When pets die, their owners face choices

It happens every December. Grown children, home for Xmas, are shocked at how poorly the old family cat looks. The decline was so gradual, Mom didn’t notice, or maybe she just didn’t want to face it. People going away for the holidays don’t know what to do about their ancient pooch who has been rapidly failing; he can’t go along to Grandma’s because he’s incontinent, and he doesn’t do well at kennels. Or maybe with the harsh winter weather, your elderly arthritic dog keeps falling on the icy walkways, or simply can’t get up anymore.

There is something about Christmas that prompts people to finally make decisions that have been a long time coming — to say good-bye to a declining pet. Many have been avoiding the issue for a while, assuming that Angel, their ailing animal, was “just getting old.” Then, when they do come to terms with Angel’s infirmities, they arrive at their veterinarian’s with a firm conviction that there is no reasonable alternative to euthanasia.

This is a delicate moment for us. We need to quickly assess many complicated things, the first being whether Angel may have an easily treatable problem. Give that arthritic dog daily anti-inflammatory and pain medication, and we may dramatically improve his mobility and quality of life. The bony family cat may be hyperthyroid, easily diagnosed with a blood test. Pop a pill in her food twice daily, she may soon be plump and fluffy again.

But we also need to consider the human factor. What some people find “treatable” is overwhelming for others. What if Angel is incontinent and the owner cannot provide the nursing care and cleanup necessary to keep both pet and home sanitary? What if there is illness or disability in the human family, making any additional care-giving or financial outlay prohibitive? What if an owner suffers from seasonal depression and projects their hopelessness onto a pet? Ideally, you and Angel have a long relationship with your veterinarian, which will help everyone navigate these difficult waters.

Let’s assume you have gone through the options with your veterinarian, and have together concluded it is time to let Angel go. What happens now? Most clinics start with paperwork — a release form authorizing euthanasia. This assures everyone that there is no confusion about what is being agreed to. Some clinics will then ask for payment, because it is usually easier to deal with the financial aspects beforehand. Despite the tender nature of your visit, it is still a service we provide.

It’s not easy. It requires training, special licenses, record-keeping, time, supplies, and emotional fortitude. This year at my office we performed six euthanasias over Xmas week alone. Although we felt it was the right decision in every case, it still affects us, so don’t be surprised if we cry right along with you.

You will also need to decide in advance what you wish to do with the remains, and if you want to stay with Angel throughout the procedure. It is a very personal decision.

I encourage clients to stay. The main reasons that people seem to want to leave are that they are trying to avoid feeling sad, or they are embarrassed to cry. Please. Stay, if you can. You’re going to feel grief whether you are there for the procedure or not.

Cry. It’s okay. It’s more than okay. It’s what you are supposed to do. Even men. Even children. Especially children. You know what’s best for your kids, but I’ve been through a lot of pet loss with a lot of children, and Angel’s death can be a deeply important, teachable moment. For grownups, too.

Now for the details. This may be hard to read, but knowing what to expect will help everyone get through it. Protocols vary among veterinarians. Many begin with a sedative or general anesthetic given by subcutaneous or intramuscular injection — a quick, relatively painless shot.

Angel will gradually relax, get sleepy, even become unconscious, depending on the medication. The actual euthanasia solution works best intravenously, i.e., directly into a vein. Since finding a vein is not always easy, especially in elderly, debilitated, or dehydrated pets, some doctors place an intravenous catheter first.

Once the injection is administered intravenously, it has a rapid, profound effect on cardiac, respiratory, and central nervous system function and breathing and heartbeat both cease within minutes. Eyes may stay open, sphincters relax. You may see small residual motions for a while as her muscles release the electrical energy. Angel may even take an occasional, sudden, deep breath.

Don’t be surprised. It’s just a reflex. This is all normal.

In the rare instances when we are unable to give the final injection intravenously, your veterinarian may opt to give it into the abdomen or heart. This is understandably upsetting but, be assured, if your veterinarian needs to do this, it is because it is the fastest, most humane option in difficult circumstances.

Occasionally people will ask if they can give Angel an overdose of pills at home. Oral medication is not reliably effective for humane euthanasia. We can do our best to make a house call for Angel, but there is no drug we can simply dispense for you to do the procedure on your own.

Once we have confirmed that Angel’s heart has stopped, all that is left is to say your good-byes and make the final arrangements for either home burial, or cremation. Again, a very personal choice. Your veterinarian can explain to you the various options and the actual logistics of dealing with Angel’s remains.

American culture nowadays tends to shelter us from the physical realities of death and dying. Yet somehow, it seems fitting, experiencing these losses during this season. The shortest, darkest day of the year has just passed. Many are celebrating the birth of baby Jesus. We are closing out the old year and welcoming in the new. Life. Death. Rebirth. All part of the natural order of things.