Wednesday, April 21, 2010

4/21/2010 Euthanasia

 Vet tip of the Day: Thinking about Euthanasia
I would like to introduce the topic of euthanasia with a few stories.  The first is one about an experience I had as a resident, and the second is about PipSqueak, a wonderful patient of mine

I completed a large animal internal medicine residency at the University of Georgia School of Veterinary Medicine.  I was on call to receive emergency patients into the hospital every 3rd weeknight and every other weekend for 5 consecutive years.  That's a lot of emergency admissions.  The sad reality of referral equine medicine is that we see a lot of very sick horses and many of them don't make it out of the hospital.

One weekend early in the first year of my residency I didn't sleep for 48 hours.  During that time I received 8 emergency patients.  Four of them were critically ill and over the course of two days I administered a lethal dose of sodium pentobarbital (euthanasia) to all four when it became clear that they had no hope of survival. Right there you come up against one of the more difficult concepts in the decision for euthanasia: no hope.  We all know that there always is hope, we just choose under certain circumstances to consider that hope too small to warrant the continued suffering of the really sick or the really old.  And let's face it, economic concerns and practical concerns influence the decision to end animal's lives as well.

That particular weekend in 1989 when I was a resident was very difficult for me. In the five subsequent years I never had to face the death of some many horses in such a short period of time.  I was exhausted, I was a new resident and I didn't have a lot of experience coping with the grief, guilt and confusion often experienced by owners when making the decision for euthanasia of an animal they love. At that stage of my career I also didn't have a lot of experience pushing the plunger on the syringe of "blue juice" that ends an animal's life.  I don't really remember all the details of that weekend.  I do remember that moment, just before performing each injection, when I wondered if perhaps there was hope, if perhaps I had misinformed the clients, if in fact the horse might survive if I could just do one more thing to turn its condition around, if I was making a terrible mistake.  None of these things was true, but the thoughts ran through my head nevertheless.  And I remember on Sunday afternoon, after I had humanely destroyed the fourth horse, sitting on the floor of the recovery stall outside the equine surgery suite and thinking, if one more horse comes in and requires euthanasia before tomorrow morning, someone else is going to have to push the plunger, I just can't take any more life today.

The second story is about PipSqueak.  PipSqueak was a grey arabian gelding who I took care of for 13 years, from the time he was 14 until his death.  Over these years PipSqueak belonged to 4 different owners, all of whom he taught the skill of riding after hounds, or foxhunting.  PipSqueak was a remarkable horse, an outstanding athlete, and a very wise soul.  Toward the last years of his life he was retired and turned out to pasture by his then owner.  His care was not adequate and he lost weight and began to have trouble getting up.  One of his previous owners, who by now was a teenage girl, saw PipSqueak's condition and reclaimed him.  She had owned PipSqueak when she was 8-12 years old and had ridden him all over the desert of Northern Nevada.  Now 15 years old, she brought PipSqueak home and fattened him up and took great care of him for another 9 months.

Although he was back in great body condition, PipSqueak's degenerative joint disease progressed to the point that he sometimes struggled for as long as 20 minutes attempting to rise, raising himself on his front legs but unable to lift his hind end to a standing position.  He was treated with joint supplements and anti-inflammatories, his hocks were injected, he was put on special footing and had special foot care, but his condition continued to deteriorate.  Finally his owner's grandmother called me one day to schedule an appointment for PipSqueak's elective euthanasia.

I arrived at the appointed time to find the entire family waiting with PipSqueak.  The horse had been bathed, his mane and tail brushed to a shimmering white, hoof dressing applied to all four feet, and he wore a beautiful new halter.  We all walked out with PipSqueak to the area where he was to be buried.  PipSqueak walked comfortably because his owner had given him one last whopping dose of bute that morning along with a bucket of grain so that he would be comfortable and feel especially spoiled in his final hours.  As we walked we shared stories of PipSqeak's many exploits over the years.

PipSqueak stood patiently while everyone said their goodbyes.  As I injected the sodium pentobarbital PipSqueak's family stood close by, speaking to him gently.  As soon as he fell to the ground we followed his descent, everyone keeping a hand somewhere on his neck or head.  We were very quiet,  his young owner began to cry and arms encircled her in her grief.  PipSqueak passed from life to death very swiftly, in the company of humans who loved and respected him, and who took the responsibility of ending his life squarely on their own shoulders, with compassion and grace.

I find the topic of euthanasia very complex, and will discuss it in more theoretical, and practical terms, over the next few days.  Please feel free to comment on this blog entry with your own thoughts and experiences concerning this topic.


I believe that education is the key to evolution.
I believe that learning never stops.

12 comments:

  1. Hi Chrysann....As you well know, I am a go-to- the-nth-degree girl and have had the good fortune of turning around what has seemed like a one way journey. Actually many times I have been faced with situations that seem hopeless only to see that certain look in my loved ones eye that says somehow that they aren't through yet. I am proud to still be in their company. I have lost my beloved 30 year old mare recently and that "look" was intermittent and just when I was faced with making a decision, nature took it course and made that decision for me. A customer's horse just went through a 4-day "colic" which obviously wasn't colic but now we think(and hope) an ulcer. For 2 of the 4 days euthanasia was on the table -but his eye said something different and final efforts with a simple regime of Gastro Gard is seemingly turning this thing around. Many conversations were had at my kitchen table about this topic and each time in these ambigious occurances-well in the end- I think those sweet souls know we are doing everything we can for them and they either intend to rally or they sometimes can give us that look that it is ok to let them go. And for me- that look has to be pretty convincing.

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  2. I as owner we so often look to the "professional" for the all knowing. We trust that they will tell us when it is time. Having had to trust a professional to tell me it was time, that my 7 year old gelding was not going to turn around thru the bout of Colic. I had to trust that he was telling me all the information I needed. Because in that moment of pure anguish, making a rational decision was so very difficult. I went thru the what if's, I held on to hope during that six hours of waiting. I looked at my Vet with tears and asked, are you sure, he told me very gently " we can hold on for human reasons, but in the a.m. it will be the same". I did not want my beloved horse to suffer, so I signed those dreaded papers. I hardly remember that moment. All I can say is I trusted my Vet to tell me, I have to rest in knowing that he made the right call for my horse and me! No going back, just learning how to go forward.

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