Wednesday, January 9, 2019

Everything You Wanted To Know About Euthanasia But Were Afraid To Ask


I imagine that many people didn't make it past the title, and that's ok. This post is not intended for everyone, but the last post reminded me that I wanted to have something on the record regarding this. It's a heartbreaking subject, but it's an important one. I understand that it could be too disturbing or emotional for some readers, and that others would just rather not know. Have no fear - if you're in either category you can happily skip this post and look forward to the next one instead (which I promise will be on a light topic).

There is a general rule that for every person who asks a question, there are ten others who have the same question but did not want to ask. I have no idea where this little bit of folk wisdom came from, but it strikes me as roughly true for many situations other than euthanasia. When it comes to euthanasia however, because of the intense emotions involved, I think the ratio is closer to a hundred to one.

Here then are the questions I have been asked:

Does it always work?
Yes, it does. It's poignant to consider that while veterinarians spend their careers trying to save lives, the one service they provide that is absolutely guaranteed to be effective is ending life.

Why do you sedate first?
Not everyone sedates their euthanasia patients first, but I almost always do. To begin with, I want to make sure that the pet is not picking up on everyone's emotions at the end. They are often very attuned to this and can become frightened, especially in a vet office. Secondly, especially in ill patients, finding a good vein for the euthanasia injection is not always that quick. Sedation can go under the skin, but euthanasia needs to be in a solid and reliable vein. I don't want the patient to become anxious if we're taking a few moments to secure a good vein, nor do I want them to move while we're injecting the euthanasia solution.

How fast is sedation?
It varies quite a bit, but usually ten minutes or so. We wait until they are woozy and unaware. Some individuals will become fully unconscious with the sedation alone.

How does the euthanasia drug work?
We use an overdose of an injectable anesthetic. It's in the barbituate class, therefore similar to some sleeping pills or the anesthetic you might have had to get your wisdom teeth out a few decades back (safer drugs are used now, you'll be pleased to hear). We use such a high dose that all parts of the brain fall asleep - first the parts that keep a patient conscious and thinking, and then the parts that control breathing and the heart beat. Because it is an anesthetic the sensation is like that of falling rapidly asleep.

And how fast is this?
Very fast. Once we get a vein it can go very quickly. Depending on the size of the patient it may take a few seconds to inject the entire dose, but they are always completely unconscious before the injection is even done, and often have stopped breathing as well.

Why do you put alcohol on the vein?
I hadn't considered how this looked until a client asked, "Why are you sterilizing that when he's going to be dead in a minute anyway?" Good question, but I'm not sterilizing it. Alcohol helps make the vein stand out better.

Are there ever any bad reactions?
The great majority of the time everything goes smoothly. The sedation we use can sometimes briefly sting a little as it goes in, but very soon after they start to feel good. And on the odd occasion while the sedation is kicking in the pet can seem disoriented, but this passes quickly. Bad reactions to the euthanasia itself are extremely rare and usually take the form of vocalizing. This is very distressing to the owner, but the pet already has enough drug in their system that they're not really aware of what is happening, or in control of the sounds they're making. And again - it's extremely rare. They do sometimes take a couple of deep breaths at the end though, when they're already fully unconscious.

Why don't they close their eyes?
When you die all your muscles relax, including those in your eyelids. Eyelid muscles have to contract to close. Incidentally, bowel and bladder muscles can relax too, so sometimes they will release these as they die. They are of course completely unaware of this.

What happens to the body now?
The crematorium doesn't pick up every day, so in most cases the body will be kept in a dedicated freezer until they come. You are probably going in a special fridge for a short while after you die, so it's really very similar.

How do I know that the ashes I get back are from my pet?
We trust the crematorium, we know the operators well and we have all had our own pets cremated there. You are also welcome to visit the facility and even take your pet's remains there yourself.

You're not going to do experiments on him now are you?
No. The fact that I have actually been asked this more than once underlines how little some people understand about science, let alone professional ethics. Not only is the very idea repugnant, but there are honestly no useful "experiments" that can be done in this scenario.

Can I donate his body to science?
In rare instances, maybe. Every now and then there's an odd case where we might learn something from the results of an autopsy. While this is not really "donating his body to science", it's kind of the same idea. We would never do so without asking permission first though. As we often feel too awkward to ask, autopsies usually only get done when a client suggests it themselves.

Do you ever get used to having to euthanize people's pets?
No. Never. My heart breaks a little every time.

(If you have any questions of your own, please feel free to ask them in the comments section below.)

7 comments:

  1. Hi there. We had to put our 13 year old cat to sleep back in May and I have a couple of questions regarding the sedation step. The sedation worked VERY quickly (less than a minute) and we noticed while waiting for our Veterinarian to return to the room, our cat had rapid eye movement while her lids were open, took breaths very far apart and even lifted her head a bit. We are very grateful for our Vet's compassion and gentleness and we would just like to better understand the physical/neurological reasons for these occurrences. Thank you so much.

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    1. I can see that you would have wondered what was happening as many people imagine that a sedated patient should appear to be fully relaxed, without any movement. I don't know which drug was used (there are several possibilities), and individual responses do vary, but regardless it does sound like she was fully sedated and blissfully unaware of what was happening. The eyes remain open because the eyelid muscles are relaxed. Even in general anesthesia for surgery the eyes remain open and we actually have to lubricate them so they don't dry out. The rapid eye movements likely indicate dreaming, and the very slow breaths just show that the sedation was profound. It's something we monitor with anesthetic patients to assess how deep they're under. Head movement is probably another sign of dreaming. Some will move their legs for the same reason as well.
      I'm sorry you had to let your poor girl go. This is always so hard, but it does sound like the end was smooth and free of pain and stress from her perspective. You have my condolences.

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  2. I know that you explained this to me afterwards but I don't really remember exactly what you said but with Trouble, he just fell asleep with the sedation and it felt peaceful..With Roscoe, he was incredibly active, having what looked like non-stop spasms or convulsions - his legs kicked constantly and it "felt" like he was in distress, even though I knew he would not have been...Are you saying that when this type of constant movement happens, it's more like "happy dreaming and chasing squirrels" than the seizure like continual movements it looked and felt like at the time? It was very very distressing and upsetting to me while it was happening because it didn't feel peaceful at all, certainly not for him and that was really painful for me..I'm just curious if the 're-frame' is that this type of ongoing movement is happy dreaming vs what it felt like to me, the grief-stricken human?

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    1. I honestly don't recall that clearly, but it certainly could have been dreaming, or if the movements were really chaotic it's possible that it was seizure-like activity. That would be rarer than rare with the sedative alone, but "anything is possible". Given his cancer I suppose there is the outside chance that he may have had metastasis to the brain which could make it more vulnerable to seizures. The really key point however is that patients don't actually experience seizures. The electrical activity in the brain that causes a seizure also suppresses awareness. Most human epileptics never remember their seizures. Plus the sedative made Roscoe unaware of anything. Either way, he was totally out of it - chasing squirrels in dreamland, or blissfully blacked out while seizuring. Terrible to have to watch though :-(

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    2. I think that's along the lines of what you'd said - that his brain would've been unaware of what his body was doing and he would've been blissfully in la-la land...That did/does make me feel better of course and I will choose to believe he was dreaming happy dreams..the memory of having to watch his body not be peaceful and how that made my heart feel, I doubt will ever leave me.I hope I never experience that again cuz the peaceful sleep was WAY easier on my heart.. :) Thanks for refreshing me on this cuz even though it's painful still to remember, the information helps a little bit..

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  3. As much as I didn't want to read this post, I really appreciate having read it. Thank you.

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  4. Thank you for this post. I had to put down my older cat a year and a half ago. Much of what you explained here was likely explained to me that day, but I was in such shock at losing my little guy that not all of it stuck with me. I am grateful that I had a caring vet that came to my home for the procedure.

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