal Medical Center. "They may be prepared to go to lengths that are not reasonable, that are verging on the inhumane, that would prolong the animal's suffering needlessly." At this point, he says, the veterinarian must step in and render an opinion based on his or her knowledge and experience. "I try to do the right thing by the animal, and then try to share why I'm doing what I believe to be the right thing with the owner, and give the owner some comfort in what's happening and why we're doing these things," Dr. Trout says.
Over the past 20 years, the veterinarian says, dogs have made their way from back yard kennels into the homes of American families as never before and "they are with the family (and) part of the family and to some owners their dogs are considered as important as a child in their lives."Asked why this has happened, Dr. Trout says it's because animals form easy relationships and "don't ask questions" so it's "love without risk." However, he adds, dog owners must recognize "that when we embrace these animals in our lives, we know we are doing it for a finite period of time; that the lifespan of a cat and dog is so short in relative terms that we are going to have to hold them in our hearts knowing we're going to lose them, and that's a tough part of this whole cycle."
Sooner or later the tough questions will confront the owners of 77.5-million dogs and 93.6-million cats in the U.S. One in three U.S. households own at least one cat and 39 percent of U.S. households own at least one dog. In 2007, according to data from the American Pet Products Manufacturers Assn., pet owners spent $40-billion on their animals, including about $203 for routine vet visits for their cats each year and $225 for routine vet visits for their dogs each year. Owners who have invested their emotions and dollars in a sick pet have got to ask themselves, "Is the right thing to stop and just cut my losses?" Dr. Trout says. "I think with these animals in our lives for so long now, because we're (veterinarians) doing such a better job, we are going to face those tough questions of "How far do I go?" and "How much is my pet worth?" Thirty years ago if a dog had painful, horrible arthritis and a miserable quality of life, the veterinarian could say, "There's nothing I can do. I'm going to put your dog to sleep." This would give owners the comfort of believing they did the right thing when the owner gave the vet the responsibility. "Those days are over," Dr. Trout points out, because the vet can point to new medications and surgical options, and can throw the decision back into the pet owner's lap. An owner may have to wrestle with, "You're telling me it will cost me $5,000 to replace a hip, a surgery that works great, and that would really make a huge difference in the dog's quality of life, but it's $5,000 and the question is 'Can I do that? Is my dog worth this much to me?'" One of the things veterinarians are going to have to learn as a profession, the animal surgeon says, is how to help pet owners with these tough choices. Pet insurance, he adds, doesn't cover the entire cost of procedures "but it could make a difference to justify some of the more expensive things. My experience with people who've had pet insurance is, generally, they're quite satisfied that it's made enough of a difference. But not everyone's going to be able to afford pet insurance."
Dr. Trout was interviewed by Diane Sullivan, a professor at the Massachusetts School of Law(MSLAW) at Andover and an authority on animal law. Professor Sullivan is the host of the MSLAW show "Educational Forum," broadcast nationally via Comcast. Dr. Trout is author of the book "Tell Me Where It Hurts,"(Crown) about his life as an animal surgeon. Besides providing an affordable quality legal education to students from minority and low-income backgrounds, Massachusetts School of Law disseminates information on vital issues of our time.
With the "great care people are taking of their animals now," Dr. Trout says, if you look over the last 20 years, "the quality of nutritional care, general health care, all the add-ons and the sort of high-tech surgery and medicine that we're now doing, animals are leading these longer and healthier lives." He says there are animal hospitals that will do skin grafts, renal transplants, and open heart surgery on occasion and that minimally invasive laparoscopic surgery is becoming more common. "Less invasive means less discomfort and smaller incisions, and so things are changing and everything that we are looking for in ourselves (humans) is coming into veterinary medicine."
Unfortunately, the surgeon says, our pets need exercise and if their owners are lazy they are not going to get it and become subject to the same panoply of diseases as their masters. "If they're sitting on the couch with us watching TV, whose fault is it that they're not exercising?" Dr. Trout asks. "Obesity has become a huge problem," he adds, as 25- to 40 percent of all dogs and cats are overweight or obese, so, of course, "all those things that we were worried about in terms of type 2 diabetes, kidney disease, arthritis, heart disease are what's happening to dogs. Pets are a microcosm of our society." Dr. Trout says he knows from personal experience with his own Labrador that "these guys are just so food-driven!" His dog gives him "a fatal combination of the doe eyes and the stares" and so "when we feed our dog they wag their tails, they're grateful and it's this positive experience" yet after you've given your dog something to eat "they look at you," as if to say 'What was that?' it goes down so fast." "What we've found in talking with dog owners is that it's difficult for them to see the reality that their own pet may be overweight or obese, instead of just chubby or fluffy," Lisa Peterson of the American Kennel Club Human Fund told Reuters. " The main cause of obesity in dogs, as in humans, is overeating and insufficient exercise. Neutering, hormonal disorders and slow metabolism can also cause dogs to pile on the pounds. Canine middle-age spread usually occurs by about the age of five or six years old," the wire service reported. It should surprise no one that the primary reasons given for obesity in dogs is overeating and insufficient exercise. "Neutering, hormonal disorders and slow metabolism can also cause dogs to pile on the pounds. Canine middle-age spread usually occurs by about the age of five or six years old," Reuters reported . Breeds considered liable to add unneeded pounds include Labradors, Golden Retrievers, Beagles, Collies, and Cocker Spaniels, among others.
Veterinarians, Dr. Trout says, are part of a complex, triangular relationship between owner and animal, between animal and vet, and between vet and owners. In this relationship the vet must "strike a balance" between objectivity and involvement because "if you become a bumbling wreck so caught up in the intensity of what is happening, the fear of losing this dog for this man, you're not going to be any use to anyone. And so you're trying to keep that knowledge there, but at the same time be surgically objective, to try to say, 'I've got to do my best for this animal, and I have to balance that between what I believe to be appropriate and what is maybe going too far.'" The question veterinarians must face are, "How far do we go?" and "When is that the right thing to do?"
One of the things Dr. Trout seeks to convey in his book is "this huge gray area" that exists throughout the medical profession in every specialty that "we're (doctors) human, and we're flawed, and we're fallible. And we make mistakes, but if our intent is still to do the right thing, then we can sleep well at night." Because of this, "When I see a client, I want them to share the experience that I'm going through, the diagnostic dilemma, the uncertainty of what is the right thing to do. I want to say, come onto this side of the examination table for a while and see what it's like, and see that we're all trying to do the right thing, but it's not that clear cut. Sometimes it is and we get lucky, but a lot of the time we're going to have to try and discover that, and if we're going to do it, let's do it together."