End of Life

A friend recently asked me how she would know when it was time to say good-bye to her old and increasingly fragile cat. The elderly feline had had a recent urinary tract infection that had made her very sick, and my friend had come to realize that her time with her beloved pet might be short.

This is a tough question, because none of us are granted the ability to know the future or our own end-time. As veterinarians, we can make educated guesses about how long an animal may have good quality of life, based upon how other patients have fared with similar diseases. But everyone is an individual, and some have surprising resilience. As veterinary professionals, many of us have seen pets with cancers or end-stage diseases that have outlived all statistics. Similarly, some animals seem to slide very quickly towards death.

It is our responsibility to be acutely aware of the daily changes in our animal companions as they age, or struggle with declining health. It is our sensitivity to their needs, and willingness to aid them, that allows us to “know” when their quality of life has declined to an unacceptable level. And I believe it is our responsibility to prevent future suffering when that happens.

Who's responsible

Who is responsible when an pet has a curable condition and the owner does not have the money to pay for care?  Is the owner ethically obligated to pay for care even if it damages them financially?  Is the veterinary community or individual veterinarian offering care responsiblefor making the cure affordable?  Is society responsible in any way?  Does it make a difference if the condition is manageable but not curable?

veterinary stem cell therapy

Autologous ("your own") stem cell therapy is currently available for dogs and horses for orthopedic conditions, and is being explored for use in other disease modalities such as liver failure.  The process involves taking a small amount of the animal's own fat, having it processed in a lab, and injecting the resulting stem cells into the affected joint.  It certainly isn't a fountain of youth, but the results are good in most of the animals treated.  It seems to be a practical, ethical path to healthier joints and perhaps can  impact other disease states.  What is the current state of autologous stem cell therapy in humans?