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Euthanasia: What Happens and Is It Painful?

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    It’s the day all of us dog parents dread. It’s the words we never want to say because our pets will live forever. And as our beloved companion reaches closer and closer to that day, we must accept the truth. That dreaded euthanasia appointment is near. Of course, we all wish that those last moments are stress-free and pain-free. We imagine our dogs’ tired and aching bodies healing and our dogs frolicking over the rainbow bridge. Yet, there are some infrequent circumstances where the euthanasia appointment turns out not to be as peaceful as expected. 

    Those who are around euthanasia more than the standard person still have trouble with it every day but it gets to be where there is an understanding that you are releasing the animal from their suffering and letting them pass into the next life.

    On the day of the euthanasia appointment, you will have so many emotions. Just know you can do this. You can do this because you love your dog. People often worry that when the time comes, they will fall to pieces. Let’s not be in denial; you probably will. But for most people, that happens after you are home, and it sinks in that your pup is no longer there. During the appointment, what is more, likely to happen is that you will find your inner strength. You will be strong and be there for your pet’s final journey. If you need to sit down, don’t be afraid to sit. Get as comfortable as you can. But if you can stay by your pet’s side, your presence will keep them comfortable. This is about making your pet’s last moments as calm and peaceful as possible, and you will be surprised that this is something you can do for them. Talk calmly and gently to your pet so they know all is well. If you can’t trust your voice, be near and calm. You are doing the right thing.

    Is Euthanasia Painful?

    Most people believe that euthanasia stops the heart, causing something similar to a heart attack. This is far from true. The fact that euthanasia is so commonly called “being put to sleep” is a testament to the procedure’s painlessness, simplicity, and speed.

    Sodium pentobarbital is one of the most common drugs used, and it works by triggering unconsciousness, which stops brain function. Because the brain controls the body, it tells the heart and lungs to work. But when the brain stops functioning, the respiratory center is depressed, breathing ceases, and the heart stops pumping.

    The pet is unconscious, so it’s more like dying under anesthesia and peacefully slipping away than dying from a heart attack on the surgery table. To better understand, here is the timetable of euthanasia according to the Humane Society of the United States Euthanasia Reference Manual

    • After 5 seconds, the pet is unconscious. 
    • Within 10 seconds, the pet is in deep anesthesia. 
    • Within 20 seconds, the pet stops breathing. 
    • Within 40 seconds, the heart has stopped circulating blood.
    • Finally, within 2 minutes, the pet is clinically dead, meaning that all voluntary/involuntary functions have ceased even though you may still stumble on the occasional muscle twitch.

    Was Your Pet In Pain Before The Euthanasia?

    If your dog was already in pain and suffering, they might have vocalized their pain during the euthanasia. For instance, if your dog has severe arthritis, they may cry out when their leg is moved for the catheter placement. Or a dog with painful cancer who can no longer walk just the slightest movement might make them cry. Laying on the floor or being picked up to lay on a table could cause discomfort. Luckily euthanasia is often quick, and they will soon be on their way to a pain-free world.

    Were Your Dog’s Veins Hard To Find, Or Did It Take Two Iv Catheters?

    In some cases, veins may be difficult to find. Like in humans, animals can become dehydrated or have very low blood pressure, making the veins almost impossible to find. Very old animals or sick animals can have constricted veins or collapse as soon as they are stuck with a needle. Repeated attempts to stick a vein only aggravate the situation, causing some dogs to resent being handled, vocalize, and put up a fight. These dogs will sometimes need to be forcibly held down and restrained, making the last moments less peaceful than expected. If this happens, trust that the individual who is performing the IV placement or euthanasia is there to help your pet at this time. If you get angry, your pet can sense your anger.  

    What About Pre-Op Sedation? 

    Many veterinary professionals will administer a sedative before performing the euthanasia. There are a couple of different names for this step, all depending on where you go. The most common is called the two-injection, pre-op, or pre-mix. These sedatives are typically given either in the muscle in the hind leg or a vein. Most vets will use a tiny needle for this. Most sedatives feel like a bee sting. I have worked with many vets over my years, and most don’t tell the owner this. I am really not sure why. But it is fast—just a tiny sting, and it’s over just like that. The purpose of this is to relax the pet or even cause unconsciousness before the euthanasia solution is injected. Several pre-euthanasia drugs might be used. The best ones are anesthetics that cause the pet to lose consciousness, like when you go under surgery. One of the most preferred is a “pre-mix,” a combination of xylazine and ketamine. These drugs may cause a stinging sensation when administered intravenously. Telazol (tiletamine and zolazepam) is also a preferred drug that stings much less. Telazol not only causes a loss of consciousness but also causes loss of pain. 

    Some vets choose sedatives instead of anesthetics. But the main disadvantage in this is a sedative does nothing for the pain. They also do not cause a loss of consciousness. For this reason, their use is less preferable. For more on these drugs, see The Humane Society of the United States Euthanasia Reference Manual.

    Why Did the Solution Go Outside the Vein?

    If the euthanasia solution is accidentally given outside the vein, it could cause a burning sensation. If the dog moves (but not necessarily has to) and soon there’s a hole in the vein or the catheter comes out of the vein, the Solution can leak outside the vein into the tissue. This being my cause, the dog to cry out. The other possibility is the dog simply feels it. Just like people “feel” the liquid going in their veins when they are getting an injection. This is another reason that sedation is so important.

    Did Your Dog Have Normal Reflexes?

    That’s its… Euthanasia is over. It’s done, right? Not necessarily. Be prepared for the end. But first, know what you are going to read is entirely normal for animals and humans. 

    The Solution has gone in, and death occurs; it is normal for some reflexes to happen. Most veterinary professionals will warn you about this. But know reflexes are not a sign of pain. Your dog may twitch, they may take another breath, they may pass gas, their lip might twitch, and or their tongue might move. They may also urinate and or defecate. These are normal reflexes that take place as well in natural death in dying dogs,

    Reflex is NOT a sign of pain. The untrained eyes of a grieving owner may prove that the pet is in pain and suffering. Or that they are “fighting for their life,” but in reality, these are unconscious, voluntary responses to the body shutting down. 

    Twitches can be scary. But they are just like hiccups. They are your dog’s body’s way of getting rid of negative, painful energy and starting fresh in their new journey. 

     Heavy breathing, this is hard to see, but this is “where they hit the Rainbow Bridge running,” 

     Lip twitches or tongue curls are the pup’s smiling once they get there. They are met at the bridge by their human and or animal friends that have passed before them. Can you imagine how happy they are…

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    A Veterinarian Shares Her Tips for Raising a ‘Forever Dog’

    Dog lovers know there’s nothing quite like the joy a four-legged companion brings to your life, especially during times of stress. Our pets may be our best friends — but do we know how to make sure their lives are as long, healthy and happy as can be?

    Not always, says Karen Shaw Becker, a veterinarian in Scottsdale, Arizona. “Dogs are dying prematurely of more chronic disease than ever before,” she writes in her new book The Forever Dog: Surprising New Science to Help Your Canine Companion Live Younger, Healthier and Longer, coauthored with animal activist Rodney Habib. Becker, who also coauthored a popular cookbook, Dr. Becker’s Real Food for Healthy Dogs & Cats, is a proponent of a proactive approach to veterinary care — helping people create the kind of healthy lifestyles for their animals that can prevent disease, rather than simply treating problems as they arise.

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    Measuring Quality Of Life In Dogs

    When dogs become older or suffer from a debilitating disease or chronic pain, their quality of life (QoL) comes into question. When determining QoL, you are determining how much a dog may be suffering and if it’s possible to make them more comfortable through further treatment or changes in lifestyle. The QoL assessment is crucial for good palliative and hospice care and is the linchpin of the euthanasia decision.

    When you consider the term “quality of life,” remember that it affects both the quality of life of your pets and your own. Assessing one’s own life does not diminish the love and care that one gives to one’s pet, but emphasizes the priorities and needs that one must cultivate for it. It can be difficult to make difficult decisions due to financial and other constraints, but it is important to take care of yourself and remember that you are doing what is best for both you and your pet. At the same time, you want your dog to maintain its quality of life. If he is in pain, unhappy or has difficulty doing everyday things, you do not want him to continue to suffer.

    senior chocolate lab with white face

    Trying to determine your pet’s quality of life is a daunting task and we are often left in denial. Dr. Alice Villalobos, DVM, has developed a scale to determine whether euthanizing your pet is the right choice for your situation. This is called the “HHHHHMM Test,” which covers five main areas of life:  Hurt, Hunger, Hydration, Hygiene, Happiness, Mobility and More good days than bad days. You can view the HHHHHMM scale here. 

    You can also use a Quality of Life calculator such as this one available by Journey’s Pets. While you shouldn’t use an online calculator or test to fully determine the qualify of life, it can be a good indicator of what steps to take next and which concerns to bring up with your vet. As useful as they may be, QoL questionnaires are at an early stage of development and should not be used by veterinarians or pet owners to make final decisions.

    It’s important to note that wagging tails doesn’t automatically equal high quality of life as many dogs display happiness through their suffering. As your dog ages and his health decreases, it can be difficult to decide when is the right time to euthanize. The concept of QoL can be applied to any animal, but they are complex and difficult to measure.

    woman looking at her dog at the vet

    Understanding and measuring the quality of life of older dogs can go a long way to ensure that our pets live the best lives we can give them and can help us know when it is time to let them go. The purpose of measuring the so-called Quality of Life Scale is to help owners measure the quality of life of a pet at a time when emotions are still raw. Saying goodbye is always heartbreaking, but when it does, we can seek solace in knowing what a wonderful journey we have made together. 

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