Euthanasia: Honoring Our Patients & Ourselves

People want confirmation they're making the right decision. The majority of the time, the animal is ready, and I can help the pet have a peaceful goodbye. Death is a part of life. That's a phrase I have started to say quite frequently. It is a part of life we do have to face and it’s a blessing for me to give people the best experience they can have.

—Staff veterinarian at a mobile euthanasia practice in Nevada, in practice 14 years

Euthanasia is the last gift we can give them. We can control their passing; we can let them pass with some dignity. Everybody has this vision that their pet is going to pass peacefully in the night in its sleep. That’s not reality. But we can make sure they pass peacefully and pain-free.

—Registered veterinary technician at an animal hospital in Ontario, in career 13 years

I get that comment all the time from clients, and honestly for me, it's not. As an ER doctor, I don't have any preexisting emotional attachment to the patient. I haven't been seeing this 16-year-old dog since it was a puppy. So it's really not the hardest part of my job. If it was, I don't know that I could still be in this job. I don't go a shift usually without at least one euthanasia. 

For me, the worst is when we have a really sick patient and the client can't afford the treatment, which is understandable, but then they don't ‘believe in’ euthanasia, and they opt to take this really sick pet home. Those are the cases that make me more emotional, because I’m not ending the suffering of that pet and I can imagine the suffering the pet is going through when the owner won't consider euthanasia.

—ER veterinarian in Ohio, in ER practice 15 years

It’s easier for us because we are not that pet’s vet. We haven’t spent 10 years caring for this pet, or we haven’t tried everything under the sun to save this pet. Some vets can feel like euthanasia is a failure of treatment, but it’s not! For us, we get to come in for a home euthanasia and help this pet have a peaceful, humane goodbye.

—Owner and founder of a mobile euthanasia practice in Wisconsin, in practice 20 years

People want to make the euthanasia decision at the best possible time. They don't want their pet to suffer unnecessarily but they also don't want to rob their pet of precious time. More and more now, we are really asking, “What is this pet’s quality of life?” versus the mindset of the pet living out every possible day. It's something people want guidance for. They want to hear it from an expert. Clients are especially worried about pain. They want to know if their pet is suffering. If a client is asking about euthanasia, if they are opening the door to that conversation—even if on paper you're thinking it doesn't seem like we're at the point of euthanasia—it’s important to dig deeper. There's something going on that led them to start the conversation.

—Veterinarian, splits time between veterinary clinic and mobile euthanasia practice in Virginia, in practice 10 years

It varies very much client to client. Oftentimes a family member is holding the pet, which in almost every case is OK, as long as I can access what I need to access. Once I've confirmed death, I give them a few minutes. Some people will say they don't want any time. Some people need more. Then I offer to let them carry the basket [with the deceased pet] out to my car.

—Staff veterinarian at a mobile euthanasia practice in Nevada, in practice 14 years

One thing I hear, especially from older clients, is that they had a euthanasia that didn't go very smoothly 30 years ago. In my euthanasia appointments, I have the opportunity to explain we're using different medications now and it's a different process than it was back then. It can be really powerful and almost healing to reframe their experience of saying goodbye to a pet.

Before I did in-home euthanasia, I would routinely take the pet to the treatment area to place the IV. But one of the things that I learned in mobile practice is that physically keeping the pet and the owner together is so important for the pet owner. Now even in the clinic setting, I rarely separate the pet from the owner. 

I’ll either go in by myself and place an IV or I'll have a technician come with me and we'll do it together. It involves getting in some creative positions and tight spaces. It's something a lot of us probably wouldn't be comfortable with right off the bat but it's not rocket science! It is something everybody can learn with practice. For some owners that makes a huge difference to have the pet physically there. Sure, it can be a little awkward sometimes, but I wouldn't dream of separating them.

Making the euthanasia appointment as good as it possibly can be, whether that's by giving the client our full attention or turning the lights off in the surrounding areas so that they have a little bit of peace and quiet. Just saying the pet's name or putting your hand on their shoulder, whatever it is, doing whatever we can to help that person through what might be one of the hardest days of their life is something many of us were not trained to do. But we’re in this profession because we want to help animals and help people and this is a way that we really can do that.

—Veterinarian, splits time between veterinary clinic and mobile euthanasia practice in Virginia, in practice 10 years

Even for clients coming in specifically for euthanasia, we still do a physical examination, since we do not have a preexisting relationship. Because of the flow of the ER, when the patient arrives, we bring the pet into our treatment area, do our quick physical exam, place the catheter, then get them back into the room with their people. Most pet owners are fine with the process, but we do get a few who don't want the pet taken away, and so we will, in some cases, place the catheter in the room. Our techs are amazing at it, but if it's a really sick animal and their veins are really poor, there are times we have to try more than once and it’s better when clients don’t have to see that.

We have comfort rooms and they are down at the far end of the hall, with a separate exit so the client can leave through that side door instead of walking back through the busy lobby. The comfort rooms all have doorbells so the client can take as much time as they need [before the final injection], and then when they are ready, they push this doorbell that chimes at the front desk so the staff can notify the doctor to go in.

—ER veterinarian in Ohio, in ER practice 15 years

It’s a wild aspect of our job that I don't think a lot of people realize. I usually take a few minutes. I come out, I take a few deep breaths, I get some water before I check in on who's waiting and who's where and who else needs what. I think one of the best things that we can do as veterinarians is really to give our presence to that owner and it's harder in the clinic setting when you’re thinking, “I still need to come up with a treatment plan for Fluffy, and I have to call Mrs. Smith back, and what medication am I going to choose for Buster’s infection.” To put that on hold for a minute is certainly easier said than done. In the mobile euthanasia setting, you’re getting in your car, you have 30 minutes to decompress or listen to some music while you're on your way. Being so physically close to everything else [when you’re in the clinic] it's a little harder to take that time.

—Veterinarian, splits time between veterinary clinic and mobile euthanasia practice in Virginia, in practice 10 years

Even in ER, we’ll go between the euthanasias and the really critical patients and then we'll have torn toenails or ear infection, or the puppy who ate a sock and we have to make it puke up the sock. It's not as much back and forth as the general practitioners have, but we do have some healthy happy pets that we bounce back and forth between. I feel like most of us have that skill set where we can maneuver between appointments.

—ER veterinarian in Ohio, in ER practice 15 years

It used to be a lot harder back in the day. But I look at it now as giving the pet a gift, letting them pass with dignity. I don’t want to say it doesn’t bother me. It’s still taking a life, so there is a toll. But I’ve come to peace with it, and I still would never be a part of something that I wasn’t OK with, so… sometimes it’s just another appointment that you switch in and you just keep going.

—Registered veterinary technician at an animal hospital in Ontario, in career 13 years

“Freeing” is maybe not the best word, but I’ll say it has been freeing to help people say goodbye. Coming out of vet school, I don't know if I just wasn't really prepared for this, or they didn't prepare me very well, but I kind of always thought if I didn't cure the pet I was a failure. I felt like I didn't do my job if I couldn’t convince the owner to go through all this treatment. But it weighs on me a lot less now. If the pet owner doesn't want to treat all this stuff that's OK, and I can help them in a different way.

—Staff veterinarian at a mobile euthanasia practice in Nevada, in practice 14 years

I remember performing my first euthanasia as a student extern. It was in an emergency room setting and the pet owner had chosen not to be with their pet. I was standing right next to the supervising veterinarian—this was just a doctor who worked at the ER who saw me there as a fourth year student—and she said, “This is an experience you need to have.” She shepherded me through doing that first one. It's been more on the job that I was taught how to deal with euthanasia.

I guess what I wish I had been taught is: it's both OK to have those feelings and to compartmentalize them and deal with them later. It’s OK to cry. It's OK to take a moment to collect yourself and to not just jump right back into the next appointment. But it is also OK to not take all of their emotions onto yourself—not necessarily putting up a wall between you and the owner—but it is OK to have a little bit of a barrier there just for yourself to be able to continue to get through the day.

—Veterinarian, splits time between veterinary clinic and mobile euthanasia practice in Virginia, in practice 10 years

Early on in my career, I was very judgy. I felt like, “Why don’t you want to be there for your pet? How could you do that to them, what do you mean you can’t treat their diabetes?” But now being in it for so long, I get it. I personally still won’t do what I consider to be convenience euthanasia, but there are so many factors. If a pet owner brings in a 2-year-old cat that just started peeing around the house and the owner hasn’t tried anything yet…we obviously recommend a workup and if they decline, then we’re not going to be part of that. We still have to sleep at night. 

But there’s a flipside of that too. One time we had a critical cat with diabetes. The client knew he couldn’t commit to the treatment and asked to euthanize. A younger technician said exactly what I said back in the day, “What do you mean the client doesn’t want to treat? It’s just diabetes.” But we have to understand, the client might not have a lifestyle or work schedule or financial ability, and euthanasia might be the best thing for both the owner and the pet. So I’ve also been on the flipside of being the person who is OK doing the euthanasia when someone else isn’t. 

—Registered veterinary technician at an animal hospital in Ontario, in career 13 years

While we empathize with those wanting to euthanize an aggressive pet, we decline those requests because it’s not safe for our team physically or mentally.

—Owner and founder of a mobile euthanasia practice in Wisconsin, in practice 20 years

I have not. I know some colleagues refuse to euthanize if they believe it is a convenience euthanasia. But I think to really be able to define a convenience euthanasia, you have to ask so many questions to get there and there's so many different things that you have to look at.

For people who bring in a pet they are ready to say goodbye to, for whatever reason—whether the owner can’t keep up with the pet financially, whether it’s physical and they literally can't pick their giant dog up to go outside, whether they aren’t able give proper treatment to the pet—there can be judgment in the clinic from team members or other veterinarians, and I feel like in the home setting it can be easier. You avoid the team member walking by saying, “Oh this dog is fine! I can’t believe they are euthanizing.” 

I have euthanized a few pets for issues of aggression, and some people might view that as convenience, but I view that as a safety issue. I'm sure there are real cases of convenience euthanasia out there. I'm sure there are. But I have personally not run into that. Deep down there's always a reason, and it may not be a reason that everybody agrees with and that's OK.

—Staff veterinarian at a mobile euthanasia practice in Nevada, in practice 14 years

I can't think of a time that I have felt like "No, I can't do this euthanasia." But I would, though. I have to be able to sleep at night. I need to make sure that this decision is one that I agree with.

I remember a dog that had really bad skin disease. He was so itchy and uncomfortable due to his disease, and even though skin isn’t a body system that we typically think of in terms of euthanasia decisions, this dog’s quality of life was definitely affected by his disease. It was a large dog and he had been on antibiotics for years, so I imagine that the expense alone from that was a lot for the owner. 

The conversation with the dog’s owner was delicate. I remember saying, “You know that all of these options are out here, there's referral options, there's medication, are you sure that this is what you want to do?” That was a harder one for me personally, but as I've had time to process it… you just don't always know what people are dealing with. You don't know what financial stresses they have, you don't know what else is contributing to their decision. So even if it's not necessarily the decision you would make for your pet, if it is still an overall kind decision, it’s OK. As veterinarians we must give ourselves permission to take each case individually and also recognize that our decision making may evolve over time.

—Veterinarian, splits time between veterinary clinic and mobile euthanasia practice in Virginia, in practice 10 years

I recall three animals in 15 years. One instance was a man whose parent had just died and he brought in his parent’s 2 cats for euthanasia. They weren’t sick, there was nothing wrong with them, he just didn’t want them. I sent him to a shelter. Maybe the shelter won’t have room, but maybe they do. 

Another time an owner brought in a one-year-old dog with chronic diarrhea for euthanasia. He claimed to have done lots of tests and that nothing was fixing the dog’s diarrhea. But in my examination, the dog was in great shape. I obviously had no idea what tests they did or did not do, but I told the owner to schedule an appointment with his regular vet or find a rescue group. 

I will euthanize for behavioral issues in ER. I know some people don't do that. But anytime anybody tells me that they're worried their dog is becoming aggressive and might hurt somebody, I'm always going to say yes. If I turn them away and then the pet bites a child or really injures somebody… I’ll always euthanize for those type of situations. Or a cat that has been peeing outside the box for years. No shelter is going to easily adopt these pets out. And shelters are overloaded. There are things worse than death. With the way that we do it, death is a peaceful way out.

—ER veterinarian in Ohio, in ER practice 15 years

I remember one dog… he was a big fat dog with diabetes. This poor dog was super dehydrated and I could not get the catheter in, I couldn't find a vein. I had a spinal needle to give an injection in the liver, but it wasn't working… it wasn’t good. Eventually I ended up finding a vein. It was hard and the owner was upset. That euthanasia did not go as planned. But the dog was completely sedated for the whole thing, he didn't feel anything, and he wasn't going to get better. That one was hard. But ultimately I find solace in the fact that he did not feel anything.

—Staff veterinarian at a mobile euthanasia practice in Nevada, in practice 14 years

I can say that the most thank you cards I ever get are after euthanasia. I’ve gotten hundreds of thank you cards for euthanasia and like 5 for “thank you for saving my dog's life.”

—ER veterinarian in Ohio, in ER practice 15 years

I remember a single woman who lived by herself. Her cat had gotten sick and lost a lot of weight. He had GI signs and he was old. It was very clear that it was his time. He was a very sweet cat and she was a very nice woman and his passing was very peaceful. It was July and here in Virginia it was very hot, and when all was said and done, she invited me to have an ice cream bar with her at her kitchen table. I don’t know, just that I had a nice connection with her and was glad to end on that note. That was a really special experience.

—Veterinarian, splits time between veterinary clinic and mobile euthanasia practice in Virginia, in practice 10 years

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