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10 Tips for Navigating Tough Decisions about your Dog

How to Cope with a Serious Diagnosis
By Karen Fine DVM, CVA, October 2018, Updated September 2021
small sick dog

Many of us—myself included—live in dread of receiving bad news about our pets. We fear the moment when, looking at our vet’s face or hearing her voice, we know that something is seriously wrong. Unfortunately, given the short lifespan of our beloved furry family members, those moments come to most, if not all, of us.

I’ve been on both sides of this situation, and I’m here to share some advice. While it can feel overwhelming to receive bad news, especially if it is unexpected, there are things you can do to help both yourself and your dog during this difficult time. Here are ten suggestions I’ve come up with after more than 20 years of guiding clients, friends and family through serious diagnoses.

1. Determine the level of urgency. If your dog is suffering and could benefit from emergency treatment (including surgery), you may not have the luxury of time to ponder all the factors. Ask your vet about next steps and how important is it that you decide immediately. If you are by yourself, consider taking a moment to call a friend or family member to talk things through. Sometimes, just saying things aloud can help you clarify your thoughts.

2. Put it in writing. You may have heard that people remember only a small percentage of what their doctors say in the examining room, and the same is true at the vet. Taking notes on what your veterinarian tells you can be extremely helpful. If you prefer, you can also ask the doctor to write down his or her recommendations.
If you take your dog for followup appointments, or to a specialist, it’s a good idea to bring a list of questions. I have often done this for medical appointments for myself and my loved ones. A list will help jog your memory during what can be a stressful conversation. It can also be a tool to help decrease your anxiety; I find that once I write down my concerns, I’m less likely to obsess about them.


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3. Consider a specialist. As a general practitioner, your regular veterinarian typically does a little bit of everything. If your dog has something that can be addressed by a board-certified specialist in internal medicine, oncology, orthopedics or another area, ask your vet for a reference, or make an appointment with your closest specialty center.

Board-certified specialists have both extensive additional training and the experience that comes with treating many dogs with the same condition. They also have access to information that your regular doctor does not; specialists stay in touch with each other and share information about research studies even before they are published. A specialist may also be able to offer more advanced treatments. While you may ultimately choose not to pursue all (or indeed, any) of those treatments, you will have made your decision with the most current information.

If you schedule an appointment, let your regular veterinarian know and ask that your dog’s health record, including digital X-rays and test results, be provided to the specialist.

Finding Veterinary Specialists

Search for a veterinary specialist near you. Here are some of the most common veterinary specialties.

Acupuncture specialists are certified by the International Veterinary Acupuncture Society (IVAS).

Behavior specialists are certified by the American College of Veterinary Behaviorists (ACVB).

Chiropractic specialists are certified by Animal Chiropractic Certification Commission (ACCC).

Dentistry specialists are certified by the American Veterinary Dental College (AVDC).

Internal medicine specialists are certified by the American College of Veterinary Internal Medicine (ACVIM).

Ophthalmology specialists are certified by the American College of Veterinary Ophthalmologists (ACVO).

Radiology specialists are certified by the American College of Veterinary Radiology (ACVR).

Physical Rehabilitation specialists are certified by the Canine Rehabilitation Institute (CRI).

4. Consider holistic care. When my dog Rana was diagnosed with cancer at the tender age of four, I was devastated, especially after the surgeons and oncologists at Tufts informed me that there was very little they could do. She was given a prognosis of just three months to live. Fortunately, I had just completed veterinary acupuncture training, and many of my teachers were leaders in the field of Traditional Chinese Veterinary Medicine (TCVM). Thanks to their generous advice and support, I had more to offer Rana, who maintained an excellent quality of life for another 18 months.

Holistic care may be utilized by itself or in conjunction with conventional medical treatment.

The important thing is to find a qualified practitioner. In the U.S., there are two TCVM schools: the International Veterinary Acupuncture Society and the Chi Institute; you can search graduates by region on their websites. Other resources include the American Academy of Veterinary Acupuncture and the American Holistic Veterinary Medical Association.

5. Beware of “miracle cures” and other online traps. Holistic pet care has grown in the last several years, and many companies have sprung up online, hawking various supplements they claim will cure your dog virtually overnight. These companies know that people are often vulnerable when their companion animals are at risk, and are searching for anything that might help. Clients and colleagues often ask me to evaluate these products. Unfortunately, many of them are just not likely to help, and some could even be harmful. True holistic care involves treating the dog as an individual, not as a representative of his or her disease. Try not to be swayed by the convincing testimonials these websites typically display; in general, it is a good idea to get your veterinarian’s opinion before purchasing something online.

6. When doing research online, choose your sources of information wisely. Naturally, many people want to research their dog’s condition online, but depending upon the websites they visit, the information they gather can vary from accurate to completely wrong. I usually send clients to, an excellent free website maintained by the Veterinary Information Network (VIN), a subscriptionbased network of board-certified veterinary specialists.

I’ve known many clients who have received valuable support from other pet owners on websites or forums for specific problems. However, keep in mind that each animal is an individual, and just because someone says their dog responded in a certain way, it doesn’t mean yours will. If you read something that is meaningful to you, write it down to ask your veterinarian.

7. Remember the real world. As I often say to people, “In an ideal world, we wouldn’t have to think about money.” But we live in the real world. Last year, when my geriatric dog Remy became paralyzed in the hind end, the neurologist thought it was most likely an incurable spinal tumor. However, there was a chance that he had a disc problem, which could be surgically repaired. Only an MRI could tell the difference. Our other dog, Velvet, had undergone an MRI a few months earlier, and we couldn’t afford another one. Although I didn’t think Remy’s paralysis was caused by a disc, it was very difficult not to know for sure.

Weighing the financial costs and benefits of diagnosis and treatment is incredibly stressful, and family members may have differing opinions, which adds to the strain. Even if money isn’t a concern, we are often faced with making important decisions without having all the facts; I’ve often told clients that I wished I had a crystal ball and could give them more information. Ultimately, both veterinarians and pet owners have to make the best decisions possible based on the information and resources that are available.

8. Consider your dog’s perspective. Sometimes, a veterinarian may recommend a procedure that seems extreme from a human point of view, such as a leg amputation or an eye removal. However, this may not be as big an issue for your dog. Relieved of a painful part of their body and unconcerned about their appearance, most dogs readjust quickly and maintain an excellent quality of life as a “tripawd,” or with only one eye.

9. Create a bucket list. Planning fun activities to do with your dog is a good coping strategy, and a way to focus on the positive. Even if your dog’s time is measured only in hours, you may be able to give him his favorite food and have friends and family visit to say goodbye. If there’s more time, you have the option of taking him to visit his favorite people and places or doing some things you had been meaning to do. I had always thought that Rana would enjoy agility, and after her diagnosis, I signed us up for agility classes (which was great fun for Rana until I fell over her and wound up on crutches).

For inspiration, check out “Buddy’s Bucket List” on Facebook or Google. Buddy was an Australian Cattle Dog who was diagnosed with terminal cancer at the age of six. His owner came up with a list of 50 activities for Buddy. He paw-painted, had a ride in a police car and had his photo in a calendar, among other things. Buddy died in 2016, but his legacy of love lives on.

10. Trust yourself. This may be the most important advice I have to offer: trust that your love for your dog will guide you as you make decisions. No one loves your dog more than you do, which makes you the best possible advocate. Many people feel guilty as they weigh the options, but remember that your relationship is built on love, not guilt. Your dog trusts you, so trust yourself.

Finally, know that many, many others have been in these difficult situations. As Irving Townsend said in his book Separate Lifetimes, “We who choose to surround ourselves with lives even more temporary than our own, live within a fragile circle … we would still live no other way.” I know I wouldn’t.


Karen Fine is a holistic veterinarian who practices integrative medicine and operates her own house-call practice in Worcester, Mass. Her free “Guide to Writing a Pet Obituary” is available on her website.