It’s the most traumatic decision dog owners have to make but veterinary surgeon Laura Keyser has some words of wisdom about the kindest options.
When is the right time to say goodbye to your beloved working dog, companion and family pet? As an owner of three spaniels that fit in to all of those categories I can honestly say that the answer is never.
And as a vet, I’m frequently faced with owners asking me for advice as to when’s the right time and the ultimate conundrum: “What would you do if he/she was yours?”
This really is an impossible question to answer, but I have to give my best and most honest advice at the time. In almost all cases the person in the best situation to answer this most difficult of questions is the owner. They just need to step away and try and get some perspective on the situation.
Sadly, there have been times in my career when I have been presented with dogs which are literally at death’s door. This is a very delicate area and it’s hard to write about it but there have been those that are unable to even raise their head off the blanket they are carried in on and are emaciated due to underlying illnesses. Too many times I’ve heard, “I thought they would just go in their sleep.” The harsh reality is that this rarely happens. I know it’s hard to let go, but it is kinder to let them be put to sleep than to prolong the pain and suffering.
In my job I feel privileged that we are able to euthanase dogs in a humane and dignified way. I have to say, as a human, I would rather end my life like that and I feel we sometimes treat our pets with more dignity than our fellow human beings.
I want to try to help you make that decision when the time presents itself for your dog. Whether your dog is young or old, suffering with cancer or other untreatable disease, or severely injured, the decision is always heartbreaking.
What is quality of life?
In a phone conversation or consultation with an owner about euthanasia, I would question you as to whether they have had a good quality of life. Now, what does quality of life mean?
At veterinary school, we were taught the five freedoms and how to ensure animals enjoy these seemingly simple requirements.
- Freedom from hunger and thirst. By providing enough fresh water and the right type and amount of food to keep them fit.
- Freedom from discomfort. By making sure they have the right type of environment, including shelter and somewhere comfortable to rest.
- Freedom from pain, injury and disease. By preventing them from getting ill or injured and by making sure they are diagnosed and treated rapidly if they do.
- Freedom to express normal behaviour. By making sure they have enough space, proper facilities and the company of other animals of their own kind.
- Freedom from fear and distress. By making sure their conditions and treatment avoid mental suffering.
Although these pertain mainly to farm animals, those in captivity, or cruelty cases, I think this is a useful and universally applicable framework for our working and pet dogs. You can probably add a few more criteria to your list of what constitutes quality of life for your dog(s) but these are the bare minimums.
Don’t leave it too late
If you ask my advice about putting your dog to sleep, I will give my honest opinion, but I will also flip the conversation around and ask you some questions; Are they pain free? Are they pleased to see you in the morning? Do they still greet you with a wagging tail when you come home? Can they get up and go out for a walk? Are they still happy? Is your dog still eating?
If your answer to any or several of the questions is no, then I really think you need to be considering putting them to sleep. Yes, we can keep them pain-free with anti-inflammatories and other painkillers, but when that dog stops wanting to go out for a walk or they have to be lifted in to the garden, then I think you have to question whether it is fair to keep them going. And yes they may have stopped eating for another reason but if the answer is no to any of the other questions then there is clearly a significant issue. I would rather know that my dog had had a long, happy life and was given a peaceful, dignified farewell, than be left to suffer on in silence.
With two geriatric spaniels now we will sadly be in this situation soon ourselves. Our eldest springer has so many orthopaedic problems affecting all four limbs that even the best surgeon in the world couldn’t fix her now. We didn’t think we would have her this long (she’s 12), but we have been fortunate that with adequate analgesia (pain relief), she still enjoys her daily walks, wags her tail and eats well. As soon as she is no longer able to do that, we will accept that putting her to sleep is the kindest option and, although it will be devastating, it will be only be fair to her and she deserves that, she has been the best first dog.
Should I stay or should I go?
For those of you that haven’t had to have a dog put to sleep before, I will try to explain in detail what will happen on the day. Once you have made your decision, give your vet a call to talk through the options. Most vets offer home visits, or you can take your dog in to the practice, and either stay with them or not. You will be asked to sign a consent form which seems formal but it is an understandable requirement. The vet will also talk through the options about what will happen afterwards.
Should you stay with your dog during euthanasia? This is a very personal decision and it is entirely your choice. Many people feel they want to be with them at the end, but you should not feel guilty if you cannot stay. You can say your goodbyes and then leave them in the capable hands of the vets and nurses. You may wish to see your dog afterwards instead and have the opportunity to spend some time alone with them. At this point, some owners choose to bring their other dog(s) in to see them and have a smell of the body before leaving. Some people believe this helps the other dog to understand where their companion has gone.
The act of euthanasia is performed by giving an injection of a drug called pentobarbitone, essentially an overdose of anaesthetic. It is usually carried out by injecting it into the vein in a front leg. This procedure may vary slightly from vet to vet, so I can’t speak for all. Some will inject ‘off the needle’, which means the needle attached to the syringe in placed directly into the vein. Others will prefer to place an intravenous catheter (cannula) in the vein of the leg and secure this with a bandage. This may be done in front of you or in a different room, with the assistance of a vet nurse. This is to guarantee venous access should the dog move at the time of the injection. This is a personal decision of that particular vet and is often based on the temperament of the dog.
If a dog becomes agitated or restless, or has behavioural problems, the vet may prefer to give a sedative first so the patient is very sleepy before the final injection is given. The downside of this is that accessing a vein can be more difficult as the sedatives cause the blood pressure to drop, and the injection may work more slowly while it takes longer to get around the circulation.
Your dog may feel a small prick as a catheter is placed first or if using a needle directly, then the injection itself is painless. They will feel like they are going to sleep as if they were having an anaesthetic. Unconsciousness only takes a matter of seconds and shortly afterwards the heart will stop beating. This will be confirmed by the vet listening to the chest with a stethoscope. It may take a little longer is the dog is extremely ill or has poor circulation.
With the best will in the world, we want this to happen as smoothly as possible and with no distress to the animal, but there are occasionally instances where it could be trickier to find a vein, or it may take a little longer than usual. Often the dog will empty their bladder or bowels afterwards, so it is worth being prepared for this with a towel. Sometimes they can have reflex gasps or body twitches, this does not mean the injection hasn’t worked, they are involuntary reflexes denoting death has occurred.
Afterwards, you have the option to take your dog home to bury them, if you have somewhere suitable, or to take them to a local pet crematorium yourself for cremation the same day. Alternatively, and most often, the vets will arrange cremation for you. Cremation can either be routine, meaning with other animals and you would not get any ashes back, or individual and you would definitely get your own pet’s ashes returned. You then have the option of a scatter tube, which can be opened to scatter them on your favourite walk, or a sealed casket or urn with a name plaque for safe keeping. Vets and pet crematoriums often offer a paw print option as well to have an imprint taken, or you could ask to keep a lock of hair. You will then be contacted by your vet practice when the ashes are ready to collect, and this can take a week to 10 days.
The last act of care
You and your family know your dog better than anyone else, so please try to make a reasoned judgement on their quality of life. As vets, we can try to help with this and make a recommendation as to whether we think it is appropriate there and then, or in the not too distant future. You may think that vets that don’t get upset during euthanasia and may seem cold or uncaring, but trust me every PTS (put to sleep) affects us. Over the years we have to learn to be blinkered so we can act in a calm and professional way to help you through a difficult situation.
Euthanasia is a sad time for everyone involved but it is the last kind gesture you can do for your hard working and loving dog.
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