Euthanasia Part 1 – Caring for the Human

Euthanasia is a big part of our work as veterinarians. It is something I have to face on every shift working in an emergency setting. It doesn’t get any easier no matter how many times I have to do it, but I have fine-tuned my approach over the years so that each euthanasia process runs as smoothly as possible and with minimal additional stress to patient and client. This week, I will talk about taking care of your client.

The most important aspect of taking care of your client in this difficult time is to make sure you really focus on communicating clearly, effectively and most importantly, with sincere empathy.

First, I listen to what their concerns are, and why they are have made the difficult decision to euthanise their pet. Quality of life decisions can be a very grey area, and sometimes what you think may be manageable as a veterinarian, can be a huge quality of life concern for the client. A prime example is osteoarthritis in older dogs – you have assessed are clinically well, except for some difficulty walking. The client sees their pet every day and notices the struggle their pets go through. Euthanasia is a difficult conclusion for them to come to and in most instances, I will defer to the client when it comes to assessment of quality of life of their pet.

One way I help clients assess their pet’s quality of life is by asking them about a few aspects of it. Things I ask include:

• Can your pet do the things that make them happy?
• Do they spend more days sad, depressed and ill compared to the number of days they are bright, happy and eating?
• Is your pet in pain? Is it manageable?

Once a client has expressed that they want to euthanise their pet. I always ask 3 things:

1. Get clients to confirm verbally that they have decided to euthanize their pet. I frame the question this way: “So my understanding from our conversation is that you have made the decided to euthanise ‘Fluffy’ today?’ Sometimes, when you ask this question, the clients reveal that they have not actually come to that decision yet, which means you will need to backtrack a little and guide them through the decision process again.
2. Whether the client would like to be present for the euthanasia.
3. How they would like us to handle the after care.

Next, I always try to manage all documentation and finances before the euthanasia so that the clients can leave after the euthanasia and begin to grieve rather than have to do paperwork – the only exception is when the patient is in a critical condition and euthanasia cannot wait.

Try not to perform the euthanasia in your consult room or in the main treatment areas – if you have a private room for euthanasia’s, that is the most ideal. This is important especially if the client comes back in the future with another pet or a new pet. They often find it difficult to walk into your consult room and be reminded of the euthanasia of their beloved pet.

I like to give clients some time to spend alone with their pet to say their goodbyes in private. When I come back into the room, I start by explaining the process of the euthanasia, covering the following things every single time:

• Euthanasia is an overdose of an anesthetic agent
• The process is quick – 10 to 20 seconds
• It is completely painless
• They don’t close their eyes after
• Can have a couple deep breaths and muscle tremors
• Can release bowels and bladder – (especially important to warn of this if the clients want to hold the pet)
• Lastly if their pet came into the hospital in shock and are obtunded and I have fluid resuscitated them and they are now more bright and alert, I warn the clients that their pet looks better but the underlying disease remains the same

Once the euthanasia is performed, I again ask if the client wants to spend a little more time in private with their pet. Finally, when the client leaves, they typically will say ‘thank you’. Don’t say something like ‘my pleasure’ or ‘you’re welcome’ like you would for a vaccination consult. This is a natural response, but would be a terrible faux pas. I simply say ‘ I’m very sorry for your loss. Take care for now and let us know if we can help in any way’.

Next week … I will discuss caring for the patient.