Dirty Mouths, Euthanasia Denial And Us

Intentionally ignoring medical care for pets is the same as intentionally causing any other sort of physical harm.

Idexx has launched a consumer website that aims to support veterinarians’ efforts to educate pet owners about feline heart disease.

Some recent new clients were special. An aged woman was accompanied by her adult granddaughter with a middle-aged min-pin in tow. The subject at hand was perhaps the most impressively putrid mouth I’ve beheld in more than 15 years of practice. And yep, you guessed it: The owner declined to treat.

How bad was said cavity of doom? Let’s just say her osteomyelitis was so severe this dog no longer possessed a cranial mandible. Her canines sagged ineffectually in what was left of their sockets, held aloft more by the mass of matted hair and heavy tartar than by the promise of any alveolar bone below.

Of course, this dog could no longer close her mouth, which was why the old woman had deigned to allow her granddaughter to drag the dog to a vet.

The woman was obviously not happy to be there. In her early 90s and hard of hearing, she loudly cleared up any remaining doubt as to her reluctance, accusing me of trying to steal her savings when her dog wanted for nothing in her care. This, after a detailed explanation of periodontal disease with a way-beyond-textbook example as Exhibit A.

Worst. Mouth. Ever.

If your patient’s disease is so severe it requires major reconstructive surgery and yet her owner denies to treat on principle—cost was initially an issue, but I squared that away with the granddaughter on the sly—then perhaps there’s a serious problem with her owner. Just maybe.

Ultimately, the owner of this dog and her granddaughter walked out the door with their dog, a bottle of antibiotics in hand. I suspect I will never see any of them again. Short of calling in Animal Services—and raising a media-frenzied stink in the process—there’s nothing I can do about it.

Or is there?

We’ve all been in this unenviable position. Time after time we see clients get away with near-murderous care: the 30-pound diabetic cats, the shattered pelvises that clients “take to another vet for a second opinion,” the blocked cats whose owners decline even the barest care, etc. Apart from wondering why these people even bother seeking veterinary care in the first place, these stories get me to thinking …

Our health and human services system may be way broken, but at least our mirror professions offer a process whereby neglectful caretakers can be charged with failing to attend to their charges’ needs. At least where the neglect is egregious.

Yet it’s perfectly legal in today’s world to allow pets to suffer flagrantly from diseases easily prevented via basic measures: Simple brushing for the periodontally challenged. Portion control for the obese. Stabilization for fractures. Euthanasia or analgesia for the painfully terminally ill.

In this society we cannot fail to offer food, water or shelter for our pets. We cannot actively hurt them in any way. Yet because we as a society relish our property rights, medical neglect is very rarely prosecuted in the U.S. Which means that certain kinds of passive maltreatment permissiveness is the de facto state of the law.

Indeed, owners can let pets languish in pain in any of the above scenarios—that is, unless someone goes out of his or her way to prove animal cruelty via neglectful prolongation of suffering. That is a duty that would most commonly end up in veterinary laps, a dirty detail ill-suited to most of our temperaments and even less commodious to those among us who expect to run a business.

Take a recent Calgary veterinarian’s example: Last summer he alerted local authorities to a client’s failure to euthanize a painfully geriatric dog. The man was charged under Canada’s Animal Protection Act and ultimately pleaded guilty to a misdemeanor charge of allowing an animal to suffer. He paid $690 in fines for his crime.

Meanwhile, a polarized public looked on with either righteous support or wary indignation: How could anyone do that to his dog? How can anyone say they can’t? What constitutes suffering?

Though this Canadian veterinarian has been much criticized, somehow I can’t find it in myself to disagree with his actions. Of course I see the obvious ramifications of a world in which pet owners might forgo vet care altogether should vets stick to their guns on welfare, or one in which only the wealthy could be trusted to care properly for their pets. But still, am I to sit idly by while obviously unwell owners decline to make treatment decisions based exclusively on their inarguably erroneous belief that their animals aren’t suffering?

Here’s one answer, according to Florida’s animal anti-cruelty statute (828):

“… ‘[C]ruelty’ shall be held to include every act, omission, or neglect whereby unnecessary or unjustifiable pain or suffering is caused, except when done in the interest of medical science, permitted, or allowed to continue when there is reasonable remedy or relief …”

Which means that, by my state’s law—if not by our Veterinarian’s Oath—my own inaction in the case of the flapping mandible is worthy of legal and ethical sanction. Not that I needed anyone to tell me what I already knew. 

Dr. Khuly is a mixed-animal practitioner in Miami and a passionate blogger at PetMD.com/blogs/FullyVetted.

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