Euthanasia - When is it time?

Advanced Animal Care Center
260 Evergreen Avenue
Huntington Station, NY, 11746

Phone: (631) 367-7387 Fax:(631) 367-7414 advancedcareforpets.com


Euthanasia
When is it Time?

The decision regarding the euthanasia of a beloved pet may be the most difficult decision one makes in one’s entire life; obviously, the consequences are irrevocable. Whatever the decision is, it should be one that you can always look back upon and know that the best decision was made and that you would make the same decision over again in the same situation.
So how do you know if it is time? There are several criteria used in evaluating life quality and you should consider them carefully.
Is your pet eating? Basically, quality life involves eating or at least interest in food. An animal that is hungry has vitality that must be considered, though this is not the only consideration.
Is your pet comfortable? The pet should be free of debilitating pains, cramps, aches or even the psychological pain that comes from the development of incontinence in an animal who has been housebroken for an entire life.
Does the pet still enjoy favorite activities? The elderly pet does not necessarily need to continue chasing balls or jumping after discs but he should enjoy sleeping comfortably, favorite resting spots, the company of family, etc. You know your pet better than any one and only you can truly answer these questions.
Dr. Alice Villalobos, the veterinarian who started Pawspice, a quality of life program for terminal pets, has published a scoring system for life quality called The HHHHHMM scale. The letters stand for: Hurt, Hunger, Hydration, Hygiene, Happiness, Mobility, and More Good Days than Bad.

Quality of Life Scale: The HHHHHMM Scale

Pet caregivers can use this Quality of Life Scale to determinethe 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 scores 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
Adapted by Villalobos, A.E., Quality of Life Scale Helps Make Final Call, VPN, 09/2004, for Canine and Feline Geriatric Oncology Honoring the Human-Animal Bond, by Blackwell Publishing, Table 10.1, released 2006.

If you are considering euthanasia, discuss the pet’s condition with your veterinarian prior to making a decision or even coming in for an appointment. Every veterinarian has a story or two about the pet that was brought in for euthanasia but turned out to have a relatively simple problem and ultimately achieved a complete recovery.The mental process of making the euthanasia decision is heart breaking and you do not want to have to undergo this process twice but, on the other hand, you do not want to euthanize a pet with a treatable disease. Many times people come in for their euthanasia appointment having already made their decision when, in fact, their pet has a reversible problem.
Do not assume your pet’s condition is untreatable.Call your veterinarian first and discuss the situationbefore you are too far into this emotional process to turn back.
Use the medical resources available to youto get all the facts and options before making this decision.


Should You be Present?
Again, this is a very personal decision. On one hand, you probably do not want your pet to be alone with strangers in the final moments but on the other hand you may not be up to watching your pet’s death. Every owner wants to think of euthanasia as a gentle slipping into death, much like falling asleep. In reality, the pet will probably not close his eyes, and there may be a final twitch, gasp, or even urination. Some animal hospitals do not allow pet owners to be present for euthanasia as it may be disturbing to an owner. To help ease this transition between and death, sometimes a tranquilizer is given first to alleviate some of the above, but you should keep in mind that this may not be how you want to remember your pet.
The issue of children being present is a personal one and the above information should be considered.

How is the Procedure Performed?
Different clinics have different approaches. At my clinic, appropriate forms must be signed in order for the procedure to take place. If the owner is to be present, an intravenous catheter may be placed. This takes a few minutes and is usually done while the owner pays for the procedure and deals with paperwork. The payment transaction is done prior to the procedure so that the owner will not have to tearfully sign checks or credit card slips just following the emotional height of the procedure.
The intravenous catheter serves several purposes. First, the euthanasia solution is painful if administered outside the vein. The catheter ensures clean access to the vein, even if the owner is holding the pet. The catheter also allows for a sedative to be administered prior to the euthanasia solution.
After the catheter is placed, the pet re-joins the owner in the exam room. The owner may spend some last time alone with the pet if desired.
The procedure itself is very fast. If a sedative is to be used, it is given first so that the pet is euthanized from a sleeping status. The euthanasia solution, generally dyed a bright color so that it cannot be mistaken for anything else, is delivered and death comes peacefully in a matter of seconds. The owner is allowed to remain with the pet for final private goodbyes. At the end of this time, after the last goodbyes and caresses are completed, the owner simply exits the room when ready and the hospital staff takes over.
Let the veterinarian know in advance if you would like a lock of hair or the collar as a keepsake.

What Happens To My Pet Afterwards?
Most clinics offer several disposal methods.
1. A rendering provider can be contracted to dispose of pet remains. This is via a chemical process called rendering, and is sometimes free of charge.
2. As another option, your pet’s remains can be part of a group cremation. There is usually an extra charge for this service.
3. If you wish, you may have a private cremation and the ashes will be returned to you either in an urn of your choosing or a cedar box (the basic option). There is an additional charge for the service and the urn.
4. Private services can sometimes be arranged through local providers.
5. Many city ordinances prohibit the burial of a pet’s body at home, so check what is legal in your area.
Autopsy (called necropsy for animals) is available and is compatible with any of the options listed above. There are different levels of detail for this procedure. If you have unanswered questions or a legal interest in these results, please discuss the details with your veterinarian.

Grieving
Grief is a natural part of loss and has predicable stages. Do not feel ashamed or embarrassed about grieving for the loss of an animal. Our pets are beloved family members and their loss is keenly felt. Still, it is important to realize that death is a natural end to life and that love will always continue. There are many resources available to assist you in your grieving process.
The UC Davis School of Veterinary Medicine has a Pet Loss Support Program that offers toll-free telephone support to callers. The hours are Monday through Friday, from 6:30 am to 9:30 pm Pacific Standard Time.1-800-565-1526
In addition, the following on-line areas may be helpful:
www.petloss.comwww.in-memory-of-pets.com/pet-loss.htm
Helpful books are available as well:
Final Farewell: Preparing For and Mourning the Loss of Your PetBy 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 Memoriumedited by Kymberly Smith, The Charles Press.
Absent Friend: Coping with the Loss of a Treasured Friendby Laura and Martyn Lee, pub. by Henston Press, High Wycombe, Bucks, England, 1992.



The 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...