Holland Street Vet talks about euthanasia

I think it is fair to say that everyone, even those who truly love their jobs, have aspects of it that they do not derive pleasure from. One of the things that I find most challenging in my profession is euthanizing an animal friend.  I think it is what turns many away from veterinary medicine as a profession and it breaks my heart to see young people with a genuine love of animals and passion for helping others turn away from this career because of it.  In my opinion, offering pets with a peaceful death is arguably one the most important services that veterinarians offer. Animals deserve to be treated with dignity and respect and to be pain free.  When all else fails and there are no other options, alleviating pain and suffering is something that veterinarians are trained to do and can do well.  It’s not easy to do that for someone you have come to know and love but it is something that must be done and I consider it one of the kindest gestures of all.

Euthanasia
The team here at Holland Street Veterinary Services, knows that euthanasia is one of the hardest decisions you will have to make. We are here to help ease that decision and answer any questions or concerns you may have about the process.

Pets give us so much and ask for nothing in return. The years pass far too quickly until the time where they slip away. The responsibility of ending a beloved pet’s life comes with a heavy burden. As a token of their undevoted love, their life may sadly come to an end, in the final gesture that we can offer them in return, a promise to relieve them of their suffering.

http://humananimalhealing.blogspot.ca/2009/02/message-from-animals-about-process-of.html

When is it time?
So, how do we decide the time has come for a pet to be euthanized?  That decision is one that must be made by the pet’s caretaker but we are always there to offer counsel. There is  a set of guidelines that we like to offer.  Is the patient well enough to eat, move around (at least to go relieve him/herself), rest/sleep peacefully? Is the pet behaving like their regular self (ie., enjoying their favorite activities, tail wagging, looking for cuddles, curling up on your lap) and maintaining some quality of life? Is your pet comfortable? How much weight loss has there been and what is the pet’s body condition? When there is serious disease or old age, there are good days and bad days. This is normal. It is when the bad days start to outnumber the good days, that euthanasia is worthwhile considering.

Here is a chart that I came across in one of my veterinary resources.  This scoring system was developed by a veterinarian,  Dr. Alice Villalobos (http://www.pawspice.com/).

Quality of Life Scale: The HHHHHMM Scale

Pet caregivers can use this Quality of Life Scale to determine
the success of pawspice care. Score patients using a scale of 1 to 10.

Score Criterion
1-10 HURT – Adequate pain control, including breathing ability, is first and foremost on the scale. Is the pet’s pain successfully managed? Is oxygen necessary?
1-10 HUNGER – Is the pet eating enough? Does hand feeding help? Does the patient require a feeding tube?
1-10 HYDRATION – Is the patient dehydrated? For patients not drinking enough, use subcutaneous fluids once or twice daily to supplement fluid intake.
1-10 HYGIENE – The patient should be brushed and cleaned, particularly after elimination. Avoid pressure sores and keep all wounds clean.
1-10 HAPPINESS – Does the pet express joy and interest? Is the pet responsive to things around him or her (family, toys, etc.)? Is the pet depressed, lonely, anxious, bored or afraid? Can the pet’s bed be close to the family activities and not be isolated?
1-10 MOBILITY – Can the patient get up without assistance? Does the pet need human or mechanical help (e.g., a cart)? Does the pet feel like going for a walk? Is the pet having seizures or stumbling? (Some caregivers feel euthanasia is preferable to amputation, yet an animal who has limited mobility but is still alert and responsive can have a good quality of life as long as caregivers are committed to helping the pet.)
1-10 MORE GOOD DAYS THAN BAD – When bad days outnumber good days, quality of life might be compromised. When a healthy human-animal bond is no longer possible, the caregiver must be made aware the end is near. The decision needs to be made if the pet is suffering. If death comes peacefully and painlessly, that is okay.
*TOTAL *A total over 35 points represents acceptable life quality

It is always advisable to have the pet examined by a veterinarian so he or she can offer their expert opinion. Please remember, old age is not a disease and some conditions which cause weight loss, dehydration and nausea are treatable. Also remember, that the veterinarian does not have a crystal ball. They can provide an opinion based upon physical examination findings, however, without basic testing (ie., bloodwork, urinalysis and radiographs), they are limited in their ability to offer a diagnosis and prognosis.

When you have made the very difficult decision, here are things to consider
No amount of preparation will make the decision or process of euthanasia easier. The end result will be the same and you will need to go through the grief process just the same. There are ways, however, that you can help to make things run a little more smoothly.

Have you thought about whether or not you would like to be present for the procedure and who will be there with you?
Again, this is an individual decision. Even within family members, some will chose to be present, others not. When we had to euthanize our family dog because she was having difficulty having bowel movements secondary to a rectal tumor, I was in high school. I chose not to attend. I said my tearful goodbyes before my brother and parents left (I don’t remember if my sister attended or not). Now, I could not imagine not being there for my pets. Most likely, I will be the one administering the overdose of anesthetic when the time comes.

At Holland Street Veterinary Services, a sedative is first administered to help the pet relax.  Sometimes, owners that are unsure whether they wish to remain for the procedure or not will remain with their pet until the sedative takes effect then leave prior to the euthanasia.  Some owners feel more at ease about the process, when they see how calm/relax their loved one is.

Having children or other animal companions present is, once again an individual decision, which bears considering.

This is a very difficult time. Having a friend or loved one there to offer support (and drive you home after), is advisable. It is difficult to forsee how we will react in the initial moments following euthanasia so it is best to be prepared.

What to expect?
If possible, we recommend that you please book an appointment so that you and your pet have the proper attention and peacefulness you deserve at this time. Each veterinarian/veterinary clinic has slightly different protocols/approaches.

At Holland Street Veterinary Services, there will be paperwork to sign prior to the euthanasia. We also ask that you settle the bill. Payment is collected before the procedure to avoid a tearful transaction at the height of emotion. During this time, we will administer a sedative to the pet to help alleviate anxiety. Unfortunately, no sedative is available for the owner who is often just a distraught, if not more so, than the patient…We will occasionally put in an IV catheter to have direct vein access. At this time the pet rejoins their family in the comfort room until he/she is sedated (usually about 10-15 minutes).

For the euthanasia, there may be only Dr. Michelle present or she may enlist the help of a veterinary technician or other team member. Euthanasia is an overdose of anesthetic and the procedure itself is very fast. The solution is injected into a vein and the heart stops- often times before the full solution is even administered. Pets may lose control of their bladder or colon at this time. The eyes remain open. Sometimes one last deep/loud breath is heard as they pass-this usually makes everyone present jump. Dr. Michelle will verify that the breathing has stopped and that there is no heart beat and confirms that the pet has passed. Clients are invited to stay in the comfort room and offer final respects. After last goodbyes and caresses, you are free to exit the room. We will take care of the rest. A separate exit is available if needed.

A collar, bandanna or locket of hair can be kept as a momento.

Have you thought about what you wish to do with the remains?
What happens to the remains is up to the client. Three options are available. The first is home burial (check with local regulations, they vary). The other two options involve cremation. Should the client wish for their pet’s ashes to be returned to them, a special cremation is requested where their remains are individually cremated. Otherwise, what is called a common cremation is requested and pets are “batch” cremated with their remains being buried in one of several crematoriums in Ontario. The company that we have commissioned to provide this service is Gateway. Additional services, including viewing, special urns with etching, paw prints, photos and mementos are also available. For a complete list of details, including urn/memento selections please check out the link at the website  www.gatewaypetmemorial.com.

Please call us anytime if you have any questions about the procedure, cremation, and or any of the services that Gateway supplies.  We want to make the procedure as easy as possible for you and your family, and offer much respect to your beloved pet as it moves beyond to the Rainbow Bridge.

What are ways to memorialize my pet?
Planting a tree (with or without ashes), spreading the ashes, creating a shadow box with paw print and collar, or having a locket with your pet’s hair, displaying painting/pictures are some of the ways people chose to remember their pets.  We invite you to send in a picture/story of your pet for us to post under the in memory of section of our website.

http://www.michvet.com/clients/dealing_with_loss5.asp
http://ezinearticles.com/?Thoughtful-Ways-to-Memorialize-Your-Pets-Life&id=4386429

http://dogtime.com/top-10-ways-to-honor-your-dog.html

http://www.ehow.com/how_4431825_memorialize-deceased-pet-that-loved.html

Euthanasia and Children
The decision for children to be present is an individual one based on ones’ own beliefs.  Often times, children (even those quite young) have grown up with the pet and view it as a sibling.  It can be difficult to explain the sudden disappearance of a loved one.  Often times this will be their first exposure to death and dying.

Please be upfront.  Children deserve a chance to say farewell and it is not fair for them to be told the pet has run away or gone to another home.  They will be terribly missed.  I would also caution avoiding the term: “put to sleep” as they may not realize that the pet’s life is ending/has ended and rather, be confused thinking they are really just gone to sleep.

I have had parents and children as young as 6 for a patient’s euthanasia.  There is never a “right age.”  Once again, the decision is an individual one and will depend upon the parent (s) and the child (children) themselves.

Here is a great link which details typical ages/stages of understanding death for children and teens and has some tips on helping children and teens cope with death.

http://www.petlosssupport.ca/userfiles/Children%20and%20Pet%20Loss.pdf
http://www.homeeuthanasia.net/children.pdf

http://www.griefhealing.com/article-helping-children-cope-euthanasia.htm

http://www.drlarrypetvet.com/child_euthanasia.html

http://www.ehow.com/how_2164446_explain-euthanasia-children.html

http://www.petplace.com/dogs/explaining-pet-loss-to-children-six-do-s-and-don-ts/page1.aspx

Grief Counseling
Grieving is completely natural.  Do not feel ashamed or embarrassed. Our pets are beloved family members and their loss is keenly felt.  There are resources out there for those having difficulty coping or needing someone to talk to.

There is also evidence that suggests other pets at home will grieve the loss of their companion as well.  That is why it can be a good idea to let them be present for the euthanasia or to allow them to “smell” the body.  Signs that your pet might be missing their friend includes, loss of appetite, starring at the window, becoming more affectionate and vocalizing.  Here is a website that discusses this matter further.

http://www.petplace.com/dogs/do-dogs-mourn/page1.aspx  http://messybeast.com/cat-grief.htm
http://www.pet-loss-matters.com/pet-grief-symptoms.html

http://www.petlosssupport.ca

http://www.pet-loss.net/resources/Canada.shtml

http://www.ovc.uoguelph.ca/petloss/about/

OVC Pet Loss Support Hotline Operation Hours & Contact Information

519-824-4120 x53694
UC Davis Pet Loss Support (Monday – Friday 6:30 – 9:30pm Pacific Standard Time) 1-800-565-1526

Poems

Treasured Friend
I lost a treasured friend today
The little dog who used to lay
Her gentle head upon my knee
And shared her silent thoughts with me.

She’ll come no longer to my call
Retrieve no more her favourite ball
A voice far greater than my own
Has called her to his golden throne.

Although my eyes are filled with tears
I thank him for the happy years
He let her spend down here with me
And for her love and loyalty.

When it is time for me to go
And join her there, this much I know
I shall not fear the transient dark
For she will greet me with a bark.
—Author Unknown

The Last Battle
If it should be that I grow frail and weak,
And pain should keep me from my sleep,
Then will you do what must be done,
For this, the last battle, can’t be won.

You will be sad I understand,
But don’t let grief then stay your hand,
For on this day, more than the rest,
Your love and friendship must stand the test.

We have had so many happy years,
You wouldn’t want me to suffer so.
When the time comes, please, let me go.

Take me to where to my needs they’ll tend,
Only, stay with me till the end,
And hold me firm and speak to me,
Until my eyes no longer see.

I know in time you will agree,
It is a kindness you do to me.
Although my tail its last has waved,
From pain and suffering I have been saved.

Don’t grieve that it must be you,
Who has to decide this thing to do;
We’ve been so close,we two, these years,
Don’t let your heart hold any tears.
—Author Unknown

Rainbow Bridge
Just this side of heaven is a place called Rainbow Bridge.

When an animal dies that has been especially close to someone here, that pet goes to Rainbow Bridge. There are meadows and hills for all of our special friends so they can run and play together. There is plenty of food, water and sunshine, and our friends are warm and comfortable.

All the animals who had been ill and old are restored to health and vigor; those who were hurt or maimed are made whole and strong again, just as we remember them in our dreams of days and times gone by.
The animals are happy and content, except for one small thing; they each miss someone very special to them, who had to be left behind.

They all run and play together, but the day comes when one suddenly stops and looks into the distance. His bright eyes are intent; His eager body quivers. Suddenly he begins to run from the group, flying over the green grass, his legs carrying him faster and faster.

You have been spotted, and when you and your special friend finally meet, you cling together in joyous reunion, never to be parted again. The happy kisses rain upon your face; your hands again caress the beloved head, and you look once more into the trusting eyes of your pet, so long gone from your life but never absent from your heart.

Then you cross Rainbow Bridge together…
—Author unknown

Links/Books
www.petloss.com

www.in-memory-of-pets.com/pet-loss.com

www.helpguide.org/mental/grieving_pets.htm

www.pet-loss.net

www.aplb.org

Final Farewell: Preparing For and Mourning the Loss of Your Pet
By Marty Tousley and Katherine Heuerman. 85 pages; illustrated. Our Pals Publishing Co, 3629 N 40th Ave. Phoenix AZ 85019. 1997

Healing the Pain of Pet Loss: Letters in Memorium
Edited by Kymberly Smith, The Charles Press.

Absent Friend: Coping with the Loss of a Treasured Friend
By Laura and Martyn Lee, pub. by Henston Press, High Wycombe, Bucks, England, 1992.

Coping with Sorrow on the Loss of Your Pet
By Moira Anderson Allen

The Rainbow Bridge: Pet Loss Is Heaven’s Gain
By Niki Behrikis Shanahan

For Every Dog an Angel By Christine Davis
Cat Heaven
By Cynthia Rylant
Dog Heaven
By Cynthia Rylant
Goodbye, Friend: Healing Wisdom for Anyone Who Has Ever Lost a Pet
By Gary Kowalski
The Loss of a Pet
By Wallace Sife
www.childrensbooks.about.com/od/themesubjectbooksby/to/petdeath.htm