In the dilemma discussed in the May issue of In Practice, Laura McLellan described a scenario where ‘Bella’, a four-year-old female French bulldog, is presented to you as an emergency during evening surgery, with acute upper airway obstruction syndrome (UAOS). She is also suffering from a grade 3 intervertebral disc extrusion causing hindlimb paresis, which had been diagnosed earlier in the day at a charity clinic. The UAOS appears to have been triggered by the stress of the hindlimb paresis and possibly the visit to the charity clinic (IP, May 2018, vol 40, pp 166-167). You wonder how you should proceed and advise the owner?
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Meghan is a student studying veterinary medicine at the Royal Veterinary College, London
The scenario presented in last month’s issue touches on more than one topic from daily clinic life. At what point do we say an animal has had too much? At what point do we push to continue the fight? Is money the final factor in the decision to euthanase an animal?
Bella presents with upper airway obstruction syndrome (UAOS) and a grade 3 intervertebral disc extrusion causing hindlimb paresis. Personally, I think it is important to take into account her age in this situation. As a four-year-old French bulldog, she is no longer a puppy, but she is definitely not yet considered to be a middle-aged dog. As a younger dog, Bella has a better probability of being able to recover and live a full life. If the UAOS can be treated medically, and Bella regains her ability to breathe normally, then I see no reason why she should not be allowed to go home with her owner.
As long as her owner complies, it should be fairly easy to keep her on strict rest, as she is a small dog. Admittedly, her quality of life in the days or weeks during recovery will be reduced. However, if she is without pain and has adequate food and water, this will be more than compensated for by positive experiences during the rest of her life. In the same way that we ask dogs that have had cruciate repairs to be crate rested for a few weeks, and we see no welfare issue stopping us from asking that, then why can this not be applied to Bella’s situation?
Even if Bella were to need the tracheostomy – one of the options given to relieve her suffering – I still believe she should be given a fighting chance. Once the stress of the procedure and recuperation has passed, there is a reasonable chance that her respiratory condition can be managed conservatively. For this reason, we should present the owner with all the possible treatment options, and not assume that because they attended a charity clinic earlier in the day that they do not have sufficient funds.
Perhaps they chose to use the charity clinic because their sister or cousin or best friend works there, or they prefer the overall care better. We should be wary of x-raying clients’ wallets. Assumptions should not be made as to the capability of what an owner is willing and able to do. Bella’s owners must be presented with realistic likely outcomes. All options, including euthanasia, should be offered in this case. But, ultimately, in this case I don’t feel that we should be giving up on Bella quite yet.
Everyday Ethics Poll
Last month’s poll asked:
You are presented with Bella, a 4-year-old French bulldog, with dyspnoea due to UAOS and hindlimb paresis due to grade 3 intervertebral disc disease, diagnosed at a charity clinic earlier that day. You commence emergency treatment (ie, oxygen and mild sedation), and then do you: (a) recommend euthanasia as the owner, who is on a limited budget, is unlikely to be able to pay for treatment; (b) recommend tracheostomy; or (c) discuss the prognosis and management options, including costs?
16% of respondents voted (a)
3% of respondents voted (b)
81% of respondents voted (c)
Vote for this month’s online poll at:
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