Compassionate Euthanasia

When my new husband and I boarded a flight to the Bahamas over 7 years ago, a flight attendant overheard us talking and realized it was our honeymoon. Minutes after we sat down in the no-leg-room class, she quietly reseated us in first class. She brought us champagne and made an announcement that was met with cheers throughout the cabin. We were amazed, and will never forget that act of kindness from this airline’s employee. I remember sitting in the cushy seat, knowing that months later I was to begin veterinary school. I knew that if I was to succeed as a business person (yes, I really did think like that), it was essential to provide the same service to my clients. 

As veterinarians, we have the unique honor of seeing our patients from cradle to grave. We also have the rare situation of needing to please 2 separate parties: the client and the patient. We usually know how to please the patient, but the client is another issue, especially when it comes to euthanasia.

As a hospice veterinarian (LapofLove.com), I deal only with end-of-life care. I have the distinct perspective of including the word “hospice” in my business name, and learning from pet owners what they expect from veterinarians during the end of life process, however long or short that may be.

Let me share the top 3 things I hear from your clients:

• “I am worried my veterinarian will judge me for wanting to euthanize Fluffy”

• “I love my vet, but it was a terrible experience last time”

• “I just don’t want Fluffy to die in that cold, sterile environment” (if only I had a nickel for every time I heard that!)

We have to realize that once the client is no longer seeking treatment and the “E” word has been used, the rules have changed. Pull out the white gloves and the silver place settings—you are now staying at the Ritz, not Motel 6. The practice of traditional medicine is over, and you have entered the building called “If You Mess This Up, You’re Screwed.” One mistake from you, your staff, or your credit card machine, and that client may have your name smeared all over their Facebook page by the end of the day.

Location, Location, Location

No matter how much soft lighting, padded blankets, or pretty pictures you place in that room, there’s no getting around the fact that it’s a hospital. If you ask me (or any of my clients), euthanasia should be performed at home, unless it’s an emergency or the family is averse to it. Not every city has a mobile vet available, but this is changing. In my opinion, even the backseat of the car or a grassy patch outside the clinic is a better place for euthanasia than a hospital floor. Just as our patients have moved from the barnyard to our clients’ beds, euthanasia is moving from the clinic to the home.

The Human-Animal Bond

I never liked removing the pet from the owner right before euthanasia to place the IV catheter. Why would you break that bond at such a delicate time? I understand that sometimes the pet is aggressive or anxious, which can be exacerbated by the owner’s presence, but a muzzle and an extra pair of hands can handle that, along with a quick IM injection and a whooping dose of sedation!

To Sedate, or Not to Sedate?

Never let your clients practice veterinary medicine. Sedation should not be an “upgrade” to your euthanasia service; it should be part of your standard Ritz-style service. Even for the price-conscious practitioner, a bit of acepromazine with a titch of xylazine (for dogs only, of course) costs just a few cents. Remember, sedation of the pet means secondary sedation of the owner. Humans need to be eased into something as drastic as euthanasia of a beloved pet, and this is just the way to do it. Most of the time, distraught owners haven’t seen their pet comfortable and sleeping in a long time, and this is the perfect way to give them one last glimpse of their pet alive and relaxed.

Just Butterfly It

If you must place an IV catheter, do it in the room after the pet is snoring. I’ve seen techs (and occasionally vets) place catheters in 2-week-old dehydrated kittens, so yes, placing a catheter can be done even in front of a client. Even better, use a small gauge butterfly catheter in the saphenous, which allows the owner to be at the front, holding their beloved pet. No one wants to see medical devices at such a time!

‘Be Kind Anyway’

Mother Teresa once said, “If you are kind, people may accuse you of selfish, ulterior motives; be kind anyway.” At such an emotional time, owners will be angry, spiteful, rude, and irrational. I actually had a client tell me that she would never return to her regular veterinarian after he “made his receptionist handle the paperwork for the euthanasia, since he was too much of a coward to do so himself.” I also had a client say she was angry at her vet because he wanted to place a urinary catheter before the euthanasia (no one explained it was an intravenous catheter, not urinary!). These are examples of what the client hears from their perspective. If the client needs time to think at any time during this process—before, during, after—give it to them. Buy a wireless doorbell from Home Depot and give them the ringer to page you when they’re ready. No matter what, talk slowly, convey empathy, and be kind anyway.

Never Leave Empty-handed

You don’t have to spend $8-$18 on clay paw prints for your clients. Worse yet, asking them to buy one is likely to be seen as a marketing effort. You should provide some token of remembrance without even asking. There are plenty of air-dry clays at your local craft store that will cost about $1 for each paw print, which is a pretty good price for client retention. Even if it’s just the small amount of fur you clipped for venous access (put it in a small bag), a hand-written certificate of the pet's passing, or a single flower, don’t let your client leave empty-handed. It’s hard enough for them to walk out of your office without their best friend, so give them something other than a receipt!

Every staff member must remember that the client is not walking into a veterinary hospital—they are walking into a pediatrician’s office. In this case, you are euthanizing a family member, and it’s probably going to be one of the worst days of their life. I’ve heard from numerous clients that the loss of their pet was harder than the loss of their parents. You have the responsibility to slow down and make this small part of your day a peaceful moment for them.

These procedures will ensure compassionate euthanasia for the pet and the client, and even make the process easier on you and your staff. They might remember when you saved their dog’s life, but they will certainly remember the empathy and compassion you showed that last day.