Most people would prefer their pet to die peacefully in their sleep, rather than having to decide to euthanise or “put them to sleep”. I have found that this thought process usually comes from not knowing how euthanasia works, what the downsides are of a natural death and not being sure when the time is right. In this article, I will answer a few of the frequently asked questions and assumptions I have come across in my work as an End-of-Life Doula for Pet Guardians working for Autumn Animals.
1. Euthanasia versus a natural death
We have all heard the stories of elderly people and pets peacefully passing away in their comfortable and warm beds, while they were sleeping. Of course, if this was a given, we’d all opt for this tranquil transition into death, but it’s not.
Modern (veterinary) medicine and care have come a long way, meaning we can treat a lot of the symptoms of conditions that come with old age, such as osteoarthritis and loss of the senses. We can also treat the symptoms that come with non-age-related diseases such as cancer. And because we can do that, hearts keep on beating for a long time after we pass the threshold of what is considered a good quality of life and well-being.
Imagine a 19-year-old osteoarthritic dog with otherwise healthy organs. We can keep them alive by putting them on an IV drip, feeding them through a tube and cleaning up their soil as they stay in their bed while giving them enough pain relief and anti-anxiety medication to stay physically comfortable. However, it is not in the best interest of that dog’s welfare to keep them alive, because they don’t have agency over their own life and are not able to perform the activities they most enjoy (eating, going for a walk, greeting their guardian). It will take a long time before they breathe their last breath. Euthanasia is a gentle way of relieving them from any physical, psychological, and emotional discomfort.
I always find it useful to turn the question around and try to put myself in that pet’s “shoes”.
What if I couldn’t use the toilet, eat, or interact with my friends and family anymore? Would I want to continue living without any sense of agency and independence?
2. Is euthanasia painful?
As with everything, the answer is: It depends. But usually, euthanasia is not painful.
In this video I describe the process of how we perform euthanasia at Autumn Animals. The only part of the procedure that might cause a bit of discomfort is when we insert an IV catheter in your pet’s front paw, but we mitigate that by giving them pain relief and anti-anxiety medication a couple of hours before the consultation and numbing the skin before inserting the fine needle. Most pets don’t respond to the placement as we are very gentle and because you are sitting right next to them, talking, and petting them, they will feel more at ease. After the needle has been placed, we have direct access to their vein, and you can hold them as you wish, or they can find a comfortable position in their bed without us having to “manhandle” them.
Not all veterinarians in the UK use two injections. Some will even inject the euthanising agent, which is a strong sedative that stops the heart from working, straight into the pet’s vein. This can be a traumatic sight for some pet guardians and not the peaceful transfer we want to see for the pet either. Other veterinarians do use a milder sedative before the final injection, but inject the fluid into a muscle, which can give a stinging sensation and the pet can respond to that with a yelp or otherwise. This again, is not the peaceful transition we’d like to see, it being both traumatic for pets and guardians. This is why we use direct access to the vein, which gives a more gradual transition from being awake to being sedated, is gentler on the pet and easier to witness for the guardian.
The first injection that is given through the IV catheter, is a cocktail of the same sedative given before surgery and morphine. This will cause a gradual drift into sedation, which will take all pain and consciousness away. Their body goes limp, and it looks like they are asleep. We would still recommend stroking them and continuing talking to them, making sure that if they have the slightest awareness, they know they are safe, and you are with them. Talking to them and showing gratitude and love is also a great way for the guardian to be present in the process, acknowledging the love and shared history between you.
When the pet is fully unconscious and you are ready, the vet gives them the final injection through the IV catheter, which is a stronger sedative that makes the heart stop beating. This usually takes a minute or two. You might see your pet take a few deep breaths, which is the body's natural response to the drugs. It’s truly a very gentle transition from life to death. After their passing, they release all control of their muscles, making them keep their eyes open, and lose any urine and stool left in the system.
Because we know exactly when they will start their transition (the moment we start injecting the second drug), you can say a prayer, tell them how much you love them, take those deep breaths with them, or give them an infinite number of kisses while they pass, which can have both a healing and empowering effect on your grieving process.
Being present and fully aware of what is happening gives the feeling of control over the situation, and guiding your pet through the process together with a veterinarian who takes their time and is understanding of your pain, makes it just a bit easier to let go of the physical attachment to your pet.
3. How do I know when it’s time to say goodbye?
A lot of people say “You know when the time is right”. I have found, that not everybody has this epiphany moment.
I generally advise families to start the conversation early in the ageing or disease process by performing a Quality-of-Life assessment (QoL) and continuing to do so regularly during the end of your pet’s life. Autumn Animals has a free assessment available on the website that can help you score your pet’s QoL on various subjects, ranging from physical to emotional well-being. It also asks the question “What makes your pet’s life worth living?”. This last question is a great icebreaker for families to start talking about what their pet enjoys the most and whether it’s time to start talking about “putting them to sleep” when the pet is not able to perform that favourite thing in life. For dogs this can be eating their favourite snack or getting up to greet their humans and for cats it can mean being able to walk around the house without help and to enjoy being stroked.
I would always recommend people have these conversations with relatives and friends who also know the pet, to keep the primary veterinarian in the loop and ask them for their professional opinion and hold them accountable.
In the end, you will decide to euthanise your pet together with your vet, or the Autumn Animals vet, so you don’t have to worry about “playing God” and not making an informed decision.
In general, we would always prefer a euthanasia that is performed (perhaps) a bit too early, than one that is performed in a rush, because your pet crashed and needs to be relieved from suffering. The latter will often be experienced as a traumatic event for the guardian(s) and not one you think back to as a beautiful ending to your physical story together.
The most frequently asked questions about Euthanasia - not an exhaustive list
These are three of the most frequently asked questions I get surrounding euthanasia. If you have more questions though, please do get in touch, or schedule a free exploratory chat with me. If you’re not in the Autumn Animals area, and you’d still like to learn more about how to make your pet as comfortable as possible in their old age, I offer virtual End-of-Life- Doula consultations and can guide you in the search for a local veterinarian who has the approach to euthanasia that works best for you and your pet.