When is the right time to let a suffering pet go? I (Dr. Henri Bianucci) always tell clients that when their pet will not eat on their own and/or are not able to sleep comfortably, they are suffering and it's time.

Pumpkin came into our lives eight years ago, when she was 12. My daughter saw her on a pug rescue website and immediately called. A quick drive to Beaufort followed.

I was at work at the time and returned home to find my wife, daughters and two strange pugs on the couch. Let's just say I was not as happy as they were, but I realized I was partially responsible for the mentality that prevailed in our home, which had led to this, so, of course, my objections were token at best.

Pumpkin was blind due to a corneal disease and her airway was so obstructed by an overlong palate and narrow nasal passages, that she could only walk a few steps without turning blue. I reasoned that we could make her last a year or two comfortable, so I performed surgery on her and this issue resolved.

Pumpkin was a darling soul and, although older, still quite a beautiful little pug.

Though sweet to everyone, she adored my wife. When left alone with me in the summer, Punky led a somewhat muted existence. But upon my wife's return she would shriek with joy, as a testament to her love and adoration.

As the years rolled past, Pumpkin grew old. Two years turned to three, four, five, then eight. Punky was now 20 years old. Her interactions had wound down to the simple act of sitting with us, which, next to eating, was her primary joy in life. Her bathroom habits had become erratic, to say the least.

One night, when the family was out of town, I was asleep in bed with Punky. In the middle of the night, I was partially awakened by her climbing over me; in my semi-sleep state I barely noticed until her third or fourth pass. I realized she was walking in circles around the bed and my head was in the path. I awakened further, noticing an unusual odor and a slight moisture on my cheek, as Pumpkin passed over. I then bolted into full consciousness and horror. Pumpkin had defecated on the opposite side of the bed and proceeded to walk laps through it.

Despite these and similar episodes, we loved Pumpkin and were willing to continue to give her all the care she needed, as long as her life was comfortable.

Things changed slowly, and then all of a sudden. She was anxious and seemed to be in discomfort, but we could not localize the source. At this point, aggressive diagnostics and treatment were not on the table.

Then, for the first time, she could not sleep comfortably. Her breathing was labored, she would not walk, and we knew it was time to let her go.

I took the day off work and took her to Angel Oak Veterinary Clinic on Johns Island. I was putting her to sleep at home, but I wanted an IV catheter in place so there would be no discomfort or restraint.

We sat in bed with her and gave her a sedative. There she was. On her bed, sleeping on my wife's lap, her favorite place in the world. We talked about her, and to her. We assured each other that this was the right thing to do, and the right time to do it. The drugs began to flow and Pumpkin did not resist. She was tired, and ready, and passed quietly and peacefully.

Afterwards, we decided that we would bury her at home, but that we would have to build a wooden box for this. I had no scrap wood and we live pretty far out of town, so I decided to go to a home construction site down the road.

Simon Black was the construction company and I pulled up and asked if they had any scraps I could use. When I told them the reason, their response was touching. "Of course we have wood, but you don't want to spend all that time building this. We could put something together in no time." I thanked them and said that was not necessary, but they insisted.

Twenty minutes later, they presented me with a beautiful cypress and pine box, with a fitted top and handle. What a beautiful place we live in, where workers would take time from their work, to acknowledge the meaning this little dog's passing has in the life of a stranger.

Occasionally, I, too, am faced with the difficult decision as to when to let a pet go, and I gain renewed appreciation of the pain that my clients go through. The simple criteria for suffering that I stated becomes clouded the closer we get to the end.

The truth is that there is no simple formula. We try and assess quality of life, but really, what does that mean?

Punkin never did much more, or enjoy anything better, than sitting with us. As she aged, this did not change much. For someone with an athletic dog that lived an active life, this quality would have seemed low.

I can say that I have never had a client say, in retrospect, "I think we let go too soon." Far more frequently, the concern is that they waited too long.

With this in mind, I knew in my heart that my dog was not comfortable, and there was nothing I could reasonably do to change this. It was time. I remembered a comment a client made to me at the passing of her dog, "There is nothing inhumane about releasing a healthy soul from an unwell body." Indeed, it is the most humane thing you can do.

Dr. Henri Bianucci and Dr. Perry Jameson are with Veterinary Specialty Care LLC. Send questions to petdocs@postandcourier.com or veterinaryspecialtycare.com.