Last week we discussed the importance of caring for the client during the process of euthanasia of their much loved pet. This month, we focus on your patient. The goals of euthanasia are always to make it as painless, fearless and stress-free as possible for the patient.
A vast majority of patients presented for euthanasia are either suffering from chronic, terminal or traumatic disease. The first thing I like to do is ensure the patient’s pain is managed. This usually means providing opioid pain relief. Methadone is my opioid of choice. Butorphanol provides minimal pain relief, but is excellent for mild sedation. Next, if your patient is in shock, you need to try to alleviate some of that through IV fluid resuscitation. This is important as poor circulation will slow the process when you administer the euthanasia solution.
One of the most important goals in the euthanasia process is to have the patient as calm and stress-free as possible. If the patient is stressed or anxious, then some sedation may be required. Diazepam or Acepromazine are good choices (depending on the condition of the patient of course), and together with the opioid you have administered already for pain relief, will help calm the patient. Try to avoid the use of medetomidine as a sedative in all but the most fractious of patients as it causes peripheral vasoconstriction which will make IV catheter placement difficult. The aim of sedation is to relax your patient as much as possible without rendering them unresponsive to the owner when it is time to say goodbye. This can be tricky as every patient responds differently to sedation, so you must make it a point to warn the owner that the sedation may make their pets very sleepy.
Where possible, I avoid performing a euthanasia without first placing an IV catheter. It makes the delivery of the euthanasia so much smoother. Including an extension to the administration line also allows you to stand a little away from the patient and their owner to give them a little privacy while you administer the euthanasia solution.
Once your patient is sedated and an IV catheter placed, I set up comfortable bedding in the room where I will be performing the euthanasia and bring the patient to the room. The amount of euthanasia solution I have with me always exceeds how much I think I will need; the last thing I want is to have to leave the owner and patient to get more euthanasia solution.
Once I have administered the euthanasia solution, I check the heart and once that stops completely, I then tell the owners that their pet’s heart has stopped, which they understand as, their pet has passed.
Performing euthanasias is the one of the hardest parts of our job but it is also a privilege we hold as veterinary surgeons, so I hope my tips will help make the process easier for you, your client, and most importantly, your patient.