“Is it okay to let her go?”

It was a warm Monday and an acquaintance had called me for a second opinion on her 9 year old dog “Emma” that was limping.  I added her on, suspecting osteoarthritis, a torn toenail or ligament, or a muscle sprain.  When I walked into the living room and saw Emma exhausted on her bed, I feared there may be something more.  I learned that Emma was adopted just 2 short years ago from a shelter where, before being adopted out, she received a surgery for cancer in her mammary glands (a common condition in unspayed females).  After living in her new home for a year, another tumor developed and she had surgery again and did well.  Emma was lucky – the shelter gave her a chance and then her new owner continued the love.  As Emma finally rose to greet me, I could see the pain in her eyes as she struggled to use her left front leg.  Yes, this was going to be more than osteoarthritis.

I performed a thorough physical examination and found all of her mammary glands to be riddled with hard tumors. After the second surgery, Emma’s owner chose not to perform radiation and chemotherapy as the prognosis for recovery was minimal as mammary tumors can spread with lightning speed and this was her second offense.  An even more devastating exam finding was the fact that the tumors had spread to the major nerve in her leg, entrapping her muscles so that she could not bend and flex naturally.  Emma had become a prisoner to the cancer itself.

As Emma wagged her tail and laid down to rest, her owner shared with me how just this morning Emma had begged to go on their daily run. An abbreviated jog was taken, giving them both some much needed stress relief.  With the medications that Emma was taking for pain, and her overwhelming love for the outdoors, she still wanted to do the things that she loved.  However, Emma’s owner knew that doing those things meant pain.  You see, our pets will often endure pain to please us – they do not have the need to complain and whine, they have the need to continue their routine and do the things they know make us happy.  They, like us, learn to keep the pain suppressed, in order to have some semblance of normalcy.

Emma’s owner had not realized that cancer was the reason Emma was limping and was not prepared for the news she received that day.  You see, Emma’s momma was moving alone to another state in just a short week.  How would she move with Emma in such a painful state – how would she move without Emma, her best friend?  We discussed all of the options, as I always do, – referral for chemotherapy and radiation, palliative hospice care through multiple pain managements, and euthanasia.  This was the point that she looked at me with tears in her eyes – “But doc, is it okay to let her go?”  “She still wants to run with me, she has always been there for me, maybe it is too soon?”

Yes friend, it is okay.  It is okay to choose to let go.  When our beloved friends have reached the point where the pain is greater than the joy and they face nothing but increasing pain in the days to come, it is okay.  No, I don’t know when they would die naturally – would it be tomorrow, next week, or even in the next month?  But, I do know this – even though our pets may still have moments of joy, it is not okay for them to be in constant pain just so that we can hold on to those precious few moments.  Pets do not fear death or hang on in anticipation of the next holiday or visit home from family.  They enjoy those treats, jogs, or petting in the moment, but mostly live in pain.

So here is what I told Emma’s owner and what I will tell you: “She deserves for you to let her go. Make it okay. The thing she enjoys the most – do it, even let Emma eat steak while I administer her injections, but then, let her go.” Emma spent the next 4 days at Opposum Lake and her favorite ice cream haunts. Then just 3 days before her mom moved away, we let Emma go.  In that same living room dog bed, Emma was given the greatest thanks for her unconditional love – her mom held her paw as she let her go.

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