Don't Wait For the Crisis: Why It's Important to Think About End-of-Life Care Now
- Liz Weiner
- Dec 7
- 7 min read
I was never mentally prepared for my dog, Tovi’s, death. It was something that honestly didn't cross my mind as a thing that would happen. Sure, I intellectually knew he wouldn't live forever, but I never actually imagined a life without him, so when he died, I was utterly unprepared for That Life.
When Tovi was twelve years old, I recall being struck by an article I came across while mindlessly scrolling on social media. It was written by a veterinarian reflecting on the loss of his dog — not only the physical loss, but also as a metaphorical chapter in his life being over. It was written with a deep emotional intensity that touched me to the core. Naive as it may sound, it was the first time I entertained the thought that one day Tovi would no longer be a fixture in my life — that this chapter we were living together would end. I felt so deeply for this veterinarian’s loss, but it was something that happened to Him. I knew Tovi wouldn’t live “forever, forever,” but I reveled in the fact that his good health and stamina would guarantee us many more years together. Even though I couldn't unsee it, it hurt too much to think about, so I quickly sequestered it to a dormant pocket of my brain, and I never thought about it again — Until I had to, and that was too late.
I’ve always found it ironic that he died only a few months after I stumbled upon that article, and yet how blindsided I was by his death. I had been so sure he would forever be the version of the one-year-old dog adopted eleven years earlier. Sure, I might have seen signs of aging here and there, but our lifestyle never changed. Days before his cancer diagnosis, we had hiked three miles through freshly falling snow. After the diagnosis, I was torn between feeling guilty for potentially pushing him too hard and for not savoring the moment more.
Looking back, I wonder how his death would have been different if I had actively prepared for the reality that one day he would die and kept that inevitability somewhere in my mind: Not in a forefront, obsessive way, but in a way that didn't let me take his aliveness for granted. In a way that I could have intentionally thought about end-of-life care: What I would — and wouldn't — medically put him through. What was financially reasonable? Were my husband and I on the same page? Perhaps I would have discussed it with Tovi as if I were asking about a DNR, and inquired about his wishes. I would have candidly told him about how insanely much it hurt to think about, but that I had to.
So while this is not the kind of thing we want to think about while we’re out enjoying life with our pets, if you wait for The Crisis to be the first time you think about end-of-life care, you may not be in the best headspace to make critical decisions. As painful as it is to think about, we will likely outlive our pets, so it’s part of what we sign up for when we become pet parents.
The reality is, fatal diagnoses can occur at any age, tragic accidents happen to even the most responsible pet parents, and pets going missing are rampant, so it is never too early to accept the inevitability of loss. Another benefit of having this forethought may make you think twice before letting your pet off the leash, leaving them alone in the yard, or propping the door open while bringing in groceries. Trust me, no one thinks it will happen to them. But, it does — all the time, even to the most well-trained pets. So, while no amount of planning can prepare you for
The Crisis or safeguard you from the pain, thinking about it can help you proceed more mindfully.
As for me, I was so unprepared for the inevitability of loss that amid my Crisis, pure impulse took over as I acted on one excruciating lifesaving measure after another. Love can be intoxicating, and it was as if my mind was drunk on it, so my decisions weren’t coming from my most rational self. Looking back, had I previously considered end-of-life care in a less emotionally intoxicated state of mind, perhaps I would have been able to pause in the midst of the Crisis to think about the implications of every procedure and what was best for Tovi.
Instead, I made it about me. I was in no way prepared to do life without him, and I wasn’t about to let that happen. Because I wasn’t ready to live without him, I pushed him too hard at every juncture, ignoring the signs that he was giving me that he was ready to end his life. Animals have their dignity and understand death as simply another phase of their journey. But because I couldn't accept it, I fought a battle that was not mine to fight, for too hard, and for too long.
It started rationally enough. After bringing Tovi to his trusted veterinarian for what I thought was a simple gastro issue resulting from something he ate (cat poop), his veterinarian discovered a large mass on his liver that was at risk of rupturing at any moment. Pure coincidence in timing — his being sick was not associated with his soon-to-be-discovered cancer diagnosis. At the time, he was twelve years old, and humane euthanasia was recommended. His veterinarian candidly told me I could get a second opinion from an oncologist, and there would be someone who would perform surgery, but he didn't recommend putting a dog his age through such a major procedure. I didn’t want to accept this. My dog wasn’t ready to die. So naturally (enter sarcasm), I sought out second opinions until I found an oncologist willing to perform the surgery, and began celebrating the extension of his life before the surgery even happened.
I was thrilled when the phone finally rang the afternoon of the surgery, and the oncologist reported all went well — the tumor was removed, and the margins looked good. But when I picked Tovi up the following day, I barely recognized him. The veterinary staff assured me he was just loopy from pain meds, but I knew my dog, and something was terribly wrong. I stayed up with him all night, only to watch his symptoms worsen. I contacted the oncologist after hours, but he reiterated that the symptoms were side effects of the anesthesia (which was now 36+ hours ago) and pain medication. Over the course of the evening into the early morning hours, he deteriorated to the point that he couldn’t hold his own body up, and the perpetual whimpering sounds coming out of him were heartbreaking. That morning, I frantically rushed him to the Pet ER. I would later learn that he likely suffered a stroke during surgery and would then subsequently develop a severe case of pancreatitis.
Enter: The Crisis.
As if it were play money, I found myself frantically swiping my credit card over and over again for “just one more day” in the hospital. The thing is, when you’ve already invested a great deal of money and energy into the situation, it only becomes harder to stop. It’s the “I’ve come this far, spent this much” mentality. But it seemed to never end, and when all was said and done, I was left dogless and carrying a balance of close to $14K. The mind on grief is truly intoxicating.
Tovi was only able to come home on a feeding tube because he wasn't able to eat or take medication on his own. My kitchen looked like a science lab with multiple pills left out for hours to dissolve in syringes that I would inject into his feeding tube. A boy who lived for treats was now vomiting at every meal as I syringed pureed food into a body that was rejecting it. I’ll never forget the look of defeat on his sweet face. It was that moment that I finally saw him as the very sick twelve-year-old dog that he had become. I finally understood that the dog I knew was never coming back, and no amount of money or love could change that. The next day, I gave him the humane euthanasia he deserved.
As for me, my grief became complicated by an overwhelming sense of anger toward the part of me that made those frantic decisions. I became fixated on auditing every decision I made along the way and begging some imaginary God to give me a do-over of the last six weeks of his life. I promised this unknown higher power that this time I would slow down. I would take deep breaths and long pauses before making decisions. I would allow myself to hear the things that were hard to hear. I wouldn’t have prolonged the inevitable and his suffering by inserting a feeding tube into a body that no longer had the will to live.
Most often, though, I wished he had never eaten the thing that led to my knowing. Sure, I would have been blindsided in a different way, but I think I would have been more at peace with the ending if I hadn't had to bear the weight of the Decisions. But, the reality is, as pet parents, we cannot fully experience love without pain, and bearing the weight is part of the commitment we make.
As for grief, at some point, we must give ourselves grace for any perceived wrong choices. I use the word “perceived” because in reality, I didn’t make an objectively “wrong” decision — I chose one of the treatment options, and it didn’t work out the way I had hoped. It’s human nature to glorify the ghost outcome, but if I hadn’t done as much as I did, I’m fairly certain I would be shaming myself for not doing more.
As for my subsequent pets, while I’ve approached their end-of-life care decisions more intentionally, I’ve also seen the role the Relationship plays in how we proceed. Although I’ve deeply loved the dogs that came after Tovi, that soul-mate connection was never replicated. So, while it was painful to let them go, the thought of not having them in my life wasn't crippling in the same way, and I was able to act more rationally.
Will planning ensure you seamlessly float through your loss? Absolutely not. No matter how much you plan, you won’t do it perfectly or without regrets, but simply acknowledging it as a thing that can happen can help prepare you for the time it does.
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For more insight on Pet Love and Loss, please visit my website, Pet Therapy Notes.
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