Author Jessica Pierce and her pet dog Ody

Author Jessica Pierce and her pet dog Ody

Bioethicist Jessica Pierce explores the practical, medical and moral issues facing pet owners at the end of a companion animal’s life.

Guests

  • Jessica Pierce bioethicist and author.

Read An Excerpt

Excerpt from “The Last Walk: Reflections On Our Pets At The End Of Their Lives” by Jessica Pierce. Copyright 2012 by Jessica Pierce. Reprinted here by permission of University Of Chicago Press. All rights reserved.

Transcript

  • 11:06:53

    MS. DIANE REHMThanks for joining us. I'm Diane Rehm. Jessica Pierce is a bioethicist who focuses on animal morality and welfare, but when the health of her elderly dog Ody began to decline, she found herself unprepared for the difficult challenges ahead.

  • 11:07:13

    MS. DIANE REHMIn a new book titled "The Last Walk," she weaves together a chronicle of his last year with in-depth consideration of the practical and moral issues facing pet owners at the end of the companion animal's life. Jessica Pierce joins me in the studio.

  • 11:07:35

    MS. DIANE REHMWe'll welcome your calls, questions, comments, 800-433-8850. Send us an email to drshow@wamu.org. Follow us on Facebook or Twitter. Good morning to you, Jessica, thanks for being here.

  • 11:07:56

    MS. JESSICA PIERCEGood morning, Diane.

  • 11:07:56

    REHMAnd forgive me, your dog's name was, in fact, Odysseus and he was called Ody.

  • 11:08:06

    PIERCEThat's right.

  • 11:08:08

    REHMHow long did Ody live?

  • 11:08:09

    PIERCEHe lived 14 and a half years.

  • 11:08:10

    REHMFourteen and a half, you know most bioethicists, I think, deal with human values, including at the end of life. What led you -- what brought you to apply those same kinds of thoughts to animals?

  • 11:08:34

    PIERCEIt was a coincidence of a couple of different factors. I was working on a large bioethics textbook, undergraduate textbook so -- and of course, one of the core issues, probably the core issue in bioethics, is end of life issues.

  • 11:08:57

    PIERCEAnd so I sat at my desk all day immersed in this material about assisted suicide and withdrawing life support and all of these sort of heart-wrenching end of life decisions that we have been dealing with with humans and, you know, at the same time, in the background of this, Ody is failing. He's about 13...

  • 11:09:23

    REHMMmm.

  • 11:09:23

    PIERCE...and getting increasingly disabled. And, of course, you know, I've worried about his death since the moment I brought him home, which is maybe a strange thing to do, but, you know, the arc of their lives is so much shorter than ours. So when you bring a pet into your life, the chances are you probably will also escort them out of this world so I worried about that.

  • 11:09:49

    PIERCEYou know, the more and more I fell in love with him, of course, the more and more scary this idea of losing him became so I'm immersed in this bioethics literature and at the same time kind of formulating thoughts about a book on end of life and animal death.

  • 11:10:10

    PIERCEAnd it just occurred to me that, you know, there's so much I don't know about how to make these decisions with Ody, how to help him through these last months, weeks, days. And I guess I wanted to find out for myself how to think through these things and I wanted to help other people be more prepared.

  • 11:10:31

    REHMAnd we should say that Ody was a gorgeous Vizsla.

  • 11:10:39

    PIERCEHe was gorgeous. I liken him to The Marlboro Man of the canine world. Just a broad-chested, you know, if you've never seen a Vizsla, they're. They look a lot like the Weimaraner except they're red and completely red, even the nose is red and just beautiful dogs.

  • 11:11:01

    REHMA dear friend of mine had one and she was indeed gorgeous, sleek and beautiful...

  • 11:11:10

    PIERCEYes.

  • 11:11:10

    REHM...and kind and friendly and she simply -- I can really see Ody through my friend's dog. Did you come to have a sense of whether dogs or animals have a sense of aging and aching and moving through that area that we all have to face some day as humans?

  • 11:11:47

    PIERCEYes and no, I think. I think with Ody, I could see him taking stock of his changing capacities. Sometimes it happens more slowly than, you know, I thought maybe it should. He tried jumping into the back of our car for months, you know, after he couldn't actually do it. He would still make an attempt.

  • 11:12:13

    REHMTry.

  • 11:12:15

    PIERCEBut he did figure out that it just wasn't going to work anymore.

  • 11:12:18

    REHMSo waiting for you then to help him in?

  • 11:12:23

    PIERCERight, right.

  • 11:12:24

    REHMAnd accepted that help?

  • 11:12:25

    PIERCEAnd he did, not always willingly, but usually. I really don't know what -- Ody was always a mystery to me, which is a funny thing because we were so tightly bonded, but he more than -- I mean, I think all animals are very other to us. Well, people are, too, but Ody especially.

  • 11:12:54

    PIERCEBut given what we know about the cognitive and emotional complexity of animals, how much is going on inside them, I think they probably are much more aware than we might think and maybe they just accept it more gracefully than we do.

  • 11:13:10

    REHMAh, ha, that's quite a thought. Of course, with humans, we do have that both verbal and non-verbal way of communicating that perhaps if we better understood creatures such as dogs and cats, we would have a clearer understanding of what they're feeling. At what age do veterinarians now consider creatures like dogs and cats to move into geriatric periods?

  • 11:13:53

    PIERCEActually, you'll be surprised. It is age seven...

  • 11:13:57

    REHMReally?

  • 11:13:57

    PIERCE...which to me seems very young and I read that actually the day after my little Pointer Maya (sp?) turned seven and I thought, no, she's not old, sort of like me thinking I'm old because she's about my age in dog years. But you know, it is the time when in humans, in your late 40s, early 50s, things start to go funny sometimes.

  • 11:14:21

    PIERCEYou start making a few more trips to the doctor and whatnot and the same thing happens with our animals. And, you know, vets recommend that starting at age seven, you go for yearly wellness visits for your now-geriatric animal. And I used to think that was maybe just a way to get some more money out of my pocket, but I really learned with Maya that it's a good idea.

  • 11:14:48

    PIERCEWe had a full blood panel done, which is part of the wellness checkup for an older animal and actually found some things going on with her liver that we were able to address, you know, before they became a problem. And I wasn't so proactive with Ody because I didn't know better.

  • 11:15:07

    REHMWell, you know, the other problem with both dogs and cats is that even as the car heads toward the veterinarian's office...

  • 11:15:20

    PIERCEYes.

  • 11:15:20

    REHM...the little creatures or large creatures become very, very upset.

  • 11:15:26

    PIERCEYes.

  • 11:15:26

    REHMMaxie (sp?) always wants to go the other way, what can I tell you? So that doing -- I do take him for a once-a-year...

  • 11:15:37

    PIERCEYeah.

  • 11:15:37

    REHM...checkup and with any injection that might be needed, but are you suggesting something more than that?

  • 11:15:49

    PIERCENot really. And, you know, your story reminds me of something in medicine they call white coat syndrome. People have higher blood pressure...

  • 11:15:57

    REHMOf course.

  • 11:15:57

    PIERCE….than normal when they are in the doctor's office...

  • 11:16:03

    REHMOf course.

  • 11:16:03

    PIERCE...and I think it's important to remember that the behavior of your animal may be different in the veterinary office. And you are the number one advocate for your animal and the number one observer of what their normal behavior is and so your vet needs to hear from you what normal behavior is for your pet and how things might be changing because as animals get older and develop medical problems, their behavior often changes.

  • 11:16:40

    REHMWhat about animals in the wild, for example? Are their lifespans different?

  • 11:16:51

    PIERCEWell, that's a really interesting question and there's not a lot of research on animals in the wild. I tried my darndest to find out what I could. There was exactly one book on older animals, a very interesting book and what she suggests is that, you know, the reason there isn't a whole lot of research is because people have always assumed that animals don't get old in the wild. But in fact they do, not that many as you might expect, but they do.

  • 11:17:26

    PIERCELifespan in the wild totally depends on species, environmental context and whatnot, but one thing I thought was interesting is that lifespan is quite variable. Wolves, for example, in the wild live typically much shorter lives than they do in captivity, but elephants live typically much longer lives in the wild than in captivity so I don't think there's any one answer to that.

  • 11:17:52

    REHMExcept that, unfortunately, these days for elephants, the illegal use and taking of ivory apparently is on the increase and that's just a dreadful thought. We are in this hour, however, talking about household pets, cats, dogs, perhaps even guinea pigs, rabbits, the way we, as humans, regard them as they age and how we can better care for them. Short break here, we'll be right back.

  • 11:20:03

    REHMIf you just joined us, Jessica Pierce is a bioethicist and writer. She's here in the studio with me. Her newest book is titled, "The Last Walk: Reflections on our Pets at the End of Their Lives." And a posting on Facebook puts this right into sharp relief. It says: My one dog that I actually put down was 15. Deaf, arthritic, in pain. We were moving to a new house with big staircases. I knew she would try to climb but not make it. I took her for one last walk around the yard, amazed at how she perked and smiled even as her feet sometimes collapsed beneath her, then we went to the vet.

  • 11:21:05

    REHMAfter she was gone, only then did I realized the bright, energetic dog I loved, great walk companion had been gone for years. If anything, I had not let her go too soon, but kept her too long. What's your reaction to that?

  • 11:21:31

    PIERCEThat's exactly how I felt with Ody after, especially, you know, if I go back and read my journal now, I think, wow, what was I thinking? And what was I not thinking?

  • 11:21:51

    REHMBecause?

  • 11:21:53

    PIERCEBecause the signs were all there that he just...

  • 11:21:57

    REHMSuch as?

  • 11:21:59

    PIERCEHe had a look of worry in his eyes all the time and he really had lost the capacity to do most of the things that he loved. His two great passions in life were people and food and he had become really socially isolated. So, he didn't really have people anymore and...

  • 11:22:22

    REHMSitting under the piano a lot.

  • 11:22:25

    PIERCEJust sitting under the piano. And part of that was that we had adopted a younger dog, Topaz, and he just made life really hard for Ody.

  • 11:22:35

    REHMOh.

  • 11:22:36

    PIERCEHe was the jealous type. And part of it was, I think -- and I've seen this with humans who lose their hearing. It's extremely isolating to not be able to hear.

  • 11:22:49

    REHMAnd you knew that Ody had lost his sense of hearing.

  • 11:22:54

    PIERCEI knew that he didn't hear much. I never had him tested at a vet but I knew that he couldn't hear me very much. I would call him from, you know, several feet away behind him and he wouldn't respond.

  • 11:23:09

    REHMHis back legs had begun to fail.

  • 11:23:12

    PIERCEYes. He had, we think -- the vets never seemed 100 percent certain what was going on with him but they seem to think he had neurological decline that was just causing signals not to get from his brain to his hind end. I'm certain that he had some arthritis as well and just a muscular atrophy from not getting as much exercise. But I think the Facebook comment is -- it raises the most vexing and anguishing question about the end of life with our pets is when.

  • 11:23:52

    PIERCEAnd how do you know if you've chosen the right time? And I -- the best answer I can give to that, you can never know. But a lot veterinarians will say too soon is better than too late because too late can get really ugly for the animal.

  • 11:24:13

    REHMDo they suffer in ways that may not be apparent as we want to us but they may be suffering?

  • 11:24:26

    PIERCEThey may. And I think that one thing to remember with animals is, of course, we need to talk about pain. Pain and suffering. And pain and suffering are not the exact same thing. Of course, pain is a form of suffering but we tend to think that physical pain is sort of the barometer for how to judge an animal's quality of life. But, you know, animals have very rich emotional lives too, just like we do and can suffer from things like boredom, isolation, just stress.

  • 11:25:06

    PIERCEI think for Ody that was a big thing and anxiety. And people who suffer from anxiety know that it causes a lot of suffering. And that's true for our animals too. And I think we have to take in to account all of those things. And just recalling our conversation about the visit to the vet, I don't -- we tend to brush those off as sort of, you know, silly fears that our animals have. But I think we need to take seriously how much stress it causes them to, you know, if were taking frequent visits to a vet to treat them for the ailments of old age, what is the cost to them?

  • 11:25:47

    PIERCEAnd for some animals, it's nothing. They love to go to the vet. And other animals hate it. So I think it really is up to the pet owner themselves to, you know, they know their animal best to judge those sorts of things.

  • 11:26:05

    REHMHere's an email from Doug in Grand Rapids, MI who's writing to seek advice on how to care for an ailing rabbit. Do you know of any exercises that I can do, says Doug, to bond with him before he passes on? I want to connect emotionally and offer some sort of security to him and also be able to separate when the doctor says it's time.

  • 11:26:42

    PIERCEWow that's a good one.

  • 11:26:46

    REHMOf course you're not a veterinarian, you are a bioethicist.

  • 11:26:52

    PIERCEThat's right.

  • 11:26:52

    REHMHave you ever had rabbits?

  • 11:26:55

    PIERCEYou know, rabbits are one of the only pets I think I did not have. I had one when I was a child, but my daughter never had a rabbit. So I don't know very much about rabbits. But what I will say is that, I'm going to find out and I can send an email to this gentleman. I know people who are avid rabbit lovers who probably -- I think they're probably good resources out there. And I don't have them at the tip of my fingers, but I will...

  • 11:27:30

    REHMAll right. I'll save that email for you. Here's one from Gerry (sp?) who says it was very difficult to put my friend of 13 years to sleep. But my dog was in misery. The thing that struck me afterwards was this, my dog had a better end and more realistic end and life care than did my grandparents. We need to accept that everyone will die and be more realistic about how we deal with terminally ill people. I'm sure that that's come into your thoughts, your writing many times.

  • 11:28:22

    PIERCEIt has. It comes up remarkably often when I talk to people about their experiences with the end of life with their pets and with veterinarians. Almost without fail, I would say, people will say to me, why can't we do this for our humans? And I think people are -- people in my field anyway, people in bioethics have been afraid of comparisons between humans and animals because I think the thought is it will somehow denigrate humans to say -- to compare their experiences to the experiences of lowly creatures like dogs and cats.

  • 11:29:10

    PIERCEBut, you know, in my view, the comparison is very much worth making. And we have a lot to learn in human medicine from our experiences with pets.

  • 11:29:22

    REHMI fully agree and indeed we recently had an author on talking about what we can learn from the care of animals. Let's open the phones. We'll go to Ryan in Jonesboro, AR. Good morning, you're on the air.

  • 11:29:44

    RYANHey, good morning, Diane. I love your show.

  • 11:29:46

    REHMThank you.

  • 11:29:46

    RYANI listen to it every morning.

  • 11:29:47

    REHMI'm glad. Thank you.

  • 11:29:49

    RYANMy question was, I have a cocker spaniel. He's about eight years old. My little brother purchased him and he's very close to the family, especially to my little brother. And he's grown so close and it's clear that he's slowing down and it's going to progress a whole lot more and so everybody is concern. And we talked about, well, how's my little brother going to deal with it because he's so attached.

  • 11:30:15

    RYANAnd I think it's very obvious that animals are smarter than we give them credit for. And I've seen the dog react to our emotions and the things that happened to us when we are sad or in distress. And I think that they do that. Do you think that as he gets closer to death that he will sense that we are worried about it, that we are talking about it? How do you think that animals react to the way we are?

  • 11:30:46

    PIERCEI think you're absolutely right that animals are very attuned to our emotions and I just read a funny story. It was on the topic of whether dogs have an awareness of death and it was a story of a dog who was laying in the room and sort of overhearing the conversation amongst family members about whether it wasn't really time to do the euthanasia because the dog was getting more and more disabled.

  • 11:31:16

    PIERCEAnd miraculously, the next morning, the dog was much, much better, which suggests to me that, yes, they do -- I think they know what's going on more than we give them credit for. And I think it's one reason why it's really important for us to be at peace with their ending because if we're at peace, they will sense that. And if we're distressed, they will sense that. And, you know, one thing I've heard, you know, on a more particular point about whether or not to be present at the euthanasia.

  • 11:31:52

    PIERCEYou know, it seems to me the best thing for an animal, for an owner to be present at the end and holding and caressing. But in some situations, the owner can be so distressed and upset that it actually can make it more difficult for the animal because they pick up on that. So I guess my advice would be, you know, talk about it a lot and think about it a lot and come to peace with it so that your animal can be at peace with it.

  • 11:32:26

    REHMAnd speaking about rabbits, we've heard from someone who says that our rabbit owner out in Grand Rapids, MI, Doug, should contact the HouseRabbitSociety.com and that there will be information for you there. And if you'd like to join us, 800-433-8850. Send your email to drshow@wamu.org. And you're listening to "The Diane Rehm Show." Let's go to Cazenovia, NY. Good morning, Cynthia.

  • 11:33:17

    CYNTHIAGood morning, Diane. And thank you for taking my call. Gosh, so much is going on in my head after listening for a few more minutes. We just actually had to put down a golden retriever very unexpectedly within a six-hour period, only eight and a half, although the vets at Cornell told us that that was old by golden standards and it was an amazing spiritual experience to share that with three of my kids, holding him while that happened.

  • 11:33:45

    CYNTHIAIt was gut wrenching, but at the same time, he was totally reassured we were there and that we stayed with him for another hour. My (unintelligible) talking about being with your animal, I think it's very important for the animal to be there for them while they're going through that 'cause they get scared. They don't know what's going on. (unintelligible) came and got us to let us know that he was not feeling well and that's how we knew he wasn't feeling well.

  • 11:34:14

    REHMInteresting.

  • 11:34:16

    PIERCEThat is interesting. And I think that that raises such a good point, which is that we need to listen to our animals, and they're probably trying to tell us a lot of things but we need to be able to and open to hearing it. And in a funny way, I think the strength with which we love them makes it sometimes hard to hear what they're telling us if they're suffering.

  • 11:34:46

    REHMOh. You know, I want to go back to something you said earlier, Jessica, which was that while Ody was still with you, you brought in a younger dog. Tell me why you did that. I think lots of people think, well, our dog is getting on, so we'll bring in a younger one to keep him or her company, or to perhaps liven up the household for the older dog. Why did you do it and do you think you made the right decision?

  • 11:35:30

    PIERCEWe did it not for Ody but for my daughter who was dying to have her own dog to raise and train and bond with. And it was a mistake. I don't think that any dog would have been a mistake and I don't -- that's a hard thing because I don't think you know ahead of time, but it was -- in the end, it was very hard for Ody.

  • 11:35:58

    REHMHow so?

  • 11:36:00

    PIERCEWell, for one thing, a lot of the attention that he should have been getting was diverted onto the puppy, Topaz. And Topaz was just a -- he was a unique personality and just he wanted everything for himself, all the food, all the attention, all the everything. And I think he sort of had it as his agenda to undermine Ody. It's very interesting to watch the politics in a multi-dog household. I think Ody -- he would have been better off without. And it's also hard having different energy levels.

  • 11:36:50

    REHMYes, yes. I can imagine.

  • 11:36:55

    PIERCEI ended up having to take a couple of different walks a day. You know, the slow walk with Ody and then...

  • 11:36:57

    REHMSure.

  • 11:36:57

    PIERCEAnd then you end up spending your whole life taking the dogs for a walk, which is okay. I can think about, you know, worst things to spend my time doing. But it was pretty overwhelming. So, perhaps your personal experience was not terribly successful in bringing that younger dog in. I know for a fact that were I to bring a younger dog in with Maxi, it sure wouldn't work.

  • 11:37:31

    REHMWe're going to take a short break here. And when we come back, we'll talk about more about owners and their pets.

  • 11:40:03

    REHMAnd welcome back. Jessica Pierce is with me. She's a bioethicist and a writer. Her latest book is titled, "The Last Walk: Reflections on Our Pets at the End of Their Lives." Let's go to Ken in Holland, Mich., hi there, Ken. You're on the air.

  • 11:40:28

    KENGood morning, thank you. I just wanted to kind of put a little twist on the discussion.

  • 11:40:33

    REHMSure.

  • 11:40:34

    KENMy pets are my world and my wife's world. I just couldn't do without them. But that's one of the things I've asked my wife. That if anything were to happen to me and I was to be killed for whatever reason, I want to make sure that she can get the pets to me so they can sniff me to know that I'm gone and not just abandoning them.

  • 11:40:58

    REHMWhat do you mean?

  • 11:40:59

    KENWell, animals can sense death. And with my pets they mean so much to me, and I to them, that if I were to be, you know, to die for whatever reason I would want the animals to be able to, you know, to sniff me and to realize that I have passed on and have not just abandoned them.

  • 11:41:19

    REHMHmm, interesting, Jessica.

  • 11:41:21

    PIERCEThat is very interesting. I've never heard that before, but I think that's a great idea. What I have heard of is some animal behaviorists recommend that if a -- you know, if there is more than one animal in the house and one of the animals dies that the other animal be given a chance to be at the wake, as it were, to view the body and smell the body. And you're absolutely right that animals do smell death. And I think that's actually a wonderful idea. I like that.

  • 11:41:56

    REHMThanks for calling, Ken. Here's an email from Mickey who says, "I understand quality of life. But I think it's also our responsibility to take care of their life to the very end moment. I understand it's very difficult to decide when to put an animal down. But I feel some owners put down their pets for their own convenience. For example, taking care of blind and sick old dogs takes lots of time and effort. So they decide it's time to let it go. I hope every owner takes responsibility for what is best for their pets."

  • 11:42:49

    PIERCEI couldn't agree more. One of the reasons I wrote the book is that I feel like we don't commit to the very end with our animals to the extent that we should. You know, when they're puppies it's all fun and games. And then they're mature adults and it's great. And then they get old and things get tough and we just throw in the towel on them. And that's really unfair.

  • 11:43:18

    PIERCEAnd on the other hand I do have to say for the pet owners who are unwilling to put in the effort, particularly I'm talking here at the very end of life when an animal is in pain and, perhaps, quite disabled, I almost think it's worse to keep an animal alive just for the sake of being committed to it than it is to euthanize. If you are not willing to put in the work that needs to be put in to keep the animal free of unnecessary pain and suffering.

  • 11:44:03

    REHMAnd that takes us to what you write about in your book, "The Last Walk." You write about hospice care for dogs and cats and palliative care.

  • 11:44:17

    PIERCEThat's right. And it's a wonderful thing. Animal hospice and palliative care are greatly expanding and are becoming more and more available. You know, they're not available enough yet. Most vets you go to will give you a funny look if you say I want to do hospice care. But more and more are recognizing the value of it. And, you know, it's a time for us really to take care of our animals the way they've taken care of us. And let them age and die more gradually than just deciding, oh, they're old let's euthanize because often they have a lot of good living left.

  • 11:45:06

    REHMBut what happens in hospice care?

  • 11:45:10

    PIERCESo it's not a place you go. It's a mindset. And with hospice you decide, you know, I'm not -- and often it's after a diagnosis of a life limiting condition like, maybe, cancer where the options you might get at the vet are aggressive treatment or euthanasia. So there's a middle way which is hospice. And you come up with a plan of care that's aimed not at necessarily extending lifespan, but at quality of life. It's just like human hospice. We want to make those last weeks, months, days, whatever they are...

  • 11:45:58

    REHMAs comfortable...

  • 11:45:59

    PIERCE...As comfortable and as peaceful and as -- you want to be with your family. And animals want to be with their family, too.

  • 11:46:07

    REHMAll right. Let's go to Paris, Tenn. Hi there, Robert.

  • 11:46:13

    ROBERTHello. I like your show a lot, Ms. Rehm. And I really appreciate, Ms. Pierce, your interest and your willingness to write a book like this. I'm 58 years old and not in the best of health. And I've got a five-year-old Yorkie that is in excellent health. And some question whether or not I will outlive him or not. And, of course, I understand fully what you just said earlier about individuals who aren't willing to provide the care for their animal because to me that's a pleasure. I've had dogs all my life and that's just part of it. If you don't -- weren't willing to care for your animal, then it's just property to you and you might as well just buy a TV set.

  • 11:46:59

    REHMSo I gather you're worried about what happens if you should precede your Yorkie.

  • 11:47:09

    ROBERTYes, I'm -- by temperament and circumstances it's -- I live alone. And I have a sister that's willing to take two dogs, a Fox Terrier and a Yorkie. And I've chuckled at some of the statements you all made because it's so absolutely apropos. And, you know, I've actually considered possibly, you know, if I know I'm going to die in a relatively short period of time, if I can't, you know find -- my sister's not willing to take care of Oscar I've actually, forgive me, but thought of euthanizing himself as well as myself.

  • 11:47:52

    PIERCEYou know, I actually write about that in my book. And you're not the first person to have that thought. And it's been done. And, you know, I think the first reaction we might have to it is, oh my God, how could you do that? But I understand the impulse behind it, particularly if you don't have any backup. If you don't -- if you think your animal is going to end up at a shelter, that's a heartbreaking thought. And I'm sorry. I'm sorry you're facing that decision.

  • 11:48:35

    REHMReally tough if you think your pet might outlive you and then be abandoned somehow. So he's got to make that decision when the time comes. Robert, let's just hope that both you and your Yorkie live good long lives. Thanks for calling. Let's go to Gainesville, Fla., hi there, Jen.

  • 11:49:05

    JENHi, how are you?

  • 11:49:06

    REHMGood thanks.

  • 11:49:07

    JENI'm a veterinarian that does in-home hospice and euthanasias for dogs and cats. And one of the gentlemen that called earlier was asking about how much they understand. And it brought to mind a story that's very special to me. Not long after I started doing this, I visited a woman and her cat. And the cat was just an amazingly perceptive and intelligent animal who was very bonded with his owner who loved him. And we had a couple visits as we talked about hospice and comfort, quality of life and when was the right time.

  • 11:49:44

    JENAnd when it came time to go to her house for the euthanasia we spent quite a bit of time talking about whether it was the right time. And the cat was on the bed next to me. And he was looking at her the whole time. And at one point in the conversation he stood up, which was considerable effort and very painful for him, and turned around and faced me. And it was -- it gave me chills. It was almost as if he was saying, yes, it's time. I'm really ready. And that was kind of a sign to both of us that it was OK to go ahead. It was a very special moment to me to share that with him and with her.

  • 11:50:26

    PIERCEThat's a wonderful story. Thank you for sharing that.

  • 11:50:30

    REHMIt's extraordinary how knowledgeable and understanding these creatures are. Jen, I'm glad you called. And Pepe in Charlottesville writes, "One of the things yet to be discussed is the cost of animal care. I know many people who have gone to extraordinary lengths and cost to care for aging animals."

  • 11:51:00

    PIERCEYes. That is one of the most important issues. So the basic answer to -- I mean, people ask is palliative and hospice care expensive? The answer is not particularly. They're more expensive, of course, than just your ordinary, sort of, well-pet visits, kind of, health maintenance that you might do with a mature dog. Certainly less expensive than pursuing aggressive treatments with your animal. And I think it's a little bit like human healthcare. It's kind of a tiered system.

  • 11:51:46

    PIERCEIf you have a lot of money there are a lot of things you can do to keep your animal comfortable. You can do acupuncture and massage and, you know, canine rehabilitation. And if you have fewer resources, you can still do effective pain management. Pain medications are relatively inexpensive. So I think if your resources are limited, the best thing to do is sit down with your vet and talk about whether you can care for your animal in a way that is going to keep the animal comfortable. Can you -- do you have enough resources to do what you need to do to do good hospice care.

  • 11:52:31

    REHMAnd how effective are those pain treatments? Do we know?

  • 11:52:39

    PIERCEWell, we don't know as much as I wish we knew. And with animal pain, like with human pain, it's very complex. You know, each individual is going to have a different response to each individual drug. And it takes a lot of persistence. You've got to try different things to see what works the best. You've to, kind of, balance pain control with side effects. And it's really -- it takes a lot of persistence on the part of a pet owner and a vet.

  • 11:53:13

    REHMAnd you're listening to "The Diane Rehm Show." Tell me how you finally made your decision about Ody and what you did.

  • 11:53:26

    PIERCESo the day -- I mean, there was a long lead up to this. And we'd been -- my husband and I had been, you know, every day or two we would ask each other is it time, you know. And I think the watershed for us -- the day that I called the vet was after the fourth night that we woke up in the middle of the night to find Ody trapped -- I think on this night he was trapped behind a leg of the piano. Just such...

  • 11:53:58

    REHMHe couldn't get out.

  • 11:53:59

    PIERCEHe couldn't get out. He couldn't -- I don't know why he was back there in the first place.

  • 11:54:03

    REHMHe couldn't figure out how to get out.

  • 11:54:05

    PIERCEHe couldn't -- I think he was confused. And that's why he went back there because there was nothing back there. But he couldn't get out because his feet -- it was a place where there was no carpet. We'd put down little, you know, runners everywhere around the house so that he could stay upright on our wood floors. But it was, of course, a place where there wasn't a rug, right in the corner. And his feet just wouldn't -- he had no purchase. And he couldn't get his back legs were so weak he couldn't get up.

  • 11:54:33

    PIERCEAnd we found him in the middle of the night covered in his own poop just with the most anguished look on his face. And I just said we can't do this to him anymore. And I called the vet that morning. I knew already who I was going to call. And I think that's a really good thing to find ahead of time. Get a relationship with a mobile euthanasia vet if you can. It's so nice to do it in your home.

  • 11:55:01

    PIERCEShe had talked me through -- I mean, I'd talked to her a few times in the weeks before. So she was expecting my call. I told when I first called, you know, come tomorrow.

  • 11:55:12

    REHMCome tomorrow not today, yeah.

  • 11:55:14

    PIERCEI need to say goodbye to Ody and, of course, my husband -- I called my husband and he reminded me that that day was for me not for Ody. So I called her back and I said please come as soon as you can. We made an appointment, which is such a strange thing, to make an appointment for the death of your beloved creature. We made an appointment for 6:30 that night. And the vet arrived.

  • 11:55:42

    PIERCEAnd I have to say as much as I dreaded that moment it was as peaceful and lovely as it could have been. Ody -- we put him on the couch in our office, which he had spent many, many, many, many hours sleeping on. It was one of his favorite places. And he fell asleep immediately just on his own. So when the vet gave the sedative -- the pre-euthanasia sedative -- he was already asleep. He didn't even notice -- didn't even flinch at the injection. And, of course, the sedative made him fall into a much deeper sleep. His breathing got very slow and she, you know, inserted a catheter and did the final injection. And it was almost instantaneous.

  • 11:56:33

    REHMAnd you and your husband were right there.

  • 11:56:35

    PIERCEAnd my daughter and Maya, our little pointer, was curled up on my lap with her head on Ody's back. And it was very interesting when the -- after the vet injected the solution Maya lifted up her head like she sensed some change. And that was the end.

  • 11:56:59

    REHMJessica Pierce. She's a bioethicist and writer. Her book is titled, "The Last Walk: Reflections on Our Pets at The End of Their Lives." Thanks for being here.

  • 11:57:16

    PIERCEThank you so much for having me.

  • 11:57:18

    REHMThanks for listening all. I'm Diane Rehm.

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