Euthanasia: The Compassionate Goodbye

• Euthanasia: The Compassionate Goodbye (216.1 KB)

There is no time in veterinary care when compassion, education, and communication are more important than in euthanasia. The word, meaning “gentle death,” refers to the practice of ending a life in a painless manner, but the procedure is anything but painless for a client—or the veterinary staff. Thoughtful planning, conscious care, and full awareness of the client’s need for education and support can provide a truly “gentle death” for patients and support pet families through the difficult process.

We are the experts and must make sure clients are well prepared for both the physical and emotional realities of euthanasia and loss.

Two realities guide the conscientious veterinary team’s euthanasia protocol. First: research shows that clients want the option to be present during a pet’s euthanasia. Second: approximately 30% of clients experience severe or debilitating grief over the loss of their pets; another 30% percent experience mild to moderate grief, akin to any other major life loss. It is imperative to conduct euthanasia, especially when an owner is present, in a way that mitigates the trauma and pain of the process.

Case Study
Let’s examine a typical case and what each team member can do to provide the best possible care.

Odo, the Weinstein’s beloved collie, has been a patient at Westview Veterinary Clinic since his first puppy check. He’s 13 now and his health has been deteriorating for a year. Jim and Susan understand that as Odo’s quality of life slips, they may have to face his euthanasia.

• Reframe the Process: Clients often fear the idea of euthanasia because they perceive it as “killing” a pet. A compassionate veterinary team can help owners understand that it’s the disease process or illness that is taking the life of their pet; euthanasia can make that inevitable end humane and pain-free.

During his last few senior checks, the entire medical team has discussed Odo’s increasing infirmity, helping his family understand his decreasing life quality. Dr. Hammond sat with the couple recently and helped them put together a personal guide to monitor Odo’s capacity to enjoy his life. She asked them to think about how they know, beyond a doubt, when Odo is happy and content. Their list included playing with his favorite toys, asking to play fetch when outdoors, showing interest in walks, and greeting Jim and Susan at the door when they return from work.

• Careful Preparation: As the doctor helped them prepare this list, she was able to help Jim and Susan understand that the eventual euthanasia, should it come, would be a release from severely decreased quality of life. At the end of the visit, the couple thanked Dr. Hammond profusely. She urged them to call when they felt Odo was showing signs of major decline.

A few weeks later, Jim called the clinic to report that Odo must now be carried in and out of the house. He has refused to eat and has to be coaxed to drink. His toys hold no interest, and Odo spends his days with his head on his paws, too tired even to acknowledge Jim and Susan. The receptionist empathizes, acknowledging the difficulty in seeing a beloved pet in such a condition.

Jim makes an appointment to bring Odo in; the receptionist makes sure to choose a time when the waiting area is not full of healthy pets and families. The Weinsteins agree to meet with Dr. Hammond the day before the euthanasia to go over the process and complete necessary paperwork.

• The Pre-euthanasia Meeting: A pre-euthanasia meeting helps orchestrate a humane, family-present euthanasia. When time permits, this visit can help clients prepare for the procedure, make decisions with a clear mind, and complete business details in advance. When the family arrives for the euthanasia, all they have to focus on is saying goodbye.

The receptionist reminds the staff that the Weinsteins are coming before the pre-euthanasia visit. When the couple arrives, she greets them warmly and escorts them to Dr. Hammond’s office. Dr. Hammond commends the couple’s courage in taking this difficult step. She describes the euthanasia process and answers questions. They discuss after-care arrangements, and Dr. Hammond helps Jim and Susan through necessary paperwork, letting them know they can pay for the procedure in advance so they don’t receive a bill in the mail later. Finally, Dr. Hammond urges Jim and Susan to spend their remaining time with Odo doing things that the family enjoys as a way of saying goodbye.

• Preparing Clients: Client preparation is essential. Explaining the protocol (including a pet’s possible clinical responses) while clients are thinking clearly makes the procedure less frightening. Clients want the option to be present during a pet’s euthanasia. Remember, although medical personnel are familiar with death and dying, most clients have had little experience with either. We are the experts and must make sure clients are well prepared for both the physical and emotional realities of euthanasia and loss. 

The Weinsteins carry Odo in together and the receptionist leads them to a prepared euthanasia room. The room has a soft mat on the floor for Odo and comfortable chairs for the family. The overhead lights have been dimmed and the room is illuminated with soft lamps. Mary, a technician, comes in and explains that she will be placing a catheter in Odo's leg to ease the injection of the euthanasia fluid. Dr. Hammond takes this time to review the procedure, and checks to see how the owners are doing. The Weinsteins sit with his head cradled in their laps as Dr. Hammond calmly talks them through each step. When she pronounces Odo dead, she covers him with a blanket, gently expresses her condolences, and she and Mary leave the family to say a quiet goodbye. When the couple emerges from the room, Dr. Hammond walks them to the door. Mary hands them an envelope of grieving resources to look over later. The Weinsteins, though teary, thank everyone for helping them through saying goodbye to their boy.

• Euthanasia and Post-euthansia Care: It is imperative that post-euthanasia care and client follow-up is handled as sensitively as the euthanasia itself. Make sure to note the pet’s death in the medical records so that continued preventive care correspondence is stopped. Have the staff sign a condolence card in which each person says something specific about the pet. Mail this the next day. When Dr. Hammond called Jim and Susan a few days later, she found that they were taken aback by how difficult it was to be without Odo. She commiserated with them that the adjustment after such a loss was more complex than most people expected, normalizing their response. She reminded them of the resource packet and urged them to look it over. Before hanging up, she shared information about a local pet bereavement group.

• The Worthy Goodbye: When it comes to euthanasia, most people are ill-prepared to make the decision and have no idea what to expect during the procedure itself. They often are surprised and frightened by the power and the duration of grief they experience afterward. As home or family-present euthanasia becomes more the norm, the exceptional veterinary team will understand the need for a client-centered euthanasia protocol and will consciously focus on making this painful experience a time of sensitive and compassionate care. Teams must conduct euthanasia, especially when an owner is present, in a way that mitigates the trauma and pain of the process.

Sensitivity & Euthanasia

1. Be aware that clients deal with their grief in different, though still normal, ways. For example, don’t assume that someone who prefers to be “business-like” about the euthanasia process is not as attached to a pet as a person who appears more emotional.

2. Be self-aware. Because of your own experience conducting euthanasias, you may have become somewhat inured to how your clients feel about the loss of their pet. Try to recognize how this can affect client interactions.

3. Learn to handle your own discomfort with another person’s pain. For example, if seeing tears is hard for you, work on that by examining where that discomfort comes from and consider whether there are alternatives ways to view and “be with” another who is in pain. Recognize that tears and other expressions of pain are a very normal and healthy part of the healing process.

Euthanasia Protocol Checklist

Pre-euthanasia Meeting
1. Go over the euthanasia procedure step by step.
2. Share potential physiologic responses pet may experience during euthanasia.
3. Discuss body care and explain arrangements.
4. Cover appropriate paperwork and sign forms.
5. Take care of billing in advance if possible.

Euthanasia Appointment
1. Schedule appointment when clinic is quiet and staff is free.
2. Avoid having family sit in the waiting room with other clients.
3. Provide a comfortable, quiet room for the procedure that has amenities such as a floor mat, soft lighting, and comfortable seating.
4. Ensure staff knows and respects that a euthanasia is occurring so that external sound is controlled (a sign or signal on the door of the procedure room is helpful).
5. If a catheter is used, place it in the pet’s hind leg to allow full access for the family at the head.
6. The doctor should describe each step of the euthanasia.
7. Normalize any physiologic responses the pet has during the procedure.
8. Respectfully pronounce the animal’s death when it is validated.
9. Express condolences as you leave the room.
10. Give the family time afterwards to say goodbye on their own (if they agree).
11. Greet them again before they leave the clinic and assure them their final wishes will be carried out.
12. Provide a packet of grief resources.

Post-euthanasia
1. Update medical records.
2. Prepare and send a personalized condolence card.
3. Check in with the family in 3 to 5 days via phone.
4. Notify clients when body care instructions are carried out or cremains are returned.
5. Ensure that cremains and/or necropsy results are handled with compassion and sensitivity as they are returned to the family.
 

Handouts

You can download our helpful client handouts that help patients cope with the loss of a pet by clicking here or just go directly to our "Handouts" section.