Zoom Recap: Euthanasia—Call #9

Although a difficult topic, euthanasia is important to discuss. During this My Lovely Feline Zoom call, small animal veterinarian and My Lovely Feline content contributor Dr. Leslie Brooks talks about the eutanasia process, including what to expect and what to do after. The call was also co-hosted by My Lovely Feline content contributor and fostering and behavior specialist Liz Italia.

Recorded: August 17th, 2020.

Disclaimer: The opinions expressed in this call are those of the guest(s) and/or host(s) and may or may not reflect the views or opinions of My Lovely Feline.

The Euthanasia Process

Euthanasia means “the good death,” and it’s the process of humanely putting a living creature to sleep to end suffering. Owners can choose to have their cat euthanized in a vet clinic or opt for a mobile vet to come to their home.

It’s entirely up to the owner and their family and what they feel comfortable with. It might be more stressful for the cat at the vet or in the home. It really differs from cat to cat.

There are two national companies, Lap of Love and Peaceful Passing, that contract mobile vets to perform in-home euthanasias. You can check to see if their services are available in your area.

Here are the most common and standard steps for euthanasias in a clinic setting:

• Private Area. Most vets have a separate area away from the loud hustle and bustle of the waiting areas. Some vets will even light a flameless candle in the waiting room with a sign that asks everyone to be quiet and respectful.
  
  
• Decision on Remains. Before the euthanasia process begins, the veterinary nurse will review it and then ask the owner if they want the cat’s remains back to bury or if they want them cremated.
  
  If an owner decides on cremation and they don’t want the cat’s ashes back, it costs $25-50 and crematoriums usually have a relationship with a local animal organization to sprinkle the ashes in a pet garden. To get a cat’s ashes back after a cremation costs $50-130 and it takes about a week.
  
  There are also different options for urns or memorial products, and some clinics and crematoriums will do a clay paw print for the owner.
  
  
• Prep for Euthanasia. Next, the vet will enter the room and review the process again. The vet will ask the owner if they want to leave after sedation, stay for the entire process, or not stay at all. It’s completely up to the owner.
• Sedative Administered. The sedative makes them really drowsy and sleepy and makes them fall asleep as if they’re going into a surgery. They are still alive and breathing at this point. The sedative is so they don’t feel anything, aren’t stressed, and are comfortable. It also helps the pet parent feel at ease. For cats, it’s usually given by injection along their spine and muscles in their back.
  
  Sometimes, it’s delivered subcutaneously, so just under the skin. A small needle is used so that hopefully the cat doesn’t feel anything. If a cat is more alert, the vet will typically distract them with food so that they can easily administer the sedative without the cat noticing.
  
  For safety reasons, most vets don’t want the owner to hold the cat. Typically they’ll hand the cat back to the owner as the cat falls asleep. It can take anywhere from 30 seconds to 5 minutes for a cat to get sleepy from the sedative.
  
  
• Final Injection. Then, the owner can hold the cat in their lap or put them on a comfy blanket on the floor or on a table. The vet will give the final injection into the vein on the inside back leg. The euthanasia solution is an overdose of a barbituate. Once it’s flowing through their blood, it causes their brain to shut down, then their heart stops and their breathing stops. The cat doesn’t feel anything in this process.
  
  There could be twitching or muscle spasms, but it’s a normal reaction. (Please note: Some vets put an IV catheter in the front leg to deliver the sedation and then the euthanasia solution. The entire process will go more quickly if this method is used, but it can be more difficult to get the line in than to do an injection.)
  
  
• Normal Reactions. As a cat passes, they might take one big last breath. There could be twitching of the eyes or muscles, and they usually don’t shut their eyes. If they had a full bladder or something in their colon, it might all get released when they pass. All of these reactions are completely normal.

Complications

Sometimes euthanasias don’t go perfectly. Vets do everything they can to prep and make sure it goes as well as possible, but sometimes there are variables they can’t control.

There are some cats that need an extra dose of the sedative because the first one wasn’t enough. Some cats don’t react at all because of the sedative, while others who have pain might have an exaggerated response to the sedative, where they jump off the table.

It’s a large stressor on vets because they want every euthanasia to be perfect to give comfort to the pet owner.

Managing Grief

There are support groups and resources for managing grief from a lost pet. No one should ever feel like “It’s just a cat” or “I’ll get over it.” Talking to a vet and being honest about needing help is an important step. Veterinary social work is becoming a bigger profession, and there are people going to school specifically for it. The Association for Pet Loss and Bereavement has a lot of resources and discussion groups.

Sometimes people are surprised by how grief stricken they are when a pet is gone. Liz shared that a veterinary social worker she knew said that’s because you get breaks from people in a home, but you NEVER get a break from your pet. If you’re home, the pet is there, which makes it a hard adjustment when they’re gone.

How to Explain Euthanasia to Children

It all depends on your family structure, dynamic, and beliefs. Dr. Brooks is all about honesty and openness, by saying they passed and explaining the situation to the child. However, she highlights that it’s important to do what you are comfortable with.

 

Q&A

What do you do as a vet if an owner wants to put a pet down when there doesn’t seem to be a clear reason why the animal is being put down?

Dr. Brooks: Every vet is different on how they handle it, and every situation is different. For the most part, it’s always something deeper and more chronic than what it seems.

Usually during the conversation before the euthanasia, a lot comes out. The reasons can range from years of problems or a family issue. Once they’ve gone through the process of deciding euthanasia, they’ve thought about it a long time.

I’ve never had it where they’ve flippantly decided to put their pet down. Behaviorally it can be difficult, where the pet bit and horribly injured someone, and we do it because of those complicated nuances.

I have a vet friend who had to put down his healthy middle-aged dog because it tore up his 3-year-old child’s face. It was very hard for him to do, but he felt he had to do it. Until we’re in those situations, it’s hard for us to completely understand.

I had to put a kitten to sleep because he was in congestive heart failure. The practice said I couldn’t be in the room because of how wiggly kittens are and that they’d put a shot in his belly and then place him in the oxygen chamber to fall asleep. Is that common practice for euthanasia on a small kitten?

Dr. Brooks: They probably put him in the oxygen chamber and then flowed in the sedative for him to breathe in until he fell asleep. That’s what we do for feral cats we can’t touch.

Then, they likely took him out of the chamber and gave the euthanasia solution as a shot in the abdomen or in the liver. We have to give the same injection for cats that have bad veins or low blood pressure. It takes longer when it’s injected into the belly, usually 5-15 min.

Have you had to put one of your cats to sleep?

Dr. Brooks: No, but I had to do it for my mom. I went to the first clinic I ever worked at and my mentor put her to sleep.

How do you mentally handle euthanasias? I imagine it takes a toll on you too. Did they teach you how to handle it emotionally while you were in vet school?

No, they don’t really discuss the mental and emotional aspect of it. It’s one of those things you learn how to do from whoever you’re working with when you get out of school. Knowing that we have the ability to end suffering is good. But then, a lot of the euthanasias we do aren’t to end overt suffering.

Many are in that gray area or somewhere in between. I feel better knowing I can help people’s pets have a dignified death. It’s still so hard though – you have this thing that’s living and breathing and then you give it an injection and it’s no longer alive.

The first couple euthanasias I ever did were emotionally hard. The more you do, the more you know you have to move on to your next patient. I don’t think you ever stop not wanting to cry, but you learn you can’t show emotion because you have to keep going.

I get so worried even to have my cat’s teeth cleaned, and I know I should. Is that normal?

Dr. Brooks: I get it – I get nervous too. It’s totally a valid anxiety and any time there is a surgery there is a chance a cat won’t come out of anesthesia, especially if there is an undiagnosed heart problem. It’s a risk, but you have to see if the benefits outweigh the risks.

Liz: It’s completely normal to be nervous about a cat going into surgery, but I think the best way to look at it is that they’ll feel better after. I had two cats where a spay surgery saved their lives, so even though we get nervous about surgeries, there are also times when the vet finds something unexpected and is able to address it.

I have a health-related question. I have a super senior who’s 16, has stage 2 kidney disease and walks on the hocks of his hind legs. The vet thought he had diabetes, but he didn’t. He’s on a steroid for his IBD, so she thought his ligaments might have stretched. Have you seen it before? Is it always diabetes?

Dr. Brooks: Yes, diabetes is the go-to diagnosis for that. Certainly if he’s been on long-term steroids, that could cause it. Any type of neuromuscular disorder. If his nerves are being pinched from something in his spine or some hip dysplasia, that could cause it too. It could be any number of things.

 

Be True to Yourself

Saying good-bye is not easy, so be kind to yourself when it comes to euthanasia. Make decisions that are best for you, your family, and your fur baby. Other people aren’t walking in your shoes. And if you need help coping, that’s okay. Reach out to your vet, associations, and online communities to get the support you need. The My Lovely Feline family is always here for you too.