Friday, November 25, 2011

Does Euthanasia Hurt My Dog or Cat

Answering Some Common Questions About
Veterinary Euthanasia

Veterinarians are often asked “Will euthanasia or the medications used hurt my pet?”  We understand that the stress of deciding when to put your pet to sleep is overwhelming – but to add on the thought that it hurts – can really put pet owners into a state of confusion.  Dr. Cherie Buisson offers some answers.

Euthanasia is a Greek word meaning "the good death".  It is a gift that we are able to give our pets - to suffer ourselves so they can be released from suffering.  Naturally, people have a fear of euthanizing their pet and agonize over whether they are doing the right thing.  Two of the more common questions we are often asked are "will it hurt?" and "how long does it take?"

Photo Curtosy: Tampa Tribune (Dr. Dani McVety)
With Lap of Love, euthanasia is not painful and typically more peaceful than most people expect.  Why?  Because in almost all cases, we give our patients an injection of a sedative before euthanasia.  This injection is given either under the skin (like a vaccination) or in the muscle. The sedation typically does not hurt – we use teeny needles – similar to a vaccine needle.  

Before humans are given anesthesia for surgery, they are also given a sedative. And we do the same for your patients. The wonderful combination of medications we use give them a sense of relaxation and in many cases can make them unconscious (some dogs will even snore!).  

Some pets may be able to move a bit while under sedation and even have their eyes half open, but they are not awareIt takes about half the dose of our sedation to make our patients unconscious.  It takes more to stop their body from moving without their knowledge.   (For instance, I have a friend who had anesthesia for a tooth removal.  While he was under anesthesia, he moved around and kicked one of the nurses.  He doesn't remember a thing about it.)  It is similar to when your dog cat (or even yourself) moves/twitches in their sleep.  It is just a natural reflex.

Once they are in a relaxed state, we can take our time administering the euthanasia solution. The actual administration of the solution is not painful – it does not sting or hurt.  In dogs, it is typically given in a vein and they do not feel discomfort. However, in elderly or sick patients and in cats, being able to find a good vein can be difficult.  Rather than poke and prod, the euthanasia solution may also be administered centrally (for example, into the abdomen).  This is also painless as our patient is already sedated.  

The drug used for euthanasia is an overdose of a barbiturate (a type of anesthetic) called Pentobarbital Sodium. (Many of us are asked if it is like what was used with Michael Jackson – and although not the exact drug (Proprofol) – it does work the same way).  It stops brain function – so the pet passes while they are sleeping and will not ‘know’ what is happening. 

How long does the euthanasia appointment take? The Lap of Love veterinarian is usually with you for less than an hour.  Most appointments last 30-45 minutes.  Sedation may take seconds or up to 20 minutes depending on how ill the pet is at the time.  Actual administration of euthanasia solution takes only seconds.  It can be followed by an increase in breathing, then breathing stops.  

Photo Credit - DVM News Magazine
The heart stops a few seconds to minutes later.  Our patients may hiccup, give a big stretch, have a final deep breath or make slight noises during this time.  These are all natural reflexes and is perfectly normal.  They happen with natural death as well.  If the solution is administered centrally, it may take longer.  Sometimes 15-20 minutes can pass before the heart stops completely – but the pet is sleeping the whole time and is in no discomfort or pain.  This is a great time to cuddle with your pet and tell them how much you love them.  Many owners are grateful to have a chance to hold their pet again knowing they are not in any pain.

Euthanasia is the most difficult decision we face as pet owners.  It is also the most generous – especially when your pet’s quality of life is diminished or they are suffering.  Be kind to yourself and be sure to ask questions.  This is your beloved family member, and it's good that you don't make this decision lightly.  If you truly love your pet and only want what is best for them, you will make the right decision when the time comes.  Be sure you talk with family members and your veterinarian.  No one should have to go through this alone.  We have some wonderful resources at www.lapoflove.com to help you with your decision.  And of course, our veterinarians are always willing to lend a hand/and an ear!s.

Please explore our website www.lapoflove.com or contact your local Lap of Love veterinarian to ask any questions you may have about hospice and euthanasia.


41 comments:

  1. Beautiful article -- I appreciate all the facts, knowing what will happen helps me feel more comfortable with the procedure (especially expecting hiccups or breathing changes or other reflexive movements). Thanks for the info!

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  2. Miss. Gardner, I just wanted to say thank you. I was surfing the web trying to find if euthanasia hurt dogs. I had to put one of my two beloved dogs down a few months ago and now my second dog is quite old and I was looking to comfort myself by telling myself every thing is fine and I stumbled on your blog. Great work and I really appreciate it even if you weren't trying. Thanks again.
    A pet lover

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    1. Thank you "pet lover" - I'm glad our blog was able to help you a bit. As long as your pet is sedated well before hand, everything should be very smooth and no anxiety.

      May you have a long time with your older dog before having to make this decision.

      Dr Mary

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    2. Thank you so much for this information. I need to know why my dog stretched and held her head up after she was given the fatal shot. She is was a coma state and was told she would not feel a thing. I was to upset at the time to ask the vet why she stretched and after reading this I am at ease knowing that everything was done correctly to make sure my baby didn't suffer at all. This is great information and I've passed it along on facebook for others to read up on this.. thanks again and my God Bless who ever wrote this, it sure calmed my soul.. :)

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  3. I only wish you guys were available where we live - because I did not want to take my boy into town to our regular vet (he hated the car) I had a countryside vet come to the house to put him to sleep. He agreed that Matti should be put down because at 15 his arthritus was too much, but suggested that we give him an extra week or two until he "when he gets really bad and can't get up you can call me". All of this despite the recommendation from our own vet who has been treating the dog for years and could see that putting him through another winter was simply not right. He then refused to take the body away saying that "people who love their dogs bury them at home" so we had to drive the body 50 minutes into town to the main animal clinic for cremation - Much as we love our boy our water is via a well so a decomposing 50kg dog is not really an option. The vet did not use a tiny needle to sedate and the dog was crying when this was administered. All I can say is that if I had the option I would choose you guys anyday and I wish I had been more careful in my own selection of vet for this procedure. I had thougt it routine and that it would be the same whoever did it, clearly not the case.

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    1. I'm sorry your experience to say goodbye was not as peaceful as you had hoped. Sometimes the medication can feel 'funny' in their vein and it frightens some dogs. (if you have ever had fluids in the hospital, you know how it feels tingly). And I am sorry about the cremation comment. Everyone is different and their situations and desires are different... no way is either right or wrong. I LOVED my dog Neo and had him cremated with his ashes back home with me. It doesn't mean I did not love him. And owners who elect to not get ashes back also don't love their pets less. For some people, they remember the spirit and not the remains. I respect everyone's desire. All I know is the people we meet - LOVE their pets and treat them with love and dignity before and after passing. May your Matti visit you in dreams and bring a smile to your face again!

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  4. My small mixed breed is now nearly 13 years old. She's still a bit spunky and still loves to be held (like a baby in a blanket..lol); however, she is not well. She has these clusters of "something" in her abdomen (not cancer, so says my vet, but not sure what it could be), her teeth are all very decayed and a few have fallen out (we do not have 800 dollars to have them all pulled), she has film over her eyes (but appears to be able to see decent enough), and she smells horribly (it's obviously from her teeth). I have been giving her antibiotics and pain meds for a year now (that was all we could afford) just to keep her comfortable and clear infection, but I am torn about having her put to sleep.

    Given the information above, can you please give me your opinion? I know they say that dogs suffer quietly, but she really does not appear to be in pain and I only give her pain meds with antibiotics when you can see she has an active infection.

    This decision has been a bit more harsh for me because just a week ago...I finally caved in to the hospital's wishes and signed a DNR for my father. He passed two days later and I am a bit traumatized. I am feeling responsible for his death; although he had a feeding tube, a pacemaker/defibrillator, and was emaciated, had CHF, seizures, and other various medical problems. He had just gotten a tracheostomy post ventilation that we (my sisters and I) had hoped he could be weaned from (he was retaining Co2 on and off for some months now - he did have COPD). I'm actually just numb now, I haven't even truly mourned my father's death with having to make all the arrangements and then traveling this weekend to lay him to rest (my sisters were way too upset and grieving deeply to help)...but I know this decision about my pup needs to be made sooner rather than later.

    At any rate, I now feel that if I put my pup down that I'm playing God or just killing everyone around me! I know that is silly, but I still have that nagging feeling in the back of my mind.

    What do you think I should do? I mean, deep down somewhere within me, I know what the right thing to do is; but I guess I just need more confirmation (other than my vet's opinion on it - she is a bit stoic and unfriendly, but I could just be reading her incorrectly).

    Please help. Thank you in advance.

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    1. Hi Charlotte,

      Thank you for reaching out and I am so sorry to hear about your father and also that you are dealing with this decision during this time. I know it is not easy.

      So how is her attitude and quality of life? Is she still eating/drinking, loving to be with you, enjoying her favorite things, disliking the things she hates?

      The problem with rotting teeth is that - yes, they hurt and the infection can go into their bloodstream and damage internal organs. At least you have her on pain meds and some anti-biotics to help slow the progress of those side effects as best as you can.

      I would encourage you to look at our free Hospice Journal - which is an online program that lets you evaluate her quality of life (select old age-multiple problems as her disease). http://www.pethospicejournal.com/ or use our PDF version: http://www.lapoflove.com/Pet_Quality_of_Life_Scale.pdf

      She is getting older and please do not think you are 'killing everyone around you' - know that mother nature is neither quick or painless and sometimes, letting our pets go peacefully is a gift we can provide. To often owners just wait until mother natures takes them but this could take months and also put their pets in severe pain and anxiety.

      Let me know what you score your baby and we can go from there.

      Warmly,
      Dr. Mary

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  5. Hi, I was wondering how you know that the euthanasia doesn't hurt?
    I've had many anaesthetics, I know a few of them hurt me going in, obviously only briefly, but they stang or burned. I don't wish to upset anyone. I genuinely want to know. My dog didn't look that happy when she was put to sleep, I knew all her expressions and unfortunately looked at her at the 'wrong' time. She looked at her leg like she wanted to pull it away, in my opinion she'd have only done this if it hurt. She also looked shocked, then passed.
    I did the best I could, I made sure the Cannula was put in the day before, so she wouldn't have the pain of that.

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  6. Hi there, Thank you for reaching out. There are many times when people and pets get IV medications or fluids and they 'feel' the liquid going in their veins. Most times this may just feel off because it is not the same temperature as our blood supply (which is typically warmer - so a cold solution going in can have an odd sensation). The drugs that you had received may have also been a different pH than the ones that we use for euthanasia which is why it may have stung.

    Most needles may prick a little (including catethers/cannulas) but this is not something we can avoid - just like in human medicine. Is this 'painful' - not really. Does this cause suffering - definitely not. And that is what we are doing with euthanasia - trying to end suffering.

    The biggest message we can tell our clients is that euthanasia does not mean you are giving the pet a heart attack. Many people think that is what we do. As you know, a heart attack is actually painful.... euthanasia solution stops the brain and then the organs slow down and stop because the brain is not longer sending messages to those organs to continue working.

    Remember that sedation and anesthesia does not always stop reflexes. A reflex does not mean it is painful. Many times a pet will be completely unconscious but they still twitch their feet when I touch a toe... this is just a reflex and not painful. Some pets will look at their leg while catheters are being inserted or fluid going in their legs. Most times it is just curiosity and maybe wondering what the cool feeling is going on in their arm.

    All Lap of Love veterinarians will sedate a pet first with a sedative given in the muscle or under the skin. Sometimes a sensitive pet will react to this. Unfortunately there is nothing we can do for this except some good distraction and love afterwards.

    Again - the main point is that the medication for euthanasia does not stop the heart like a heart attack and is not painful at all.

    Warmly,
    Dr. Mary

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  7. Two days ago I euthanized my beloved Darwin, an eight year old labradoodle. He had lymphoma. I would have preferred to have the procedure done at home as I have done for two previous dogs, but for various reasons could not. The quality of the experience of a home euthanasia is one of safety and warmth for both pet and humans and I will do my best to have that be the way for Darwin's sister, Sophie, when and if she is euthanized.

    I chose to have Darwin highly sedated before the IV injection so he would not be aware of the IV process. The medications (two of the following three medications: Telazol, Dedomitor, Butorphanol) took about 10 minutes to have him sleeping. Starting about 8 minutes after the sedative shot, Darwin's reaction was something that confused and distressed me. He was lying down with his head up and he started swaying it to one side and then the other. These motions were almost moving across 180 degrees in a slight circle 8 pattern. His eyes were glazed and he did not seem to be distressed at all ... he looked like he was dealing with dizzyness. He soon put his head down and was asleep. I believe that he was not feeling pain, but I am sad thinking that he may have been scared being dizzy. Is there anything that you can share about his behavior and probable experience?

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  8. Hi Kim - I am so sorry to hear about Darwin! So young but I bet those were some wonderful 8 years.

    First - I am so glad he was sedated first. I want you to feel confident that he felt nothing but 'warm and fuzzy'. The medications the doctor used were perfect - I have used that same concoction.

    Second - this is not abnormal and can happen. Please trust me when I say that all vets wish this procedure can be PERFECT and then 'what is perfect'. Perfect would be if we never had to make this decision - but heaven needed Darwin back.

    When you get 'sedation' - you (and pets) can get loopy and you lose control of some functions. Some dogs can bob their heads. As a vet - I hate this... NOT because the dog is anxious or feeling scared... but because the OWNER is scared. I know medically - the pet is fine.. but sometimes there are no words of comfort I can give the owners.

    It was like he was drunk - not the overly dizzy drunk - just the type when you are happy, chatty and loving life. THAT it what he felt. Please know he was 'ok' and that you were there to say goodbye. They say the last sense to go is the sense of hearing - so being there talking to him is what is important. He may have 'seen' 2 of you but he heard your voice. :)

    I don't like using the word 'sedative' for the first injection because owners will assume their pet will be totally asleep - that is actually what the second drug does... makes them sleep. The first is just to feel good... and he did. A head sway/booble/loop - even some chittery barking is not abnormal or 'wrong'. He was a happy dog feeling great and no inhibitions.

    I know he is watching over you now and would not want you to worry about that experience. Remember him as a healthy and happy boy and an angel free of disease now.

    Warmly,
    Dr. Mary

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  9. Your insight is comforting. I snuggled up close to him and spoke sweetly to him through the process and as he lowered his head, he layed it across my neck. Such a wonderful last act. I will do my best to hold on to the thought that he was without pain and anxiety ... hopefully a little happy-loopy ... as he experienced the sedative effects. Thank you, Mary.

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  10. Dr. Gardner, I made the tough decision to euthanize my 12 year old dog last week. He was suffering from chronic bronchitis, arthritis in what appeared to be his entire spine and Melanoma. He was in remission for the melanoma for eight months and then the melanoma showed back up again in his liver, spleen and his lungs. I agonized over doing everything I could for him and when to let him go. When my frame of mind changed from quality of life to quality of death, I knew it was time I needed to say goodbye. My trusted vet who is also a friend came to my house to euthanize Tucker. While I was giving my beloved Tucker treats, she first administered a sedative injection in the scruff of the neck. Within a minute he dropped his head and stopped taking treats. She then said it's time to administer the second sedative and at this point Tucker will no longer be aware of what is going on. I am not sure what she used but it was a dark yellow color. She administered this into the scruff of the neck too. But when she administered this second sedative he perked up, lunged at her and was yelping. He followed the yelping with a panicked look on his face and he was crying. She was shocked and kept touching him to try to figure out what was wrong and every time she touched him he cried out again. I was trying to console him and he eventually relaxed enough for her to proceed to the final injection of anesthesia directly into his vein. I am struggling so hard with the way Tucker passed. I thought I was giving him a peaceful death and it appeared to be a painful and scary death. I am trying not be upset with my trusted vet. She was clearly very upset at what had happened too. I am devastated that Tuckers death appeared to be scary and painful. I have been searching the web trying to find answers to what happened and I have found your blog to be helpful. Do you have any thoughts on what happened? I have two other dogs and want to avoid a death like this for them if I can. Also, do you think he was aware of all this since it happened while giving the second sedative shot? From what I have read on your blog, it would seem as though he would have been completely aware.

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    1. Dear jindnvr - First and foremost I am so sorry you had to say goodbye to Tucker. I know he has a special place in your heart.

      As a veterinarian that just does end of life care - I want you to know that we ALL - ALL - want it to go 'perfectly' - but this is medicine and it isn't always exactly as we hope - there are at times, things that may look uncomfortable, not-peaceful and even frightening.

      I typically give two injections. The first is a mix of pain meds and sedative. The second is the anesthesia medication to end life. But all vets have different ways to administer and drugs they prefer. There is not one way that is any better than the other.

      She may separate her first injection into two different kinds. The yellow liquid you described is probably Acepromazine. This usually does not hurt or sting. (There are some drugs that can sting a little).

      With that being said - an animal or a human being can have an adverse reaction to any drug. And on top of that poor Tucker had a serious illness and that could complicate things and how drugs are processed. I have also noticed that pets that are typically 'ok' with shots or touching - seem to get less cooperative when they are painful. I have been to many homes where the HAPPY Lab wagging his tail - lunges at me when I give the first injection. And it's because he is so painful and any little extra bit of unusual stimulation will upset him. It's like when I have a migraine - I don't want anyone even touching my finger - everything is hypersensitive.

      So I don't believe your wonderful vet did anything wrong or could have made it any better. I believe the first drug made Tucker feel good and relaxed and the second may have startled him. He was snoozing and he was woken up with a pinch.

      What I do know is that most animals - when given these sedatives - do not know what is going on. It is like when we go in for surgery. That first drug they give us makes us feel awesome - but also can do some odd things. I have personally tried to 'pick up' strange people on my way into the surgery ward! I have never been so embarrassed in my life until I woke up from anesthesia and they told me that I tried to pick up the female nurse 1/2 my age. :)

      What I do know is that the final medication is painless - it stops our brains so that we fall asleep. Then our heart and lungs stop. So Tucker passed away in his sleep... exactly what we all want to have happen.

      I also know that you were awesome in asking to have it done in the home. He was comfortable and surrounded by the things that he knows. I hate to say this but in the clinic - things can also go 'wrong'. But most times, we shield clients from that. I know from personal experience that it is difficult on 'Us' - the vets that go to the home - because we are doing EVERYTHING in front of you. We can't be blocked by the door of the treatment room. And if it doesn't go perfectly - we do feel so bad for that. But there is nothing we can do sometimes.

      Also - an unassisted death (ie - "Natural Death") is not always peaceful either. Tucker would have suffered way more than a reaction to a drug if you didn't do this for him.

      I am sorry if this is so long. It is important for me to have you comfortable with what occurred and have no regrets.

      I hope this helps?
      Mary

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  11. I write this with a very heavy heart as I had to put down Zoe, my 12 year old mini schnauzer on Jan. 8th, 2014. I have worked in the hospice industry for over 24 years, so I knew I was going to have hospice come to my home when the time came. She hated the Vet and the last thing I wanted to do was cause her more pain and suffering. She was diagnosed on Dec. 17, 2013 with lymphoma, lung cancer and a thymoma in her chest area. The Vet placed her on thoradal and morphine, I called a local animal hospice and the Vet came out to my home and explained in detail about the sedation, she said it would take Zoe 10 to 15 minutes to fall asleep. I wanted Zoe to pass away in her bed in my arms. The Vet had be hold her while she injected her on the top of her neck, Zoe struggled for a few seconds, but finally lied on my chest as she always had done. In less that 5 minutes after the sedation Zoe hiccuped twice and then took her last breath. I called the Vet into my room and she told me she was very sick and that sometimes the sedation alone would take them. She did administrate the euthanasia solution into her abdomen because we both wanted to make sure she was gone. Have you ever had a case that the sedation took the dogs life? I know what I did was for her and this was the last act of love I could do for her, but I still have questions and I miss her so very much. It is the most difficult decision I've made in my life. Sincerely, Diana

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    1. Hi Diana,
      I am so very sorry about your loss last week. I know this is difficult and you may have some doubts.... but what you did was provide her with a peaceful passing in your arms - I wish all passings are like that.

      I will admit that probably 2% of my patients will pass from the sedation alone. And almost all of them are very sick and although I can never tell for sure - I feel as if they were very near unassisted death. This tells me that Zoe was weak and her body was ready to move on to her next adventure. The second medication is just an overdose of anesthesia - with that sedation and anesthesia medications can depress the central nervous system enough that a pet will pass.

      I hope this information provides you some comfort.

      Mary

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    2. Thank you Mary, it was very helpful. Zoe was such a healthy dog and within 3 weeks of her diagnosis she was gone. I am experiencing so much pain that I am barely functioning. Some people do not understand that Zoe was my baby, not "just a dog". I know time heals all hearts, but Zoe took a piece of mine that I will never get back. I thank you for providing pet hospice, she was at home and was not afraid. She just went to sleep in my arms and 5 minutes later she was gone. That was my very last gift for her, I hope she knew how much I loved her and still do. A huge thank you to Dr. Rebecca Westbrook in Dallas, TX. She came to my home and watched over my 2 other mini schnauzers as Zoe passed away. I finally understand all the thanks I have received in the past 24 years from family members that have used hospice.

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    3. Don't worry - we all know your Zoe was not JUST A DOG! Zoe was your co-pilot in life. Grief is a normal emotion - she was a huge part of your life. Sometimes honoring her memory helps. Please post a memorial, her story and pics on our memorial page. http://www.lapoflove.com/Pet-Memorials-Tributes we also have some good pet loss resources on our website: http://www.lapoflove.com/Pet-Loss-Resources
      Take comfort in knowing you provided her the perfect life and the perfect passing to her next adventure - where she will always be watching over you! <3

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  13. Can you help me to understand what happened to Sidi? He was and old dog brought to the vet for euthanasia after days of being in severe pain unable to sleep. The vet did the euthanasia as we comforted him. He cried out in pain before he died! A full 10 seconds of crying out as she administered the drugs. This was a fully trained vet. Can you tell me why Sidi did that? I asked the vet what happened and she said it was just his brain reacting. I don't believe it. That event tore my soul to pieces. Ever since then I have not allowed a vet to do euthanasia without first putting them under anesthesia, fully SLEEPING when the euthanasia is administered. Please help me understand what happened.

    I've seen some euthanasias not go well. Our cat had lymphoma with tumors in her lungs and had some labored breathing, (the vet advised me not to take her home to die a natural death, she said it would be very painful) I asked for her to be sleeping first before the euthanasia. The vet said she could not do that because of Little Girls lymphoma, she would not be able to breathe under anesthesia. So instead she gave her pills to sedate her. It took two doses and Little Girl was still pretty active. Well the vet determined Little Girl was ready and started the process. I can tell you Little Girl struggled and resisted the whole ordeal. Again I have seen two euthanasias that disturbed me. I have had two other old dogs (lymphoma and crippled) that the regular euthanasia was peaceful. Thank goodness Big Girl and Jake had good euthanasias. And a cat, that I asked for him to be under anesthesia first (young Merlin with kidney failure). He was fully asleep when he died. Of course it was very expensive.

    Recently I was not present when our much loved cat Buzzard (fluid in lungs, lymphoma) needed euthanasia. My husband was there instead. I'm too afraid to be present any more.

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    1. Hi Missy,

      I am so sorry for your loss - I know this is a difficult time for you and also if it was not a pleasant experience.

      I am confident that the reaction you saw with Sidi was not actually a 'painful' reaction but more dysphoria. Let me explain why I think that. Some vets will do two injections. The first is an injection of a light sedative to make them comfortable. I do this for three reasons - one, because I like the pets to be in a more relaxed state before doing the final step, two - I am alone during euthanasia's and if they are relaxed, I can place the catheter easier and third - it secondarily relaxes the owner. Owners like to see their pets comfortable before hand. This step is not medically required and there may be occasions where I don't do this. For example, the pet is recumbent and non-responsive already.

      The second step in the process is the injection of the anesthetic overdose. This drug travels to the brain and anesthetizes the pet first - then the overdose completely shuts the brain down and thus no messages are sent to the muscles - and the heart is a muscle. So that slows down and stops after a minute or so. This is not painful at all - it literally is an anesthetic given at a higher dose.

      Now why do some pets have a reaction during this process? There could be a few reasons. One could be that Sidi felt the drug in the vein but not in a 'bad' way. Have you ever had IV fluids and you feel the fluids going up your arm? This senstation bothers some people even though it is not painful. The main cause of this is temperature change. The medication is at room temperature (75 degrees lets say)... pet's body temperatures are normally 100 - 103. So when they feel the fluid's colder temperature, they may react. Pet's (and humans) that are already in pain (as you stated poor Sidi was) are hypersensitive to touch. For example, if your very sick or have a migraine - you don't want anyone to touch you - or even the sensation of clothing on the skin is uncomfortable. Is that painful? Not really - but the sensation can bother people and for pet's the only way they can tell you that it bothers them is to whine, bark or whimper.

      The other reason is that Sidi was vocal as she went under anesthesia (the first process the drug produces). Just like humans, some pets will vocalize as they become sedated. Inhibitions are lowered and some will bark, vocalize, twitch, etc. I myself, when I go under anesthesia talk a lot. Other people just simply fall asleep.

      Lastly - after helping over 2,000 families in 4 years, I have seen that pets that are closer to dying naturally tend to have more reactions. When pets die 'naturally' - they can stretch their heads back, vocalize, twitch or even have seizures. This can also happen with medically induced passings but I tend to see this more when the pet is so sick that they were already beginning the processes of shutting down.

      Your kitty's situation is a difficult one. I always give the first injection to make pets calm. But when pets have any type of respiratory issue, I notice that they don't always sedate well and/or I wont give as much because I don't want them to go into respiratory distress before I am ready to give the euthanasia solution. So I don't disagree with your vet - under full anesthesia, she may have done poorly and suffocated before the euthanasia solution could be given.

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    2. FULL anesthesia is not necessary for euthanasia because the drugs we give will first put them under anesthesia - and then quickly the overdose takes effect. It's not medically wrong to put them under anesthesia but an unnecessary step. Plus we then have to intubate them, etc - this is not a pleasant experience for everyone involved.

      What I can tell you is that ALL VETS want this appointment to go as well as it can go. None of us 'enjoy' having to say goodbye to our furry family members and veterinarians are tasked with this duty often. I guarantee you that I say I small prayer before every euthanasia that it all goes 'perfectly' and that there are no reactions. 90% of the time, it is smooth and perfect. But some times things happen. What I can tell you though is that it is more painful for you than it is the pet. Which isn't necessarily better but the reason I tell you this is so that you know that your babies were not suffering.

      I'm so sorry that the previous experiences were so traumatic for you that you can't be present. I would encourage you to try to be there next time (hopefully not for a while) - because your pets love you and for them to hear your voice as they leave this world to begin their next adventure is a give you can give them.

      I hope this helped a little. Feel free to email me directly if you have any questions. drmary@lapoflove.com

      Warmly,
      Dr. Mary

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  14. I had a similar experience to Missy. Just 11 days ago, we had to say goodbye to our beloved 14.5 year old Eskie, Chloe. She and I had a connection that was so strong and my heart is just broken. Chloe had a tumor on her trigiminal nerve sheath that she just lived with for about a year with rather minimal affects. Lately she had ear infections that we now know were probably tumor progression into the ear canal. Chloe's last 24 hours were spent with vestibular symptoms and we knew we had to set her free, as painful as it was, because the vestibular symptoms were getting worse and worse as the day went on. We had to bring her to the emergency vet. They took her in the back and we heard her yelp a couple of times and when they brought her back to us, she had a catheter in her hind leg. The thing that tears me apart is this: we sat on a blanket on the floor and I held Chloe in my lap. The vet came in the room with 2 syringes and before he sat down, asked my husband and I if we'd ever been through euthanasia before, and we said we had. The vet said "ok, then I don't have to explain to you what's going to happen". I should have taken that as a red flag. He sits on the blanket next to us and it seemed so rushed. He pushed in one of the syringes into her catheter and then immediately the other one. As the 2nd syringe was going in, Chloe started yelping, and she continued yelping, each time quieter and quieter until she was gone. As she was yelping, I asked why is she doing that? The vet said "I don't know, it's probably the brain. About one in 100 dogs do that." THEN, he warned us about agonal breathing, which Chloe didn't do. No comforting us. He listened to her and said there were no heart sounds. It was one of the most traumatic experiences of my life. It was devastating to have to bring Chloe there in the first place, but to have that experience be the opposite of peaceful has been almost more than I have been able to handle. I wrote to the emergency clinic about our experience but have not gotten a response other than a sympathy card in the mail. Please tell me if it's "normal" to push the 2nd syringe that quickly after the first, and more importantly, if Chloe was experiencing pain when the lethal drug was administered. She brought such joy to my life that I want to remember her with happiness, and not be so grief-stricken by the final moments of her life. I miss her terribly, and I do know that we did the kind thing for her, but I am very distraught by this. Please help. Thank you.

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    1. Hi Josie,

      I am so very sorry to hear that your experience was not a good one either. Dr. Dani and I have a mission in life and that is to try to teach as many vets across the country how to perform a euthanasia more delicately - including in the clinic. This is the most important appointment you will have with your vet and should be handled as best as possible under the circumstances. I always ask families if they have been through the experience before, but regardless of the answer, I explain how I do things. Because we are all different and each pet (and each disease) may respond differently. So I am sorry that he didn't explain the procedure again to you. Not that this is an excuse in any way - but many vets do not 'like' the euthanasia appointment and feel emotionally uncomfortable and do not know the best way to handle things. We are scientists and not always the best communicators. But hopefully your letter to them will hit a nerve and he will learn from this.

      About being painful - which I think is the most important thing. The final medication itself is NOT painful. It literally is an anesthetic. Before a pet (or human) is anesthetized, the pain they may already be in doesn't always stop (unless they are heavily medicated on pain meds before hand). So what we may see is that when the anesthesia is taking place, inhibitions are lowered and the pets natural responses to the pain they are in are vocalized.

      The other cause for vocalization is that those medications can cause a level of dysphoria. Please know this is not an 'anxious' feeling. They don't know what is happening. I myself have had 12 surgeries and I am a very dysphoric patient when I am going under and coming out of anesthesia. They normally have to put me in another room because I am loud and make strange noises. This can upset other patients in the recovery room. I have no recollection of me doing that at all - but it is a running joke in my family.

      More likely your Chloe was just going through a level of dysphoria like I do. What I want you to know is that it was not her yelping from pain. Simply the way her brain was reacting to the anesthesia.

      As far as giving the second medication that soon after the first - this is not abnormal. Since the first was given IV - it takes effect very fast. We technically can give the second medication without the first. The second is an anesthesia drug and does not need to be preceeded by anything. But we all like to give the first medication to make the pet feel calm and comfortable.. .and the owners as well.

      Again - I am so sorry for your loss. I hope this helps a little. Her last moments in her mind were of you holding her in her lap (nothing else) - and that should bring you some comfort. That is why we named our company 'Lap of Love' - because it's the best place to be as we say goodbye.

      Hugs,
      Dr. Mary

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    2. Dr. Mary,

      Thank you so much for your response. That makes me feel so much better and I think will aid in my healing, especially that her last memories are of me holding her. It makes me cry but they're almost heart warming tears than tears of pain. Thank you so much again.

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  15. Today I had to put my sweet cat to sleep. I'd had her for 20 years.

    The vet told me that my baby wouldn't feel any pain. But she jerked when they stuck the needle in.

    It broke my heart.

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    1. Hi Amie,
      I am so sorry for your loss - 20 years - although a long time - is not long enough.

      The medication itself is not painful - it truly is an anesthetic - but of course any pet or human will 'feel' a needle go through the skin - and most of us will react with a reflex of pulling the arm away. Humans 'know' what is happening and will voluntarily keep their arm still - but you can't tell a pet that - so they may have a reflex to pull away. I usually give a light sedative in the skin before I try to put a need in the arm - but they still may feel that needle through the skin. So yes, she may have felt that needle - but in no way was she suffering which I know is what you are truly concerned with - so please don't let that upset you - know that you actually did give her a peaceful passing - because passing 'alone' (what some call 'naturally') - is NOT without discomfort in many cases.

      Hugs
      Mary

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    2. Even though I close my eyes and still see that horrible "jerk" reaction... I force myself to believe that you are right, and that she didn't feel pain at that moment. Thank you for your kind words, and the kindness you show to those who comment here. You are giving us the peace of mind we're looking for.

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  16. Can you please tell me what happened? I just need some reassurance please.

    I had my cat put down today at home - a first time experience. I'm not upset with my vet she has been the kindest, gentlest and most conscientious vet I have ever dealt with.

    My kitty was actually still relatively healthy and she commented on how bright-eyed he was, but unfortunately, one side of his face was being ravaged by cancer which made it necessary to stop his suffering.

    I held him on my lap and she gave him a dose of whatever into his abdomen. This was supposed to be enough to put him peacefully asleep and then slip away. However, while he certainly was in a deep sleep, he continued to slowly breathe.

    So after about 20 minutes I guess she decided the dose was insufficient and rather than prolong it, she gave him a heartstick. Now my understanding is that this should be a painless procedure if the cat is heavily sedated. But when she stuck the needle into his heart it was like he "came out of it" temporarily, arched his back and cried out. That shocked me in a bad way. Seconds later he started the tongue licking and gasping and then he was gone in about 30 seconds.

    The tongue licking and breathing I know can be a normal response, but the - what appeared to me to be painful - back arching and crying out has upset me.

    Can you tell me the truth of what that was and what happened please? Obviously, like everyone else I had hoped for just a quiet gentle passing.

    Thank you.

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    1. Hi WLD,

      I'm not only sorry for your loss but also sorry that you have some concerns with what happened. I can say that I think your veterinarian is great - doing this at home is wonderful. You have a gem there.

      As far as giving it in the abdomen - this method is used a lot - it does however take much longer (20-40 minutes) but is without any discomfort. I just put my own dog to sleep and I gave it in her abdomen. I will admit that although I knew medically she was perfectly fine - I was getting anxious at around 20 mins. I was dealing with the thought of her passing for months and then that day - by the hour and minute. So at minute 20 - my emotional budget was tapped out and I just wanted her to go. But it took another 10 minutes. So it wasn't necessarily not enough medication - but sometimes that method is a lot longer and more anxious for the owner.

      When she gave it through the thoracic cavity and into the chest - I believe that it was just an actual reflex and not a mental state of pain. The other thing I would attribute this to is simply 'dysphoria' - I talked about this a few messages above. This is actually probably more likely - so it was not a 'cry out in pain' - but a vocalization that some pets do when they reach a certain plane of anesthesia. Unfortunately for you and the veterinarian - it occurred at the moment of injection into the heart.

      As for the gasping - this is probably more due to his condition. I see 'gasping' more commonly in nasal tumors and lung disease. When awake - the body has a way of compensating for breathing that looks less stressful - but when unconscious - the body does what it needs to do. In facial cancers and lung cancers - the process of breathing becomes so difficult for the pets - and the body naturally breaths in a rhythm that appears more like gasping.

      The only thing I can assure you with is that your pet was under a good plane of sedation/anesthesia - so there was no conscious perception of pain which is what you are most concerned about. Unfortunately however, you feel that is was painful and I am so sorry for that. What I can also assure you is that by doing this at home, in your lap, with good medications like your vet used, your baby passed more peacefully than he would have if you let mother nature take him. She is neither fast nor painless.

      hugs
      Mary

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  17. Recently we had to put our dog down. The whole process didn't go so smooth. No fault to the vet, as our dog was suffering from epitheliotropic lymphoma. Her poor skin was making it hard for the vet to find a vein for the injections. She had received the sedative, and it had kicked in pretty quickly. When the vet had returned to administer the euthanasia, she was poked a few times trying to find a vein and when they thought they finally found it, I watched a tear come out of my dogs eye. They only believed that half of the medicine got in the vein, so they got more and turned her to her other side to see if they could find a vein easier on that side. A few more pokes and tried to inject, which could visually be seen that it was not correct as her skin started to bulge by the injection site. As this was going on a tear then came out of this eye. Eventually they got the medicine in, and our dog passed. My question is though, is it normal for tears to come out of a dogs eye when being put down? Or was this because she knew what was going on and was sad? Or was it a reaction to pain from being poked a bunch of times and not being able to move? It just tore me up to see that, and it did seem like she knew and was sad. I tried searching the web for answers to no avail. Your help would be very appreciated.

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    1. Hi Marcki,

      I'm sorry to hear about your recent loss. Finding a vein can sometimes be a challenge even in healthy pets but much moreso in sick pets. What I can tell you is that pet's do not cry (shed tears) do to any emotional response - like sadness or pain. That simply is fluid production from the gland in the eye that helps lubricate the eye. This fluid may have accumulated in the eye and with a decrease of blinking due to sedation or her being so sick - the accumulation simply drained out of the eye - which is a tear but not an 'emotional' tear like we have. Your baby was also under a nice sedation so I'm sure she was calm and comfortable and unaware of what was going on around her. The sedation we use makes them unconcious - not simply a muscle relaxant - so she did not 'feel' anything and couldn't move... she literally did not feel anything. I hope this helps a little? Dr. Mary

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  18. Dr. Gardner,
    I had to take my beloved Shelby to the vet last night to be put to sleep. I don't know the meds used, but the doctor did use two vials for her IV. After the doctor pronounced her as passed, she let out a yelp and took several "breaths" which the doctor said was completely normal as the muscles and diaphragm contract and air is expelled. It was completely upsetting, and I would like to know if this is indeed normal? I have never heard of this happening, but the doctor assured me over and over that she was already gone.
    Susan Wilinski

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    1. Hi Olivia,

      I am so sorry for the loss of your Shelby. I know it was a difficult decision.
      What you described is what we refer to as ‘agonal breaths’ – and your veterinarian is correct – it is simply the contraction of the diaphragm which expels air and it looks like a gasp – this can happen after the heart has stopped. This even happens in humans – and sometimes a long time after the heart has stopped. Although it is upsetting for you to see – please know that Shelby did not feel any distress. She was unconscious and probably already gone at that time.
      I see this occur maybe 10% of the time – it is a natural act and not abnormal – but not so common that I warn every owner. I actually see this more often when the pet is closer to dying on their own – because when pets (and humans) die on their own – this also occurs. Most people are not present when their pets die on their own so they don’t see it happening – but it does.
      In 1999 I lost my first dog (Snow White) – she was in a bad dog fight and fought an infection from that fight – she was very ill. One day in the clinic I was there visiting her, she was in my lap – she looked hat me, put her head back and died (we were not euthanizing her – she died on her own). She then did the ‘gasp’ (which is what it looked like to me). I remember that that upset me. But more upsetting was that she was gone. The death of Snow White was what made me quit my job and pursue becoming a vet. When this happens to my patients, I hate it. Not because I think the pet is in any discomfort – because I KNOW they aren’t. But I KNOW it upsets the owners. I wish it never happened because it looks like they are in discomfort and gasping for air. 
      I hope this helped comfort you a little. Your vet sounds great and they explained it well – it just is still unfortunate that you are unsettled by that.
      I want you to only think pleasant thoughts when you think of Shelby and the fact that her LAST memory was of you being with her.

      Dr. Mary

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    2. Thank you, Dr. Mary. I had been torturing myself since Tuesday night with all kinds of crazy thoughts running through my brain. It's just that she had passed and a couple of minutes later she let out that bark and then it looked like she was actually taking breaths. It wasn't just one gasp and done. I just wanted a peaceful and painless passing for my girl as she had been with us for more than 12 1/2 years and grew up with my children (this is Susan, Olivia's mom). Thank you for taking the time to respond.

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  19. I understand that northern breeds may have "dysphoric" reactions to opioids and benzodiazapenes. During euthanasia my dog shrieked or screamed during the entire first injection, then jumped on the couch and ran as far away as she could in the backyard - even though she had a tumor the size of a tennis ball on her hind leg. My vet says this was not pain but dysphoria. Do vets not believe animals can experience mental pain? To me, this looked like a very bad drug trip and I'm not convinced it wasn't painful. Thanks.

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    1. HI Catherine,

      Yes - almost all vets believe pets not only experience physical pain but also 'mental' pain... that's why dogs and cats look 'scared' when they come to the vet office - they know something may be happening - like a thermometer where it shouldn't go or a vaccine. :) We know dogs and cats are happy to see owners and some are anxious when they aren't around. So yes, we all believe they have 'feelings' in that sense.

      The drugs we use by themselves are not painful at all. For example, Ketamine (a drug I often use) is used by human anesthesiologists and I myself had that for a pre-sedative for a recent surgery - and it definitely did NOT hurt. Did I feel the catheter, and other pokes that the nurses did - yes. When humans and pets are painful - like your baby was due to the tumor - they are more sensitive to stimulus. Whether that is a needle prick or touch. I've had pets bite their owner so hard when they simply touch them - because they are in pain. So maybe the needle did cause some agitation. Then the dysphoria started to kick in. I know this may still not settle your concerns about what had happened. As "perfect" as I hope all my euthanasias go - there are times like those that do occur. And nothing I can say to the owners make them feel better.

      Even if it was my own dog, I would be upset because I am a mom first - but the 'vet' part of my brain would finally take over and I would KNOW that she is not feeling pain (physical or mental) - it's just dysphoria - which isn't even similar to mental pain. They just don't know.

      I myself have dysphoric states when I am coming out of anesthesia - it's almost embarrassing (I've seen videos) - but I don't remember any of it.

      Again - I am so sorry for your loss. Your little one was lucky to have someone care so much about her.

      I had a Samoyed - I had to let her go last October. I love the northern breeds! :)

      Mary

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  20. Had my cat put down today at home.They administered anaesthetic before euthanasia. I was asked if she had eatten anything, which she had and only just befour the anaesthetic . The vet said that she might be sick and she was lots. She then glazed over, eyes half shut and her head up right not fully asleep still licking her lips which she dose when she's stressed. I asked for the anaesthetic before the last dose in the hope to make it less stressful for her. I now regret this as her last moments was her feeling sick and being sick. also she wasnt fully asleep after 5mins of this injection. The vet said it can take up to 15mins to take effect but my vet seemed okay with how sedated she was after 5mins. Dose it sound like she had the peacful pass over that I was hoping for? x

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    1. Hi Alison,

      I am so sorry that you have doubts about your cat’s passing. I can tell you however that it was peaceful.

      First of all – if it were my cat or dog – I would ALSO give food, treats, etc beforehand. The chance of vomiting is there but I would rather risk that but have them enjoy the treats! 

      As far as the first medication – the goal of that medication is for them just to relax a bit – not necessarily to fall asleep. That medication is usually a combination of a disassociative (so they feel stoned for lack of a better word) and a muscle relaxant. However – side effects could be the tongue hanging out, licking, eyelids open (remember the eyelids are a muscle, so when relaxed they are actually open) and the pupils dilated (because the pupils are also a muscle and when relaxed they dilate – but owners thinks the pet is scared).

      The second medication is what makes the pet fall asleep and the overdose doesn’t wake them back up again. I just euthanized a pet today for a human anesthesiologist and she asked me what medications I used, when I told her she said, “Ohh – he is going to feel great! Thanks for explaining it.” Some people think we give poison or even something that stops the heart. But in reality it is exactly what we get for surgery. A ‘pre-cocktail’ to make us comfortable and then anesthesia. In euthanasia, we simply give an overdose.

      When we go under for surgery – they don’t want us to eat because we could vomit and then we may aspirate the vomit. But when we say goodbye to pets, I don’t mind if they vomit – because they enjoyed the food so much. I’ve had some dogs eat the vomit! GROSS – but then again, some dogs eat cat poop. 

      I hope this helped ease your mind a little.

      Warmly,
      Dr. Mary

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