Euthanasia

We all know that there are people who don’t enjoy the holidays.  But did you know that veterinary staff members often dread the holiday season? Why? Well, there’s an odd phenomenon that starts anywhere between Halloween and Thanksgiving and sometimes drags on through March or April – the euthanasia explosion.

There are lots of reasons why there is an increase in pet euthanasia during the holiday season. It’s colder (except here in Florida for some reason), so pets with arthritis or who are very thin are often worse when the temperature drops. There is the stress of changes to the home – decorations, work schedules, visitors.

Pets can be exposed to toxins and foreign bodies that aren’t usually in their environment. Their owners are often very stressed, even if they love the holidays. Stress can cause a flare up of old disease or bring on new diseases in both pets and people. Finances are also pretty tight for many during this festive, gift-laden season. Pet owners sometimes try to wait on veterinary care until after all the chaos (and expense) is over.

Whatever the reason, veterinary teams are performing euthanasia at a much higher rate than usual. Patients we have loved and sometimes known their entire lives are passing. While we band together to provide a peaceful end for our beloved patients and their families, inside we are feeling the weight of grief. For while nothing compares to the loss of your own pet, helping multiple families through this process takes a toll. Compassion fatigue (secondary trauma from helping sick and injured patients and their families) can bring veterinary professionals down, especially when they are trying to navigate their own holiday stresses.

I have some advice for both pet parents and veterinary teams during this time.

Be kind – both halves of a pet’s team of caretakers are under pressure. We all need to remember patience and empathy. Everyone has the same goal: to help the pet. Today I was touched when I thanked a client for her patience because I ran late after performing a euthanasia. She told me she was grateful her pet wasn’t in that position and was happy to sit tight while I helped a grieving family. I didn’t have to apologize for being late, and she didn’t have to give me a gracious response. But because both things happened, we were able to find common ground and help her cat with no conflict standing in our way.

Consider in-home euthanasia – veterinary teams and clients should check and see if anyone offers in-home services in their area. I urge all pet owners to consider having their pets pass at home. It is much less stressful for most pets and clients to not travel to a busy veterinary hospital. So many clients have no idea that house call euthanasia services exist. At the time of a pet’s passing, having options is important. I get referrals from veterinarians all the time, and their clients are grateful that they had the option, even if they don’t take it. To find a list of providers in your area, visit inhomepeteuthanasia.com

Plan ahead – a planned euthanasia is the exception to the rule. Most clients call me the day they need me. We should be staying in close touch with each other when your pet is very ill. We should be talking about the possibility of euthanasia any time there is a serious or chronic illness. The more communication we have, the better off everyone will be. Clients get the support they need and we have a better chance of preventing suffering. If you know a client has a pet that is stressed in the office, consider prescribing some gabapentin, trazodone or other good anti-anxiety drug (NOT ACEPROMAZINE) to use before euthanasia. That way, whether the client comes to you or elects home euthanasia, they can do something to help their pet be less fearful. Leave a little room in the schedule for the inevitable last-minute euthanasia appointment so the team can provide a good passing.

Treat for pain – recognizing pain in pets can be difficult. If your veterinarian says your pet is in pain, please believe them and give their pain medication as directed. Here is some information on pain for pet owners: //ivapm.org/for-the-public/animals-and-pain-articles/ Veterinary teams – please use a multimodal approach to pain control. And please, please, please put down the tramadol. It has been shown to be a poor pain medication for dogs. It does make them sleepy, which can look like pain control. The IVAPM can help you find a better pain control plan. I talk to at least 3 owners a week whose pets are painful and have no pain medications or tramadol is their only medication. We can do better.

“Watch and see” is a gamble. Trying to limp along a pet’s illness until January can have dire consequences. We may be unable to treat or it may be far more expensive to treat once the disease process has progressed. If your pet is having problems, at least contact your veterinarian for advice rather than hope things don’t become critical. Remember that it is against the law for veterinarians to prescribe drugs for a pet they’ve never seen or haven’t seen in a long time. Be sure to keep your pet up-to-date on exams. Vet teams – take the time to figure out how to keep pets as comfortable as possible if their owners can’t or won’t bring them in.

Remember that a pet’s “team” consists of owners and vet professionals working together. We aren’t at war with each other. When it comes to end-of-life care, all of us need to be extra sensitive and try to keep our strong feelings from making us say or do something we’ll regret.

Don’t forget to practice good self-care. None of us can take good care of others if we are not taking good care of ourselves. If you are having trouble, please seek help. www.APLB.org can help with pet loss support before and after a loss. Vet teams, visit this site. Best wishes and many thanks to everyone caring for pets this holiday season.

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.

Ask any veterinarian when they euthanize the most pets, and they will tell you “during the Winter holidays.”  In fact, Lap of Love Veterinary Hospice, the nation’s largest provider of in-home end of life care for pets, will see an increase of 20-50% in home visits for euthanasia or hospice care the weeks following both Thanksgiving and Christmas.  You may not imagine there being a season for this, but there is, for a few reasons:

1. “I just want one more Christmas with him.”

Holidays are a time for family to come together, and pets are sometimes more appreciated than that one uncle that always complains about the food! Kids spend hours playing with the dogs, cats, or other companion animals, and we watch these furry sidekicks age with them over the years.  As a child, I remember being just as excited to see Sandy, my Grandparents’ terrier, once a year as I did the human family members! As Sandy got older, I wanted her to be a part of one last holiday with us, she was such an important presence to me at their house.

Hospice care is hugely valuable at this time. Families know their elderly pet is reaching the end of their life, and they want to spend just one more holiday together.  Hospice allows that to happen; we help their pet remain as comfortable as possible for as long as possible, coaching the family through the euthanasia decision based on the medical condition of the pet and the family’s wishes.

2. “My family will finally be able to say goodbye together.”

Children come home from college, relatives come to visit, family and friends are finally together. For some pets, especially those outgoing elderly Golden Retrievers or Labradors, this is pure heaven!  Having family gathered around, sharing memories of a life well-lived may be the best “goodbye” any of us can imagine.  And for some lucky pets, this is how they make their exit from their failing bodies.

Some of the most peaceful experiences I’ve had with families include everyone gathered around, sharing stories, giving a toast to their pet, followed by the delivery of that final euthanasia medication. Then everyone hugs each other, and I leave the home knowing their support system will get them through the grief of loss,  and it’s simply beautiful.

3.“Wow, he looks way worse than the last time I saw him.”

Another interesting phenomenon happens when long distance family and friends see an elderly pet for the first time after an extended absence. They may be happy to see the aging furry family member, but at some point make the comment, “wow, he looks way worse than the last time I saw him.”  This might be met with guilt or surprise by the primary care taker, who sees the pet everyday.  This realization sometimes brings to light the rapid decline of the pet, and the decision to say goodbye becomes easier and more supported than it had been previously.

4. “I’m so worried about her being alone while we’re gone.”

This is a valid, and surprisingly common concern for pet parents during holiday travel.  With an extended absence away from a senior or geriatric pet, owners may feel guilty or stressed about asking someone, even a close friend, to watch him/her.  In some cases, they may even be considering saying a final goodbye before they leave town simply because the stress is too much on their elderly pet, and/or an immense burden on a caregiver.  No, this is not a selfish decision, and sometimes this holiday time away from home is a safe, supported environment to grieve with family and friends.

Losing an elderly pet is never easy, especially during the holiday season.  There are always numerous factors affecting a pet’s quality of life, and also the pet parent’s quality of life. These are all valid concerns and must be weighed within the boundaries of the disease process that the pet is experiencing; some diseases can be extended with hospice care, some cannot.  Talk to your clients about their options, fears, and concerns.  There is also a great deal of information including video tips and quality of life scales, on my website, LapofLove.com.

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 Dani McVety is co-founder of Lap of Love Veterinary Hospice, the nations largest network of veterinarians dedicated solely to end-of-life care. She is also a certified body language instructor and frequently writes and speaks on related topics empowering listeners to provide the highest standards of care and communication. Dr. McVety and Lap of Love have been featured on numerous local, national, and professional media outlets including The New York Times, CNN, The Doctors Show, and many more.

The worst feeling in the world is euthanizing a patient. It is heartbreaking to listen to the owner cry. It is hard to watch the tears fall and see them at their most vulnerable. Before they walk out the door after saying good bye to their best friend, I have had many owners say to me, “This must be the worst part of your job. I don’t know how you do it.”

 

To be honest, it truly is the most difficult part of my job, and it has taken me many years to make peace with how I handle euthanasia. I came to the conclusion a few years ago that I wouldn’t just be the technician assisting the veterinarian for euthanasia. I was going to embrace it. I was going to give 100% of myself to keep the patient as comfortable as possible. I was also going to allow myself to be open, vulnerable and genuine with a client. I am sure that those sound like simple things. But truly embracing euthanasia is anything but simple.

 

It starts with the patient. When a pet comes in to be euthanized, I think about how this is their last moments on this earth. They shouldn’t be scared, anxious or stressed.  I am a huge advocate for sedation for euthanasia. I discuss giving a sedative with the owner and allow them the ability to choose if they feel their pet needs it. Very rarely will an owner decline sedation. I explain how it allows the pet to be calm, less anxious. This is a stressful time for the pet and the owner. I also explain seeing their pet relaxed, may help the owners feel more relaxed in the situation.  I also try my best to provide warm blankets, lots of pets and definitely lots of treats for the pet.

 

This ends with the owner and how they perceive their experience.  Some owners have had previous traumatic experiences with euthanasias.

 

Some owners haven’t experienced having to put a pet to sleep.  The most important thing I can do is make sure that this is a smooth, peaceful and comforting event for them. I will talk with them about what consists of.  I explain that their pet will peacefully fall asleep. I will answer any questions they may have.  I provide them with as much time as they would like to spend with their pet before we proceed. I also will listen to any stories and help them navigate any guilt that they are feeling. I will provide an endless supply of tissues.  I will put my hand on their shoulder or give a hug if needed. I will walk them out to their car and tell them to “Take care.”  I will do this all holding back tears, although sometimes they will fall.

 

Euthanasia is the ugliest part of our job. But we can make it a beautiful thing by being present, supportive, open and vulnerable for our clients. We can give them the peace of knowing they made a necessary choice. Not every client will remember their first puppy visit at a clinic. But all of them will remember having to put their pet to sleep. It will be burned into their memory. Do your best to make it as smooth of a transition as possible.  So to truly embrace euthanasia, you have to always give everything you have to give emotionally to your patients and clients.

 

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

Jade is a licensed technician of 9 years who lives in Port Orchard, Washington. She enjoys emergency and critical cases, dentistry and creating a bond with her clients and team. During her off time she is busy keeping up with her two crazy Basenjis!

An article caught my eye the other day. It told the story of a vet, Jian Zhicheng, who worked at an animal shelter in Taiwan. She had euthanized 700 animals in two years – many of whom were healthy and perfectly adoptable. The fact was there was no space to keep them and no one to want them. She worked hard to promote adoption over buying. But animal rights activists threatened her and called her a butcher.

She took her own life. Distraught by the overwhelming burden of euthanizing animals who have nowhere else to go and being labeled nothing short of a killer by her fellow humans, she injected herself with euthanasia drugs from the shelter.

This story hit me hard. Anger swelled inside me: this woman’s life has needlessly ended. She took on the weight of other people’s criticism, the weight of solving a problem that came to feel insurmountable.  The problem that Jian Zhicheng faced is one that many, many shelters in our own country face daily. Too many animals, not enough homes.

Having worked in animal shelters, I have heard no end of criticism of the “kill shelter.” I have seen the distrustful glint in the eyes of the public and even volunteers. I guarantee that if you’re an average member of the public, you hear the words ‘kill shelter’ and a shiver runs down your spine. You automatically think of a horrible place filled with horrible people that murder animals rather than try to find them a home.

Let’s break it down, okay?

Kill shelters are in truth open admission shelters. An open admission shelter is required to take in whatever animal crosses its doorstep. Let’s say they have space for 100 dogs and 100 cats.  On Monday, they start out the week with 80 dogs and 80 cats. Someone comes in to surrender their 13-year-old golden retriever that has lived with them forever. They’re moving and can’t be burdened by an arthritic dog with a weak bladder any more. Right behind the golden comes a mama dog with a litter of 6 puppies. Twenty minutes later, two dogs that were adopted on Saturday have been brought back because they peed inside the house. Three cats come in – all from the same place – their owner died and the daughter wants nothing to do with litter boxes. Two 1-year-old labs are dropped off – baby on the way so no more time for high-energy dogs.  A litter of kittens come in with their mama, still nursing. Five minutes later, another litter of kittens come in but there’s no mama – and they’re only four weeks old. So, we’re up to 86 dog kennels needed (the pups stay with mama in one kennel) and 84 cat kennels (the motherless kittens have been frantically placed with the last available kitten foster). Whew. Still space, right?

Then the animal control officers come in. Officer One has brought in  7 cats – three from traps and four abandoned – and 4 dogs, all without collars, tags or microchips. Officer Two has brought in 3 more dogs who were reported for chasing chickens. Officer Three has been very busy – 2 abandoned kittens, 3 cats roaming at large and 9 stray dogs nosing through the trash at the landfill. That brings our grand total up to 102 dogs (plus the puppies with their mama) and 96 cats. Two dogs more than the shelter can hold. A rolling cage is wheeled into the laundry room to hold one of the dogs – a chihuahua shaking with fear. A staff member takes home the elderly golden retriever to administer meds and free up a kennel.

It’s only Monday. And the shelter has room for 4 more cats and no more dogs. And yet Tuesday will come with more dogs and more cats. Followed by Wednesday with more dogs and more cats and a couple of parakeets.

Potential adopters stroll up and down the aisles, peering into kennels. The mutt with a gentle soul and good manners is given barely a glance as one couple shakes their heads and leave, complaining that there were no yorkies. or pomeranians. or westies.

A young woman brings her son to see the animals, only to turn right around and leave when she finds out it’s a ‘kill shelter.’ She pauses just long enough to look over her shoulder in disgust at the front desk workers, her gaze saying,”How can you be so cruel?”

Another potential adopter wants a dog who is housebroken and already knows commands for sit, stay, lay down, shake, roll over, play dead. Yet another wants a puppy and the puppy must be fluffy. The little pittie-hound mix pups are totally ignored.

In the background, a shelter worker crosses her fingers that her favorite, a 10-year-old border collie with a heart murmur, weak hips and the sweetest disposition will finally find a home. She’s been here a long time – longer than she has any right to be.

Thursday comes. Adoptions were good this week but with so many owner surrenders and strays, the shelter is at capacity – technically over if you count the three rolling cages stuffed into the back hallway to hold the three little dogs who did not get along with their family’s new puppy.

It is euthanasia day.

Who gets to live and who will die?

And who are the people behind that grim decision?

They are the ones who everyday open their hearts to the sure prospect of hope mingled with a bitter disappointment. They are the ones who look past the mange, the stinky ears, the overgrown nails, the tangled hair to see animals who were created with intention by God. They see the souls – the sometimes gentle, sometimes fearful question in the eyes of those animals: is it going to be better now?

As they bathe 6-week-old puppies, frail from blood loss because they have been covered in so many fleas, these shelter workers vow silently to show these creatures that yes, it is going to be better now. When officers bring in an emaciated dog, abandoned inside a kennel for weeks – they passionately swear that yes, it is going to be better now. When a recently adopted dog is picked up as a stray and the ‘owner’ says to just keep him, the worker who did the adoption kneels down in front of those questioning eyes and promises, it will be better.

And when it isn’t – when no one chooses them, when the shelter runs out of space – their hearts break completely. And these workers go home and smile for their families and try to bury the guilt they feel that they were not able to help that one. and that one. and that one.

The ugly truth of the animal shelter isn’t the workers pulling up the syringe of pentobarbital. It isn’t the shelter director who is agonizing in his office about the high intake and low adoption rate as he brainstorms new ways to attract potential adopters.

It’s you.

The person who thinks it’s fine for their intact male dog to roam the neighborhood, spawning litter after litter of unwanted puppies. Puppies that end up at the shelter for someone else to deal with.

The person who thinks they’ll make big bucks by backyard breeding … until the inbreeding starts creating puppies with deformities … puppies no one wants. Puppies that end up at the shelter for someone else to deal with.

The person who spends $500 on the puppy for sale in the back of the truck at Wal-mart, encouraging that backyard breeder to keep right on breeding, never knowing the mama lives a mostly neglected life in a filthy cage outside until she becomes so covered in mammary tumors that she ends up at the shelter for someone else to deal with.

The person who takes that puppy home and loses interest once the puppy reaches 7 months old and starts digging or chewing or barking – time to drop her off at the shelter for someone else to deal with.

The person who decides they’d like to travel more and it’s time to dump their senior dog, the one with lumps and sores, at the shelter for someone else to deal with.

The hunter who abandons the gun-shy dog on a back road, driving away in a cloud of dust, leaving him for someone else to deal with.

The nice middle-class family who refuses to get their dog spayed and complains when a wandering intact male leaves her with a litter of unwanted puppies. Puppies that end up at the shelter for someone else to deal with.

The person who hides behind a computer screen and leaves nasty messages, calling the shelter employees cruel, cold, unfeeling … all while petting the dog they purchased from a pet shop – shelter mutts are for someone else to deal with.

The person who complains that too much of their tax money has gone to the shelter – how could they possibly want to increase their budget for things like spay & neuter clinics or humane education or microchipping? That should be left for someone else to deal with.

The person who complains about the massive and daunting problem of animal welfare in this country … without offering any solution or any help. That’s for someone else to deal with.

For someone else to deal with.

The ugly truth is that so many people want to pass off their responsibility to someone else, anyone else. That’s why animal shelters exist. The emotional burden of what happens to those unwanted animals is passed off too – to sit squarely on the shoulders of the shelter workers and the volunteers and the rescues trying their damnedest to make a difference, to save lives.

The ugly truth is there is no easy answer. The real answer is simple but it is so hard because it requires persistence and endurance – there is no instant gratification. The only answer is spay and neuter. Pet overpopulation is an overwhelming problem and the only way to solve it is by reducing the population. Right now, society’s answer has been to reduce the population on the back end – i.e. killing. According to the Humane Society of the United States, 2.4 million adoptable cats and dogs are euthanized every year – that’s an animal every 13 seconds. The ASPCA reports a higher estimate of 2.7 million euthanized animals per year.

That’s madness, isn’t it?

Let’s change that.

Spay and neuter your pets – there’s no excuse for Rex to be accidentally spreading unknown litters around the neighborhood.

Adopt, don’t shop – shelter pets have every bit as much love to give as one from a breeder.

If you must buy, do your due diligence and fully inspect the premises of the breeder. See where mama lives full-time, not just when buyers come by. Ask about mama’s vet care. Ask for references.

Accept responsibility for the animal that you brought into your family. Dogs and cats don’t speak our language – they have to learn what we ask of them and that requires patience and consistency from you. They want to love you and that requires attention from you. They will get sick, they will get hurt, they may be inconvenient to care for – but that’s what you signed up for when you picked out the puppy with the waggly tail and the kitten with the fluffball fur.

If you do none of these things, then do this at least – look closely at those shelter workers and think – THINK- about the pain they willingly take on every day because someone else chose not to hold up their end of the bargain. And swallow the criticism that can float so easily to the surface. They are in the trenches – and what’s more, they repeatedly choose to be there because if not them, then who?

And that is the thought of every committed person involved in animal sheltering – if not me, then who?

 

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

Heather Hunt is a writer based out of Corvallis, Oregon. Having worked for open-admission shelters on both coasts, she has seen the nitty gritty of the animal sheltering community – both the good and the bad but mostly the good. She is a proud foster failure, sharing her home with five rescue hounds (and her patient husband). You can read more of her writing atwww.thesimplelens.com.

When people hear I’m a veterinarian, they usually say, “Oh, I love animals. I would love to do that. But I could never put them to sleep.” In truth, I never had any real trouble performing euthanasia during my first years as a vet. It was always sad, but so often necessary and generally so peaceful. I cried sometimes, and took some home with me briefly at night, but from the beginning I was able to disconnect enough from the task that thoughts rarely lingered.

One night a few years ago, I dreamed I was being euthanized.

It was the most terrifying experience I’ve ever had in a dream. It was vividly real. I remember calmly watching as a butterfly catheter delivered me to blackness. There was no noise. I knew a moment of panic and suffocation. Then I woke.

Since then I’ve felt the keen edge of our awesome responsibility – to usher a life out of existence, to extinguish a light that was burning, no matter how faintly, of its own volition. I feel immense gratitude that as far as I can tell, my patients don’t see it coming, and don’t know to fight it.

Some euthanasia is black and white: suffering must be eliminated, illness is incurable, quality of life is below any reasonable standard. Others are gray. No obvious suffering, but professed inconvenience; family does not comply with care instructions; or there hovers the ever-present servant of death: lack of funds. Both the black and the gray are more difficult for me now, and I bear the weight of them at night and in the automatic way I draw up sedation, the conversations I have with owners before and after, the dwindling volume of pink solution in each bottle, and the sad bundle I can’t bear to see linger on a treatment table waiting for its paw print.

I often assume all vets are like me – always acutely aware of the immense power we carry in being able to stop a heart. Then I remember that I personally spent very little time with this idea during the first years after graduation. I was far more concerned with how to keep animals alive than with how to let them go, and all they carried with them when they went.

Of course, nurturing life and maintaining health is a much larger part of what I do every day. But I believe I underestimated, with baby vet naïveté, how much the lives we end can, and should, affect how we practice and how we feel at work. I will always view euthanasia as a gift we can give.

It’s never been a responsibility I did not want. The difference is that now, with names stacking up in a drug log, the perspective that can only come with experience, and the memory of how helplessly I waited for oblivion in my own unsettling dream, when the time comes I am always breathless, never nonchalant.  When we walk down the hall, syringes in hand, papers signed, a pale horse walks with us, and demands respect.

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. Katie Berlin is a small animal general practitioner in Mechanicsburg, PA. She is also a reader, a rider, a runner, a lifter, a teacher, and an art lover. She graduated from Williams College in 2000 with a degree in Art History and worked in art museums before going back to school and earning her DVM from Cornell in 2009. She is an avid supporter of Fear Free practice and the battle against compassion fatigue in the veterinary profession.