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Comments on: An elderly client is having difficulty managing her pet’s condition

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Last month we asked: What would you do if an elderly client, whose cat is displaying clinical signs of polydipsia, polyuria and vomiting, is having difficulty managing her pets condition?

4% said they would reiterate the importance of diagnostic testing

67% said they would prescribe symptomatic treatment

28% said they would advise transferring ownership to someone better able to manage the cats condition

7% said they would advise euthanasia

Vote in this month’s poll at: twitter.com/Vet_Record

*15 respondents

Reader comments: an elderly client is having difficulty managing her pets condition

An elderly client brings in her 10-year-old cat, Holly, who is experiencing polydipsia and polyuria. Holly vomits during the consultation and appears lethargic. You recommend performing blood and urine tests to check for renal function and to rule out any metabolic or endocrine disorders. The client then raises her concern that, due to her age, caring for both herself and Holly is becoming too difficult. She is not sure whether she can manage the long-term treatment that Holly requires. She becomes very tearful and, although unsure of what to do, is considering euthanasia as an option. She asks what you would do if you were in her position (IP, October 2019, vol 41, pp 397-398).

It is all too common in veterinary practice to see clients that, due to financial, physical or other means, are unable to provide the necessary care for their pet. Clarissa Wu’s article, in last months issue, describes one such case in which Holly, a 10-year old cat, is suffering with vomiting, lethargy, polydipsia and polyuria. Wu outlines four possible options to manage the case: diagnostic investigation, symptomatic treatment, placing Holly with a new owner and euthanasia.

Based on the scenario Wu presents, we do not have all the clinical details. In particular, how long has Holly been experiencing the clinical signs and what clinical state is she in during the examination? Does she have true polydipsia, or is she just drinking more because of dehydration and possibly inappetence? Does she genuinely have polyuria, or has she urinated in the house because she is does not want to venture outside?

If Holly has only had the clinical signs for one or two days, and her clinical examination is relatively unremarkable, then there should be a reasonable chance that her condition is treatable. For instance, since the clinical signs were reported by the owner and were not seen first hand by the vet, Holly could simply be suffering from gastritis or cystitis and it would be morally problematic to euthanase her for these conditions alone.

On the other hand, if Holly’s condition is chronic and she presents with a poor body condition score and severe dehydration, there is a higher chance that she is suffering from a condition that is either untreatable or requires long-term management, which the owner cannot afford or otherwise manage. If Holly is suffering from a condition that carries a good prognosis, then euthanasia and rehoming are not in Holly’s or the owner’s best interests.

Therefore, this scenario raises the question of at what point should veterinarians offer euthanasia as an appropriate treatment method? It also illustrates how important empirical information is, in this case relating in particular to the clinical condition of a patient, in everyday ethical decision making.

Steven McCulloch

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