Difficult decisions towards the end of life.

A few weeks ago I was asked by a close friend to put her dog to sleep at home. Timmy was a farm dog really, who slept in a stable, but just as much of a family member as any house-dog and much loved. I trusted Timmy’s owners’ judgement completely as to when the “right time” came to part with Timmy, and I was already familiar with his medical history.

I was glad to be able to carry out the euthanasia in the way in which his owners wanted. Timmy was in familiar surroundings, greeted me like an old friend and showed no distress at all. With his owners beside him, I clipped some hair from his front leg and injected a strong solution of anaesthetic into his vein. He went so peacefully that there were only a few tears, mixed with feelings of relief. Timmy was buried on the farm.

Amber curled upOne of the questions people commonly ask when they first know that you are a vet is “How can you bear to put animals to sleep?” The answer is that it is still one of the most difficult parts of veterinary practice, even after many years. You become used to the technicalities of carrying out the procedure in various different circumstances, because you have to. You never become immune to the feelings of owners at this time, and never should. If you are satisfied that what you are doing is in the animals best interests and you carry it out with as little distress as possible, then you feel that you have done a necessary service.

Not everyone is fortunate enough to be able to plan exactly when, where and how their pet’s life might end, but sometimes considering some of the options in advance can be a good idea.

We would all prefer it if our dog or cat would live a happy life and then die at home in bed at an old age. Unfortunately this does not always happen, and many owners are faced with the difficult decision whether to have their pet put to sleep (euthanased) in order to prevent suffering.

Deciding when the right time has come can be difficult. No-one wants to cause unnecessary suffering by leaving it too late, but equally it would be regretted later if a hasty decision was made. Vets can advise what the likely outcome of any illness is going to be and what treatments, if any, could help. If everything has been done that should be done, then it may come down to the small things in life: does your dog still enjoy a walk, recognise members of the family, enjoy their food; does your cat show an interest in surroundings and people?

Home visits for euthanasia are often requested, and if this is your wish it would be worth talking to your veterinary practice in advance. Sometimes, however, it is easier and safer to do this at the surgery because of the availability of experienced helpers, and the availability of other drugs, if for example sedation was needed in a scared animal. The other big factor could be the time of day. In a night-time emergency, it may not be possible for the vet and nurse on duty to travel far from the surgery because of other patients.

Labrador cropEuthanasia in most cases is quick and painless. An injection is usually given into the vein because this will work more quickly than if given by other routes. Sometimes a sedative may be needed first, if an animal is nervous or aggressive. The decision whether to be present or not is an entirely personal one for the owner. Some people will feel they want to be present and others will prefer to leave after signing the consent form. If you are not present, your pet will be handled by gentle, caring, experienced staff on your behalf. If present, it may be better for both the owner and the animal if the holding is done by the veterinary nurse, who can raise the vein for the injection at the same time. This leaves the owner free to be where the dog or cat can see and hear them.

Most practices will use the services of a pet crematorium who will offer various different types of cremation or burial, depending on individual wishes. For example, you may wish to have your pets ashes returned so that you can keep them or scatter them in a favourite place. If you have a suitable place you may choose to bury your pet at home.

There is no right or wrong way to grieve. The bonds that exist between people and their pets are strong and the loss of a pet can cause a similar sense of loss to any other bereavement. Many people like to remember their pet with photos, by planting a tree or placing a plaque in a special place. Some practices keep a book of remembrance or a wall of photos of past and present pets. Vets and nurses also like to remember their patients.

Some practices have staff who have been specially trained in supporting clients who are going through bereavement and if you would like this help, do ask at your surgery. If not directly available within the surgery, counselling services are available including support from the national charity the Blue Cross. It can be especially important to help children talk about their loss as it may be their first experience of death. Other pets may also grieve. Some people think it helps to allow other pets to see the body of the pet who has died, and I have certainly no reason to think this is harmful or distressing to them.

Euthanasia and death are subjects that all of us would prefer not to have to consider, but sometimes things can be made a little easier for everyone by thinking ahead, so that if the worst happens, we are as prepared as possible, and left with happy memories.

  • Diana says:

    A sensitive approach to a difficult time in pet owners’ lives.. below is a link to the story of our beloved Flat Coated Retriever, Harry, who left us 18 months ago.. as told by our other Flat Coat, Charley.

    Sadly Charley has the same illness state now but we hope we will be better equipped to deal emotionally when it is time to say goodbye.

    http://dordognedoings.blogspot.com/2009/07/my-best-pal-harry-by-charley.html

  • Two years ago I had to have my beloved border collie Meic put to sleep, here in France. Anything who thinks the French are insensitive to animals has not met the same ones as I have.

    I arrived at the vets’ surgery during the sacrosanct lunch hour, which is very strictly observed here, and the surgery was closed. More in hope than anticipation, I rang the bell. My usual vet, who is a lovely man who looks like an exremely young John Snape, for Corrie fans, let me in, with my dog, and agreed to immediate euthanasia.

    Without too many details, my dog’s veins were shutting down and he needed an injection directly into the heart, which the vet said would normally require the presence of a vet nurse, and they were all on lunch, but given the urgency, he went ahead, with me helping. He could not possibly have been more kind, sensitive, understanding and animal-friendly at such a sad time.

    When I got a replacement dog, I took him in for castration and hind dew claw removal and a different vet, needing to talk me through the complications of cryptorchidism, took me into the side room, not usually used for consultations, where Meic and I had said our final farewells. I was finding that hard, so explained the circumstances and he too was so sensitive, kind and thoughtful, with many “desolé, madames”, ushering me into a different room and completely understanding of my grief, even six months on.

    Thank you, France, for taking me and my pets to your heart and sharing my love of them!

  • Dawn Hills says:

    Very very good article. i have had various animals put to sleep over the years and have always chosen to be present. Its done with love and is totally painless and peaceful. I also have Lewis’s ashes (mycat) who I had for 14 yrs

  • Jenny says:

    Hello Diana
    Thank you for your comment. I have just read the lovely story of Harry, as told by Charley, and found it very moving. What a lovely tribute and a fitting way to celebrate Harry’s life.
    Since I wrote the blog I have very sadly lost my own older boxer, Martha, so my family is going through similar sadness. Maybe in a while I will be able to write something in tribute to her.
    All the best to Charley, Willie and Totty.
    Jenny

  • Jenny says:

    Hello Marie
    I am very glad that when you had to make that difficult decision to have Meic put to sleep, you were helped by the kindness and sensitivity of your French vet. I know from my own experiences as a pet owner that it can make a big difference when coping with your loss.
    I hope your new dog brings lots of happiness.
    Jenny

  • Jenny says:

    Hello Dawn
    Thank you for your comment and I am glad you liked the article. When you have to have a pet put to sleep it can certainly help to see how quick and peaceful it is.
    I hope you have lots of happy memories of your cat Lewis.
    Jenny

  • Diana says:

    Thank you for your kind words Jenny and I am sorry you are suffering from the loss of your old pal, Martha.

    Time is a healer, but losing a family member, often called by many a pet, is so difficult. Fortunately the happy memories and fun times become more frequent, although the tears still flow.

    I agree with Marie regarding French vets, our vet was wonderful with Harry, and despite the language barrier, both our eyes said it all.

    Some French vets specialise in farm animals only and it is up to any ex pat to talk to others to find out where the empathy can be found.

  • Susan says:

    Dear Jenny, Diana, Marie, Dawn and all who have loved pets,

    In 1982 I began counseling people through the illness and death of their pets, because it hurt so much every time it happened to me. I work at a big veterinary teaching hospital in NYC and think this blog and comments should be required reading for all our doctors and staff. Dr. Sheriff has done pet lovers and caregivers a real service by explaining what really happens during euthanasia.

    My heart goes out to all of you who are mourning the death of someone you love. it hurts like crazy and it can last a long time. It’s an honor to read their stories & yours.

  • Jenny says:

    Hi Susan
    The counselling you offer sounds like a really valuable service which could help many people who are coming to terms with a bereavement. I agree about how much loss hurts, and it doesn’t seem to get any easier no matter how many times you go through it. Thanks for your kind comments.
    Jenny

  • In what is otherwise a very good article the statement that “Most practices will use the services of a pet crematorium “ illustrates the confusion and lack of understanding about the pet cremation sector. Regulation and control over the pet cremation industry is virtually non-existent and your pet is unlikely to get the cremation service you expect when you arrange the cremation through your veterinary surgery. I have been running a pet cemetery & crematorium for over 25 years and the poor working practices and failure to provide a cremation service the pet owner expects is as common now as it was then. The brochures have become glossier, the people may appear kindly and caring but the result, either through ignorance or intent on the part of the operator, is that pet owners are being misled about the cremation of their pet.

    Veterinary practices are quite rightly concerned with keeping pets healthy and alive with the best possible quality of life. They are our trusted professionals in that respect. However, the majority fall short when providing a cremation service. Vets have no knowledge of this area and yet will pass pets’ bodies over to companies in the mistaken belief they are all the same. The decision to use a cremation company is usually based on the level of profit they make and the fact that the company will also take away all the veterinary waste from the practice. Pet crematoria are not all the same and most pet owners would be upset to find out the truth about what goes on behind the scenes. The majority of pet owners who request a cremation do not get the service they expect and pay for. Knowingly or unknowingly the mis-selling of these services is far more common than any of the cases illustrated in the recent Panorama report on the BBC.

    The Association of Private Pet Cemeteries & Crematoria is the only organisation setting standards for this sector and provides extensive information to enable pet owners make the right choices. If a vet does not use a member of that organisation then pet owners should question them about the service they are selling. Both the owners and the vets may be surprised to find out how little they know.

  • Anita Davidson says:

    My first dog,aJack Russell Bitch who had a heart problem from birth was put to sleep by a very inconsiderate vet who could not even wait until I got out of the room before he bundled her into a green plastic bag.The memory of that will aways be with me.Thankfully the two other dogs which I have lost since then were done with much more respect.

  • john grainger says:

    HI

    I just had my cat put too sleep, because she had kidney failure. we called the vet out because she was breathing bad. The vet said it was best too put her too sleep, so we agreed. He said that he couldnt get a vien in here leg so he put the needle in her chest and injected the anesthetic. 1 or 2 secs later she said breathing as if she had water in her lungs she was convusing this went on for 2 mins then he gave ur another injection into her chest cos he said the first one wasnt working as fast, then blood started coming out of her mouth and he said she had bitten her tounge , which i thing is a lie cos i think the first injection went into her lungs, waited another 3mins then he gave her another injection and said he was trying too get the needle into her heart. it took nealry 15 mins for too die. i always thought 1 injection and she would be dead in secs. she had a horrible death in my eyes. Do vets put cats too sleep this way or is bad practice.

  • Jenny says:

    Hello Anita,
    I am sorry to hear that you had an unhappy experience when your Jack Russell
    bitch was put to sleep. You are right that being allowed time and shown
    respect at this time can make it a little less difficult and I am glad that
    this has happened with your other two dogs.
    Jenny

  • Jenny says:

    Hello John,
    My condolences on losing your cat recently in such a distressing way. It can be very difficult to find a vein in a very ill animal because the veins tend to collapse., especially in cats or smaller dogs. Other methods of giving the injection would then have to be considered. Injecting straight into the heart can be a suitable route in some circumstances, and I have used this method occasionally. If successful, it would be quicker than using sedation first. Sedation takes a few minutes to work as well and can cause vomiting which is also distressing to witness. The pros and cons of each method would
    have to be weighed up, aiming to cause minimal distress to both animal and owner. On a house visit another consideration might be which drugs were available and who was available to assist. It is difficult to comment on whether the decisions made by your vet were the best options without knowing the full circumstances, but if you feel unhappy about this I would advise you to discuss it with the vet or the practice owner. They may be able to offer you some explanation as to why things did not go as you would have
    wished.
    Jenny

  • pol says:

    my dog was put to sleep 3 days ago because i was 100% sure she was dying, Telephone conversation with vet came to the same conclusion. Now shes gone i have read an article on addisons disease .I feel racked with guilt that i may have ended her life unnessceray.She had rapid weight loss,could not walk without swaying,At the end could only walk 3 paces then would collaspe and would wee herself.refused food and water.

  • Gemma says:

    on Friday the 26th of January 2013 my nearly 19 year old cat became even more worse, she lost the strength in her back legs and kept on falling which was not her, she kept on looking but was not looking or paying any attention to any of us, she looked straight at us, whai also was not her, this happened at night, i decided to take to the vet the next morning, she looked great she moaned like usual and looked at everyone, so I was hoping she got back to normal, but we all decided to take to the vets for an check up, when I put her in an cat cage, she could move her legs to get in the cage, so I moved her body in the cage, the last time we took her to the vets three years ago she moved all legs and kept on crying, but when we took her to the vets this time she cried in the car, I tell the vet what happened, then the vet took her out of the cage, felt her legs and also tryied to make her walk on the table but sadly this time it was her front legs have gone now, but the vet said that she has got more strength on her back legs, the vet said that she has got an blood clot on her legs and not her heart, which she said to us that normally it goes to the heart, i also noticed before of all this she has lost weight and walked more slower when normal expectually waking upstairs, we thought it was old age, the vet decided it was better for her to put to sleep, my dad signed the form for permission, so i went outside the room because I dont want to see her die, now we all regrette not taking her body home, but we know that she’s not in pain, I also wanted to know why the vet didnt mention about the tablet or giving her the tablet, If the vet did would that make any difference in her health?

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