DrAndyRoark.com

Articles, Videos, & Training on Pets & Veterinary Medicine

Euthanasia

Essentials – Canine Euthanasia (HDYTT)

by

Dr. Andy Roark and Dr. Amanda Doran review canine euthanasia. This is an excellent episode for anyone on the healthcare team and we hope it will be a great refresher and conversation starter for veterinary teams.

The views and opinions expressed in this article are those of the author and do not necessarily reflect the position of the DrAndyRoark.com editorial team.

ABOUT OUR GUEST:

Amanda Doran, DVM

Dr. Amanda Doran is a practicing certified hospice and palliative care veterinarian (CHPV) in Duluth, MN. She has worked in the veterinary field for nearly 20 years and held every position from kennel assistant to veterinarian. Dr. Doran’s articles have been featured on DrAndyRoark.com, and she has been a guest on Dr. Roark’s Cone of Shame podcast. Dr. Doran’s medical interests center on end of life care, animal welfare, effective client communication, personal resilience for veterinary professionals, and the human-animal bond. She shares her home with her partner in crime, 2 goofy husky shepherds and a crabby old peach tabby. She also slings tarot cards for fun.

Thanks for the Reminder to Feel

by

As vets, we have wins and losses. That’s the job. And amidst challenging clients, long work hours, insurmountable debt, huge caseloads and attempts at work/life balance, it is easy to lose track of why we entered this field. We advocate for the innocent, we heal those who are deeply loved (and in that process, those who love them), and when the time comes, we give them a death with dignity.

Often I don’t feel sad after a euthanasia. I normally feel the burden of responsibility, but not sadness. And that is a choice I actively make; we as veterinarians can’t emotionally survive if we don’t put up those barriers. But that is a dangerous path – barriers become walls, and walls become apathy.

BUT, once in a while, a critter comes along who dulls the sharp edges of those barriers, who reminds us why we choose this career in the first place. A sweet animal who makes us feel not only their loss but the loss of all the other animals we’ve helped to die.

In my case, that critter came in rather… unusual… form.

Andie was a hairless rat, with a kink in her tail. She was presumably found abandoned in a graveyard five months ago. When I carried her around in my scarf under the guise of “monitoring” her (her owner saw riiiiight through that), she surprised and delighted my colleagues. She was so imperfectly perfect. She melted my heart in a way far “cuter” critters have failed to do.

Yesterday, I was the one to give her her last breath. And I feel so, so deeply, painfully sad about that; yet I also feel honored that she arrived in my life just in time to give me such a beautiful kick-in-the-shins to remind me to, you know, FEEL once in a while.

Goodbye, sweet Andie, and thanks for the reminder.

The views and opinions expressed in this article are those of the author and do not necessarily reflect the position of the DrAndyRoark.com editorial team.

ABOUT THE AUTHOR

Carrie Daly is a 2009 graduate of the University of Minnesota and a transient ER veterinarian – having practiced in Hong Kong, Minnesota, Oregon, and soon Colorado. She is a mom to 4-year-old twins and a 3-year-old son, and thus considers herself to be both a manager and purveyor of chaos. She enjoys international travel, unsuccessful attempts at meditation, running trail ultramarathons, writing on her Facebook blog (The Five Mayhems), and above all else – napping.

The Things We Say at the End

by

As a small animal house-call vet, about 20 percent of my practice is hospice or euthanasia care. I’ve seen quite a variety of reactions of people to their pet’s passing and I’m always struck when people apologize for their emotions, or things they say to their pet at the end. As a lifetime pet owner and a vet for twenty years, I understand grief very well, and no one owes me any apology for expressing feelings for their loss.

When our animal friends come to the end of their lives, we almost always have something to say to them. We remember their first day with us, the day we found them, cold and shivering and hungry, the day we picked them out from the shelter, the barn, the breeder or the person who couldn’t keep them, For some, they remember the day they were born in their home. We remind them of the day we knew they would stay with us their whole lives and we whisper, “I knew then I had to keep you.”

We retell to them the memories, all the joy they gave us. We remind them of the trips to the lake, the ocean, the woods, the hours of happy mornings we spent snuggling in bed, happy evenings spent sharing bites of pizza or apples and snuggling on the couch. We remind them of naps in the sunshine, splashing in the water, runs in the field, the games they invented that we played along with, a lifetime of silly rituals no one else would understand.

We tell them how much they meant to us, how they kept us whole. “You were there when I was sad. You were there after the accident, when my body was broken. You were there when I was so sick from chemotherapy. You were there when I got divorced. You were there when my wife died. When my brother died. When my child died. You were there when I wanted to die.”

Sometimes, there are no words. There is only sobbing, or screaming, or stony tearless silence. It can take weeks or months, years, a lifetime to say the words we just can’t find at that moment. Sometimes we can write them down later, or say them when we’re alone. Sometimes we can never say them out loud.

Most of our animal friends live a short life compared to ours. We know that in our heads, however our hearts will always struggle with that truth.  But with each ending, whether the words come easily or not, veterinarians, veterinary nurses, and veterinary staff understand that some things need to be said. You don’t ever have to be ashamed or afraid of being judged, because we understand how deep, how precious, how profound your love is for the animals you share your lives with.

Today when one of my clients had to say goodbye, all he said through his tears when he held his companion was “thank you.” I think, in the end, that’s what we really mean to say. Thank you, for everything.

The views and opinions expressed in this article are those of the author and do not necessarily reflect the position of the DrAndyRoark.com editorial team.

ABOUT THE AUTHOR

Dr. Amy Cottrille is currently a house call general practitioner for dogs and cats in Seattle’s suburban Eastside area. Her professional special interests include hospice care and pain management. Dr. Cottrille shares her home with her husband, three children, and a variety of spoiled pets, including regularly fostering kittens for MEOW Cat Rescue. As a Washington native, she enjoys outdoor activities of all sorts.

Why We Should Stop Trying for a Perfect Euthanasia

by

Talking with other veterinarians about hospice is something I do every day. I’m in a Facebook group online called Veterinarian Palliative Medicine, and I can be happy for hours comparing notes and techniques with my colleagues, knowing they will understand my struggles.

Recently we had a heartfelt discussion about getting over the anxiety of providing home euthanasia for clients. We agreed that we all want every single one to go perfectly smoothly for the family and that when the inevitable “difficult” euthanasia happens, it makes us feel horrible. It makes us feel like failures.

The Bar’s Pretty Low

Veterinarians tend to be perfectionists, and we are harder on ourselves than anyone else in our lives. Euthanasia is one of those times when we really have unrealistic expectations. The good news is, most of our clients DO NOT have the same expectations. In fact, many of them have had such terrible euthanasia experiences that “I hope you don’t have to wrestle him to the ground” or “I hope he doesn’t scream” is the very, very low bar they have set for us.

Death isn’t pretty. It isn’t smooth. It’s nothing like the movies. A natural death can be downright terrifying, especially if there is no hospice assistance to lend peace to the transition. So, if God, Mother Nature, and all the Saints and Angels can’t guarantee a peaceful passing, then I’m letting you all off the hook.

Here are the things that most concern your families:

  • Am I making the right decision or selfishly killing my best friend?
  • Is it going to hurt?
  • Will you be giving sedation first?
  • Should my kids be present?
  • Should my pets be present?
  • Can I handle being there?
  • How do I know that I’m only getting my pet’s ashes and not someone else’s?

“How good a phlebotomist are you?” has never come up.

Here’s What a Good Euthanasia Looks Like

Here’s how to make euthanasia as peaceful for your families as possible:

Set expectations – don’t give them every single possible side effect or issue, just the things you’ve seen multiple times or things you suspect might happen due to this particular pet’s disease process. I tell clients up front that I sedate so if I don’t get the vein on the first try, it doesn’t hurt. If they are in a hurry, let them know you will do the best you can, but that if it takes longer, you’ll support them the whole way.

Validate their feelings – it’s OK to cry, it’s ok to be scared, it’s OK to doubt your decision… It’s just OK.

Take the burden off their shoulders – I’m here to take care of you. I’m not here to judge. Cry as much as you want. Tell me what you need. I’ve got you. Hang on tight.

Focus on the pet and help them focus on the pet – give them homework to find something tasty and forbidden to feed their pet on his last day. For what it’s worth, watching a dog eat an entire sheet cake is the BEST. THING. EVER. You can’t help but smile through the tears. As a bonus, they don’t tend to notice the sedative injection when they are horking down a cheeseburger and donuts.

Above all, stay calm. They are looking to you to see if they should be more alarmed and upset than they already are. Keep your voice steady, reassure them, squeeze their hand, and tell them everything’s going to be OK. And then silently tell yourself.  And in case that’s not enough, I’ll tell you too.

The views and opinions expressed in this article are those of the author and do not necessarily reflect the position of the DrAndyRoark.com editorial team.

When Euthanasia is the Best Option

by

Euthanasia… it is a touchy subject. A lot of people don’t like discussing it. It has a stigma to it. People assume that if you are euthanizing an animal you are just giving up on them or that you don’t care anymore.

These are the many reasons why veterinarians see animals for euthanasia that probably should have been put to sleep much sooner. We as humans project our emotions onto these animals and feel like we are letting them down but in return we are actually letting them suffer.

As veterinarians we don’t want animals to suffer but we also need to guide owners towards the best options.

Euthanasia is not cruel. By definition euthanasia means easy death or painless death. We are able to give this gift to suffering animals when their bodies are no longer able to function.  Euthanasia is not giving up either. It is hard to convince owners sometimes that the best option is euthanasia and it’s even harder to convince rescues that euthanasia is the best option.

On a daily or even weekly basis rescues bring in animals that were either found or surrendered to them. These rescues try hard to help every single animal they have under their care.

The hardest part is that volunteers and laypeople typically staff these rescues and when faced with decisions regarding an animal’s health, they don’t always fully comprehend the repercussions of their decisions based on their goal of helping save every animal.

While they focus all of their efforts on one animal they may be missing the bigger picture.

Here are a few examples.

1. A local rescue presents a dog with a fractured rear leg, severe arthritis, emaciated, and heartworm positive. The dog is 14 years old and is also intact. The rescue wants to do everything to save this dog. The fractured leg will need surgical repair. The dog will need to be neutered as well. Because of the heartworm disease, surgery is going to be complicated because the animal is already showing signs of heart failure.

If the dog makes it through those surgeries and heartworm treatment it now has to be on chronic NSAIDs for severe arthritis and pain. These treatments, even with discounts for the rescue, can range anywhere between 3500-6000 dollars depending on area. The rescue wants to pursue treatment because they don’t want this animal to die.

Because of the cost of treatments it bleeds the rescue fund almost dry and while this animal is getting help there are now several other animals that are denied rescue help because of lack of funds.

2. A rescue takes in an owner surrendered dog that has a history of aggression. The dog has been to several behaviorists, trainers, and households. It is currently on behavioral medications but still managed to become aggressive and attack the prior owners son and killed their cat.

The rescue doesn’t want this dog to suffer so they take it in and want to find it a “good” home. After several failed attempts they decide they are just going to have the foster family keep it as an outside dog since it seems “happy” tied to a kennel and won’t have to be euthanized.

3. A rescue brings in a litter of kittens to evaluate. The mom cat died unexpectedly and the kittens don’t seem to be doing well. The kittens are 8 weeks of age but are covered in fleas, are half the weight they should be, and all have enlarged abdomens.

On further inspection the enlarged abdomens are caused by a yellow-tinged fluid, which usually indicates FIP (a non-curable disease). The rescue wants to save these kittens even though their prognosis is grave.

As owners of pets, we are their legal guardians. We are their advocates. We want them to be happy and healthy. Yet too many times we allow them to suffer because of our misconceptions regarding euthanasia.

As veterinarians we try to guide you to make the best decision for your pet and will always offer euthanasia as a treatment plan, not a way out. Euthanasia isn’t cruel or selfish- it is an option we are able to give our best friends in their time of need.

Emotion plays such a huge role in rescues and it is hard not to get attached to everything that comes in. But in a lot of situations they need to realize that to save many you may have to make that hard decision to euthanize one.

The views and opinions expressed in this article are those of the author and do not necessarily reflect the position of the DrAndyRoark.com editorial team.

Why I Support Pet Owners Who Drop Their Pets Off for Euthanasia

by

If there’s one thing I’ve learned being in hospice practice it’s that every grief journey is different. That’s why it pains me when I hear people pass judgment on a person who can’t or won’t stay with their pet during euthanasia.

Of course, we’d love all pets to pass in the arms of the one they love best, but sometimes that’s just not possible. Before we cast stones from our glasshouses, let’s consider WHY someone might not stay with their pet.

Years ago, I had a lovely family present me with a tiny Calico cat named Little Jeannie. She was 5 years old and six pounds of feisty adorableness. Jeannie hadn’t been feeling well, so she wasn’t her usual self.  We ran labs, all of which were normal. Because she was vomiting and not eating, I hospitalized her.

Nothing I did helped. I watched helplessly as this young, sweet cat deteriorated before my eyes. In a matter of 36 hours, she went from very sick to dying despite treatment.

I talked seriously with the owners about taking her to a specialist all the while knowing that it was very unlikely they could help. I was pretty sure she had Feline Infectious Peritonitis, one of the worst diseases in veterinary medicine. It’s a virus with no cure. The owners and their children were devastated. They elected to euthanize her.

I asked if they wanted to be present and was surprised when they said no. They had done absolutely everything I asked, spent large amounts of money and still I couldn’t save their beloved girl.

They kissed her goodbye (she barely noticed), and left crying their hearts out. I had no doubt of the love these people had for their cat – NONE. They just couldn’t bear to see her leave them. I euthanized her and then broke down, something that rarely happens to me. It was agonizing for me. I can’t even imagine that family’s pain.

We never know what’s going on in a client’s heart, head, or home. That person we judge could have just lost a family member. They could be suffering from depression or feeling suicidal. Maybe they have PTSD. Maybe they are afraid that their anxiety will betray them and they’ll have a panic attack in front of us.

Whatever their reason, it isn’t our place to push, or lay a guilt trip, or sneer. Rather, we can give them the gift of empathy and say, “You don’t have to be here. We will hold her and tell her goodbye for you. We will see her safely to the other side”. Those words could ease their pain. They could save a life. And isn’t that exactly what we are here to do?

A Veterinarian’s Promise

You left your baby with me

I knew you couldn’t stay

I told you I’d be by his side

I promised you I’d say

That mom and dad both loved him

And though they missed goodbye

They held his memory in their hearts

Their love would never die.

Just because you weren’t here

Doesn’t change the fact

That you gave him a gift today,

A final selfless act.

Though my hands held him gently

As he ceased to breathe

Know that YOUR hands gave him to me

For a peaceful way to leave.

-Dr. Cherie Buisson

The views and opinions expressed in this article are those of the author and do not necessarily reflect the position of the DrAndyRoark.com editorial team.