Dr. Lisa Radosta, Veterinary Behavior Specialist, is on the podcast to discuss the behavioral euthanasia, the guilt and shame that pet owners experience as they consider it, and how best to support and talk to your veterinary team.
You can also listen to this episode on Apple Podcasts, Google Podcasts, Amazon Music, Soundcloud, YouTube or wherever you get your podcasts!
LINKS
Florida Veterinary Behavior Service: https://flvetbehavior.com/
Dr. Lisa Radosta Homepage: https://drlisaradosta.com/
Dr. Andy Roark Exam Room Communication Tool Box Team Training Course: https://drandyroark.com/on-demand-staff-training/
Dr. Andy Roark Charming the Angry Client Team Training Course: https://drandyroark.com/charming-the-angry-client/
Dr. Andy Roark Swag: drandyroark.com/shop
All Links: linktr.ee/DrAndyRoark
ABOUT OUR GUEST
Dr. Lisa Radosta graduated from the University of Florida College of Veterinary Medicine in 2000. She completed a residency in Behavioral Medicine at the University of Pennsylvania. During her residency, she was awarded the American College of Veterinary Behaviorists Resident research award two years in a row.
Dr. Radosta is the owner of Florida Veterinary Behavior Service, a specialty behavior practice in southeast Florida and co-owns Dog Nerds, an online educational resource for owners whose pets have behavior disorders.
She is a sought after speaker nationally and internationally. She is a coauthor of several books including: Behavior Problems of the Dog and Cat, 4th edition and From Fearful to Fear Free. She is a contributing author for Blackwell’s Five Minute Veterinary Consult, Blackwell’s Five-Minute Veterinary Consult Clinical Companion: Canine and Feline Behavior, Decoding your Cat, Canine and Feline Behavior for Veterinary Technicians and Nurses and Feline and Small Animal Pediatrics. Her new textbook, Handbook of Behavior Problems of the Dog and Cat, 4th Edition is due out May, 2023.
She has published research articles in the Journal of Applied Animal Behavior Science, Journal of Veterinary Behavior and The Veterinary Journal and written review articles for Advances in Small Animal Medicine and Surgery, Compendium, NAVC, Veterinary Team Brief, Clinician’s Brief and AAHA Newstat. She has served on the Fear Free Executive Council and the AAHA Behavior Management Task Force.
She has been interviewed for many publications including Cat Fancy, Dog Fancy, Palm Beach Post, NAVC Clinician’s Brief, Sun Sentinel, WebMD, AAHA trends, Real Simple, Good News for Pets, Catster, DVM 360 and AAHA News Stat. She has appeared on Lifetime television, Laurie Live, local news in southeast Florida, Mitch Wilder’s Amazing Pet Discoveries, Nat Geo Wild, Animal Planet, Steve Dale’s Pet Talk and Dogs, CNBC and Cats and Scapegoats.
EPISODE TRANSCRIPT
Dr. Andy Roark:
Welcome everybody, to The Cone of Shame Veterinary Podcast. I am your host, Dr. Andy Roark. Guys, I am here with a really interesting episode. It is bit of a heavy episode. But this is a lot of head candy. This is a lot to sort of chew on. It’s a lot to kind of put in your mind and roll around and process. I am here with veterinary behaviorist, Dr. Lisa Radosta. And we are talking about behavioral euthanasia. And the first thing she tells me is how she doesn’t like the term behavioral euthanasia and we should stop using it, and we just start from there.
And anyway, this is a great thought-provoking interview. I am so glad that she came on and just talked through this with me. But I love her perspective. I think she provides a lot of clarity in how to work with these cases, and also how to feel okay about these cases, and also how to help pet owners feel more okay when they’re going through a situation like this.
So anyway, really good episode. I hope you guys are going to really enjoy it. Dr. Radosta throws out a bunch of really good resources, and I link to them in the show notes so you can check those out as well. Guys, let’s get into this episode.
Kelsey Beth Carpenter:
(singing) This is your show. We’re glad you’re here. We want to help you in your veterinary career. Welcome to the Cone of Shame with Dr. Andy Roark.
Dr. Andy Roark:
Welcome to the podcast, Dr. Lisa Radosta. How are you?
Dr. Lisa Radosta:
I’m doing great. How are you?
Dr. Andy Roark:
I’m great. I love having you here. You are one of my favorite people to talk to. I have already been picking your brain. As soon as you arrived I was like, “I have questions for you.” And I should have just hit record because you’re amazing. But, for people who don’t know, you are a fellow Florida Gator. You are a boarded veterinary behaviorist. You are the owner of Florida Veterinary Behavior Service. You have been a guest on the podcast a number of times in the past, and you are a generally wonderful person to talk to. And so I have a question for you. It’s not a fun question, but I think it’s really important. It’s something that I’ve been rolling around with a little bit recently. I’ve seen some of these cases.
I wanted to talk to you today a bit about behavioral euthanasia. The idea that we have behavioral problems that have come to a point where the owners say, “I cannot rehome this pet,” or, “I don’t feel comfortable rehoming this pet, and I think this pet should be put to sleep because it’s dangerous.” Something like that or… Yeah, let’s just go with that.
I think a lot of vet professionals really struggle with this idea. That I have heard of clinics that just say, “We don’t do behavioral euthanasia here.” And I don’t want to cast judgment, I want to understand. And so as I started to parse my own thoughts and sort of say, “Are there lines in the sand for me?” I think everybody’s got their own. But are there rules or a general perspective or even a philosophy to look at these cases? I wanted to talk to you about it and sort of get your insight as a behaviorist. Let’s just start really high up. Lisa, how do you think about these cases?
Dr. Lisa Radosta:
Yeah. So if I may turn things around and disrupt just a little bit.
Dr. Andy Roark:
Sure.
Dr. Lisa Radosta:
I want to lose behavioral euthanasia, and I want to just say euthanasia. Because the last time I checked we didn’t say kidney failure euthanasia, brain tumor euthanasia. No, we just say that patient was euthanized, right? So euthanasia is euthanasia. It’s a choice to end suffering. And I think by taking the tag of behavioral off, we can start to open our minds to the suffering of animals with behavioral problems, and we can begin to put it into the same bucket as all the other ways that animals suffer.
Dr. Andy Roark:
I like that a lot. You’re already framing this up really nicely. Let’s go ahead and start to unpack. When you start to look at cases that come to you and people say, “I have a Belgian Malinois and it scares me.” Or, “It scares my spouse. And we’ve had some incidents. It bit one of the neighbors.” How do you start to look at those? Because, obviously, as a behaviorist, you have tools in your tool belt where you can work with this pet. And oftentimes, I think that we immediately want to fix the problem. How do you start with that? So when you’re looking at the beginning of these cases and you know that euthanasia might be required if we can’t make headway here, how do you start to set those cases up? How do you set expectations, things like that?
Dr. Lisa Radosta:
Yeah. The first thing is I recognize that behavior is different, whether it’s at specialty practice, where I am, or in primary care. So when a pet parent comes to you and her older cat is urinating everywhere, she doesn’t come to you with all of the advice from all of her neighbors to euthanize her pet. The advice, “Then go to your vet.” “Well, my cat had hypothyroid.” “My cat had kidney…” “My cat.” Right? But when the dog bites someone, the advice starts coming in, “You need to euthanize.” “I would never live with that dog.” “That dog’s going to bite your kid.” So all that advice feels really different. It’s terminal advice.
And so she comes, he or she, they come to our office with a lot of emotions. And the first thing I do is let them talk. Then I express empathy and I normalize what they’re feeling. You know what? Because they say things like, “And I’m scared.” And I say things like, “And if you weren’t scared, I think you were really weird. You should be scared. Your dog’s 90 pounds.” And I saw this case about a month ago, and he had bitten through both ladies’ hands.
Dr. Andy Roark:
Oh gosh.
Dr. Lisa Radosta:
Bit both her hands. She’s a graphic designer, can’t use her hands. And I said, “You should be scared.” At that point, you can see stress starts to dissipate. They’re like, “You get it.” I’m like, “Of course I get it. Of course, yes, you’re normal. You’re afraid of your dog.” And then I also normalize, “But you still love him.” They’re like, “We do.” Normalize what they feel, because that doesn’t feel right. Why would someone that loves me hurt me? Right? Okay, but that’s not what they think when their dog has lymphoma. Right? They don’t take it personal. Okay So first we normalize, we express empathy.
Number two, now we get into the ethics of who are we as veterinary healthcare team professionals. So ever since I euthanized my first own pet, my first pet as an adult that I had to decide to euthanize, I knew in my heart that no one could make that decision for me. So I was in vet school, in my junior year of vet school. So from that, I’ve created this 23 years of veterinary practice. I refuse to tell someone when it’s time because I feel for me. No judgment of any other vet. For me, it feels disrespectful because that’s not my family member, yet I am making a final decision. So I don’t generally… Nothing’s a hundred percent. I don’t generally bring this up. Clients start to bring it up. They start to say, “My friend said that I should euthanize him. I’m going to be sued,” or, “I should put him to sleep,” or across the rainbow bridge, we’re going to call it.
Then that gives me a chance to say, “Okay, let’s talk about options. What do we have on the table?” So for this case that I saw, single lady, two dogs, one was aggressive, one is just a regular Joe. Aggressive dog is biting her, is biting visitors. You can’t make this up, is biting the other dog. It gets worse. She lives in a one bedroom apartment by herself. No significant other that even comes to stay with her. So I say, “Okay.” She’s opened up the door, “I don’t know what to do, she’s crying. I don’t know what to do, I’m sad. I’m bored, I need her.” I say, “Okay, well, let’s just talk. What can we do right now?”
So here’s what I know. So I’ve already done a physical. I already know this dog is also sick. That’s another checkbox, right? And I say, “Okay, well, here’s the thing. What I need you to do to be safe is you’re going to live for about the next four to six weeks in protected contact, like at the zoo. He’s going to be behind a baby gate, separated from your other dog and you.” She was able to leash and muzzle pretty reliably. He muzzled up and they will leash him. “You’re going to muzzle him, you’re going to leash him.” She doesn’t have a yard. “You’re going to walk him in the back, he’s going to go to the bathroom, he’s going to come inside. I’m going to prescribe medications that are going to relieve his stress and make this easier on you. I’m going to give you ways that you can get him in and out safely. We’re going to wait for our meds to work. We’re going to set you up in the trainer. And then we’re going to slowly add back in the skills he needs to live with you safely.”
He may never be able to meet visitors. I’m not even going there yet. That’s an option. Re-homing is not an option. This dog doesn’t have a breeder. There’s no place for this dog to go. I make it real clear, this dog can’t go to a shelter. Sanctuaries are unicorns and there’s a lot of ethical concerns around certain sanctuaries depending. Right? So I explain that to them. And then we talk about humane euthanasia. And I say, “Your dog’s suffering. There’s no doubt your dog’s suffering. Let’s just forget it’s a dog and look at what your dog does. And now it’s your best girlfriend. If I’m out with my best girlfriend and we’re drinking martinis as we do, and she tells me that she hits her partner, she hits her mom. Anytime a visitor comes in her house, she tries to stab him with a knife. She cries all the time because she’s upset. She’s suffering. She’s suffering.” So we talk about the suffering that occurs when you have emotional disease, and we try to kind of broach it in that way.
Dr. Andy Roark:
Yeah, I really love that.
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Dr. Andy Roark:
I was was going to ask you about managing guilt on the part of the pet owner, and I think you really kind of already answered that question in a lot of ways. Because it’s such an emotional decision for them. But I really love this idea of you can take the guilt away if you can get them to buy into the idea that their pet is suffering. I really like that.
Dr. Lisa Radosta:
Yeah. I tell people it’s normal. Feel guilty, it’s normal. But guilt doesn’t move us forward, it’s the opposite. The more we sit in guilt, the more we are stagnant. And I also tell them, and I did tell this to that particular client, I said, “Oncologists get all the credit.” I’m like, “You’ve given this dog two years he would never have with anyone else.” If an oncologist gets two years out of a job’s lymphoma, they get a big Christmas basket full of cookies and candy, right? Come on, this dog has a disorder he had from puppyhood. You gave him two years with a chronic disorder. Wow. Where’s the wow in that?
And I’m not saying all dogs should be euthanized, my God. Or all cats with behavior problems. That’s not what I’m saying. I’m saying that if we had this dog with a chronic kidney disease and the pet parent couldn’t, physically could not, forget money, could not do the treatment, who’s going to stand in judgment of her? Who’s going to do that? And if you are, then you better be prepared to adopt that dog into your home and do the treatment. So who’s willing to do the treatment on this 90 pound dog? I’m not taking him into my home, that’s for sure. You see what I’m saying?
Dr. Andy Roark:
Yeah. Oh, definitely. Do you think that vet professionals struggle with these cases more or in a different way than pet owners do?
Dr. Lisa Radosta:
I think they do. And I think my heart goes out to shelter workers because they really struggle. I recently had a shelter reach out to me, and I meet with their medical director once a month to consult. And she has a real hard time, because the morale goes down when one of these long-term cases that is good with a couple of people there, but no one else can walk the dog. And she wants to clear space to bring another animal in that she can’t adopt out. And yes, I think that we think of it differently, but it’s only because we’re not really thinking about behavior disorders as systemic disease, which is what they are. Right? We’re thinking about them as somehow in a separate bucket, and it’s just not true.
Dr. Andy Roark:
Yeah. That absolutely makes sense. What mistakes do you think… what do you see most commonly GPs making? Are there pitfalls that we fall into? I know everyone’s trying to do their best, but are there places that you see practitioners who are trying to support pet owners that fumble or they make their lives harder than they have to be as they navigate this already challenging time?
Dr. Lisa Radosta:
Yeah. I think that, first of all, we need to forgive ourselves. There are some days where I have bad days. Where I have days I’m not at my best, and by the end of the day, by the millionth appointment, I’m not as patient as I should be. Right? So we have to first forgive ourselves for whatever mistakes we make. If I back up from that and I say, well, how can we be better? Don’t judge. Clients hear you. You say all these wonderful things, then the client pushes you with that question I wish they would never ask, “What would you do if this was your dog?” And then you know shouldn’t answer, but you’re tired. You’re tired, and you say, “I would not live with this dog.” That’s all they remember.
Then they come to this specialist and they say, “My vet said I should euthanize my dog.” Again, I think your vet said more than that, but okay. Number one, let’s not put ourselves into someone else’s place, except to empathize. Right? And number two, let’s not judge. Because, I’ll give you an example, we’ve all done this in [inaudible]. One of my residents saw this patient. The patient has a dog living in a household with other dog. This dog was tearing the other dogs up. And so she gave the first recommendation, you always give separate dogs for safety while we get this plan in place. The client went home, came back to the next recheck, didn’t separate the dogs, there was another fight. And this happened for about three appointments.
So it was real easy for the vet, for my resident to go, “What’s wrong with this lady? What is wrong with her? She obviously doesn’t care about the dog. Maybe I should report her to animal control. This is animal abuse.” She’s mad, right? So by the fourth appointment, the lady says, “No, my husband has terminal cancer and my husband will not separate these dogs. And I just want you to know that.” Okay, well, God, if we had maybe asked differently or had some empathy in the beginning and said, “Explain to me why you don’t feel comfortable separating, because I know that you know it’s safest. So what is happening?” And then I usually say, “You don’t have to tell me if you don’t want to. But if you do, sometimes it can be helpful.” So it’s hard when you’re tired to find that space to do that. But let’s not judge and let’s not put ourselves in a space where we’re making a decision for someone.
Dr. Andy Roark:
I just had a case last week with this cat that came in. And it’s a four-year-old cat, and it’s gained two pounds in six months. It’s a 10 pound cat now. It’s eight pound cat, and now it’s 10 and change. And I saw this chart and I’m like, “What in the world are they doing with this poor cat?” And so I go in to kind of give them a hard time about the fact that they’re letting this cat gain weight and do these things. And very quickly, it is a wonderful lady, and she was like, “Oh no, this is my dad’s cat and he loves this cat and he has dementia. And whenever the cat yells, he gives her treats, and then he forgets that he’s given her treats.” And we kind of had a good-hearted chuckle at like, “Oh, she’s got him trained.”
But again, when you understand the context of what’s going on, it doesn’t change the fact that, and I don’t want this cat to continue to gain 25% of her body weight every time I see her, but I also understand where this person’s coming from and I can be kinder, I can be better. And so anyway, I love that. Dr. Radosta, you are amazing. I so appreciate your time and you being here. You do so many things, you have written so many books, you present all over the place. Where can people find you online? Where can they learn more?
Dr. Lisa Radosta:
So they can go to drlisaradosta.com. They can go to Instagram or Facebook at Dr. Lisa Radosta. As a veterinary healthcare professional, you might like what we put on LinkedIn. And then we have our website, which is flvetbehavior.com. And the reason I bring up our website, even if you live across the world, is that we have handouts and videos that are meant for pet parents. So if you don’t know what to say, that might be on our website. You can send the pet parent there or to our YouTube channel and you’ll get what you need.
Dr. Andy Roark:
That’s so awesome. I love the stuff that you put out for pet owners as well. It’s always great to have good resources to send people to. Because you know that they’re going to search online, and so you could just to be able to point them in a good, supportive way. That’s awesome. Thank you so much for being here. Guys, thanks for tuning in. Take care of yourselves, everybody.
And that is it, guys. That’s what we got for you. I hope you enjoyed it. I hope you got something out of the episode. Thanks so much to Dr. Lisa Radosta for being here. Thanks to you for being here and listening. Yeah, if you like the podcast, do me a favor, leave me an honest review wherever get your podcast. It means the world to me. Anyway, that’s all I got. Gang, take care of yourselves. Be well. I’ll talk to you soon. Bye.
