Animal Behavior
Hype and Myths About What's a "Natural Death" For Dogs
Sweeping statements about how wild animals die aren't backed by facts.
Posted March 24, 2019
In previous essays, Dr. Jessica Pierce and I wrote about how some pet euthanasia services use false information and myths, packaged as "data," to mislead potential clients. Her essay, titled "Pet Euthanasia Advertisements Prey on Pet Owner Fears," and mine, called "Beware of False Information Used by Pet Euthanasia Services," focus on misinformation about what constitutes a "natural death" and the behavior of wild animals, including wild relatives of domestic dogs, put out by Home Pet Euthanasia of Southern California. She writes, "using claims about 'what nature does' or 'what wild animals do' and using these to make ethical judgments about how we should care for and interact with our companion animals is extremely problematic, particularly when the claims about 'nature' are unscientific and misleading, as they are in the posting [by Home Pet Euthanasia of Southern California]."

Both of our essays are available for free online. My piece also focused on the myths contained in their advertisement including, what's a "natural death" for wild animals, the role of pack leaders among wild animals, and the misleading claims about the nature of "human pack leader-dog relationships." I noted five areas of concern based on what we know and don't know about the behavior of wild animals: 1) The use of the word "nature" and the phrase "natural death." 2) Their writing, "When an animal ages, weakens or becomes ill, nature remedies this very quickly and animal suffering does not drag on and on. The old and weak die rather rapidly. Brutally, yes, but quickly! This is the way of nature." 3) Their writing, "Yet, their [pets'] survival instincts still dictates [sic] to hide pain and weakness! They will carefully hide their symptoms until they can no longer bear their suffering in silence and then, and only then, will they display weakness and pain (see 'understanding pain')." 4) They're claiming, "A predator or even a pack leader will terminate a fellow pack member’s suffering." I have no idea where this misleading fabrication comes from, and perhaps that's what their photograph of a wolf seemingly killing another wolf refers to. 5) Their writing, "When it comes to our pets, it is up to us, as pack leaders, to recognize suffering and to replace nature's way either by active medical intervention and aggressive pain management or by euthanasia."
The information put out by Home Pet Euthanasia of Southern California, stated with a strong voice of authority that could fool many people, is frightfully incorrect. There is so much wrong with what they claim it's almost laughable. However, of course, given the topic at hand, it's not laughable at all, but very sad because of the vulnerability of the dogs and their humans. Dr. Pierce concludes, "It is essential that scientific information and language be used cautiously and correctly. This is particularly true in the realm of end-of-life care for pets, where both animals and human caregivers are extremely vulnerable."
I received a number of emails from people about my essay and many people were truly put off by the nature of their advertisement. One likened what they were doing to "ambulance chasing," while a few people noted that they would feel used when they and their dogs would be in such a "fragile" state.
Sweeping statements about how wild animals supposedly die are fraught with error
I figured that it would be a while before I would see another piece about how we should reject the idea of a "natural death" for our companion dogs. However, I was wrong, and recently read an essay by By Tara Parker-Pope called "Knowing the Right Time to Say Goodbye to a Pet" with the subtitle, "End-of-life decisions for animals are difficult. A veterinarian has developed a scale to help clear up the confusion." I was interested in what Ms. Parker-Pope had to say about this touchy topic as she wrote about her dog, Fluffy, and also to learn more about "a scale to clear up the confusion" about when it's time to end our companions' lives. I wondered how a scale could possibly deal with all of the idiosyncrasies of the myriad situations with which people were faced if and when they were faced with having to say goodbye to their companion dog. Simply put, there are large individual differences among dogs, among human guardians, in dog-human relationships, and the specific contexts in which this incredible decision has to be made and this makes me wonder how a scale could deal with these and perhaps other variables. (See Canine Confidential: Why Dogs Do What They Do, Unleashing Your Dog: A Field Guide to Giving Your Canine Companion the Best Life Possible, and numerous references therein.)
In her essay, Ms. Parker-Pope writes, "A natural death is what many of us hope for with our pets. They are members of our family, deeply enmeshed in our lives, and for many of us, thoughts of euthanasia seem unfathomable, so we cling to the notion that natural death is desirable. But my veterinarian advised me that my end-of-life scenario for my dog wasn’t realistic. In most cases, a natural death, she told me, means prolonged suffering that we don’t always see because dogs and cats are far more stoic than humans when it comes to pain." I felt a warning flag being raised because this repeats the myths put forth by Home Pet Euthanasia of Southern California.
Measuring quality of life using scaled estimates of different types of behavior
"Optimizing end of life care and quality of life for animals is an extraordinarily complex endeavor and, as we have seen, relies on an extremely nuanced appreciation of how pain and behavior intersect. As if gaining access to how an animal is feeling weren’t hard enough, there are layers of additional complexity arising from the patient’s relationship to his or her human caregiver(s). The knowledge, attitudes, and attentiveness of pet owners will influence how well they read their animal, and how responsive they are. Their own emotional state can influence what they 'see” in their pet. (Jessica Pierce)
"A recent U.K study found that fully a quarter of all people acquiring a pet knew nothing about the type of animal they chose to buy and had done no prior research."
Ms. Parker-Pope goes on to write about veterinarian Dr. Alice Villalobos, a nationally recognized oncology veterinarian, who "said that many pet owners idealize a natural death without thinking about what a 'natural' death really means. A frail animal, she noted, doesn’t linger very long in nature." She goes on to quote Dr. Villalobos as follows: "When animals were domesticated they gave up that freedom to go under a bush and wait to die...They become very quickly part of mother nature’s plan due to predators or the elements. And yet in our homes, we protect them from everything so they can live a long time — and sometimes too long.” It simply is not true that wild animals typically "go off to die." This is another myth about how wild animals choose to die. While A few individuals might, there's no credible evidence this is a robust trend, yet the myth persists. (See "Do Animals Really Leave Their Group to Go Off to Die?")
Dr. Villalobos has also developed the HHHHHMM scale to help people make end-of-life decisions. You can try to scale here. The letters stand for Hurt, Hunger, Hydration, Hygiene, Happiness, Mobility, and More and you can choose a score of 1 (unacceptable) to 10 (acceptable). If your dog scores more than 35, "the score suggests that supportive care likely is still appropriate and that both human and animal are still benefiting from the relationship." We're also told to pay special attention to Hurt: "If your pet is struggling with pain and/or breathing, but scoring well in other areas, you should still have a conversation with your vet about the most compassionate course of care for your pet." Concerning this scale, Ms. Parker-Pope writes, "I revisited the scale several times, just to remind myself that I was doing the right thing. The scale allowed me to make a more detached assessment of Fluffy, and it was a tremendous source of comfort during a very difficult time. It wasn’t an easy decision or a pleasant one. But it was the right decision. And in the end, Fluffy did drift away on her favorite soft pillow, just as I had hoped." I'm truly thrilled for Fluffy, Ms. Parker-Pope, and her family.
All well and good, however, it's essential to ask how good people really are at making these sorts of quantitative assessments based on their feelings about what their dog is going through. Are they accurate estimates or simply sort of accurate guesstimates? I've studied dogs for many decades and have shared my home and heart with many wonderful dogs with radically different personalities, but I'm not sure I use this or other quality of life scales all that accurately, or at least accurately enough to make the incredibly difficult decision of whether or not to end their lives. I also knew each and every individual extremely well, because I worked at home a lot and was fortunate enough to be able to spend a good deal of time just hanging out with them and watching them in all sorts of situations. When the time came for me to ponder how they were doing--their quality of life--I depended on my observations and also talked with my veterinarian, neighbors, and other friends who knew each dog very well.
Another way of trying to understand what a dog is going through is to use a checklist, rather than a scale, such as the one offered by BrightHaven. Using the acronym PEACEFUL, it focuses on healing rather than cure and can be downloaded here. They note that it is important for the caregiver to: Discuss findings with loved ones & support team; Realize that s/he has choices; Understand the implications of each choice; Consider his/her own spiritual beliefs; Look at things from the patient/animal’s perspective; and Remove fear from the equation.
Echoing my concerns about the quality of life scales, in an important data based essay called "Improving Pet Owner Assessments of Quality of Life," Jessica Pierce writes, "Many QOL [Quality of Life] tools...are available online to pet owners, and veterinarians often recommend the use of such tools for clients. Yet although these simplified tools can sometimes help owners see gaps in care, more often they function as decision trees for euthanasia, and not rigorous ones at that." The scales "are rarely statistically validated and often lack the nuance required to carefully assess subjective states of an animal. They instruct people to look for certain behaviors, such as incontinence, but give no guidance about how such behaviors might reflect an animal’s internal state, nor do they give any hint at just how complex 'reading' an animal’s behavior can be. They do not account for the individuality of animal patients, nor do they pay attention to the complex interplay of effect, illness, and behavior. QOL tools tend to focus on what the caregiver him or herself thinks is important—which may not track well onto what the animal wants or is experiencing."
Dr. Pierce goes on to note that we need to recognize our own limitations in understanding dogs and other animals "including lack of observational skills and behavioral training and the potential for human emotional 'contamination' of behavioral observations." Furthermore, she writes, "Studies repeatedly show owners missing important behavioral cues. Although pet owners can usually recognize sudden changes in behavior, they are not skilled at recognizing subtle behaviors related to pain or the presence of disease, or at identifying gradual changes in behavior over time. [i] For example, in a large survey of dog owners by Mariti et al., only half of the respondents were able to correctly identify what 'stress' is (a short or long-term alteration of homeostasis that can lead to illness). [ii] Although many owners were able to recognize overt behavioral indicators of stress such as trembling, whining, and panting, few could identify more subtle stress behaviors such as an averted gaze, nose licking, or yawning. Packer et al. found that 58 percent of owners of dogs showing clinical signs of brachycephalic obstructive airway condition did not believe their dog had any breathing problem. [iii] Brown et al. found that owners had difficulty remembering the time their dog was in pain, and pain scales conducted by owners didn’t correlate with the vertical force produced by arthritic dogs, suggesting that dog owners may not be good at detecting when their pet is in pain [iv]"
Furthermore, it's surprising how many people who choose to share their homes with a dog aren't "fluent in dog" or "dog literate." Many people know more about their mobile phones and other devices than they do about their sentient and highly emotional dog being. Dr. Pierce notes, "A recent U.K study found that fully a quarter of all people acquiring a pet knew nothing about the type of animal they chose to buy and had done no prior research. [v]" She goes on, "It goes well beyond the ethical obligations of veterinarians to provide this education for pet owners, but as long as there are such enormous gaps in pet owners’ understanding of animal behavior, veterinarians will need to do what they can to plug the holes." (See "New Study Shows Importance of Understanding Dog Behavior" to learn how a study of pain in dogs shows how important it is to know about dog behavior, especially increased sensitivity to noise.) I'm a fan of all people who choose to bring a dog into their homes and hearts and who take the time to become amateur ethologists and become to "fluent in dog." This really isn't asking too much, because when we make the decision to welcome dogs into our homes we become their caregivers and they assume we have their best interests in mind from "cradle to grave," the cradle beginning when we welcome them into our lives.
Clearly, we need much more research into just how accurate QOL life scales really are. While they may provide a guide to how one's dog is doing, in and of themselves they may be of limited use in assessing an animal's state of health. And, because of what's called “caregiver burden” [vi] and "when caregivers are so stressed that they suffer from reduced psychosocial functioning, their ability to provide good care—including, presumably, their ability to make and report objective and accurate behavioral observations of their animal—may be compromised." An assessment of how a dog is doing may not be as detached as some make it out to be.
I want to emphasize that I'm not saying the HHHHHMM scale isn't useful or that it's necessarily always inaccurate. As a scientist and "dog person," I would like to see some data that show how the score a person comes up with can be statistically validated and how it correlates with an independent assessment by a veterinarian and possibly by other people who also know the individual dog. I couldn't find any such studies.
Where to from here? Be cautious of what you read in popular media and of sweeping generalizations about what dogs like and don't like
Spreading myths about how wild animals die and a misunderstanding of what the phrase "natural death" means need to end. I believe that most people who choose to share their homes and hearts with a dog or other companion animal want to do the best thing for them, but making comparisons with wild animals and focusing on what's a "natural death" really makes little sense to me. However, if these sorts of comparisons are put forth for whatever reasons, they have to be accurate and many are not.
We also need to be very careful of statements that say something like, "Dogs do this or that," because of the enormous within-species variation among these amazing beings. There is no being called "the dog." Dogs, even very young siblings, show incredible individual variation and explanations of behavior patterns that might work for one, two, or even 10 dogs, might not work for many others. One of the most exciting aspects of studying dogs centers on their marked differences in behavior, personalities, and how they adjust to living in a human-dominated world. And, it's their individual variability and differences in the varying situations in which they're studied that's often responsible for differences in the results from experiments that focus on similar questions.
Focusing on some other myths to which people are exposed in mass media, I'm often asked questions such as "Is it okay to hug my dog?", "Is it okay for my dog to sleep in my/our bed or bedroom?", "Is it okay to play tug-of-war with my dog?", and "Is it okay to roughhouse with them?" The simplest answer is that they're all okay if the dog(s) likes it too. This is where knowing dog behavior and knowing your dog as an individual are critical. For example, many people became concerned when they read some essays that suggested that it's not okay to hug a dog. However, this misleading advice wasn't based on systematic research, but rather a very preliminary study, along with a misreading of some of the behavior patterns dogs perform after being hugged, suggesting they didn't like it. The bottom line is that hugging is fine if your dog likes to be hugged, and it isn't okay if they don't. You've got to know your dog and interact with them on their terms. (See "Hugging a Dog Is Just Fine When Done With Great Care.") The same is so for where they sleep and whether it's okay to play tug-of-war or to roughhouse with them. (See "Should Young, Old, and Sick Dogs Be Banned From the Bedroom?", "What's Happening When Dogs Play Tug-of-War? Dog Park Chatter," and "Get Down and Dirty With Your Dog: Bow, Hug, and Tug.") Last year a woman thanked me for giving her "permission" to hug her dog, because when she stopped after reading some essays that said it wasn't okay her dog clearly missed her hugs. And, just today, someone told me that the best advice that I and some other people gave him was that it's okay for him to get down and dirty with dog.
It's high time to separate unsupported beliefs from facts about dog and other animal behavior and to put to sleep the above and other myths once and for all. Folk tales can be very harmful for dogs and let's be sure they're not killers and used to make incredibly difficult decisions that are ill-founded. (See "Let's Give Dogs a Break by Distinguishing Myths From Facts" and "Dogs Live in the Present and Other Harmful Myths.")
Information on the web and in popular media can influence the choices people make, and it's important for it to be correct. This means not offering up beliefs as facts and "not using misinformation in a self-serving way" as someone wrote to me. When it comes to life-death decisions, it's paramount to separate what Thomas called "unsubstantiated nonsense" in an email to me. Another person who wrote to me called them "flat out lies intentionally used to deceive readers." Another wrote a comment about my previous essay seriously wondering how "Highly educated people could put out the nonsense they do...clearly they haven't taken the time to learn what is actually known about death and dying among wild animals." Another asked if they would offer their services for free to dogs who are clearly moribund.
What really matters is that each and every human who chooses to share their home and heart with a nonhuman companion gives them the very best life possible, and this means caring for them with even more respect and love when their life is coming to an end. (See Unleashing Your Dog: A Field Guide to Giving Your Canine Companion the Best Life Possible.) I like to say that people should "Choose a Dog Trainer as Carefully as You Would a Surgeon" (also see "Dog Training's Dirty Little Secret: Anyone Can Legally Do It.") and the same goes for choosing someone to end the life of your companion dog or other animals at such a terribly difficult, sad, and vulnerable time for all involved. You can never be too concerned or too careful.
When we love and respect dogs for who they are, it is a win-win for everybody. We are most fortunate to have dogs in our lives, and we must work for the day when all dogs are fortunate to have us in their lives, too.
References
[i] Reaney, S, Zulch H, Mills, D., Gardner, S, Collins, L. Emotional affect and the occurrence of owner reported health problems in the domestic dog. Applied Animal Behaviour Science 2017; 196: 76-83.
[ii] Mariti, C, Gazzano A., Lansdown Moore J., Chelli L., Sighieri C. Perception of dogs’ stress by their owners. Journal of Veterinary Behavior: Clinical Applications and Research. 2012; 7, 213-219.
[iii] Packer, RMA, Hendricks, A, Burn, CC. Do dog owners perceive the clinical signs related to conformational inherited disorders as 'normal' for the breed? A potential constraint to improving canine welfare. Animal Welfare 2012; 21: 81-93.
[iv] Brown DC, Boston RC, Farrar JT. Comparison of force plate gait analysis and owner assessment of pain using the canine brief inventory scale in dogs with osteoarthritis. Journal of Veterinary Internal Medicine 2013; 27, 22-30.
[v] People’s Dispensary for Sick Animals. PAWS Report 2017. https://www.pdsa.org.uk/media/4371/paw-2018-full-web-ready.pdf.
[vi] Spitznagel MB, Jacobson DM, Cox MD, Carlson M. Caregiver burden in owners of a sick companion animal: a cross-sectional observational study. Veterinary Record 2017. DOI: 10.1136/vr.104295.