Euthanasia

About Euthanasia

There are variations in the agents used for euthanasia but most of them are concentrated barbiturates that are injected

Thiobarbiturates have three effects that can induce death. They are fairly potent depressives of the central nervous system activity in the brain stem, which leads to depression of all bodily functions controlled by the brain stem. This action is responsible for the loss of conciousness associated with barbiturates in adequate doses. In large doses barbiturates have a direct depressant effect on the heart muscle as well and will cause the heart to cease to function. This is probably the actual cause of death in most instances when barbiturates are used for euthanasia. There is also a respiratory depression associated with barbiturates but it is probably not a factor since the other effects are more rapid. In surgical uses of barbiturates this can be a very important factor and must be monitored closely.

As far as we can tell, unconciousness precedes the cardiac depression and this is painless, as far as can be determined.

Mike Richards, DVM

Dealing with Pet's death

Q: Hi Doc ! I certainly enjoy reading the newsletter and have appreciated the info you have given me concerning my staffy bull's cushings disease. In a pensive mood I was wondering though, are there any symptoms I should be watching for that might indicate the "end" is near? Since losing most of her hair on her head she looks at me with the wrinkles over her big brown eyes and appears almost human... and she would certainly tell me if she could; but I don't want her to suffer. She still manages to climb on the bed and guard my feet, she comes to me to be petted and have her ears scratched, and her appetite has always been good. She gets the lysodren every third day and keflex and phenobarb daily. The only things I have noticed are that she seems to be confused sometimes and stumbles now and then. She was shivering today, and I wondered if 'something' hurt. I'm sure dealing with a pet's death is one of the most difficult aspects of your practice, but I try to be a realist even in difficult situations... fourteen in dog years is a long time even in the best of health. Besides, though I have no doctrine to support my theory I expect someday to romp with every pet I've ever had in the Hereafter! What do you think?

Pam

A: Dear Pam-

The last part of your question is the easiest for me. I think that dogs and cats are just as likely to have an afterlife as humans are. I can't imagine any reason why not.

The confusion associated with aging is sometimes responsive to a new medication, l-deprenyl (Anipryl Rx) which is also the newest of the medications approved for the treatment of hyperadrenocorticism (Cushing's disease). I am not sure whether or not you can use Anipryl concurrently with Lysodren but the manufacturer would know. We have used this medication once in a dog that had signs of both hyperadrenocorticism and senility and it worked well for the confusion fairly quickly (a week or so) and then worked well for the hyperadrenocorticism much more slowly. It took at least a month for the clinical signs to improve for the Cushing's disease. You might want to ask your vet about this. Anipryl is more expensive to use than Lysodren but has less lab costs associated with it since it doesn't have to be monitored as closely.

For the more general question of how to you tell when the time has come for euthanasia, I think that most clients really reach a point where they aren't questioning when the time will come or whether the time is right, they just know that it is. Some clients (and me, unfortunately) reach this decision only after their pet has shown clear signs of severe pain, total inability to eat or other severe signs that are hard to miss. Other clients reach this time when the pet becomes inconvenient to care for or when pain and suffering are chronic but not severe. In the overall scheme of things the difference in timing is usually so short that I think very few people make really bad decisions. It is a time to trust your instincts. You will probably know exactly when the time has come. Somehow, Psaltee will tell you.

Mike Richards, DVM

Considering Euthanasia

Q: I have an 8-year old Yorkie. He has really bad breath. We took him to the vet to have his teeth cleaned. The vet did a blood test and said he has kidney disease. The vet said he has gum disease and his teeth are loose. He's lost a couple of pounds in the last year and he won't eat anything now. He hasn't eaten in two days. The only thing he would eat before was chicken. Is there any chance he will recover or should we put him to sleep? What treatment do you suggest? When should we put him to sleep?

A: Gayle-I can't tell you when to consider euthanasia without knowing a great deal more about you and your dog -- more than it is possible to know "over the computer", probably. Kidney disease in dogs is harder to control long term than it is in cats. In general it has a poor long term prognosis if there is not a correctable underlying cause. Despite this, some dogs do well for considerable periods of time after the initial recognition of their kidney problems. Depending on the lab values (how bad the damage appears) it may be worthwhile to clean the teeth and remove severely affected ones. This can help reduce the amount of discomfort and stress and increase the chances of successfully dealing with the renal disease.

It would be best to discuss your concerns with your vet in this case. Most vets are willing to spend a little extra time to counsel clients when euthanasia is being considered.

Mike Richards, DVM

The decision to euthanize - when is it time?

Q: Dr. Mike: I have a black Labrador Retriever who is 13 years old. He has hip dysplasia (was born with it), and it has steadily grown worse. It is now to the point where it takes him up to a minute to get up. My wife and I have a 5-year-old daughter who is very attached to the dog. We've often discussed what to do as the inevitable approaches. Once our dog can get to his feet, for the most part he's fine, able to go on short walks. He does not appear to be in any pain and does not whimper. However, he's been falling a lot, which has caused us to start thinking about putting him to sleep ... but at what point? And what do you tell children at that age? Our dog has received Cosequin as a test by our local university. Didn't know if he actually received it or was part of a placebo group. No real benefits seen. Our dog cannot keep aspirin in his stomach. Nor Ecotrin. Hip surgery has been discussed and some other medications, yet we're trying to weigh the financial considerations, chances for recovery, age of the dog, and impact upon our child. Thank you for any assistance you can provide in helping us work through this time. J.C. Missouri

A: J.C. - I am sorry for the delay in replying to your question. Our site just got busy enough to overwhelm me. I am hoping that you have tried carprofen (Rimadyl Rx) in the time since you wrote. This medication can have amazing results in dogs with degenerative joint diseases. I have a good friend and patient who could just barely walk a month ago who is going up and down stairs now since being put on Rimadyl. If you have tried this and it hasn't been helpful or if it upsets your dog's stomach, too, don't give up before using corticosteroids. These are a last resort because of side effects but when you compare any possible side effect with euthanasia it is usually better to risk the side effect. Especially since they are not as common as people think when using cortisones in dogs.

Handling the eventual decision to euthanize when young children are involved is harder to give general advice about. Very young children do not seem to notice the loss of a pet very much, at least based on the conversations I have had with a number of clients and experiences with my children. Some children will have developed a strong sensitivity to death by five or six but most of the time the really strong reactions occur in kids who are eight or nine or older. There is a time in adolescence when the loss of a pet seems to be especially difficult. It seems to correspond to the time when teens are searching for some idea of who is really on their side in life. Since pets can almost always be counted on as friends, their loss is very hard during this time. I am not a psychologist and these are simply my observations. I suspect that your daughter will do better than you think when the time comes but that you will have to help her understand. Just the fact that you are worried about it is a good sign and I think you'll do OK.