Pet euthanasia has come a long way in the past 10 years. Thanks to advances in medical technology and an increased understanding of the needs of both patients and their families, euthanasia is now more humane and compassionate than ever before. Euthanasia experts have found ways to celebrate the bond between patient and practitioner, protect patient comfort, and elevate client pre-planning and communication. As a result, everyone involved in the emotional journey of euthanasia can be adequately supported through these advancements. Thanks to these improvements, euthanasia has become the most respectful and dignified way to comfortably end a pet’s life.
But pet euthanasia is an emotionally charged topic, and it’s one that veterinary teams naturally approach with caution. However, euthanasia can also be a very rewarding aspect of veterinary work. Though often viewed with hesitation, especially among less experienced vets, as veterinarians we are truly fortunate to have the privilege to alleviate suffering.
It gives teams the opportunity to provide comfort and closure for families who are facing the loss of a beloved pet. And while the decision to euthanise is never easy, it can be a deeply fulfilling experience for everyone involved. In this article we’ll take a closer look at what clients can look out for, some of the challenges surrounding pet euthanasia, and how veterinary teams can ensure this care is delivered at the appropriately for clients and their pets in need.
When is the right time to euthanise a pet?
Euthanasia is a decision that no pet owner ever wants to face. It can be a difficult and emotional time, and it is important to guide the client when making the best decision for their sick pet. If the client is considering euthanasia, there are a few things that they will need to take into account:
- The client will need to consider their pet’s quality of life. Is the pet in pain? Is the animal unable to eat or drink? Are they having difficulty with mobility?
- The client will need to consider their own emotions. Are they able to care for a sick or dying animal? Are they prepared for the grieving process?
- The client will need to consider the financial cost of caring for a sick or elderly pet. Veterinary care can be costly, and they may not be able to afford the advanced treatment options that their pet needs.
That decision is individual to every pet, and every owner. Moira Anderson Allen, M.Ed. recommends these factors to consider when assessing a pet’s quality of life:
Mobility
Mobility issues are common in older pets. A dog may no longer be able to climb stairs or hop into a car; a cat may lose the ability to jump onto a bed or chair. At this stage, however, the pet may still be healthy and happy. There are many ways to make accommodations for reduced mobility. For example, the client could install a ramp or set of stairs to help their pet get around. They may also need to adjust their feeding and exercise routines to compensate for their pet’s reduced activity level. With appropriate planning and guidance, the client can make sure their beloved pet enjoys a long, happy life.
Appetite and Prehension
A healthy pet should have a good appetite and be able to eat with gusto. If the pet in question is unable to eat or digest its food properly, it will slowly starve. If the animal has difficulty chewing or swallowing due to dental disease, if it regurgitates immediately after eating, or if the client has to coax it to eat, there is a problem that needs to be addressed. The ability to eat is a critical health issue for any elderly pet.
Breathing
Breathing is arguably the most important process in the body and critical to sustaining life. Unfortunately, elderly animals are highly prone to cardiac or respiratory disease, making it increasingly difficult for a pet to breathe. If the client notices their pet panting or labouring to breathe, it is important they seek veterinary care immediately. Stabilisation and a chest x-ray followed by a thorough diagnostic plan may help to determine the underlying disease process, and guide appropriate medications and a treatment plan to alleviate symptoms.
However, if severe pulmonary oedema (fluid in the lungs) is present due to cancer or advanced cardiac disease, the treatment may be more involved and in the worst cases euthanasia may be the most humane option. In such cases, breathing can be critically impaired and the best course of action may be to consider euthanasia.
Discomfort
Discomfort in animals can be difficult to determine, as animals (particularly our feline patients) instinctively mask discomfort as much as possible. The client may pick up clues by watching their pet’s posture and expression or changes to their usual routine. For example, the pet may not have an appetite and may be reluctant to get out of bed or go on their usual walk.
Clients may be able to discern subtle changes in their pet’s body language. Discomfort can cause an animal’s face to appear furrowed or “worried”, rather than relaxed and happy. Additionally, an animal in pain may sit hunched or “hunkered” and tense, rather than relaxing and lying down. Lack of mobility and unusual aggression in otherwise friendly animals can also be a sign of pain.
Incontinence
Some pet owners feel guilty over the natural annoyance they feel when a pet becomes incontinent. Incontinence, however, can also be stressful for the pet. As a basic survival mechanism, animals learn not to “mess where they sleep” (for the smell would draw attention to the location of one’s den). When an animal can no longer control when or where it urinates or defecates, the client can be sure it is not happy with the situation.
Incontinence can be caused by a variety of medical conditions, such as nervous system disorders, bladder or urinary tract infections, renal disease, and hormonal incontinence. If the pet is incontinent, it is important to advise the owner of the importance of a clinical exam and appropriate diagnostics (e.g., urinalysis, ultrasound, blood work).
In some cases, incontinence can be resolved with medication or surgery. In other cases, pet owners must simply learn to deal with the situation and provide their elderly pet with extra care and patience. Either way, it is important to remind the client that the pet is not acting out of spite when they have an accident – so there’s no need to feel guilty.
Cognitive Dysfunction
Mental deterioration and reduced cognition are common signs of ageing in humans, and recent studies have proven this to be similar in our animal companions. As pets get older, they may start to “forget” things, begin to wander aimlessly or stare at walls. This confusion can unfortunately develop into fear. In some cases, this may be the result of hearing or vision loss and if severely impacting quality of life, then pet euthanasia should be discussed.
Happiness and Quality of Life
Happiness is a subjective emotion, and one that is difficult to quantify in an animal. However, if the client has been observing their pet closely, they are likely to be able to tell when it seems ‘unhappy.’ This reduced quality of life may be noticed when the pet no longer seems interested in its food, toys or surroundings. Physical contact with the pet owner and other family members may also be less enjoyable for the pet. Most pets are easy to please; therefore, if it is no longer possible to make the pet happy, it is likely that it is not receiving much joy from life.
Response to Treatment
Clients naturally want to do everything they can to help their pet when they become ill. However, sometimes the most humane course of action is to alleviate suffering. Many medications have deleterious side effects, repeated trips to the vet cause emotional distress, and more invasive treatments can take a physical toll.
Eventually, we may conclude that our efforts to treat a pet’s illness are more stressful to the pet than the condition itself — and that our efforts to save a pet’s life are actually diminishing, rather than enhancing, the quality of that life. Response to treatment is an important consideration when deciding whether or not to pursue aggressive medical treatment for a sick pet and whether timely euthanasia is necessary.
It can also be useful to guide the client into deciding when these signs are indicating that euthanasia is necessary. For example, providing a useful handout like How Do I Know When it’s Time? (Ohio State University) can offer a useful self-assessment for clients struggling to make the challenging decision.
The Challenging Veterinary and Mental Aspects of Pet Euthanasia
For those of us in general practice, performing and assisting clients through their pet’s euthanasia is likely a day-to-day part of our professional lives. And although it might be a common task for many veterinary professionals, that doesn’t mean that it’s without its challenges. In this article, we’ll discuss three of the most challenging aspects of pet euthanasia.
The Mental Cost of Pet Euthanasia
The mental costs of performing euthanasia, even when it is the right course of action, can be significant. As veterinarians and veterinary nurses, we often form strong bonds with the pets we treat, especially those we may have known throughout their entire lives. When we have to say goodbye to them, and even be the one to do it, it can be very difficult. This mental impact of euthanasia can also be significant on all veterinary staff involved.
Many of us struggle with feelings of guilt during times of euthanasia, even when we know that we did everything we could. We can all agree that providing this service can be emotionally draining, but it is also an essential part of our job. By sharing our experiences with colleagues, the wider veterinary profession, and educating the general public, we can help others to better understand the mental cost of euthanasia and how to cope with it.
The Financial Cost of Pet Euthanasia
Price shopping for euthanasia is something that we as a veterinary profession may encounter quite frequently. While we understand that clients want to be informed about the cost of euthanising their pet, it is important to remember that this critical decision should not be made based on price alone. Seeking a euthanasia service based entirely on cost is not something that should be recommended. Beyond cost, the most important thing is to be a veterinarian that a client trusts and feels comfortable with during this highly emotive time. During such an emotionally-charged time in their pet’s life, it’s also vital to know how to communicate effective with clients.
There are many methods of euthanasia and options for after-care and commemoration, and some of them are less ideal for the owner depending on the circumstance. Typically, the cheapest options may be the least pleasant for an owner seeking a comfortable and supportive experience. To make a death pleasant (at least as pleasant as it can be) requires a staff’s time and dedication, often additional medication or equipment, and increasingly often also support from external services (e.g., Pets in Peace). All of these added aspects make for a more pleasant euthanasia, and resultantly an increased cost.
Education on Pet Euthanasia
One of the most significant challenges behind euthanasia lies in education – vet school can only teach us so much about carrying out a peaceful and supportive death for a patient and client in need. Many students and graduate veterinarians rarely receive direct guidance on proper verbal and nonverbal techniques that make this “most difficult appointment” just a bit easier on everyone, including the veterinary professional.
It is not always easy to walk into an examination room for a euthanasia appointment and know what to say to a crying teenager, or whether to hug the elderly man who just lost the pet that was the last link to his late wife. We may have been delivered lectures or attended professional development sessions about empathy, body language, and about “being present” with another person in pain, but this changes completely when placed in that situation. As veterinarians, we must support each other, and seek training on how to deal with our own emotions as well as those of the animal owner in order to provide the best possible care during these difficult times.
But euthanasia isn’t just a challenge, it is a privilege and should be viewed as such. As veterinarians, we are leading the way in The Good Death Revolution, which we will discuss next.
The Good Death Revolution
As veterinarians, we are the only medical professionals licensed to euthanise. As such, we have a great responsibility to handle this procedure properly. Unfortunately, new graduates are often unprepared for this task. In fact, according to numerous discussions we have had with new grads, about 75% of them have never administered a life-ending medication. This lack of experience can lead to veterinarians feeling unsure and unprepared when the time comes to euthanise a patient. While it is impossible to completely remove the emotional weight of this responsibility, veterinarians can take comfort in knowing that they are providing a service that is humane and necessary. With proper training and care, they can help their patients achieve a peaceful passing.
The euthanasia appointment doesn’t need to be an unpleasant burden in the day, but rather a rare gem of connectedness and intimacy. It provides teams the chance to slow down, to listen to stories, to take deep breaths in quiet reflection in an otherwise chaotic schedule. Euthanasia, while sad and heartbreaking, can lead to rich personal satisfaction when performed well. When love is at the heart of your work, the veterinary profession finds peace, even when life is lost. We understand that euthanasia is a difficult decision for any pet owner, and we are here to help them through this process. The goal is to make sure that the pet is comfortable and pain-free, and that the client has the support they need during this difficult time. We appreciate the trust that the client places in us, and we will do everything we can to honor that trust.
Someone who is pioneering the good death revolution is Dr. Kathleen Cooney, CHPV, CCFP, the Director of Education at the Companion Animal Euthanasia Training Academy. Kathleen has been practicing advanced end-of-life care since 2006 and is well-known for her work in companion animal euthanasia and has authored two books on the subject. Dr. Cooney has collaborated in euthanasia training for the AVMA, AAHA, IAAHPC, HABRI, the Fear Free program, and is Founder and Director of Education for the Companion Animal Euthanasia Training Academy (CAETA). The core certificate program is Dr. Cooney’s design and is based around the The 14 Essential Components of Companion Animal Euthanasia. She is a strong advocate for best practices in all aspects of end-of-life care and speaks nationally and internationally on such topics.
The 14 Essential Components of Companion Animal Euthanasia
Here is Dr Katheleen’s list of 14 essential components of companion animal euthanasia as developed by the Companion Animal Euthanasia Training Academy (CAETA). Spelling out ‘good euthanasia,’ each step aspires to minimise stress for the pet, provide emotional support for the caregiver, and streamline the actions of the veterinary team:
G: Grief support materials provided
Examples: Printed pet loss guides, books, or direct links to online resources.
O: Outline caregiver and pet preferences
Examples: Talk about what’s important to the caregiver and pet. Match what they need.
O: Offer privacy before and after death
Examples: Make sure a family has time to be alone with their pet if they request it.
D: Deliver proper technique
Examples: Always use the most efficient and appropriate technique based on the pet’s health and available supplies.
E: Establish rapport
Examples: Slow down and emotionally connect with the caregiver and pet before proceeding.
U: Use of pre-euthanasia sedation or anesthesia
Examples: Sleep before euthanasia reduces anxiety and pain, and increases technique options.
T: Thorough, complete consent
Examples: Every euthanasia must always be properly documented in your records.
H: Helpful and compassionate personnel
Examples: Engage staff to assist who are naturally empathetic. The use of a ‘euthanasia attendant’ is strongly encouraged (more about this later).
A: Adequate time
Examples: Slow down, block out enough time to complete all 14 components.
N: Narrate the process
Examples: Describe what each step of the process looks like, being mindful to keep language simple and gentle.
A: Avoid pain and anxiety
Examples: Be gentle when handling the pet, use sedation whenever possible, and go slow to reduce anxiety.
S: Safe space to gather
Examples: Consider using a quiet room in the hospital or performing the euthanasia at home.
I: Inclusion of loved ones
Examples: Talk to caregivers about who should be there, including other household pets bonded to the one being euthanized.
A: Assistance with body care
Examples: Preplan with families around what’s important to them and carry out their wishes as if the pet were your own.
While euthanasia is typically performed by a veterinarian, the assistance of support staff that help to ensure everything goes smoothly is critical. This staff includes veterinary technicians, veterinary social workers, assistants, receptionists, and grief support personnel. These individuals work together to ensure the pet is fear free and the client is carefully looked after. While many people may be involved in the pet’s care, one consistent person increases the likelihood that everything flows smoothly. Having a euthanasia attendant helps to provide peace of mind for both the pet and the owner during this difficult time.
Shifting Hospital Culture Around Pet Euthanasia
Like any other progressive movement, advanced euthanasia did not happen overnight. And there are lingering obstacles that continue to stifle necessary change. Number one is the old paradigm that if it’s not broken, don’t fix it. It can be hard for veterinary teams to make lasting change around euthanasia. Reshaping a hospital’s culture takes time and commitment, but it can be done and done well.
The key is open communication between the staff, administration, and pet owners. When everyone is on the same page, euthanasia becomes less of a taboo topic and more of a shared responsibility. With euthanasia comes great sadness, but also the opportunity for healing and closure. Done correctly, euthanasia can be a gentle and peaceful experience for all involved.
