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Wednesday, October 12, 2011

Is Euthanasia Painful?

Stefanie sent me this email...
I have been reading "No Compromise" by Melody Green (a non-fiction book - an account of Keith Green's life and ministry) and towards the end - in just a very brief paragraph, it is discovered that Keith and Melody's dog becomes ill and they take it to the vet who tells them she has advanced cancer and the dog can either be euthanized at the vet office or taken home and shot. The vet strongly urged Keith to take it home and shoot the dog because it was more humane. I was a little taken aback by this and wondered - since this had happened in the early 80's - just how far humane euthanasia has come? I mean, were the injections given at that time painful or ineffective? 

Some of my older readers may be able to help with this.  I started working for a vet in 1984 and remember euthanasia as a simple, painless injection.  I had dogs euthanized before that, but wasn't present.  Still, I don't remember hearing it as a painful procedure.  Readers older than me may be able to give a different perspective.

The American Veterinary Medical Association does have guidelines for humane euthanasia of all animals.  Believe it or not, a properly aimed and delivered gunshot is considered a humane method of euthanasia.  However, you have to do it the right way and have the right caliber of gun in order to provide an instantaneous kill, and because of this I really don't recommend anyone trying it.  I've seen and heard of euthanasias attempted in this way going horribly wrong and the animal suffering.

For all of my studies and practice, euthanasia on companion animals is done by an intravenous injection of pentobarbital (sold under various brand names).  In more dilute solutions, pentobarbital can actually be used as anesthesia, though not really safe anymore compared to other modern drugs.  In human medicine it has been used to treat seizure conditions and similar brain disorders. The concentrated euthanasia solutions therefore induce a sudden and deep anesthesia, followed in seconds by cessation of brain activity and then heart activity.  Because we're basically overdosing the pet on anesthesia, they literally fall asleep and don't wake up, hence the common term "putting them to sleep". 

The procedure is generally considered quick and painless, no worse than being induced for anesthesia.  In most cases the only pain involved is the quick needle poke from the injection or IV catheter (which I prefer to do, especially if an owner wants to be present).  That doesn't mean that every case goes well.  I have had pets suddenly move, pulling the catheter or needle out of the vein (another reason I tend to use IV catheters, as this is less likely to happen), requiring a second poke.  Occasionally a pet will need a higher than normal dose, which is why I typically go ahead and give a little more than the calculated amount, and also keep the bottle in my lab coat pocket in case I need to give a little more.

Very rarely does the injection go horribly wrong. My worst experience was during a routine euthanasia on a cat.  As soon as I gave the injection the cat screamed, launched itself straight up off the table a full 1-2 feet in the air, and then landed on the table dead.  It happened suddenly, and I was at a loss.  It freaked me and the owner out, and I had no explanation for the sudden reaction seconds before death. In my so-far 14 years of practice that was the worst one, and I hope the only one like it.

The huge majority of euthanasias are smooth and quick, with the pet quietly passing away within 10-20 seconds of giving the injection.  Obviously this is the way we want it, as a dignified, peaceful exit from their life.  And that's the way I've observed this procedure for a little under 30 years.  If it wasn't so painless and easy, I wouldn't feel as comfortable doing it when the end of life comes.  But with the drugs available, it's a way to end suffering, not cause more.