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What Do You Believe About Pet Healthcare?

What are Your Core Values and Beliefs Regarding Pet Healthcare?

“It is a virtue to contemplate and face your fuzzy, grey, moral frontiers on a continual basis.  Sharpen your focus on the near concepts and ever-more dilemmas pop up on the horizon.  This is how we know ourselves.  This is how we know if we are being good pet parents.” –Doc Truli

Do you believe in chemotherapy for pets?

See if you agree or disagree with this comment: “I do not believe in chemotherapy for pets.”

Some people intuitively and vehemently believe that a cat or a dog should never undergo chemotherapy.  They have seen human loved ones suffer and do not think a creature who cannot tell you if it is suffering, and if it wants treatment, should not be asked to go through chemotherapy on our behalf.  Other people believe any chance for extension of life or a cure is worth the temporary setbacks.

Do you believe any surgery that medical science has approved is okay?

Full mouth tooth extractions

How do you feel about this statement: “I do not believe in extracting all of a cat’s teeth, even though the vet says it’s the only way to cure her mouth pain.”

As a veterinarian, I extract teeth in cats to cure feline stomatitis-gingivitis when medications and cleanings have not worked.  But I have been told by some people, “There has to be a different way.  I am morally opposed to that solution.”  I’ll tell you what: modern medicine knows of no other way at this time.  But I cannot argue with a person’s core moral beliefs.  I tried my best to educate this person and explain the situation, and she thoroughly understood the situation.  She just has a firm moral point of view on the subject.  Perhaps you do, too.

Amputation of a dog’s leg diagnosed with osteosarcoma

  • Does it make a difference to you if the dog is young or old?
  • Fat or thin?
  • Sick anyway with some other disease?
  • Does it make a difference how long the dog is expected to live?
    • one year?
    • three months?
  • Would you change your mind if you knew the osteosarcoma was incredibly painful and no amount of opioids or anything was going to take away the pain?
  • Would you change your mind if you thought the dog would suffer a pathologic fracture at the site of the cancer and bleed in front of young children?

What about “routine” surgeries?

  • spaying and castrating?
    • what if your dog gets pregnant and needs a c-section?
    • what if your dog makes unwanted puppies at a construction site down the street and they starve to death?
  • declawing cats
    • would you change your mind if the owner was 65, diabetic, lived because of the cat, and couldn’t risk a skin infection from inadvertent clawmarks?

Do you believe in euthanasia?

It’s okay to think about it.  Some people do not believe in it.  Most people express a wish that they could leave this world with dignity someday.  You may be having extra trouble making decisions for your older, or infirm pet because deep-down, you do not believe it is right to decide to euthanize anyone.  But we are also mindful of prolonging suffering in a little animal that depends on us for everything.

Hindsight is 20/20.  (We say that often at the animal hospital.)

The Center for Humans Interactions with Animals in Society

The first center at any major university to study and form a peer group to review research and hold conferences specifically devoted to the scientific study of the relationship of humans and animals together in society was founded by Dr. James Serpell at the University of Pennsylvania School of Veterinary Medicine.  If you enjoy contemplating and debating veterinary medical ethics, this is the premier starting point for your journey!

VirtuaVet Society

VirtuaVet is building on online home for interactive discussions and debate regarding issues of interactions of humans and animals in society and our moral and ethical obligations toward animals.

Doc Truli believes, “Committing our intellectual, emotional, and spiritual capital to the study of the moral imperatives inherent in our relationships with animals , as well as each other, actually is our first moral imperative.”

Please write VirtuaVet or leave a message on this page if you are interested in becoming a founding member of this community.  Original opinions, true argument, and first thoughts are especially respected and valued in this endeavor.

-Dr. Sandra Truli Springer, VMD, CVA, CVFT, CVTP

Dr. Sandra Truli Springer, VMD, CVA, CVFT. CVTP

Call 877 DR TRULI | 877-378-7854 or Text 813-714-7863 for an appointment


7 Responses leave one →
  1. November 3, 2010

    I couldn’t find a date on this invitation, but it’s a subject that I’m intensely interested in. How far DO we want to go in medical care for our pets? Do we want to carry it as far as we have for humans? Personally I don’t. Case history: 17 year old female Himalayan who had been relatively healthy throughout her life except for intestinal lymphoma at the age of 11 for which she had surgery and complete recovery. Blood test apprx. 3 months prior to the time in question showed that she was borderline kidney failure. She subsequently began to exhibit signs — excessive drinking, frequent urination, etc. At that time she also developed a corneal ulcer in her left eye which did not respond to treatment and we were hustled to a specialist who said the eye needed grafting or removing. He recommended grafting. When asked if he would do this on his own cat, considering age and compromised kidneys he responded “yes.” He also discovered an ulcer developing in the right eye. She underwent surgery, and we began treatment for both eyes. On first followup exam, surgery went well, and right eye had improved. Second follow up exam – surgery still good, but ulcer was back in right eye and he said we might have to consider surgery on it as well. At that point I decided that one more follow up visit was all she would get so that I could get the medications she needed for both eyes and the stitches removed from the graft. I didn’t want to subject her to the 45 minute drive each way and I certainly wasn’t going so subject her to another surgery…. that’s another $3000 in my area plus follow office visits and meds at about$300 each time. I have the money set aside for this, and though expense is always an issue it was not THE issue in this case. I planned to transfer any subsequent care to my local vet, knowing that they would not be happy with this decision. You might ask why some of us wait so long to bring in a cat? Pain in any of my cats worries me greatly, and yet I am in terror of bringing in a cat that needs relief and being thrown into the medical blender of testing and aggressive procedures. Let’s step back and take a moment. Just ONE moment, to ask if it’s warranted. Fifteen years ago, or even ten, the vet would have explained to me all that this might involve for my elderly kitty. I’m relatively well versed in feline health and I still managed to be sucked into this maelstrom of medical care. As loving pet owners we feel such guilt at not giving our pet every opportunity to live one more day, but at what expense in pain and suffering to the pet as well as ourselves. I cringe when I hear of anyone schlepping a failing older animal back and forth to the vet for continuing medical intervention. I know everyone is different as is every pet and every vet, but in my case I would be thinking each time: “please Mr./Ms. Vet help me decide to let this poor old soul go. Josephine was my Himalayan’s name and I had her euthanized about this time last year after eye surgery, 2 months of vet visits and me torturing the poor old thing with my nursing. Her eyes were actually holding their own for the time being, but she had become incontinent, stopped eating, and was clearly miserable. I had to make the decision on may own which is as it should be, I suppose, but I miss the days when the vets felt more inclined to help in this difficult time.

    • November 4, 2010

      Dear Molly,
      Please accept my condolences on Josephine’s passing. She must have been a light in your life, as my HImalayan Buster (VirtuaCat) is for me.

      The invitation is timeless. You raise essential points about what makes up life and our role in it as the guardians of our cats and the gatekeepers to the car and the animal hospital.

      An essential ability and sense is the perception and evaluation of the “will to live,” or the “spunk” or the essential energy of our animal companions. Many people have lost the ability and the personal confidence to “know” when the life force is gone or almost gone. It must be separated from the detection of pain (which is often temporary), or the haze of emotional depression (rarely even talked about in our pets.) If we felt we could perceive the vital force left, through the vigor of response, the shine and directness of the gaze, the interest and reaching out for life, we would better know what course of treatments and hospice care were fair and reasonable, and what constitute futile cat wrangling and compromise for no good reason.

      Depression and pain can make our cat turn inward, not seek company, not look around. Dehydration makes the body feel light and brittle, like a dried tree branch.

      I propose, doctors address dehydration, pain, and depression. Give it a reasonable amount of time, maybe a week. Maybe two. If the dull, lackluster, dim look and feel remains, the vital energy is almost done. It is time. I’ll bet Josephine was just not responding to the kidney treatments. And the corneal ulcers were another sign of the lack of basic integrity left in her bodily systems; they were trying to fall apart before your eyes.

      So, it should not be a question of age. I’ve done massive surgery on several 20 year-old-cats that went on to good quality life for 3 years more! It should not be a question of modern medicine, which deals with the probabilities and statistical normals for research data from groups of cats.

      Really, isn’t the “chance,” “unusual,” “miracle” what we all hope for our own families? And yet our allopathic medical system gives us group data and historical odds. So we’re hoping we’re the exception and our decision-making is supposed to be based upon the 95% confidence interval; of a standard deviation mathematical calculation applied to incomplete historical medical records and single-variable closed-system restricted medical research studies.

      I believe life is non-linear, and the chances of miracles and far-fetched pleasant surprises far, far higher than any science predicts. Heck, that’s a big reason I started writing these stories, to counter the flood of “data” that tells us to stop hoping and praying and believing in ourselves and our families, especially our animal friends.

      Perhaps old-time docs still felt confident in their ability to detect the strength and will of the cat and let us, the emotional, bereft pet parents know what they felt in a semi-objective way. As a doctor, I try to give my clients this perspective on their loved ones. Admittedly, it had little to do with science and medicine, but everything to do with healing.

      What do you think?
      -Doc Truli

  2. November 7, 2010

    Doc Truli,

    Thank you for your thoughtful and insightful answer from both a medical as well as an emotional point of view. One of your statements brought up an interesting question in my mind. I do know that cats can be anxious, scared, and I’ve often thought on occasion that one of my cats was a little “down” for one reason or another. However do beings that live in the present experience emotional depression? In general, to be depressed, one has to be thinking about the past, the future, or how ones current circumstances are a result of the past or will affect the future. I agree that making sure your pet is in no pain is paramount, much as we do for our human family members. However, when a human patient is sent to hospice it essentially means that all support is removed with the exception of pain medication as needed. If the patient can’t or won’t drink or eat, these are not provided for them in the way of tubes, force-feeding and what have you. I do object to keeping an animal going with these measures and putting the family through this trauma unless there is better than a reasonable chance of recovery. I do understand the concept of unexpected recoveries or miracles, but with pets, unlike with people, we still have the freedom to say at what price? And by that I don’t mean purely monetarily. Is the family up to the possible on-going nursing care involved for a pet. Some are and do it gladly, but others are not, but do not know how to say I would rather help her cross the bridge. The guilt involved in this decision is overwhelming.

    The guilt involved in pet medical care actually begins much earlier than end of life issues. If you love your pet, you are urged to purchase wellness programs, pay for yearly fecal exams, blood screens, vaccines, dentals, etc. How much of this really IS essential to the ongoing health of your cat. How does the average person decide?

    • November 7, 2010

      Good points!
      1. Depression- Can animals “suffer” in the Buddhist sense of the term? I don’t know. Depression, I say yes. Here’s how I know they don’t only “live in the moment” as you’ve described. First of all, they have memory. So that’s bringing other times on a timeline into the present. So I think reflection and memory and opinions about those experiences are there for our pets. I knew a family with 2 12-year-old Shih Tzus. One grew ill and passed away. The other one was quiet, did not play, lost weight from decreased eating, and stared at the wall part of every day for 2 months. Then she gradually shook herself out of it and acted normal. After 6 months, they visited their vacation home on the West coast of Florida. They had not been there as a family since before the companion Shih Tzu’s passing. Her friend perked up in the driveway, rushed through the front door, barking, and sniffing, and looking everywhere in that house, looking for her friend. Like she thought,”Oh! This is where my friend has been all this time!” Just like a person with wishful thinking. She was bummed, but not deeply changed after that day.

      I had a poodle patient that belonged to a clinical psychiatrist. Dog housemate passed away, poodle sat in coat closet facing wall day after day. We checked everything physical with laboratory tests, etc. Finally, mom said, “Could she be depressed?” So we tried a little elavil. Better in 3 days. Weaned off in 2 weeks. Hmmm….

      Depressed from illness? I think of it as a physical and mental fog, a physiologic depression. I do not know if a cat is regretting life or sad about the end — I doubt it — cats don;t seem very regretful. But depressed in a sluggish, dull, non focussed, not interacting with you or the environment, yes. And that can be treated, or addressed, with physical and pharmacological intervention (sunshine, walks, massages, etc.)

      2. Regarding the pawspice care nursing. Some people do certainly believe it is unethical to syringe or tube feed an animal that has a terminal diagnosis and does not relish the treatment. At the University of Pennsylvania School of Veterinary Medicine Ryan Teaching Hospital, it is part of the nurses’ contract that they may refuse to “force feed” a patient with no adverse effect to their career. It’s a personal decision. Perhaps with a better cultural understanding and less fear or sadness about death, we could know how to treat our cats to a good death, and not stumble around so much wondering if what we are doing is right or not.

      3. Guilt? I don’t think it’s guilt. Uncertainty. Just not knowing what is right…Go with your gut. Or you could say, do what spirit tells you. Or, if you pray, follow the advice that you hear in response to your prayers. Whatever way you connect, the guilt enters if you listen to humans and society and go against your instinct, your personal belief, your spiritual knowledge. Do you feel what I’m saying?

      4. The pet medical care guilt. Do you mean, wanting to do everything the doctors say is right and good, but either financially saying no, or your cat says no by refusing treatment? Your veterinarian should answer your questions about the pros and cons of each recommendation. The potential benefits, and the detriments of not checking things. With enough questions and answers and medical coaching, the course of action that is perfect for you merges like a glowing path in your mind. Doubt falls away with open communication. Find a veterinarian you can see and talk to in this way. Even a super educated and empathetic nurse can coach you through these decisions so you feel no guilt or remorse. (Yes, it can be that pleasant to go to the vet’s!)

      I hope VirtuaVet continues to help you. I’m going to ponder your discussion more, because, as you know, everybody has these worries and concerns and I write these stories to help alleviate the layer of guilt and uncertainty.

      Doc Truli

      • November 7, 2010

        Yes! I have heard many stories of pets missing an animal or human companion. That certainly would be depression. VirtuaVet is fabulous for addressing these issues. I’ve been reading some or your resources listed with a great deal of interest – i.e. pet law, and The Center for Human Interactions …

      • November 9, 2010

        I had planned to drop this discussion as it is such an emotional one. Also I felt (feel) that I may be coming from an entirely different background and point of view having grown up in a farming community in the early 50’s. Still I’ve come a long way in the evolution of my thinking in regards to my beloved pets. But I could not get this one statement out of my mind from your last post: “At the University of Pennsylvania School of Veterinary Medicine Ryan Teaching Hospital, it is part of the nurses’ contract that they may refuse to “force feed” a patient with no adverse effect to their career.” Pawspice is a totally new concept to me. In fact the first time I heard the term was on your blog recently. The fact that a Veterinary school is treating terminally ill animal patients with ‘fore feed” methods indicates to me a horrendously wrong turn in the direction we are taking in medical care for our pets. I’m relieved to read on second review or your post that that I’m not the only one who finds this unethical.

        I think this adds a little more clarity to my statement concerning the “guilt” I mentioned and that you rightfully questioned. Yes, I did mean that the pet owner finds it difficult to go against the veterinarian’s recommendations in regards to these matters and feels a lot of pressure and guilt as a result. It’s also easy to get caught up in the machinations of the veterinarian’s attempt to ‘help’ the animal and in hindsight realize that you’ve subjected the poor animal to needless torture it is incapable of understanding. I’ve been there a number of times — wanting relief for my pet and in essence ending up with excessive and unnecessary testing and life saving measures.

        I SO envy you the perfect action that merges like a glowing path in your mind. In 60+ years it has never merged for me and I don’t expect that it ever will. I know that there is no easy solution to these weighty ethical and emotional issues. If we haven’t solved them for ourselves, how can we expect to solve them for our pets? However, I do hope that the veterinary medical community will take stock of the trends and try not to bring our pets into the same cloudy miasma that we find ourselves.

        • November 9, 2010

          Hi Molly,
          Thank you so much for your contributions. Most likely, you have already helped someone who is reading and not ready to comment.
          If I was unclear about the term “force feeding,” I meant syringe-feeding or tube-feeding, where a red rubber feeding tube is inserted down the patent’s throat. It takes about 3 seconds, and while scary, it is fast. Some people consider a pet that does not want to eat, and has an imminently terminal illness, to be “telling us” something. Other people wish to keep doing whatever they can to keep the animal going.

          We can use our sense of compassion, and realize the cat or dog that is terminal, in pain, and beyond recovery, may not wish to be disturbed by eating!

          Anyone reading this should distinguish terminal illness from other illnesses. Cats and dogs can live happy, full lives with low-profile feeding tubes installed through their sides straight into the stomach! The tubes do not get infected, they do not hurt, and a pet who cannot eat enough maybe saved with this procedure. For instance, my friend’s dog developed an esophageal stricture after vomiting a lot from eating shoe leather. The stricture is a band of scar tissue that only lets liquid down her throat. Other than regurgitating all food, she’s happy! The solution when the stricture repair did not work (after 5 tries?), a low-profile “PEG” feeding system. It’s been two years, and she’s a wonderful, sweet, happy little dog. Anyone who sees her falls in love with her.

          So, by force feeding, I do not mean fois gras-style stuffing. If someone has reached the end of their life, food is not necessarily the most basic love and care that they need!

          (BTW–I grew up across from a dairy farm in rural Northeast PA in the 70’s. My parents never took the pets to the vet–they still don’t. I think my upbringing gives me perspective lacking in textbooks.)

          Molly, I wish you well. Thank yo so much for your input in this interesting and challenging discussion.

          -Doc Truli

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