I honestly think that euthanasia is one of the most important (if not the most important) parts of our job as veterinarians. Guiding our clients as to when is the right time, counselling them, comforting them, and trying to help them manage their grief.
When euthanasia goes smoothly, it gives the owner a peaceful lasting memory of their beloved pet. But what about when it goes wrong? How can we deal with this, and how can we try to prevent things from getting out of control?
As a practising small animal veterinarian for the past 17 years, I have done hundreds of euthanasias, and on the whole, things have gone smoothly. But it is just horrible when things don’t go to plan. I am sure that we can all think of times when it has all fallen apart.
As recently as last week, I had one such case. Bob (not his real name) was a 15 year old terrier with horrendous uncontrolled dry eye, respiratory disease, probably Cushings, and who knows what else. I am sure you can picture the sort of dog I am talking about. Hugely loved by his elderly owner, who just couldn’t bear to lose him.
When the time finally came to euthanase Bob, it was never going to be an easy task. He was so stressed by his uncontrolled respiratory disease, that any restraint caused him to panic and turn cyanotic. His owners were distraught by the thought of losing him, and their grief was making his anxiety worse. In the end we opted to use a mild sedative dose of butorphanol to facilitate the procedure. However, he was so anxious that this really had no effect. The dose was repeated, and it did help to settle him a little.
I always take my euthanasia patients away from their owners to place an IV catheter (I find this takes the pressure off both vet and nurse, trying to get a vein on an elderly or unwell patient, plus the patient normally relaxes a little too, without grieving owners present). With Bob, he had such poor circulation, and pronounced angular limb deformity in both front legs (the typical “Queen Anne” legs seen in breeds such as Shih Tzu’s) that access to the cephalic veins was near on impossible. I suspect the restraint to raise the veins was causing elbow pain.
So what next?! We looked at access to other peripheral veins, but his circulation was so poor, that this was still going to be very tricky.
In the end, we decided to give heavy intramuscular sedation using Alfaxan, so that the owners could stay with him until he was very sedated, then once he was unresponsive, we took him away and gave intracardiac pentobarbitone.
As he finally slipped away peacefully, I felt a rush of emotions. Sadness for the family of this much loved pet, frustration that he had no doubt suffered in the last few months of his life, and relief that we were able to relieve his pain and suffering in the most peaceful way that we could.
I truly and honestly believe that euthanasia is the final act of kindness that we can do for our beloved pets, and feel privileged that I am able to help make their final passing as peaceful as possible. However hard it can be!
