Expert: Janice Reeves - 5/15/2006

Question
I hope you don't mind this question, but I am trying to make an informed decision concerning my dog that has had chronic kidney disease and will at some point in the future (hopefully not too soon) go into full renal failure.  My philosophical perspective does not allow me to treat animals any differently than I would a human, so most of the advice I gather refering to pets might not be exactly appropriate.  Knowing the biology is nearly identical between canines and humans, I believe the process will be the same.  This is why I believe your experience as a hospice nurse will be appropriate for my question.  I want to make sure we can provide the most comfortable situation when the time comes.  How painful is death from renal failure?  Can you offer any advice about type of care I should be prepared to provide with the assistance of my vet?  Is this the type of disease and death that some humans might consider euthenasia or physician assisted suicide?  I am in the weird spot of being generally against euthenasia for animals, yet can imagine scenarios where I wouldn't fault a human for making the decision.  Thanks for any advice you might be able to share.

-Matt

Answer
Dear  Matt,

This is certainly a difficult time when a pet (has become family).  Seeking information to make an informed decision is admirable as many fail to set aside emotion.   You are a guy after my own heart.

End stage renal failure for people usually occurs by the person sleeping more and more and often slipping into a coma.  There may be urine although its presence is not of quality hence the kidney failure.

The only pain I have witnessed was associated with not being moved or other conditions that caused pain before the kidney failure.  If pain has been present please continue pain medication even if in a coma.   It is unfair to assume a coma blocks pain when it may only be the body is unable to respond to loved ones in a traditional way.
Because of the coma I am not familiar with this end of life disease as being one known to seek euthenasia or physican assisted suicide in genera.


I recommend supportive care and if you wish to take your dog home ask the vet to provide/teach you how to give medications for comfort.  

I hope this has been helpful and encourage to seek the support of  group for the loss of pets that may be in your community.

Your dog has been very lucky to have you and  your love.
Jan