The lasting resonance of using "against medical advice" in vet medicine can complicate a family's already difficult decision

Instead of a traditional blog post, I'm offering up a vlog entry this week. I highlight a situation I've seen in my work in pet sitting and especially as one that has come to specialize in pet palliative and pet hospice care.

As pet professionals, our jobs, especially when a family is facing a grim diagnosis, can be very challenging, there's no doubt. This is especially true for veterinary doctors, vet techs (nurses) and support staff. And as professionals, how we use the words at our disposal is as important as the skills and knowledge that we've attained. We can't forget that.

Lorrie Shaw is a freelance writer and owner of Professional Pet Sitting. She has been a featured guest on the Community Cats Podcast, talking about how experienced pet sitters can be a valuable asset for families with pets, as well as in the animal rescue, veterinary and animal hospice communities. Shoot her an email, contact her at 734-904-7279 or follow her adventures on Twitter. 

Natural disasters magnify the conflicted decisions that are made despite the human-animal bond

In the hours since Hurricane Irma made landfall, I've read a couple of articles that have been circulating on social media about the pets that were left behind by their humans to fend for themselves. Left in enclosures, chained outside—even chained to cars. There has been so much in the way of commenting, knee-jerk reactions, armchair-ing and demonizing by well-meaning people.

But when I read things like this, I can't help but be reminded of how, when a Very Big Crisis occurs, humans often lack the resources that they need to not to only cope, but survive the upheaval of a traumatic event. Resources that are beyond financial. And in the event of an evacuation for a hurricane—having to leave one's core source of safety and stability and wholeness, their home—resources that are barely sufficient to keep themselves safe and sane. People often have to seek refuge in places that are hardly enough to sustain them, let alone their pets: a family member or friend's home, a temporary shelter, or in some cases, goodness knows where. 

When people are forced into that kind of situation, they often feel understandably conflicted and cornered, that they have no other choice but to make decisions that are less-than-ideal.

This is no Pollyanna-tinged point of view, no excusing the choice, but an explanation. An explanation of feeling powerless, frightened and the limbic brain taking over because this is very much a fight or flight alternative, and yes, our objectivity and compassion and are easily eroded when that's the case. This is the ugly part of our humanness.

How do I know this? Because I see it everyday in my work. In the trenches of pet sitting and animal hospice. Yes, it can be impossibly ugly and difficult to be witness to, but not for the reasons you think. 

The ugly, amplified view of everyday 

I see people make unfortunate decisions every day that in ordinary circumstances they'd never otherwise consider, only because they lack resources to do better. And believe me, that's not lost on them. These situations run the gambit, and sometimes they lead to outcomes that no one, including the family, wants to see.

One example that comes to mind are the folks that I encounter who can't bring themselves to get their pet to the vet for an assessment when I first gently declare that I'm seeing significant changes in their pet's health, then need to gradually be more urgent as the weeks or days tick by, my quiet moral support steady all the while. Time that passes by as the pet receives inadequate, misguided or no palliation at all for a clearly terminal illness that they likely won't weather the way they deserve to, nor be euthanized for in a timely or peaceful manner. 

Why? Because as I've seen time and time again, 'getting there' mentally, admitting to ourselves that there's something serious going on that will take our pet away from us—the one constant that is there, the one tether to normalcy that we might have, yeah, that—is so mind-bending that we shut down. We avoid it. If we avoid it, it's not happening. ['It will be okay...'] The truth is that we have only so much space, so much bandwidth for crisis, to be fully engaged in crisis-mode, and our brains are designed to operate that way. And when we have low resources to start with—varying degrees of the always stigmatizing mental illness, anxiety, financial instability, little or no outside resources, existing crises—we have far less bandwidth. We go into survival mode, a state of being with inherently very narrow margins. 

Yes, this what happens, the kind of thing we on the fringes of the situation prefer to ignore. 

But you know what? I don't judge people in that space. I can't. All I can do is try to help empower these humans that are doing their highest to have access to resources if possible and make the best choices that they can. And when they can't, I do my best to support them through the glaring clarity of hindsight that rears its head.

This is happening everyday, all around us, these decisions that are made. The choices that leave people grappling with knowing what they have to work with leaves them feeling terrible, and yes, internally judging themselves. Though it might not seem like it, the mental paralysis of doing nothing when a pet is terminally ill, hoping all will work out fine—they aren't going to die, they can't, I need them, everything in my life is Hell—and a family deciding to leave their pets behind during an impending hurricane because they feel no choice and wishing for the best is very much sourced from the same place in our psyches. 

It's people, just trying to cope as best they can, given the set of circumstances before them. But, hurricane fare is more compelling, right? 

So, the truth is that we don't know the stories, the families behind the gripping, heart wrenching photographs of dogs chained to trees, confined in enclosures outdoors, left behind. I have a hard time imagining that these humans were looking for an opportunity to be cruel to their pets, goodness knows there are lot of ways to do that on a regular basis. I'll wager they wouldn't be that seemingly cruel on any other day than on the one that they have to flee for safety from a tropical cyclone.

Think about that: chaining your dog to a car. 

What does that say to you? What it screams, begs to have to me hear is that 'I was desperate and I couldn't make another choice. Look what I had to do. I felt like it was the best chance, a proverbial red flag, to perhaps have someone help them when I couldn't.' 

What we do need to remember is that in the 12-year wake of Hurricane Katrina, we know better, and are doing more to accommodate families with pets in the event of a natural disaster, but we've still a long way to go. In the days leading up to Hurricane Irma, I heard plenty of chatter about the lack of resources for the thousands of families who needed to relocate with their pets temporarily, so that is, in my opinion, telling of why some families made the choice that they did. The choice to leave their pets behind. One that as I understand it, they'll be prosecuted for. 

We judge people for staying put in the event of a hurricane, which they often do because they lack resources like a place to go, money or reliable transportation to get far enough from harm's way. Or, though they won't admit it to others, but they don't want to leave their pets. We judge them more harshly for evacuating like they've been directed, but leave their pets because those family members are not welcome, allowed or valued as much by others as their human counterparts. I propose that instead of judgement, we look with at situations like this with the clarity they deserve and create an environment of cooperation, support and caring so that families don't need to be backed into this corner.

Lorrie Shaw is a freelance writer and owner of Professional Pet Sitting. She has been a featured guest on the Community Cats Podcast, talking about how experienced pet sitters can be a valuable asset for families with pets, as well as in the animal rescue, veterinary and animal hospice communities. Shoot her an email, contact her at 734-904-7279 or follow her adventures on Twitter. 

Why does the age-old conundrum of children not taking responsibility for family pets thrive?

I can recall to what seems like a lifetime ago, sitting in the passenger seat of the car when my 8 year-old stepson bounded into the backseat, teary-eyed at the prospect of having to get rid of his cat, Silver. He and his mother were moving again, it seemed, and the year-old cat wasn’t welcome in their new digs.

“Dad, can he come and live with you?”, his face pleading.

My then husband looked my way, knowing that he and I would have to talk about this in private for several reasons. First, it was a big commitment, taking responsibility for a young cat -- any animal, really -- something that he knew I took seriously. His son’s mother also had a habit of welcoming pets into their home life with a casualness that made me cringe: Silver had a sibling that was adopted at the same time from the shelter, and had ‘accidentally’ made their way outside just a short time before. Before that, there was a puppy that grew into a youngster who ‘disappeared’. As the boy's father and I discussed later, I didn’t want either of them to think that our taking pets into our home would be handled with the same laissez-faire attitude, nor would we be taking anymore animals off of her hands, among other things.

“Silver will have a permanent, stable home here, with us,” we explained to both my stepson and his mother days later, making clear that if he came to live with us, he wouldn’t be going back with them if their living situation changed. This was an arrangement that I especially felt was mindfully fair, given their track record with pets, not to mention the fact that this young child needed to have some semblance of what a responsibility of having a pet is really like, and Silver deserved to stay in one home. They happily agreed, (and of course they wanted the cat to come back with them months later when they moved, a request that I reminded them was out of the question), so we had ourselves a cat.

I should interject that I had no expectation that an 8 year-old would have any responsibility in caring for Silver. Doing so would be unreasonable and futile in my opinion, and I made that clear to his father going in. (After all, we were the ones taking on the responsibility for the pet.) Instead, he would be witness to the grown ups of the household modeling of thoughtfulness, sacrifices of time and resources, care taking, the joys of watching a young cat unfold into a full-fledged adult, as well as the difficulties, like when pets are sick and we have to sacrifice more so that they can have what they need. While in our midst, he’d really have no choice but to be tied to our commitment; before doing things for ourselves, especially traipsing back and forth to fun outings -- no, wait -- the adults needed to ensure that Silver had fresh water and food, and was the litter box tended to? If the grown ups couldn’t proceed before that was done, that meant the younger family member couldn’t either. As we thought about vacations, no fun planning for anyone until care was secured for the pet.

You get the idea. And so did the kid. Sort of. Well, as best an 8, 9, 10 year-old is able to.

The truth is that he wouldn’t have learned any more had we insisted that caring for Silver was ‘his’ responsibility. We didn’t absolve him of any responsibility, we exemplified it day after day and he saw what comes from honoring commitments and taking care of another living thing. And, this same thing was patterned when we welcomed Gretchen into the family, which changed the dynamic of intention and caregiving and sacrifice further. Expecting a child to take responsibility for a pet is a recipe for disaster and strife, though it is a bonus when they do pick up the slack, and by osmosis, he did at times.

I read a post by Certified Animal Behavior Consultant and fellow writer, Steve Dale this week regarding the collective disposability of pets, at least some species of pets, that some families seem to feel. In an exchange with a parent who was looking to re-home a pair of hamsters because their daughter had “gone through that phase”, Dale voiced his concerns about any lessons that were to be missed out on for her offspring, and that pets, in this case, hamsters, are not disposable -- the latter being something that the parent indicated they felt.

Dale’s feelings on this are understandable. And he’s correct in saying that no pet is disposable. But I’m ambivalent about his assertion that the parent can mandate that the child continue to care for the hamsters, and that if that doesn’t pan out, well then, the parent can assume sole responsibility of the pets to “offer the lesson that these animals aren’t disposable”.  

There’s a problem: just because it’s the right thing to do, it doesn’t mean that the child will actually learn a lesson because the parent has stepped up to the plate after the original plan implodes, and often, they don’t. Often, they learn that they can just pass the buck. Someone else will take care of things instead.

The context of how a pet is welcomed into the family makes an impact.

Children are more apt to be empathetic, caring and responsible toward pets when they see that modeled with a sense of thoughtfulness and consistent diligence by their parents and other adults in their life from the start. That is, rather than us buying a cute hamster for our child on a whim because they’re cuddly and small and live in a cage (and cost so little, another issue) -- what’s the big deal, right?? -- we instead cultivate a different mindset: welcoming a pet into the family because, as a whole, we’re ready for that long-term commitment and want to share in giving them the kind of life they deserve. Yes, that means selecting a pet based on what we as families can handle, what can be afforded and what is an overall good fit for the family unit, and talking openly about it, not because of the pet’s appearance or that kitten that is part of a litter from down the street is free and it could be a good lesson as any in empathy. And, though it doesn’t mean that the young members of the family need to be exempt from the care taking and day-to-day responsibilities associated with having a pet, it does mean that parents need to dive in with the knowledge that ultimately, they’ll be responsible for ensuring that said pet is not only tended to, but patterning that sense of diligence everyday through open dialogue, action and inclusion that in most cases will take root.

That, in itself is the lesson, the solution to the exponential problem: the numbers of homeless animals that are waiting in shelters because of a family’s inability to keep them, the surmounting population of pets who are still with their families but their human-animal bond is broken because of behavioral and health issues stemming from lack of enrichment and interaction. I could go on. I’ll be honest in saying that though it might be an unpopular view in some circles, in my experience, in some cases it’s better for a pet to be re-homed successfully if its possible. The fallout from neglectfulness or when the animal-human bond is broken (or never really established) isn’t pretty, and I’ve seen it first hand.

So, while Dale was on the right track in saying that the family should honor their commitment, that commitment first has to be centered from the right place. People are more likely to carry on a healthy mindset of welcoming pets into the family if they see that patterned for them as children.

Lorrie Shaw is a freelance writer and owner of Professional Pet Sitting. She has been a featured guest on the Pawprint Animal Rescue Podcast, talking about her career working with companion animals and in animal hospice -- as well as the benefits of introducing palliative care with one's pet earlier. Shoot her an email, contact her at 734-904-7279 or follow her adventures on Twitter.