ADVANCED DIPLOMA IN

VETERINARY SUPPORT ASSISTANT TRAINING

MODULE 18: Euthanasia

Undoubtedly, the most emotionally challenging part of working with animals is

euthanasia. This module discusses how owners decide if a pet has reached the end

of their life, as well as the practical aspects of how euthanasia is performed.

18.1 Making a difficult decision

18.2 End of life choices

18.3 Euthanasia etiquette

18.4 How euthanasia is performed

18.5 Burial or cremation

18.1 Making a Difficult Decision

It is the decision every pet owner dreads having to make. Our pets are treasured

members of our family and watching their health slowly worsen is both upsetting and

painful for the owner. Many conflicting emotions run through the mind including the

wish to keep a beloved pet with us for a little bit longer, while watching a decline in the

pet's health.

Other feelings also come into play such as not wanting to “play God" and take a life.

There is also the huge emotional attachment an owner feels for their pet that may blind

them to the need of ending the suffering for a much loved animal. Indeed, everyone

working at a veterinary clinic will have experienced the loss of a pet at some point in

their life, which helps them to understand what owners are going through.

Working at a veterinary clinic brings you into regular contact with people who may

have such weighty matters on their mind. Some may even ask you for advice. What

you say could make their decision easier or more difficult to bear. Rarely, will you know

everything about that family's circumstances, so it is important to be sympathetic.

However, always tell the client only they can decide what is best for their pet.

Be Careful Not to Judge

It is a rare person indeed, who is not infatuated or obsessed by their pet. Do not be

fooled by the seemingly off-hand owner who is dismissive of their sick animal.

Sometimes, the only way they can cope with the prospect of losing that pet is to

pretend the animal is not a significant part of their life. The alternative would be to

break down in tears in front of strangers, which leaves many people feeling vulnerable

and exposed. Never think that because someone is matter-of-fact about their pet's

impending demise that they don't care. They do; they just can’t cope with showing it.

The other circumstance you will almost certainly encounter, and find difficult to cope

with, is the owner who cannot afford treatment and so opts for euthanasia. Again, do

not judge. It will be tearing the owner apart inside that they cannot do everything they

want for their pet. Deciding to let the pet go is often an incredibly brave and selfless

decision. What they are doing is sacrificing time they could have spent with the pet to

save the pet from suffering. Rather than leaving a pet without treatment for a painful

condition, it is best to let them go.

Knowing When the Time is Right

When an owner gets a puppy or kitten, they know the pet will predecease them. Yet,

when the pet ages even this forewarning doesn't make the decision any easier. When

a pet becomes seriously unwell, it is a delicate balance to judge how much good, pain-

free time the pet has left against not letting that beloved animal suffer. Making that

decision to end a life is a hard thing to do.

If you encounter an owner who is wondering

what to do for the best; never make the

decision for them. However, what is helpful is

to suggest ways of making that decision

clearer. For instance, you might suggest they

write down a list of things they consider are

essential for any animal. This might include such things as having a good appetite,

being able to go for walks, not soiling themselves, and showing an interest in what's

going on around them. You might also suggest things as not being sick on a daily

basis, not being in pain, and sleeping through the night.

Encourage the owner to write this list down. Once it is in black and white, then it is

easier to compare their pet's behavior with what is/isn't acceptable. This can help clear

their thinking on what is quite naturally a very emotional topic.

Some pointers to consider are:

Does the pet soil himself? (Animals are very dignified, and the key to this is they

don't foul themselves)

Does the pet groom himself? (Most animals take good care of their coat and a lack

of grooming is a significant indicator that all is not well)

Does the pet enjoy food and have a good appetite?

Are they in pain? (As indicated by changes in character, such as becoming more

withdrawn, or becoming snappy and irritable)

Does the pet have a condition that is only going to deteriorate?

In an attempt to cling onto an ailing pet, the owner may say that the cat still purrs, or

the dog still wags his tail, therefore it is wrong to let them go. It is worth bearing in mind

that cat's purr to comfort themselves, and a dog that no longer wags his tail has

probably been allowed to go on for too long.

What if You Don't Agree With the Euthanasia?

There will be times (hopefully very few and far between) when you encounter a

client that wishes their healthy pet be destroyed for convenience reasons. It might be

that person is moving and the new rental property doesn't allow pets, or the owner

now has young children and can't cope with a dog as well.

In these circumstances remain polite and tactful. Quietly ascertain as many of the facts

as you can and then relay them to a senior member of staff. It might be that the clinic

has unofficial links to a rescue center or a good relationship with the local ASPCA

inspector. Either way, there may be a way of solving the problem without ending the

pet's life.

Never make promises to the owner. Suggest to them there may be an alternative route

and would it be all right if you made some inquiries. Most reasonable people will be

only too happy to find a solution that doesn't involve euthanizing a healthy animal.

18.2 End of Life Choices

Once an owner decides it is time to let a precious pet go, they may phone the surgery

to discuss what happens next, and how to make the arrangements. At such a delicate

time, it helps if you are aware of the choices available so you can tell them, and make

the arrangements with the minimum of fuss.

The two main options are for the veterinarian to visit the owner’s house and put the

pet to sleep in the familiarity of their own home, or the owner visits the clinic with the

pet.

On first appearance, home euthanasia may seem far nicer to the pet, but you need to

take into account each individual animal’s character. If a pet is particularly territorial,

then they may actually find it more upsetting to have a stranger intrude into their core

territory. However, the other side of that argument is that if the pet hates car travel or

becomes stressed at the clinic, then a home euthanasia may be less distressing for

them.

Another factor to consider is cost. A home visit for euthanasia is more costly than

bringing the pet to the clinic. While this may not be the deciding factor, it is something

that should be mentioned to the owner in case it is a consideration. Also, home visits

may need to be done at a time convenient to the veterinarian to fit in with clinics and

surgery. So, while every attempt is made to give the client a firm time for the visit, the

nature of veterinary work is that an emergency may come in at any time. This means

the veterinarian is not able to leave the clinic and the client is left waiting at home.

If the client visits the clinic, they are more assured of knowing the exact time events

will take place, and less likely to be kept waiting at what is a very trying time for them.

If the client decides to visit the clinic, then try and book the appointment at a quiet time

when there are fewer people around, so the owner is not faced with a crowded waiting

room. If you are not sure what the best time is, then it is perfectly fine to take ownership

of the appointment. Take the owner's phone number and proceed to call them back

once you have spoken to the relevant veterinarian. Under these circumstances, most

vets will see a patient outside of normal clinic times in order to minimize a client's

distress.

18.3: Euthanasia Etiquette

When a pet is put to sleep, you must behave in a professional manner even when you

feel very emotional yourself. It is perfectly natural to feel upset (you are in the wrong

job if you don't) but your job is to make everything run as smooth and pleasantly as it

can under the circumstances.

Be thoughtful. If you see a patient is booked in for euthanasia, be on the lookout for

their arrival. If the clinic has the luxury of a side room or separate waiting area, then

usher the client into that more private space. If for any reason the vet is running behind,

offer to make the client some refreshment such as tea or coffee. Try to keep the client

informed of how much longer the wait will be and explain the reason for the delay.

Make sure the client is well supplied with tissues. If they want to talk, try to make the

time to sit and listen. You might do well to ask if they have any questions about what

is about to happen, and then do your best to answer. They may be unfamiliar with

what happens when a pet is euthanized. You may be able to explain about the

injection, how long it takes, and what happens afterwards so they are more at ease

when they go in to see the veterinarian.

This could also be an opportunity to ask them if they have thought about what they

wanted afterwards, in terms of either taking the animal home to bury or for the clinic

to arrange cremation. If they would like individual cremation, then now is the time to

give a brochure with the different urns available and talk to them about the cost.

Depending on the practice policy, this is also an opportunity to ask if the client would

like to pay now rather than afterwards. While this may seem a little cold as you read

this, many clients are grateful because they can get payment over with and

concentrate fully on their pet. It is often even more upsetting to pay afterwards with the

grief of losing the pet still fresh and raw.

If you are aware that a euthanasia is taking place in a consult room, try not to disturb

them. Stay out of the room unless you have a specific reason to enter such as the

veterinarian needing your help to hold the animal.

18.4 How Euthanasia Is Performed

In order to prepare yourself, or indeed to tell an owner

what to expect, it is helpful to know what happens when

an animal is put to sleep.

The animal’s life is brought painlessly to an end by an

overdose of pentobarbitone. This is a drug that induces

an anesthetic like state (so the animal drifts into

unconsciousness) but is strong enough to stop the heart

from beating. This results in the animal passing

painlessly away.

The drug is most commonly given into a vein, often in the front leg. One exception is

thin, elderly cats where it can be given painlessly into a kidney where it circulates

around and stops the heart. However, in this module we look at the procedure for

intravenous injection.

The Protocol

Consent form: The owner signs a consent form giving permission for the euthanasia. This is a chance to talk about what happens next and avoid any misunderstandings that the pet’s life is about to be drawn to an end. It also makes clear who the legal owner of the animal is and that they give permission for euthanasia to be performed.

Quiet environment: Try to make the room as peaceful and private as possible by drawing the blinds and placing a blanket on the consulting room table to make the pet more comfortable.

Intravenous access: Some clinics have a vet tech preplace an intravenous catheter into the pet’s front leg (before going in to see the veterinarian), while other clinicians prefer to skip this step. If no catheter is in place, then the clinician will clip fur from the pet’s front leg and apply spirit to the skin that helps show the vein more clearly.

Hold the animal: The owner may hold the animal, or a vet tech or VSA. The key thing is to raise the vein on the front leg (See Module 6) so it is ready for the intravenous injection.

Pentobarbitone injection: The veterinarian gives the injection that puts the animal to sleep, and stops their heart.

Confirm death: The veterinarian then confirms the animal has passed away by listening with a stethoscope for a heartbeat and checking for eye reflexes. Once death is confirmed, the owner may spend time with the pet to say their goodbyes, or the veterinarian may cover the body with a blanket.

18.5 Burial or Cremation

Once the animal has passed away, the final choice is what to do with the body. The

options are:

Home burial

Mass cremation

Individual cremation

A home burial is self-explanatory in that the client takes their deceased pet home, digs a grave in a favorite spot, and buries the pet there This is a lovely option if the client has the space since their pet remains close to them in a place associated with happy memories. However, if the owner lives in an apartment, they have a large dog, or are soon to move, then cremation may be the better option. The body is collected by the animal crematoria for cremation and the ashes returned to the clinic about a week later.

Mass cremation refers to the body being cremated with the remains of other animals. This means the client cannot ask for their pet’s individual ashes back. Some owners prefer to remember their pet as they were in life, so getting the ashes back is not a priority. In which case this option is ideal.

Individual cremation means the individual pet is cremated on their own, and so the resulting ashes are those of that pet. Some owners prefer to get the ashes back. Either in a scatter box so they can spread the ashes on a favorite walk or resting place, or in an urn as a more permanent reminder of their pet.

It takes great skill and diplomacy to inform an owner of these options at a time of emotional distress. Moreover, it is important to do so. To withhold information on the grounds the owner was upset can backfire at a later date. Such as when they learn there was an option to get ashes back, but they weren't told about it. They may have wanted to hold onto that link with their pet but feel aggrieved that they weren't offered the chance. Even though it was not mentioned because of their extreme distress at the time.

If this all seems a little daunting, don't worry. You will be working with a team of

professionals who have experienced this many times before. Watch and listen to how

they handle the situation. When it comes time for you to step into such a sensitive

situation, what to say will come naturally to you.