EUTHANASIA is the anaesthetic
with no return. It needs the same
conditions as any other anaesthetic,
which are quiet surroundings,
confident staff to reassure the
patient and a choice of the most
suitable drugs for the
circumstances.
It is a big part of the workload of
any practising veterinary surgeon. They
do not tell you this at college and they
fall short in explaining that apart from
caring for the animal, the veterinary
surgeon has to deal with a great deal
of human grief which involves the
animal’s owners and the practice staff,
including oneself.
The
decision to end the
patient’s life is
often a
difficult one.
It may seem
clear to the
veterinary
surgeon that the animal is entering a
phase where its life contains more
suffering than joy, while the owner is
overwhelmed by the loss of the pet
and wishes to avoid the pain of
parting with it.
This is the “life at any price”
thinking which neglects to accept that
it is the animal that is paying the price
in its suffering.
Manageable discomfort
On the other hand, some owners
cannot cope with what the veterinary
surgeon sees as manageable
discomfort. Costs may enter the
equation but sometimes the owner
chooses not to face the sheer weight
of responsibility of providing care or
changing a lifestyle to accommodate
the animal’s needs.
Either way, emotion is the big
player. Veterinary staff are good at
providing support and sympathy, but it
is very important that the owner’s
needs are recognised, he (or she) needs
to be treated gently and given time to make his own decision. Patience
towards the human and pain relief for
the animal are the key to minimising
their suffering.
When the euthanasia is being
carried out, good technique and
forward planning can help everyone
concerned. Ideally, the procedure is
planned in advance; the owner will be
offered, by the receptionist who books
the appointment, the choices of how
the body will be treated.
Ideas can change
The choice between home burial,
standard cremation and return of
ashes can be made at any time; fine details about timing or containers may
need to be discussed with family
members, ideas can change but
throughout there needs to be
reassurance that the practice respects
the animal’s body.
The era of disposal of cadavers in
landfill is over, thank goodness, but it
does mean that the veterinary practice
has to take on some of the functions
of the undertaker.
Euthanasia needs to be smooth
and painless. The animal needs to be
spared the misery of its owners who
are grieving in anticipation of their
loss. The owners can cry as much as
they need to once the beloved animal
is unconscious, but it is of the most
enormous help to the animal if the
owners can remain positive until it has
passed away.
Animals are aware how their
humans feel, their life is fine-tuned to
reading what is going on and reacting
to it. If the owners are allowing their
grief to show, the animal will be
anxious. Pet and owner try to comfort
the other, clinging and embracing.
We are all afraid of death but this
is the time for the humans involved to
play responsible adult, acting as if for
an Oscar if necessary.
The owner needs to be encouraged
to support the animal, to visualise and
talk about the animal’s favourite thing,
a walk, food, petting while the nurse
raises the vein and the veterinary
surgeon injects. As long as a positive
attitude is created, the animal will join
in and pass away smoothly.
Human grief needs to be
postponed. Otherwise the animal will
be fearful and defensive and hard to
handle.
Controversy exists whether to pre-
medicate. Some veterinarians like to
sedate the animal so that it is deeply
relaxed and unworried before the
intravenous injection. Others prefer to
inject so that one minute all is normal
and the next there is a dead dog.
I choose the degree of sedation
that seems most appropriate,
considering the needs of the owner
and the animal. Any nervous animal
gets sedation, sometimes I use the
rapid route.
It depends on a host of variables,
the character of the animal, the
feelings of the owner and the tradition
of the practice. Euthanasia means
“gentle death” and that is what I want
for my patient.
The process of euthanasia has a
varying effect on the owner’s
emotions. Some are deeply traumatised
to the point of needing to be sat down
with a box of tissues, a glass of water
and a sympathetic nurse.
It is necessary to
make sure that they are fit
to drive and that they
have someone at home to
talk to. I always suggest
that they can telephone
the practice to talk about
their loss, though very
few clients do this.
The Blue Cross
provides a good
bereavement counselling
service so I give the client
their contact details where
it seems appropriate.
If it is at all possible I
leave the clients with the
animal’s body for a few
minutes’ privacy. Too many people
have said to me “I hate this room”
when they come back into the surgery where their last animal has been
euthanased. Some practices do have a
separate room for euthanasia, but this
is not always possible.
Demanding
Euthanasia carried out at home is
demanding for the practice but
probably the best for pet and owner,
the animal can “go to sleep” in its own
familiar environment. Always bring a
nurse! Two humans are very much
better than one, both for treating the
animal and talking to the owner, to say
nothing of transporting the body.
Follow-up with a sympathy card
and a practice information sheet about
the process can help, but grief tends
to last for about two years. It needs to
be allowed for, especially in practice
staff where euthanasia can mean the
loss of a well-known and well-loved
patient that they have treated for many
years.
It can also trigger sad feelings about the death of a
close relative, such
as mother or father.
Above all, it is
repeated regularly
and can be a source
of attrition within
the practice.
While a varying
amount of grief
overlies euthanasia,
we need to
remember the
positive aspect that
is its core.
We are able to let
an animal avoid the
suffering of extreme pain, debility or incurable disease, “to
cease upon the midnight without
pain”.
