Dealing With the Diagnosis 

When you are emotionally invested in someone’s care, whether that someone is human or your pet, you take on the emotional burden of that care and, even if you are grateful to do it, it does take a toll on you.

Sometimes you can start to feel burned out, more anxious or short-tempered, or even physically or emotionally exhausted throughout the care process.

One of the most important ways you can get through what we call compassion fatigue or empathy fatigue is to acknowledge that that’s what it is. Most people don’t want to talk about it. They are so grateful to have their pet in their lives that they don’t want to complain about their feelings. They take on this emotional burden by themselves. When you do that, in addition to compassion fatigue, you start to feel alone and different from others. So talking to others who may potentially be going through something similar, or could understand, may really help provide that outlet or release that you need.

Anticipatory grief is very common when our pet gets a cancer diagnosis because we automatically go to the worst-case scenario: “This is terminal, this is the end. What do I do? Am I going to lose my pet today? Am I going to lose my pet very soon?”

You are automatically thinking is a space where you typically wouldn’t be. You are going through the stages of grief, but even before you’ve lost that pet.

Trying to balance the time you have left – and you don’t know how long it will be – with trying to make meaningful decisions for the rest of the course of your pet’s life, can be overwhelming. You may need to decide whether you will try to treat the diagnosis with a curative option, if that’s available, such as chemotherapy or radiation therapy or surgery, or whether you are choosing a palliative approach to maintain your pet’s quality of life as high as possible for as long as you can.

What are the goals in deciding to treat versus not treating? Is it quality of life? Is it extending your pet’s life? Is it buying yourself a little more time to be okay with what is potentially to come?

Is it saving money, and that’s something that people don’t always like to talk about, but it has to be part of the conversation. What is feasible to spend?

For example, if you can find a way to pay for your dog’s surgery, but you can’t pay for the after-care, and the supportive care they’re going to need after that, you may decide not to go that route. It’s important to learn what your options are.

You may think, or someone close to you may say, “I don’t want to put a dog through chemo,” but when you start talking to the oncologist, you may realize that it’s a very different process than the same treatment option might be for a human, even if it’s the same drug. It’s actually a lot kinder of a process for animals.

In the human model, we might administer four or five drugs at once, and it’s definitely going to make the patient nauseous or place them out of commission for a while. With companion animals, we do it a little differently. It may be that those four drugs are spread out over four different weeks and they come in once a week, for example.

Sometimes we get paralyzed in this anticipatory grief, and we feel like, “There’s nothing I can do. They have cancer and that’s it.” We go to a place of blaming ourselves and feeling hopeless, and feeling helpless, but, in reality, there are things that can be done. So acknowledging that grief, even though you are waiting for the other shoe to drop, which is how clients often describe it, finding the areas that, even if it’s something you need to adapt. If there’s a way to come up with a new normal that can satisfy what you are trying to do for your pet and what they enjoy doing in the confines of their diagnosis or their limitations.

One thing that you can do if you are choosing an option such as chemotherapy, if that’s an option for your pet, is to take as many notes as possible in terms of how your pet reacts to each drug. Be aware of what they are being given so that you can document their reactions. If they are given this drug on a Tuesday, say, how they acting for the rest of that day? How does the following day look for them? Do they have diarrhea? Do they have nausea or vomiting? Are they eating?

The more you can document all of that information and have dates and times of the day and symptoms that you can then share with your veterinarian, the better your care team can figure out the best treatment plan and revise it as you go forward.

Being your pet’s advocate is a huge part of the process.

Another example of how you might take a positive approach is around feeding your pet. At times, your pet’s appetite may change. Obviously, if you are doing anything with your pet’s food, you want to make sure to check in with your veterinarian to make sure what you are doing is acceptable within the confines of their care, especially if they are on special diets. But there are ways to entice your pet to eat.

For example, if your animal is not eating, you may want to try warming up the food, or putting some broth in it, or even some warm water. Or if they are eating dry food, you may want to add a little bit of canned food if that’s feasible, or vice versa -- just changing up the food.

In that powerlessness we have to find ways to take our power back, and that may not look the same as before. Find the areas where you do still have control. We may not be able to control the course of the disease, or we may sometimes be able to control certain aspects through treatment and pursuing various options, but we might not be able to predict how an individual pet will react to those treatments.

Find the areas in which you can still bring something positive to your pet’s life. Our pets live in the moment. We humans, on the other hand, are not terribly good at living in the present moment. But we have to remember that our pets are. They don’t know they have cancer. And they don’t care that they have cancer. They care about their immediate environment, their immediate needs.

And they care a great deal about how their “pet parents” are doing. You are the source of their security and they will react to y our emotions. That’s very important to understand. If we are anxious or upset, they will absorb that immediately. As a result, the more we try to stay positive around them when they are in the room with us, the better off they will be.

Staying positive will help in a couple of different ways. First, it will probably force us to find something to be positive about. Even if initially we are doing this for our pets, it may bring us into a better mood, and that will help our pets not have to focus on, “Why is our human upset?” It’s important to keep in mind how much our moods affect our pets. Sometimes our pets can do physically worse because they are focused on why their humans are constantly crying and anxious.

Of course, it’s understandable when you are going through this process to feel so many emotions. What’s important is for you to find an outlet for those emotions. You need to have that “me” time outside of your pet, even if you feel like you can’t possibly schedule a minute for yourself. Remember that you are benefitting your pet and yourself by scheduling that time.

So, for example, when you’re in the shower, that’s the time to cry it out as much as you need to because your pet will not be in there with you, reacting to you. It’s finding that safe space. Yoga, meditation, exercise, a support group – finding some time, some space to rejuvenate yourself and recharge yourself so you can give your best self to your pet. That way, the time that you do spend with your pet is the best quality time that you can spend together.

Also, it’s important for you to find ways to work within your pet’s new limitations. Maybe your pet loves going to the beach, but under the current conditions, they can’t because of their physical limitations. Is there a way you can bring the beach to them? If they enjoy the water, for example, maybe you can fill up the bathtub and let them play around for a little bit. If it’s warm enough out, and it’s feasible, maybe you can get them a little baby pool in the back yard.

Are there ways that you can adapt to what they can do with some of the areas that they’ve enjoyed in the past? Even if your pet is more physically immobile, if they used to enjoy hiking or running around in the back yard, if they can no longer do that, maybe trying a puzzle game where they can find treats without having to get up or move around much still engages them in that cognitive process. It’s enriching to them and it can be done right there in your living room. If they are confined to a particular room you can try to bring experiences to them, even if you can’t bring them to all of those activities outside. That would enrich their lives.

First, you need to acknowledge that those feelings are normal in this process. You need to give yourself permission to feel exactly how you are feeling and how you need to feel in that moment – without judgement. It doesn’t mean you’re a monster. It doesn’t mean you’re a bad person. It means you are a human being going through the grieving process.

We don’t always think about those types of feelings as being real grief, but they are. Anger, denial, and bargaining are all stages of the grieving process. You are aware of the ending of your pet’s life. You just don’t know when it’s going to be so it makes it harder to plan for. But you’re still going to go through those first stages of grief. You’re still going to go through denial and that anger phase. It may manifest itself as anger towards yourself or towards your pet, anger towards your veterinarian, anger towards anyone or anything or nothing at all, but just that feeling of anger.

And there’s the bargaining that comes into play. We like to make plans, and when we can’t do that, when we can’t anticipate, it’s very frustrating and even frightening for us. We plan so many details of our lives and our pets’ lives that, when we are thrown into this place of lack of homeostasis, a place where we can’t visualize how things are going to play out, it gets very stressful for us.

It’s important to find a way to structure the things we can, being open to different possibilities, planning what we are able to plan, even if we don’t know what the future holds. You may, for example, want to think in advance while you are still enjoying the company of your pet, about how to prepare for your pet’s end of life, whether you want a private cremation or a group cremation, or if you choose to, if you are you able to bury your pet at home. You might check with your jurisdiction to find out about whether you are able to do that.

You might plan on whether you want to do an at-home euthanasia or whether you want this final act to take place with your veterinarian who has been seeing your pet, whether that’s your oncologist or your home vet. Talk to veterinarian about that. Find out what hours are available, what days of the week they might be available. What happens if you are in an emergency situation? What phone number should you call? What’s the number for the nearest Emergency Service?

The more that you can plan in advance, the more you can take care of the details, of that process, the more you can get a little bit of that power back. Things may change when the time comes so having a Plan A, B, C, and D can be helpful. And once you have some of the planning out of the way, you can really focus on this time, living in the moment, and trying to learn from your pet, how to live in the moment.

It may not be something you’ve done very much of before and you may have always appreciated them for that. Sometimes having a diagnosis like this may be a gift in some ways because it forces you to really see that time is limited. We may not know the time frame, but knowing that the end is coming closer makes us appreciate every second we have with them now.

How does that take shape? It may mean just putting down the smart phone for a few minutes and, instead of looking everything up online, just cuddling with your pet. Just hold them, sing silly songs to them, give them a massage, which is a great way to connect at that human-animal bond level. And sometimes, if they are getting older and have arthritis or different physical limitations, they may really appreciate a therapeutic massage. Increase your bond with your pet through loving touch. You can both appreciate that time together.

Finding ways to just really connect with them and schedule time that’s not just for their medical needs is very important. Yes, we make our schedules as best we can around their medical needs, medications, visits to the veterinarian, and all that hard effort is amazing and wonderful and should be commended.

But you need to schedule some quality time, too. You can play a little music in the background if your pet likes music or if that helps calm you. Maybe make it a joint meditation time, where you may be meditating in your own way and your pet is a part of that process with you. That way, you can really practice making the best of each second that you have.

That doesn’t necessarily mean actively running around and doing all of these things. It may just mean sitting quietly with them and embracing their company in whatever state that they are in.

There are times when we start thinking about all the things we wanted to do with them before the end. When it’s feasible to do something, you do what you can do. It’s really about acceptance and working towards acceptance and it probably won’t happen right away.

It’s going to be a journey. It’s going to be a process. It’s okay if you’re feeling like “I should be doing better at this and I’m not.” You need to be kind to yourself in this process. Try to focus on how your pet thinks of you and look at yourself in that way. We focus so much on how much our pets bring to our lives because they are incredible and they bring out our best selves. But you also need to honor that you are one of your pet’s favorite people, or maybe even your pet’s favorite person.

Your pet would want you to be okay, even if you are not in a place where you can say, “I’m going to do this for me.” You can try to focus on your own wellness as a way of honoring your pet and honoring your pet’s wishes in this process. That’s going to help you and that’s going to help your pet, and it will help make this experience be a little bit less scary for both of you throughout the process, however long it’s going to be.