Owners of pets with chronic or terminal illnesses commonly ask veterinary professionals - how will I know when it's time? Meaning, how will they know when it is time to consider humane euthanasia to end a pet's suffering?
Most professionals are proficient in guiding and advising their clients and their recommendations are typically based on their knowledge, expertise, and individual experiences or beliefs - which introduces the possibility of personal bias. Their recommendations take into account objective information such as lab test results or findings seen on imaging (e.g. x-rays or ultrasound). However, there is a potential for a mismatch in a professional's subjective assessment of a pet's quality of life and that of the pet's owner. A systematic approach in assessing quality of life with a standardized set of questions or factors to consider would be most helpful to clinicians and pet owners. In addition, this type of instrument would be helpful in clinical research trials when evaluating and comparing treatment options for specific diseases or conditions.
In a 2018 Specialty Update we reported on a paper that describes the CORQ - Canine Owner-Reported Quality of Life Questionnaire.
The primary goal of the authors was to construct a standard tool that could improve outcome assessments in veterinary clinical cancer research. The questionnaire asks pet owners to indicate how many days during the last 7 days (0 to 7) that the pet displayed the following:
1) Lack of energy
2) Decrease in appetite
3) Reluctance to get up
4) Pain or discomfort
5) (Cancer treatment) interfered with the pet's enjoyment of life
6) The pet enjoyed being near the owner
7) Was playful
8) Showed normal amount of affection
9) Enjoyed being pet or touched
10) Pet did its favorite activities
11) Slept well at night
12) Acted like his/her own self
13) Had trouble getting up or lying down
14) Had trouble going for a walk
15) Fell or lost balance
16) Did not eat his/her normal food
17) Had trouble getting comfortable
Owners were then asked to mark on a visual analog scale where they would rank their pet's overall quality of life during the past week ranging from "Worst imaginable" to "Perfect."
While this simple tool was developed and is validated for assessing quality of life in dogs undergoing cancer treatment, it has not been evaluated for external validity (e.g. for use in assessing other animal species or other canine illnesses). This questionnaire does, however, offer pet care professionals and caregivers the opportunity to consider their responses to these questions in pets with any chronic or debilitating condition. This tool can serve to compliment the conversations and interviews we have clients and ensure that we consider important pet-centric issues that can affect quality of life.
Learn more about this questionnaire in our video presentation (running time: 16 mins).
Here's a preview:
