HOW CAN I TELL IF MY PET IS SUFFERING?

This is such a hard question to answer. Formally, Quality of Life (QOL) is defined as ‘ a multidimensional, experiential continuum representing how one feels about one’s life”. Quite a concept isn’t it? How do we apply this to our pets?

QOL refers to a state of mind, and is a conscious, subjective, mental experience. It is not measurable or quantifiable. Feelings are either pleasant or unpleasant, and QOL could be represented by the ‘summation of pleasant and unpleasant feelings over a life’. Anything that does not impact on feelings is not relevant to QOL.  For example, a human with an amputated limb might feel a reduced QOL because they ‘felt’ incomplete, or maimed. A dog with this injury that was otherwise active and pain free, would not have a decreased QOL because it does not psychologically ‘feel’ the loss of that limb.

In addition to the existence of unpleasant feelings in our companion animals, we have to consider their magnitude. Things such as heart failure with secondary lung oedema (fluid accumulation) causing decreased oxygen transmission to the body can lead to extreme and prolonged discomfort and distress, occasionally only partly relieved by medication. A broken limb however, will lead to temporary extreme discomfort until the pain relievers are given and the limb is stabilised.

Social relationships or the loss of them has been shown to affect human QOL, and given that our pets have the ability to bond, we believe that the loss or change of social relationships can affect QOL also.  Stress and mental stimulation also play a role. Individual pet personalities or breed idiosyncrasies also affect quality of life.

If you are in dilemma about your pets QOL, try and define for yourself and for your vet, what your definition of ‘good’ quality of life is for your pet. This definition could be as simple as enjoying their walks with you, and having a good appetite. If you can make that ‘definition’, then your vet can help advise you whether there is a realistic chance of returning your pet to the degree of QOL that you think they need to be happy. It may be that there are drugs or procedures that may help, or there may be nothing your vet can offer.

You will be surprised at the answers you receive if you ask your vet to help you define QOL.Its important to understand that pain and suffering are two different things. Pain can be controlled by medication in many cases. Emotional distress because they can’t go on their twice-daily walks any more, or just follow you about your garden, may not be.

In addition to defining quality of life for your pet, it may be time to start considering what a good quality death would be like for your pet, and ask your vet to try and help you achieve that for your pet. Try and define in your own mind, what will be the most important thing about your pets passing, when you look back on it in the future, and explain to your vet what your ‘worst’ fears involve. Your vet will do their best to help you achieve the ‘best death’ possible for your pet.

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WHEN IS THE ‘RIGHT TIME’ TO PUT MY PET TO SLEEP?

Death by euthanasia is always the hardest choice for you as a pet lover, and often the one that causes the most grief for you. However it is important to remember that it is often the ‘best death’ for the pet. Not all ‘natural’ deaths are peaceful. Remembering this fact may help you with your decision-making and your grief. Euthanasia can be the end point of chronic disease, or acute trauma, or simply because extreme old age has sucked all of the joy out of your pets existence, and you are unwilling to see them suffer. 

Many vets have been trained to not answer the question ‘what would you do if it was your pet?’ because it may lead some distressed owners into decisions they would not make otherwise. However, in a clinical setting, I find it very difficult not to answer truthfully. That answer is not always what the owner wants to hear, but if they have asked me directly, then I usually will give a definite answer.  When people ask me that question, they are asking for guidance. Having said that, your own vet may not feel comfortable answering the question, and you need to be prepared to honour that.

Sometimes, as an owner, you are waiting for your vet to bring up the subject of euthanasia, and they are avoiding bringing it up for fear of upsetting you. Do not be afraid to ask if euthanasia is a humane and valid treatment option in your pet’s individual case. For example, when a pet has been intensively treated for several days or longer, having seen the owners invest so much emotionally and financially into trying to make their pet better, veterinary staff may be reluctant to bring up the subject.  Sometimes the owners themselves feel guilty about raising it; not just because of the pet, but because the vets and nurses have worked so hard! Its important to let your vet know that it’s ok to talk about it, by bringing it up yourself.

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WHAT SHOULD I TELL MY CHILDREN and SHOULD THEY BE PRESENT?

The decision to euthanase a pet can result in considerable confusion for a young child, and this is often complicated by the distress you feel as a parent. For a more detailed discussion on the subject of pet loss, grief and children, please click here.

As far as home euthanasia goes, some people believe that children under the age of eight are too young to be present when their pet is put to sleep. However I have seen children as young as four be present (with excellent parental support) and appear to suffer no ill effects.

Basically as parents, you should make individual decisions, based on your own feelings and beliefs, and your child’s temperament. If your child is going to be present at euthanasia, it is best to have a pre-euthanasia discussion with your vet if at all possible, to fully understand what will be happening, so that you can explain everything in advance to your child.  A good way to explain a decision of euthanasia to a child is along the following lines “because everyone loves Fluffy so much, we don’t want her to suffer. Although we will miss her we are going to help her to die, because she is in pain now, and we cannot fix her’, or similar words, appropriate to the circumstance and the childs age. Child psychologists agree that euphemisms should be avoided, and that the truth should be gently told.

Vets and nurses can often help you explain the medical aspects of death to children: we can explain gently how euthanasia is done, why it is a kindness, how the pet will look after it has died and so forth. We can also help children understand why a pet did not survive an illness or accident, and we can act as ‘lay’ counsellors at a time when you may be swamped by your own grief. How you and we deal with children’s grief can have a long-term effect on their ability to deal with death and loss in the future.

It is also of course, important to consider the wishes of the children with this issue. If you or your child does not feel the need for them to be present during the euthanasia, then an alternative is to invite them back into the room after the euthanasia procedure to say goodbye. Seeing that the pet is actually dead often helps give children a sense of closure.

Many different things factor in to how a child will deal with death. Their age and maturity are important factors, together with the pre-existing relationship between them and their pet. The circumstance of the pet’s death is important, as are any other events or losses that the child has experienced.  The ability of the parents and others (including veterinary staff) to provide support will also play an important role in helping the child work through the grief.

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HOW IS EUTHANASIA DONE?

There are several ways that euthanasia can be performed by a veterinarian. All of them involve the administration of a very strong anaesthetic overdose that removes the pet’s consciousness first, then gradually stops the breathing and heartbeat. How the drug is administered may vary depending on the veterinarian and the patient. For more detailed information on the methods of euthanasia click here.

When your pet is euthanased in the vet hospital, most veterinarians will use a concentrated anaesthetic overdose, which is given straight into your pet’s vein via a needle and syringe. It causes minimal discomfort to your pet, and is very fast once the drug is in the pets system, causing your pet to lose consciousness within seconds of the full dose being administered. It is a very humane death. However this method does require close restraint by the nurse, to prevent movement of the pet’s leg while the needle is placed into the vein, and during the drug administration. Depending on the pet’s nature, sometimes muzzling is required for the safety of the veterinary staff. Occasionally this kind of restraint may be distressing for the pet or yourself. A variation on this method that some vets use is to use a small tourniquet to hold the vein raised instead. Many vets who are very practiced at this method (for giving IV antibiotic injections etc) swear by this method of drug administration.

The second ‘commonly’ used method to euthanase a cat or dog, is employed when restricted vein access precludes the giving of the overdose into the vein. This is common for patients who have had prolonged or intensive illnesses and therapies, and may have scarred or damaged veins as a result. It is also common with very elderly cats suffering from kidney failure, who may have very poor blood pressure. Likewise some very small dogs that may not have good vein access, or larger dogs that have fear related aggression and cannot be handled closely with safety, may benefit from this second method.

In such cases your vet may elect to give an injection into your pets muscle, using either a very heavy sedative or an anaesthetic agent, which will make your pet gradually fall asleep. Once your pet is asleep/unconscious, your vet will then give the overdose injection directly into a body organ. Your vet will most commonly choose the kidney or the heart to give the drug into, and with both methods, death will come quickly. They may choose to give the drug into the abdominal cavity instead which will lead to a slower path to death, but no distress, as your pet will already be heavily sedated or anaesthetised. This method is often employed for home euthanasia by housecall vets, but usually for smaller pets.

At Epitaph we do things a bit differently in most cases, because our mission is to ‘enhance’ your experience of the passing of your pet, along with minimising pet-distress. We do not want to rush you, and many owners find that the ‘needle/vein’ method of euthanasia is too fast for them emotionally, leaving little time to say their goodbyes. While there is absolutely nothing wrong with the above methods of euthanasia (and we will sometimes use the second method on a case by case basis), we prefer to allow the owners to be more involved with their pets physically during death, and this can sometimes be difficult using traditional methods of euthanasia.

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WHY MIGHT HOME EUTHANASIA BE A BETTER CHOICE?

People request home euthanasia for a variety of reasons. Some people request a home euthanasia for reasons of convenience only. Their pet may be too large to safely get to a vet clinic, or unable to physically get themselves into the car any more. They may love their pet very much, but they don’t necessarily want to be present for euthanasia, and as long as their pet does not suffer, they are happy. These people rarely use Epitaph, as our depth of services would be considered‘unnecessary’ to them.

Other people have a pet that has terrible fear of going to the vets, and they wish to minimise their pets stress on its last day, by having a home euthanasia. Their pet’s mental wellbeing is extremely important to these owners, and they often wish to be present at the time of euthanasia, in order to minimise their pets fear. These owners often use Epitaph services, as our mission is to minimise stress for the patient, and in fact enhance the experience of their passing as much as possible, by including family members and other pets.

The third main group of owners who request home euthanasia are those owners who have an extremely strong bond with their pet. They usually consider their pet a member of the family, and not ‘just’ a pet. They wish to be present at the euthanasia, and they wish their pet to die in familiar, comfortable surroundings at home, even though they may be physically capable of being transported to their veterinary hospital without fear. These owners will often involve extended family, children and pets in the euthanasia process, and it is these clients who appear to find Epitaphs services the most helpful for them, in a time of severe stress.

Naturally these three categories are not mutually exclusive, and there may well be overlap between the groups.

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WILL MY VET MAKE A HOUSE CALL TO EUTHANASE MY PET?

Many veterinary hospitals are happy to offer house calls for euthanasia as a part of their service, especially to long-standing clients. Emotionally, nothing is more supportive than the involvement of the veterinarian who has helped you and your pet through the final stages of your pets’ life, especially if you have a strong relationship as a team. However, many veterinary practices are unable to offer the service, due to practice policy, staffing or other circumstance.

A veterinary practice’s day is usually divided into sections, an example being consultations from 8am to 12pm, followed by surgeries until four pm, then consultations again between 4pm and 7pm. There may not even be a formal lunch break in between. Sometimes this simply does not allow the time for a home visit, especially in ‘one-man’ practices, where staff simply cannot leave the hospital ‘unattended’ in the case of emergencies occurring.

Even with bigger practices, where there may be more likelihood of some ‘spare’ time in the middle of the day for house calls, many vets feel uncomfortable scheduling a home euthanasia for that time, in the case of unpredicted emergencies forcing them to be late to visit, or worse – forcing them to cancel their visit. This is very distressing for owners who ‘psyche themselves up’ for the visit. Likewise your Vet would hate to be ‘rushing’ you through a euthanasia process, just because they are running late for evening consultations etc.

Most vets understand that a request for home euthanasia signals a stronger bond than most, and are reluctant to offer anything less than what they consider a ‘perfect’ home euthanasia. In these cases, they will often suggest that you contact Epitaph as an option.

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WHO CAN BE PRESENT WHEN MY PET IS PUT TO SLEEP?

With an Epitaph home visit, you may have as many people present as you wish. We occasionally place some restrictions temporarily on numbers present in the room while the IV catheter is being placed, due to the need for peace and quiet, but otherwise numbers or ages of people present are not a problem.

One of my most memorable home visits was with a delightful family whose 20yo cat was seriously and fatally ill. The whole family (from 4yo to the grandparents) were present, there was vibrant music in the background, and everyone (except the 4yo, my nurse and me) had a glass of wine! It was a wonderful ‘wake’ for their dear friend, and this visit stands out in my mind as a sheer delight, and as an example of the spirit of Epitaphs goal; to celebrate a pet’s life during its passage into death.

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CAN I HOLD MY PET WHILE THEY ARE EUTHANASED?

With an Epitaph home visit, you are encouraged to maintain some form of physical contact with your pet during all the procedures. Usually the only exception is the period of time that the IV catheter is being placed by my nurse and I (usually a couple of minutes). During this time we may suggest that you are in front of your pet so that it can see you, although in some cases, it is in fact better or you to step outside (people with needle or blood-phobias etc).

Once the IV is placed, the attachment of an extension set allows me to be approximately 1.5m away from your pet during the administration of any further drugs. Some examples of what this freedom allows are dogs lying on their owners laps on the sofa, or lying outside on the grass in the sun, or just simply curling up in their favourite baskets by the fire. We have euthanased pets in the park, on their owners beds, and in the car (their favourite place to be!)

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WILL IT BE DISTRESSING TO WATCH?

In the past euthanasia was often carried out ‘behind closed doors’ in a somewhat ashamed and ‘furtive’ manner. Clients were discouraged from attending, as veterinary staff believed that they would find it too stressful. No harm came to these pets, and they died peacefully, but it gave the image of ‘secret vets business’ and something to hide. As a result many current pet owners have extreme anxiety about euthanasia. These days we see euthanasia less as a failure and more as a gift that we can offer a suffering animal. Euthanasia is often the best death possible for an animal, but usually the hardest possible for the owner BEFORE it occurs, because of the emotions involved. Afterwards many owners are ‘pleasantly’ surprised that their fears were so much worse than the reality. There are so many ways that we can make the whole process easier to go through for the owner, and multiple ways to improve things for the pet.

With an Epitaph home euthanasia, and the use of the IV catheter and extension set, people report that they feel that the euthanasia was better for them because it gave them time to hold their pet, and talk to them, versus the very ‘swift’ administration of drugs via a needle and syringe. They verbally controlled when the anaesthetic dose was given, and when the overdose was given, which made them feel safer and calmer during the procedure.  With an Epitaph euthanasia, most owners do not find the process itself distressing, rather it is grief at their loss that causes pain. For more information on grief and pet loss, click here.

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SHOULD MY OTHER PETS BE PRESENT FOR EUTHANASIA, AND WILL THEY GRIEVE?

At Epitaph we see no problem with having other pets be present for the euthanasia of a terminally ill pet. We believe that animals have a strong understanding of death, and where we have had pets as our witness, they have without exception appeared calm during the procedure, though occasionally showing altered behavioural patterns immediately afterwards. It is important for pet owners to realise though that surviving pets may NOT behave as we assume they will upon the passing of their mate. Some pets ignore their lost mates body completely, others sniff it all over, before going and lying down quietly. It is a very individual response. What is most important is to decide whether excluding or including other pets in a euthanasia ceremony will be distressful for the patient who is actually dying. If the answer is yes, then the other pets should be excluded, but instead allowed to pass time with the deceased pets body after death.

Many veterinary staff have witnessed in our own animals, or had clients tell us of pets that appear to be grieving the loss of another. While it is impossible to prove this theory, most of us believe that pets are capable of love, and therefore believe that they feel loss.  In some cases, perhaps the pet is just sensing the owners sorrow, but in absence of proof otherwise, we like to believe that they are capable of grief in their own right, and don’t just act as a receptacle of ours. Behaviours that you might notice include lethargy or apparent fatigue, loss of appetite or increased finickiness, or clingy behaviour. There may be signs of restlessness or changed sleep patterns and barking at night.

If we believe our pets are grieving, what can we do to help? Maintain a regular routine. Even if it changes after the loss, make the new one as regular as possible as soon as possible. Avoid reinforcing negative behaviours (i.e.; don’t offer multiple food choices to a finicky eater). Don’t increase attention to the remaining pet unduly, as it may lead to anxiety disorders later. Allow new hierarchies to form in multi pet homes. This applies mainly to dogs, but can apply to cats also. Don’t be tempted to intervene…they will work it out.

Should surviving pets say ‘goodbye’ to a body? There are different thoughts on this one, but we are inclined to think (as mentioned above) that if possible they should. Animals understand death, it is part of life. What they may find harder to deal with is just the sudden ‘missing-ness’ of a pet that walked out the door alive, and just never came back. This is a hard one to prove, but we believe in letting our surviving pets see the body where possible. If it helps humans grieve more healthily (which has been proven), then it may help them too.

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WHAT HAPPENS TO MY PET'S BODY?

Before or after your pet has been euthanased, you will be faced with a decision about what happens to their body.

Many owners choose to bury their pet’s body at home. Different councils/shires will have different regulations on pet burial, so it would be worth seeking information this prior to making your decision.

Some pet owners elect instead to have a ‘group’ cremation for their pet. This will be performed by a pet crematorium. In this case of Epitaph clients, our group cremations are performed by Lawnswood Pet Cemetery and Crematorium. When your pet is cremated in this manner, they are with other pets at the time of cremation, and as such, you are not able to receive their ashes back.

However most of Epitaphs clients request a private cremation or individual cremation for their pets. This means that their pets body is cremated individually, and is returned to them in ash form, just as human ashes are returned to family members when a loved one dies. This allows you to make a decision on whether to bury your pets ashes, or scatter them in a meaningful location, or even just to keep them inside in a special place.

With Epitaph home euthanasia, we offer you the choice of using our pet hearse service to transport your pet to the cremation company of our choice (Lawnswood) for either group or individual cremation. If you prefer to use the cremation company of your own choice, the may be able to pick your pet up from your home with prior arrangement.

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HOW CAN I MEMORIALISE MY PET?

People remember their lost pets in so many ways, some are internal, and others involve actions or words. Some suggestions for pet memorialisation are listed below. Some might work for you, others not. The important thing is to find the ‘right fit’ for you and to help your family find ways to help them memorialise their pet too.

  • Look at photos; and talk about stories to those who will listen.
  • Frame pictures or create a scrapbook.
  • Make a donation to a pet charity in your pet’s memory.
  • Hold a funeral or memorial service.
  • Make a shrine inside, with photos, candles, and perhaps your pets ashes.
  • Plant a tree or shrub where your pet most liked to lay outside, or was buried.
  • Place your pet's nametag on your key ring.
  • Write a poem, song, or story to honour your pet. No one else ever need hear it but you.

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HOW CAN I EASE MY GRIEF?

Grief has no timeline, and no one can tell you when you should move through it. However there are things that you can do to help yourself through the worst of the pain. I have listed some simple suggestions below, but the one that I like to remind my clients of, is that our pain and grief are a reflection what our pets meant to us, and to try and rush that pain away does their memory no service. Instead accept the grief, and embrace it for what it represents to you. The loss of a great friend.

  • Give yourself ‘permission’ to grieve.
  • Try to get lots of rest, good nutrition and gentle exercise.
  • Surround yourself with people who understand your loss.
  • Do not listen to those who cannot understand.
  • Learn all you can about the grief process.
  • Accept the feelings that come with grief.
  • Be patient with yourself. DON'T let society dictate how long mourning should last.
  • Don't be afraid to ask for help.
  • Seek telephone support. Click HERE.
  • Use our Web based grief forum to share your pain with others who understand. Click here for this free service.

Click here for more information on pet loss and grief.

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WHEN SHOULD I GET A NEW PET?

People’s thoughts on getting another pet vary enormously depending on the bond they had with the lost pet, and the needs of other members of the family. Difficulties can arise when multiple family members have different needs. The choice is a personal one, and if possible should be delayed until all the members of the family are in the acceptance phase of grief (click HERE for more information on grief and pet loss). People who get a new pet too soon may resent it for not ‘being’ the old pet, instead of loving it for its own characteristics. Children may feel guilty or disloyal if a new pet is brought into the family too soon, and this can also send the wrong message to children about death and loss. If you have a surviving pet that you believe is grieving, then it is worth delaying allowing a new pet into your life, until you feel that both you and your grieving pet are ready. Getting a new pet too soon is rife with potential problems for both of you, and done too soon, might prevent either of you from loving the new member of your family the way you would really like to in the future. And remember to always avoid the word ‘replacement’ when discussing when to allow a new pet into your lives. We replace possessions and things, not animals that we have loved as family. 

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