It’s true I’ve never considered myself a deeply religious person. Yet I fancy myself unusually tolerant of others’ beliefs. A recent case of two dying cats, however, put this latter claim to the test. Here’s the story: A litter of three foundling kittens arrived at the hospital a year ago. Two robust boys and one scrawny girl rounded out the bunch. Sickly though they all were in an upper-respiratory kind of way, they recovered nicely from their rough start. They all went on to live in and around a clean two-horse stable surrounded by a family of healthy cats. The owner declined vaccines because of their rough start and frequent bouts of diarrhea (and, truth be told, because she has a penchant for non-traditional approaches anyway). This fall all three fell ill again, this time with the nastiest case of unrelenting diarrhea yet. The boys appeared to power through nicely with treatment. The girl faded and fell ill enough to hospitalize. Her lab work subsequently revealed a mighty panleukopenia. This cat’s diarrhea and panleukopenia weren’t even the worst of it. The blistering, unresponsive fever and her miserable malaise were more my concern: Even if I could support her long enough to get her past her viral infection (incredibly doubtful), would it be worth it? Spiraling out of control by the hour, the little girl finally devolved into a pathetic lump of a cat with a condition I couldn’t manage at all. Yet her owner was hell-bent on saving her in my makeshift ICU isolation unit, where there was no way I could care for her properly overnight, instead of at the specialist’s nearby 24-hour facility. This was when I finally begged her to reconsider euthanizing her—to no avail. No, instead I was told, “God would take care of her.” But is it His will to let her suffer? When later in the week another of this client’s cats came down with what appeared to be the same thing, she declined further testing and advanced treatment, claiming this was “the work of the devil,” which presumably explains why euthanasia was not an option for this one, either. One’s the work of God’s will and the other’s the Devil’s doing. What am I missing here? Proof, yet again, that my boyfriend and I are cosmically linked in an animal sort of way arrived in the guise of his own patient on the same week. His case, however, dealt with a surgically manageable malady—a 100 percent curable one. Yet the owners refused to operate based on their belief that “God is the one who cures.” OK, so why are you here, again? Because we live in Miami—not exactly a hotbed of fundamental religiosity—veterinarians here don’t often find themselves in this situation. We’re not frequently in a position to wonder how best to manage these extremely trying ethical dilemmas, though I’m sure vets elsewhere must deal with this on a more regular basis. It’s difficult for those of us who believe in a god who accepts science, technology, innovation and intervention to understand why some forms of medicine are deemed worthy and others regarded as unacceptably invasive or otherwise theologically ill-advised. Why clients might decline euthanasia based on religious principle I can usually comprehend. After all, I come from a Catholic background where actively hastening death is considered verboten when it comes to humans. Nonetheless, prolonging intense suffering in an impressively incurable animal doesn’t even register on my moral radar screen. Ultimately, my boyfriend’s not-to-treat scenario resolved itself when the clients had a change of heart and opted in favor of surgery. This patient is doing very well and is on his way to a complete recovery. Unfortunately, God took care of my patients, too. They died overnight. Try as I might to square this suffering-accepting religious approach with my tolerant worldview, I truly can’t. Accepting a belief in the power of God to give and to take away in ways that allow for extremes of agony—when other options are readily available—is inconceivably out of whack with my moral compass. Doing so would invalidate everything I’ve come to believe in when it comes to why I practice veterinary medicine. It’s anathema to our veterinarian’s oath, isn’t it? It’s perhaps inevitable that some of us will feel tremendous guilt when we prolong an animal’s life under these conditions. I don’t know how it is for you, but leaving any case like this alone in a hospital to die overnight is a surefire recipe for sleeplessness. It’s those pesky, predictable questions that always keep me up: Should I have been more forceful with the owner? Should I have refused to treat these cats at all? Should I have sent them home so at least they would have been saved the experience of expiring alone in a cold hospital? So they would have died sooner? Should I have paid for expensive overnight care out of my pocket to help assuage my guilt? It’s times like these when I have great faith in my boyfriend’s credo: You do your best and then you go home and have a beer. I’ve got to say, that’s the most tolerant religion I ever heard of. Sign me up for the Fellowship. <HOME> Patty Khuly, VMD, MBA, is a small animal practitioner in Miami and a passionate blogger at www.dolittler.com. She earned her veterinary degree in 1995 and her business degree from Wharton in 1997.
