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When is it time to say goodbye? - (10/16/2018)

By Dr. Ron Gasbarro 

This story is not about pharmacy as much as it is about the pharmacist. His beautiful, funny, talented Scottie is 13 years old. She is fading quickly. The pharmacist has a very good veterinarian. He trusts the vet with his Scottie as much as he trusted the vet with the dogs that came before the Scottie. Dogs provide tremendous companionship and entertainment. However, their final months can be fraught with heartache and expense. A New York Times survey found that people are willing to spend an average of $10,000 to keep their dog alive if it is sick. The pharmacist agreed with the sentiment but why keep the dog alive if it is suffering? And yet, the pharmacist tries. 

Pets typically do not carry health insurance. Toward the end of a pet’s life, visits to the vet with all the diagnostic tests, blood work, medications, and even surgical procedures can easily run into the thousands. Is it fair to expose the unwitting animal to chemotherapy with its toxic side effects? All the dog knows is that she loves you and trusts you. The spirited once active dog – who could do tricks! – is not there anymore. All the pharmacist sees are her dark eyes following him around the room. Eyes that seem to say, “What is happening to me? I don’t feel the same.” And yet, the pharmacist tries. 

The pet healthcare industry is driven by free-spending empty nesters who spend money on pets instead of children, according to analysts. Some of them are baby boomers whose kids have left the house, while others are young professionals without children. Many of these pet owners treat their animals as humans. The pet health care industry, which closely trails human care in levels of technological advancement, is becoming more and more capable of accommodating pet owners seeking treatment for life-threatening maladies. Ten years ago, you could not get the kind of care that is available today. If a dog had a tumor, then the consensus was to let the tumor grow and then euthanize the dog. But the human-animal bond is growing. And MRIs, pet scans, ultrasounds, and x-rays are there for the asking. Is it right to keep the dog alive beyond its natural lifespan to forestall the owner’s loneliness and grief? Is this the same dog who once stole a mouth-watering filet mignon from the grill who now will not even look at a teaspoonful of baby food? And yet, the pharmacist tries.

Putting the dog to sleep is the humane way to go. Soft and gentle drugs will carry the dog out of her misery. Better to make that long, emotional journey to the veterinarian than to find that the dog died from a heart attack or at the bottom of the stairs when, sick as she was, went looking for you. Her face seems to tell you, “We are not having fun anymore.” Still, she trusts you with her very life. For the owner, the feelings of guilt are like a cloudburst, wrenching and choking. And yet, the pharmacist tries.

The pharmacist realizes that he is mourning his dog while his dog was still alive. So, he makes the decision to let her go in the most compassionate way because she cannot understand what is happening. The pharmacist knows that there is always a sign when one of his dogs passes on. It could be a mysterious distant bark. It could be a star in the sky. It could be a feeling that she is near. He gave the dog a good home, and a safe, full life. He will tuck the memories into his heart. Until we meet again, my charming friend. Sweet dreams. And, I, the pharmacist, cried. 



Ron Gasbarro, PharmD, is a registered pharmacist, medical writer, and principal at Rx-Press.com. Read more at www.rx-press.com  



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