The Human Animal Bond, Bereavement, and Euthanasia

The Human Animal Bond, Bereavement, and Euthanasia

Veterinary Technology

Level 4

THE HUMAN ANIMAL BOND

•  Due to urbanization, animals live with owners, increasing familiarity, dependency, and bonding.

•  80% of companion animals live inside.

•  Many people consider their pets to be like children.

•  Attachment to pets is more intense when the animal functions in more roles; such as an assistance dog vs. a hunting dog.

PET LOSS AND VETERINARY MEDICINE/THE GRIEF PROCESS

•  Vets/technicians are faced daily with complex issues of attachment, loss, and grief.

•  Owners often turn to staff during grief because they believe we understand their loss.

•  Staff members must be comfortable in discussing death and the grief process.

•  Formal training is rarely given on this subject.

THE NORMAL GRIEF PROCESS

•  Elisabeth Kubler-Ross created the classic 5 step model.

•  Individuals vary as to how they progress; most fluctuate between stages and bounce back and forth.

1.  Denial - normal defense mechanism that buffers humans from unbearable news or reality.

•  Staff often perceives this as the owner not understanding the prognosis or perhaps not hearing.

•  Repeating the information is advisable, but owners will only accept the reality when ready. (Be patient)

2.  Bargaining - various impotent attempts to control or reverse the reality.

•  Praying or negotiating with God.

•  Seeking second (third, fourth, etc.) opinions.

•  Replacing a lost pet too soon.

3.  Anger - direct or indirect feelings of anger or guilt

•  Owners often blame staff, yell at personnel, refuse to pay the bill.

•  Staff must use tolerance and understanding to avoid becoming defensive.

•  Allow clients to vent but don’t admit any mistakes.

4.  Depression - complete and overwhelming sadness

•  Follow-up is important.

•  Referral to a counselor can be made if worried.

5.  Acceptance - normal functioning is restored

•  Pet is not forgotten.

•  Length of time to reach resolution varies in individuals.

Euthanasia - induction of a painless death (Greek root meaning “good death”)

•  relief of suffering

•  killing of unwanted, abandoned, stray, or undesired animals

•  not always in the common interest of the patient, client, and veterinarian

THE DECISION

•  Owners perceive their pet’s illness involves some degree of suffering.

•  Pet’s place in household and relationship with owners may vary.

•  Financial constraints are often a major factor.

•  ALL options must be made available to clients with detailed prices so an informed decision can be made.

•  Once the decision is made, staff must support it, regardless of personal feelings.

•  Convenience euthanasia is dealt with differently between practices.

NEARING THE END

•  Ensure all parties understand what euthanasia means. (Avoid “putting to sleep, put down, etc)

•  Decide where procedure will be done.

•  Decide who will be present for procedure.

•  Decide how pet’s body will be handled after. (bury, cremate, etc)

•  Explain exactly what to expect during procedure.

MECHANISM OF ACTION OF EUTHANASIA

•  Sodium pentobarbital is most commonly used (barbiturate)

•  2ml for first 4.5kg then 1ml/4.5kg additional weight.

•  following IV injection, solution is rapidly carried to the heart

•  passes through the lungs (no effect)

•  pumped through left side of heart and into body

•  first affected organ = brain

•  results in rapid unconsciousness

•  followed by depression of brain centers that control breathing and blood pressure

•  by 25 seconds, the animal is brain dead

•  heart continues to beat for up to several minutes

STAGES OF EUTHANASIA

•  STAGE 1 = VOLUNTARY EXCITEMENT

•  STAGE 2 = INVOLUNTARY EXCITEMENT

•  STAGE 3 = ANESTHESIA

•  STAGE 4 = MEDULLARY PARALYSIS

STAGE 1

•  fully awake, conscious

•  capable of feeling injection

•  respond to external stimuli

•  administer a tranquilizer if difficulty handling

•  quiet surroundings

•  handle calmly, gently

•  do not begin injection until in vein

•  use sharp needles, inject rapidly

STAGE 2

•  not fully conscious

•  vocalizes or shows movement

•  paddling

•  jerking

•  howling

•  sneezing

•  not often seen with rapid IV injection

•  if undercalculated

•  lose the vein

•  IH/IP injection in cats: if injection misses liver and IP space and goes into fat/muscle

STAGE III

•  unconscious

•  unresponsive

•  normally short duration

•  if undercalculated

•  lose the vein

STAGE IV

•  last reflexes that maintain life are gone

•  breathing stopped

•  pupils dilated and fixed

•  heart may contract

•  “last gasp” sometimes seen

•  reflex only

PRE-EUTHANASIA CONSIDERATIONS

1.  Procedures to reduce animal anxiety.

•  Do not expose cats to dogs.

•  Use people that the animal is familiar with, if possible.

•  Animals should be talked to and petted.

•  Room should be away from ward.

•  Room should be quiet and comfortable.

•  Bitches and queens should be euthanized prior to puppies and kittens.

2.  Tranquilizers and Sedatives.

•  For fractious animals and/or when restraint is unavailable.

•  SQ or IM injections.

EUTHANISIA PROCESS REQUIREMENTS

1.  Room, Materials, and Equipment

•  Good lighting.

•  Sturdy table.

•  Limited access, quiet.

•  I.D. forms, euth drugs and tranqs, needles of varying size, syringes of varying size, tourniquet, clippers, alcohol, cotton, muzzles, leather gloves, heavy quilt, clean up materials.

2.  Preparation to euthanize.

•  Set EVERYTHING up prior to bringing in animal, EXCEPT for disposal materials.

•  Verify all paperwork and make sure you have the correct animal. Do this several times.

3.  Handler responsibilities.

•  Restrains the animal properly, gently, and responds to directives from the injector.

•  Keep animals head AWAY from injector.

•  Be careful not to restrict breathing.

•  Be watchful of the injection. (release pressure when vein is found)

•  Maintain restraint until the animal collapses.

4.  Death verification.

•  Dilated pupils, absence of breathing, and cardiac standstill.

•  Listen for heart contractions with a stethoscope or visualize when using IC injection.

TROUBLE SHOOTING:

•  Unable to see the vein: adjust lighting, clip more hair, apply more alcohol, squeeze the paw, use a tourniquet.

•  Difficulty passing through skin: change needles.

•  Unable to enter vein: withdraw slightly and re-adjust.

•  Hematoma development: withdraw completely and make another attempt proximal to the first. Never inject into a hematoma.

•  Unable to inject after trying two veins: get someone else. No exceptions.

•  Animal is agitated after multiple venipuncture attempts: administer tranq.

•  Vein is lost during administration: quickly reinsert proximal and continue. If too excited, administer a tranq and retry.

•  Animal will not die: give additional solution. (possible miscalculation or improper preparation of syringe)

STRESS

•  Primary cause of burnout is frequent performance of euthanasia.

•  Common stress factors cited by animal caregivers:

•  Anger towards the public for lack of responsibility.

•  Perceived negative attitude from public for performing euthanasia.

•  Feelings of isolation.

•  Bearing the sadness of ending an animals life.

•  Becoming close to an animal and it’s owner during a time of emotional turmoil.