Do We Sometimes Go Too Far in Veterinary Medicine? A Vet’s Honest Perspective
Do We Sometimes Go Too Far in Veterinary Medicine? A Vet’s Honest Perspective
Written by Alessandro Didiano (doctor in veterinary medicine, MRCVS)
Disclaimer: This article is personally written by me, a licensed veterinarian with more than a decade of clinical experience.
A few years ago, I was an ambitious intern in a big referral hospital, one of the most well-known veterinary hospitals in Europe. During one of my shifts, I assisted the surgery specialists in treating a sweet 14-year-old golden retriever named Max. He’d been referred to us by his primary vet after suddenly collapsing at home. His gums were pale, his belly distended, and his heart racing. A quick ultrasound confirmed what we feared: a ruptured splenic mass. The bleeding was life-threatening.
Max’s family was devastated. He had been their daughter’s best friend since she was born. The little girl was autistic and had always struggled to form friendships with other kids. Losing Max felt unthinkable for all of them.
We discussed the options. The mass could be cancerous or benign, but either way, it was bleeding profusely into Max' abdomen and needed urgent intervention. The only choices were surgery together with blood transfusion or euthanasia. The family chose to operate.
We performed a splenectomy that night. Max needed two blood transfusions during the procedure and a few days of intensive care to stabilize. He pulled through. Unfortunately, the pathology later confirmed it was hemangiosarcoma, a highly aggressive cancer with a poor prognosis. Still, his family wanted to try chemotherapy.
Within a month, Max suffered an episode that left him unable to walk properly. An MRI revealed a cerebral stroke. Again, his family chose to treat, and he spent another week in intensive care. Then came another stroke. Then, two nights later, a cardiac arrest. The next day, I found Max on a ventilator, kept alive by the machine.
He remained like that for 24 hours in our ICU.
Eventually, after long discussions, his family made the decision to let him go. The journey had been long and painful.
And for weeks after, I couldn’t help but wonder:
Why didn’t we stop sooner?
The Advancements (and Dilemmas) of Modern Veterinary Medicine
In my 11 years as a clinical vet, I’ve witnessed true medical miracles: animals walking again after spinal surgery, or surviving once-terminal illnesses (like FIP for cats), or gaining extra time (months or even years) thanks to treatment options we didn’t have just a decade ago.
But sometimes, in our well-meaning intention to prolong life, we need to pause and ask a difficult, uncomfortable question:
What if we sometimes go too far?
Veterinary medicine today often mirrors human medicine. We have advanced imaging (CT, MRI), complex surgeries, chemotherapy, immunotherapy, blood transfusions, mechanical ventilation, dialysis, and ICU care. These are amazing tools, no doubt , but they come with emotional and ethical (and let’s be honest, also financial) weight. Not every pet is a suitable candidate. And not every condition should be treated aggressively.
Sometimes, the question shouldn’t be “Can we?” but rather “Should we?”
Before I am misunderstood, I want to be clear: I am not against chemotherapy, invasive surgeries, or any other life-extending treatment. I’ve recommended them on many occasions, and I will continue to do so when appropriate. For example, in cases like splenic tumours in dogs ( where there’s a 50% chance the mass is benign), I believe that, as long the animal is stable and the owner understandx exactly all the implications, surgery is absolutely worth it. Or when a house cat is diagnosed with a small cell (low grade) lymphoma, and oral chemotherapy could extend their life by up to three years with minimal side effects, that’s absolutely a conversation worth having.
What I’m reflecting on here isn’t the treatment itself, but the context.
How Our Culture Shapes These Decisions
In my experience as a vet (and as a close observant of human nature) our drive to push medical boundaries is often rooted in something very deep. It’s linked to how we, as a culture, view death.
Modern human medicine has trained us to believe that the ultimate goal is to prolong life. I’ll never forget a family acquaintance who, at age 50, was diagnosed with a very aggressive cancer. He chose not to pursue chemotherapy, which might have extended his life by a year or more. Instead, he decided to spend one final month at home, with his wife and daughter, before passing in his own bed. Well, I was at his funeral , and I heard someone call his decision “selfish”. Let’s reflect for a moment about this.
In our society, death is often seen as a failure, not a natural part of life. And sometimes, that mindset can influence our work in veterinary medicine. When a pet falls ill, our instinct is to extend. And sure, sometimes that’s the right approach, but not always.
Our pets can’t understand future rewards. They don’t know what chemotherapy is, or why they’re isolated in a hospital cage. They only experience the present moment. And when that moment is full of pain, fear, or confusion, we have to ask: “Are we preserving life, or prolonging suffering?”
The Veterinarian’s Role: To Guide
In practice, I always try to give families options. I do my best to present facts, without pushing my own beliefs. When someone asks, “What would you do if he/she was yours?”, I politely decline the question, because, well, they’re not mine.
I usually say: “I know the medicine. You know him/her. Let’s make the best decision by combining those two things.”
This means analysing each case individually.
Twice-weekly oral chemo for a calm house cat with minimal side effects and a good chance of gaining two more years? Let’s talk about it.
Weekly intravenous chemo for a 13-year-old Cavapoo who hates the vet and might get two more months (but only with biweekly blood checks)? Let’s sit down and think carefully.
A large, invasive jaw surgery for a 10-year-old Rottweiler with severe anxiety? Technically possible, but...would it be right for him?
Again, I will never tell you "do it" or “don’t do it”.
I’m simply saying: Let’s sit down and think this very carefully.
Seeing It Through the Pet’s Eyes
In all of this, we must remember who the patient is, and how they experience the world.
Dogs and cats don’t understand treatment plans. They don’t grasp prognosis. They don’t know we’re trying to buy time. They only know how they feel, right here and right now.
When we put an elderly pet through multiple hospital visits, painful procedures, medication side effects, or long ICU stays, we have to ask: "Is this for them, or is it for us?"
Conclusion: Striking the Right Balance
We’re lucky to live in a time when veterinary medicine can offer so much. But that power comes with responsibility.
We can’t let our amazing modern tools cloud our true mission: To alleviate suffering and preserve dignity.
Sometimes, doing more doesn’t mean doing better.
Sometimes, the most compassionate act is knowing when enough is enough.
Our pets don’t need endless days.
They need good days.
And it’s our job to make sure they have them.
This article is dedicated to Max.