Buzzards Bay Veterinary Associates

BBVA Buzzards Bay Veterinary Associates

230 Main Street * Buzzards Bay, MA 02532 * Tel: 508-759-2521 * Fax: 508-759-6782

Euthanasia: The Final Decision

Euthanasia literally translated means “a good death.” In veterinary medicine, we can offer this option as a means to end suffering at the end of the life of an animal patient. Whether or not a human being has the right to end the life of another sentient being, either human or animal, will likely always remain a controversial subject. There are some people who are morally opposed to euthanasia for their pets. The purpose of this article is to explore some of the common situations where euthanasia is employed, when euthanasia is not indicated, as well as to discuss what to expect if and when you find yourself in a situation where you face the decision to end your pet’s life via euthanasia. Finally, we will explore the grieving process and touch on when to add a new pet to your family.

When is euthanasia appropriate?

This is an extremely difficult question to answer as the ethical and emotional aspects of this question can be challenging to consider. In general, the decision to proceed with euthanasia usually is made when a pet has an end stage disease which cannot be relieved to any extent with medical or surgical treatment. This determination should be made after a thorough physical examination and diagnostic testing. A lifetime of companionship from your pet warrants an investigation into what disease processes may exist in situations where the animal is not doing well. “Old Age” is not a disease. Animals do not die from “Old Age,” but rather from complications of systemic metabolic, glandular, cancerous, or orthopedic diseases.

Chronic diseases may be treatable with supportive home care measures. Sometimes an initial period of hospitalization is needed. Treatable does not necessarily mean curable, but manageable in the sense that medical therapy results in maintaining good quality of life for the patient. Good quality of life means that your pet is comfortable. In some cases of chronic disease, your pet may not have the same activity level as he or she had when healthy. In general, a good quality of life means that your pet is eating, is well hydrated, can ambulate comfortably, is not in severe chronic pain, and is not experiencing respiratory distress, difficulty breathing, or protracted vomiting and diarrhea resulting in dehydration. Euthanasia is appropriate in situations where a period of hospitalization would not result in attaining good quality of life. An example would be an animal with end stage metastatic lung disease (cancer which has spread to the lungs). This animal may be able to be maintained in the hospital on an oxygen cage, but he or she may not be able to survive at home in normal atmospheric conditions. Another example would be an animal with end stage kidney disease, which has not responded to IV fluid therapy and hospitalization to “flush out” the kidneys. This animal could not lead a good quality of life off of the IV fluids. Some kidney patients will respond to this therapy and can go home on special therapies, which can enhance their quality of life. Rarely with a physical examination alone can it be determined that an animal “must be euthanized.” Diagnostic testing is extremely important in order to gain information on an animal’s potential prognosis, as there could be treatment options, which give your pet some additional time with a good quality of life. If you find yourself in a situation where euthanasia is recommended without the benefit of additional testing, you may consider getting a second opinion for your pet.

Occasionally pet owners can prolong their pets suffering by not recognizing a situation where additional treatment is futile. This is where your veterinarian may intervene as an advocate for the animal and encourage you to consider euthanasia. This is a rare occurrence, as most people are willing to consider euthanasia when their hospitalized pet is worsening and does not have any chance of improvement. As animals do not understand what is happening to them, it is unfair to allow them to “pass away at home” or “pass away on their own” in a hospital setting unless they are given the benefit of generous pain control. For pet owners who are morally opposed to euthanasia, administering pain control medications and sedatives while allowing the patient to die on his or her own is a humane option but may be costly and/ or time intensive.

Behavior problems are currently the number one reason for pet euthanasia in this country. There are situations where euthanasia is appropriate for behavior problems, but again, this is reserved for what is considered end stage disease. An example may be separation anxiety which is so severe that an animal has repeatedly caused damage to itself and its surroundings and which has not responded to intensive therapy administered by a board certified animal behaviorist. This situation, although very unfortunate, may take months to years to end in euthanasia. Severe dominance aggression is another situation which may eventually result in euthanasia. Again, this is considered if after repeated attempts at therapy the patient remains extremely dangerous even to its owners or if the pet is too dangerous to attempt treatment. Some animals with behavior problems can be managed if they are kept as only pets, if they attend day care, or if they have the benefit of veterinary care from a board certified veterinary behaviorist. One of the best ways of avoiding this type of situation is to work very hard from day one of getting a puppy or kitten on socialization and obedience training. Puppy classes can make the difference in a happy pet/ owner relationship and one that ends in euthanasia. Also, pets with behavior problems can have underlying physiologic disease.

Some people and their pets are faced with a situation where there is a severe medical problem, which could be treated, but not without great amounts of critical care and expense to an owner. Additionally, there are situations where extreme physical impairment on the part of the pet owner would make treatment impossible. Unfortunately, some pet owners have to choose between treating their pets and making financial ends meet. In these extreme situations where treatment would be possible but not without severe or impossible financial hardship to an owner, euthanasia is a humane option for the patient.

When is euthanasia not appropriate or should be reconsidered?

As a pet owner, legally, your pet is considered your property. It is therefore your right to decide what actions to take with your pet. A veterinarian has the right to refuse a request for services based on ethical grounds. An example of this type of interaction would be what we in veterinary medicine consider “convenience euthanasia.” This is a pet owner who wishes to have their pet euthanized because they are moving, bored with their pet, or can no longer afford its care. Many veterinarians would not agree to perform euthanasia in this situation. Responsible pet ownership means that you commit to care for a pet for the rest of his or her life. This means that when the going gets tough for your animal, that you return the love and companionship by doing as much as you can to allow your pet to have a good quality of life until the end. In extreme situations you may be forced to surrender the care of your pet to another party: It is up to you to find the best home possible if this is the case.

As we discussed above, euthanasia is a viable option for animals that have end stage diseases and no longer have any hope of attaining a good quality of life. This does not mean that if your pet is diagnosed with an end stage disease and still has quality of life that euthanasia is always appropriate. Ending the life of your pet while he or she still feels good, eats well, and gets around well just because you do not want to “see him or her suffer” could be considered a selfish choice. A more generous decision is to commit to help your pet with reasonable supportive care such that he or she can continue living a good quality of life for as long as possible. For each pet owner the decision on how long to treat will be different and will depend on how a pet’s disease progresses, the financial consequences, and how much time the owner can commit to the care the pet will need.

How can I memorialize my pet’s life?

Owners who are considering euthanasia for their pets may want to save his or her collar or take a clipping of their pet’s hair coat. Some owners will make a paw print of their pet with Plaster of Paris or have this done by an artisan. An artist’s sketch, a personal poem, or a photograph could also be a nice touch in remembering your pet. You may elect to take a few days off of work before you are planning your pet’s euthanasia in order to spend some special time together.

What happens to my pet when I decide it is time to pursue euthanasia?

It is important to know what happens when a pet is euthanized, as many people want to be present with their pet in his or her final moments. The decision to witness the euthanasia of your pet is yours to make. There is no right or wrong. If you do not think that emotionally you can handle this event, be assured that the veterinary staff can administer the euthanasia and comfort your pet in his or her final moments. The most humane and widely accepted standard of euthanasia involves the administration of an intravenous injection. The drug most commonly administered is a barbiturate called pentobarbital. This medication causes rapid death by severely depressing the centers of the brain that tell the lungs to breathe and the heart to beat. As soon as the drug crosses the blood-brain barrier the animal is rendered unconscious. Usually the heart and lungs stop functioning within one minute of this painless injection. It is common practice for the nursing staff at a veterinary clinic to place an IV catheter in a pet’s vein before the administration of the injection. Depending on the situation, a pet may also be sedated before the barbiturate injection is administered. There are no side effects of the euthanasia injection that are adverse to the pet, as the brain is immediately affected and the pet becomes unconscious. Rather, there can be body effects that can be difficult for owners to witness. Usually these are minimized if sedation is used before the final injection is given. Common body effects include muscle twitching, body movement, vocalization, loss of bladder or bowel control, or a “ghost breath.” Perhaps the worst body effect is the “ghost breath” as it looks as if the animal is gasping for air. It is important to remember that this is a reflex and that the heart and lungs have stopped functioning at this point. The body effects can occur up to an hour after the injection has been administered.

What should I do with my pet’s body?

Your pet belongs to you in life and in death. It is your decision what to do with your pet’s body after he or she has passed away. Knowing the possibilities and having the decision made ahead of time seems to help a lot of people when facing this difficult decision. There are several options for your pet’s body. You may take your pet home for burial on your property. Different towns or jurisdictions may have regulations regarding this practice. It is your responsibility to find out what these are and follow them accordingly. Your pet’s remains can be cared for via a private pet cemetery. Usually the pet owner will make these arrangements for either a private burial plot with marker or a private cremation where you receive your pet’s remains in an urn. Most cemeteries will pick up your pet’s body from the veterinary clinic so that you do not have to endure delivering to such a facility yourself (unless, of course, you are more comfortable doing so…). There is also the option of the animal hospital where your pet was euthanized arranging for the care of the body. Some facilities offer a group cremation. For this service, they have contracted with a local pet cemetery that they feel is reputable to provide this service. Other facilities will use a local landfill to dispose of the bodies of deceased pets. For some owners this is not disturbing as they feel that the body is a shell for the animal soul to fill and is not important. Other owners are uncomfortable with this arrangement. It is up to you to ask specific questions about exactly what happens to the body of your pet if the veterinary clinic cares for your pet’s remains.

As we discussed, your pet is your property in life and in death. It is never acceptable for procedures to be performed on the body of your pet unless you have given express permission to your veterinarian. Some pet owners offer this opportunity as a way to help their veterinarian learn new procedures. Again, this is a very individual decision. It is unethical for anything to happen to your pet’s body except your specific instructions regarding its care. Please know that not only it is unethical not to carry out your wishes but it is also not legal.

Is it normal for me to be so upset at losing my pet? After all it is only an animal.

Perhaps the pet owner above who was so upset at the thought of what potentially could happen to her pet’s body was grieving. The grief process is a complex series of emotions and reactions that we transition through. Anyone who would mock a grieving pet owner with comments such as “he is just an animal – you can always get another one…” obviously has never experienced the wonder of the human-animal bond. The loss of a pet is the loss of a family member. It is completely normal to grieve. It is also normal for the other pets in your house to grieve. They may seem more restless, lose their appetite, be constantly looking for the lost pet, etc. after an initial loss. The stages of grief for humans are described as denial, anger, bargaining, depression, and finally acceptance. It may take days, weeks, months, or years for you to recover. There are pet loss support groups, hotlines, and counselors out there to help.

When should I get another pet?

This decision is entirely personal. It is important to remember that you will never replace a lost pet, but rather get to experience the joy of a totally new individual. It is probably important to allow yourself some time to grieve the loss of your pet, but how much time is up to you. It is best to get a new pet when you are emotionally, physically, logistically, and financially prepared to experience a new animal in your life.

Other resources:

Free literature from our hospital: A Final Act of Caring, Goodbye my Friend

Tufts Animal Loss Support Hotline 508-839-7966

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