Humane Decision Making with Regard to Euthanasia

If you are reading this blog I am going to make some assumptions about you. You are likely considering euthanasia for a pet. You have put some thought into your reasoning but perhaps are not completely comfortable yet with the decision and are making an effort to find out more. Or perhaps you are completely confident but just curious to hear the opinion of a medical professional on the subject. For taking that simple step, congratulations. Your love for your pet is thus proven to me and needs no defense. The difficulty of the decision also speaks for itself. You know how hard it is. You are experiencing it. I know how hard it is. I have experienced it in the past with my own pets. As a veterinarian I have vicariously experienced it many times over through the pain of my clients and patients. It is truly one of the most difficult decisions you will ever have to make. Being confident that you are doing the right thing is sometimes elusive. To help, I would like to provide some personal insight along with thoughts from other veterinarians who have developed approaches to help analyze the issue and make more concrete, more informed decisions.

First my thoughts, for what they are worth.

The best decision maker for a pet is that pet’s owner. You may need help. You may not. But you are the best person for the job. This likely sounds obvious but needs to be stated in my opinion because it is at the heart of things.

A visit to your veterinarian is an essential part of the decision making process.

From there, focus should be put on assessment of your pet’s quality of life. To help with that I would direct you to these wonderful and very well thought out approaches below. The hope is to formalize the decision making process so that nothing goes without it’s proper attention and a reasonable ‘weight’ is given to each consideration. This removes some of the emotion from the process and makes for a more objective assessment while reminding us that human quality of life issues should be taken into consideration also. Please visit:

Veterinary Practice News: Quality of Life Scale

Petmd.com: The decision to Euthanize

Natures Corner Magazine: Deciding When & How to Euthanize

When explaining the steps involved in a humane euthanasia I often find it helpful to start at the end. This is because it is the step that most people are familiar with and the one that is common to all veterinarians. It is an intravenous injection of pentobarbital. Some veterinarians prefer the ‘direct’ method of administration. This is where the injection is given directly from a needle on a syringe. This appears to be the quickest and easiest way to perform a euthanasia. There are reasons why I do not prefer this method, however, and I would like to take the time to explain my reasoning.

The ‘ease’ of the direct method relies on some underlying assumptions holding true. You assume the fully awake and aware patient will not move when poked with a needle. You assume infallible venipuncture skill on the part of the veterinarian (100% success with regard to venipuncture is not realistic since many older patients have very small and fragile veins). You assume the rigid needle will not rupture the vein it is in, causing painful extra-vascular injection of the drug.

In my 8 years of experience as a veterinarian I have come across too many instances where one or all of these assumptions did not hold true. Pets move. Venipuncture experts move (ask any human phlebotomist about the challenges their job can sometimes entail), veins rupture. Pets that have never bitten anyone in their lives have bitten their owners just after being stuck by a needle. A needle poke is just not something that is in a pet’s capacity to anticipate and suppress a response to. It hurts for a second and is surprising. What seemed to be the quickest and kindest approach suddenly turns into an uncomfortable and difficult situation. For all of these reasons I much prefer what we can refer to as the ‘indirect method’. This means to first give any patient undergoing euthanasia a dose of a pain reliever and sedative (via simple intramuscular injection which is much easier to achieve than IV injection), set a soft and secure IV catheter after they are sedate, and then proceed with the pentobarbital injection. Does this change the number of needle pokes for the better? No, but the pet is much less likely to move during the procedure. The patient does not experience the psychological or physical discomfort associated with the rest of the procedure. No one will be bitten. Everything is much smoother and more humane.

So is the direct method inhumane? In my opinion it all depends. I have used the direct method myself on several occasions (on semi or fully comatose patients) and had no problem. Just like any other medical procedure it is fine in certain circumstances, not in others. Having performed many of the procedures under many different circumstances, I can tell you with confidence that your pet, yourself and your veterinarian will be much better served by the slightly more involved but infinitely safer indirect method.

Blog Coming Soon

Opportunity to meet founders Dr. Adam Carter and his brother Heath Carter. Learn about why we decided to start an In-Home End-of-Life Pet Service for the Greater Omaha Area.