Date:   24 August, 2008    
Focus: Small animals - dogs, cats, hamsters & rabbits.


BE KIND TO PETS Community Education Project supported by Toa Payoh Vets and Asia USA Realty. Written: Mar 8, 2005. Updated: Aug 23, 2008.
Dr Sing Kong Yuen, BVMS (Glasgow), MRCVS

Bringing veterinary medicine and surgery anatomy alive to a vet student studying in Australia

Picture narrative written in 2005
Narrative written as a case study: Aug 23, 2008
Dr Sing Kong Yuen, BVMS (Glasgow), MRCVS


"It is best to phone your daughter," I said to the parents who brought the old aged handsome-looking Miniature Schnauzer in for euthanasia. "By getting her pet put down without informing her will cause much unhappiness."  

"The breath is so bad that our groomer refused to groom him nowadays," the mother said. "He is so smelly and the house stinks."

"Is the Filipino maid doing a proper job of cleaning him?"

"My maid does not do the bathing and cleaning," the mother explained. "I bathe the dog myself. After 2 days, the bad body odour and bad breath fills the house. Belinda does not any grooming of her old dog. " 

I said, "Your daughter works long hours and needs to travel overseas to work. Perhaps she has no more energy left to bathe the dog when she reaches home past midnight."

The mother said, " I have to do all the grooming. Friends come to the house and complain about the smells." 

"But this Schnauzer has grown up with your daughter during her teenaged years, " I explained. "I can still remember her wearing braces to straighten her teeth."

How fast children grow up. Their dogs age much faster as one dog year is said to be equivalent to 7 years of human life.

"Can this dog still eat, drink and walk?" I asked the parents.

"Yes," the mother said softly.

"Many modern Singapore daughters are well educated. And sophisticated. But one common thread amongst these girls of the internet age is that they will never agree to putting their old dogs to sleep just because they are suffering from bad breath."

"How about me spending so much time every 2 days or so to bathe this dog to get rid of the bad body odour? I have told Belinda that the old dog is suffering and therefore ought to be put to sleep."

"Did she give her consent?"

"No," the mother said. "I have talked to her for many weeks."

"There will be long-lasting tension in your mother-daughter relationship if you just get the dog put to sleep while she is at work and not aware." By not informing her daughter and getting the dog to be euthanised on a working weekday, the mother would have made a mother's coup d'etat. When the daughter comes home and presented with euthanasia of her old friend as a fait accompli, it would be very unpleasant for the mother.

"Belinda will not forgive you. I don't think she will move out of your house as she is a very filial daughter. But every strain in the mother-daughter relationship just gets bottled up. One day she may abandon you."

No mother or most mothers will prefer their unmarried daughters to stay in their house as grown up children are always their "babies".

I said, "Now you show her that being an old canine companion is a great liability and do not deserve compassion. When you are old, just send you to an old folk's home instead of being compassionate and caring for you in your house?"       

The father seldom talked much in most veterinary visits. He would wait outside the surgery in his car reading his PDA. He was the driver. So, much of the decision is made by the wife. 

"Why don't you phone Belinda?" I suggested.

The mum fished out her latest mobile phone and dialed. "No euthanasia" was the expected and confirmed reply. Belinda would have rushed down to the veterinary surgery if she could and if she could not trust her parents not to get the dog put down.

"What to do next?" the mother asked me.

"I would advise that the dog be given 2 days of antibiotics and then get his mouth checked thoroughly under general anaesthesia. His bad breath is due to a severe periodontal disease and mouth ulcerations and infections."

Usually I advise 10 days of antibiotics to kill all the bacteria in the gums and teeth structures. But 10 days may be not good for the dog. What if the mother presents euthanasia as a fait accompli by taking this old Schnauzer with cataracts to another veterinarian since I had reservations about putting him to sleep in the first place?
Anything can happen when mothers are under duress of having to care for this 15-year-old Miniature Schnauzer and three more others in the house. She has no spare time for herself and she is now in her late fifties. A time to smell the roses, not halitosis of the old Schnauzer. 

After 2 days of antibiotics and the initial antibiotic injection, the old dog was given dental work. This time Belinda was present.

"What are the risks of him dying?" she looked at me with eyes that silent tears flowed.  

"40% chances of dying under general anaesthesia," I estimated after examining the dog's heart. There was no pre-anaesthetic blood tests done. Would the test help if the results showed that the dog was suffering from liver and kidney failure of old age? The blood tests ought to be done but not in this case.   

Belinda adjusted the cap to see me properly and said, "The risk is too high." In her military camouflaged blouse in a trim figure, she looked good.

Now that she is an accountant, I presume that 40% is an unfavourable outcome. If one stands a chance of 40% of losing one's money in a business venture, she will advise against the investment. So 40% of the dog dying is too risky.

However, she must have considered her mother's feelings. Her mother could not cope with the frequent bathing of the dog to get rid of the body odour. She had no time to do it. The groomer refused to do the bathing too. The Filipino maid must have given up too. I don't know whether she had consulted other veterinarians about the bad body odour as I did not ask her and presumed she had done so. I presumed that the veterinarian would have advised her about the high risk of anaesthesia in a dog who is equivalent to a human age of 105 years old.

I assumed that the baby-boomer generation of whom the mother is in the category  would think this pragmatic way, "If the dog dies on the operating table during dentistry under general anaesthesia, I still  have to pay for dental work done. Why not just pay for the euthanasia?"

I doubt she will think this way as she can afford the dentistry. But this is a common thinking of many in the baby booming generation that had seen deprivation of food and human hunger.

Back to the present, I asked Belinda, "What do you propose?" Has she got any alternative? Antibiotics will not be effective if given for a long time. She must consider her mother's feelings.

Her mother looked at her and did not say anything. She wavered. To take the risk or not? The dog is 15 years old. He may live to 20 years old if he does not die today under general anaesthesia. On the other hand, today might be her last day with her dog.    

"Let the dog get the rotten teeth taken out," I advised Belinda. "You and mum go home first and wait till I telephone you."  I had seen this dog as a puppy when he came in for his puppy vaccination. I lost touch with the family over the years.

I put the dog under gas mask anaesthesia. The bad breath was due to the loose teeth and a huge ulcerated gum tumour of over 3 cm in diameter. Dogs and people with poor oral hygiene do develop mouth tumours over time. I extracted all the loose teeth, leaving two strong canine teeth behind. I cut away the gum tumour as much as I could.

There was another old Miniature Schnauzer paralysed due to a slipped disc.

The poor mother had to clean up after the old dog peed and pooped. She did a good job but it was tiring. Bed sores developed at the hip area. Would she do a coup d'etat?

Not this time. I asked her daughter whether she wanted the dog put to be put to sleep as this old Schnauzer was not having a good quality of life. He could not stand or walk. But he could eat and drink based on my observation of the dog warded for some 20 days. The bed sores in the hip and elbow would not heal.

"No," was Belinda's inevitable and firm answer and she got the dog home. Belinda took some time to care for the dog's wound after work. It is definitely very difficult to be a mother and an old dog caregiver nowadays. Some daughters studying overseas raise hell and fire whenever the mother decides on euthanasia.

It is best that the veterinarian makes sure that the parent is advised to talk to the progeny to get consent. Otherwise, there will be hidden and grave cracks in the mother-child relationship in this time-pressed society. Anger from the progeny may  be directed against the veterinarian sometimes.

In August 2008, I had a case where the parents got a young dog put down due to chronic dermatitis but had not asked consent from one daughter in her late 20s. She came to the surgery in a fiery mood to ask for an explanation and a veterinary report to be mailed to her. I told her that I saw her father phoning some family members and had their consent. I presumed the father had not asked her. In any case, I obliged and did not charge her for the veterinary report.  

Maybe the veterinarian ought to have another euthanasia consent form from all family members to state that they have authority and have had consented to have the family dog put to sleep. It is an impractical suggestion. But presenting euthanasia as a fait accompli by a family member is not uncommon and the veterinarian has to be alert and careful. The price of family disharmony is too high to pay if one family member is not informed.              

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