Euthanasia, and the process of euthanizing, is not a new concept or experience for me. My first euthanasia experiences were assisting with the euthanasia of research animals while working for the USDA and veterinary micropath department of the vet school. Horses, sheep, goats and cattle were the species involved in various research studies. There was a set protocol in place that made the process fast and efficient, which while it sounds cold, was also very humane. Some animals appeared healthy on the outside, and these were the more difficult ones to euthanize at the conclusion of a research study. Other animals were deeply affected by disease, and it was a deep relief to see them at rest and at peace.
While respectful and maintaining dignity of each research animal, the emotional element that is embedded in the relationship between owner and pet was missing. It wasn’t until I was working at a small animal hospital before veterinary school that I was exposed to the emotional elements that follow with the decision of an owner to say goodbye to a beloved pet. These cases, I will admit, tear me up. I have always linked with people’s emotions, and have an unwavering empathy for people. When an owner is sobbing or tearfully talking to their pet for the last time, I cannot help but shed tears. I’ve faced some unkind remarks from colleagues for this visceral reaction I have, but the truth is…I’m okay with it. It’s my most candid display of truely caring, both for the animal and the person attached. There is no shame in it.
Throughout veterinary school, I never had a patient that was euthanized. But I experienced my own loss in veterinary school when my 18 year old lifelong companion, my childhood cat, was euthanized after secuming to alimentary lymphoma. It was the single most significant and profound loss I’ve had in my life so far. It was traumatic, painful and was compounded by the fact that I probably waited a little to long to come to the decision. I didn’t realize this until after he was gone, and it remains a haunting realization.
Then, my internship brought forth many euthanasia experiences. I performed my first solo euthanasias in my final six months. For the most part, the process went quickly and well. The nature of euthanizing a horse appears sudden and abrupt. One minute the are standing, then they collapse. Sometimes, it is violent. There are many factors that contribute to how a horse goes down, and how quickly they are gone. Of the euthanasias that appear more difficult, or prolonged, I have noticed that these horses tended to have underlying cardiac or neurological diseases. There is individual variation, even without underlying disease (that we are aware of). On a rare occasion, there has been human error…but this is a deceiving statement. When it comes to injecting the solution, the most important part is that the entire solution enters the vein. In horses, this is the jugular vein. The Drug acts to stop the heart. The appropriate amount must enter the bloodstream, for a partial dose can render a situation fraught with danger, stress and possibly chaos. There are plenty of stories of euthanasia gone ary. It’s a haunting experience for everyone involved…and certainly the very last thing a veterinarian would ever want an owner to witness.
My first bad euthanasia experience happened on the second to last day of my internship. It was a middle-aged gelding that presented for severe colic, and Surgery was not an option. Despite medical management attempts, he became progressively uncomfortable and the decision was made to euthanize. It was the resident and I on the case, and owners were a younger couple struggling to keep their composure as they made the difficult decision. They had also decided to not bare witness, and were about to leave after final goodbyes. As they were stepping out, they changed their minds. They wanted to be present. We had to load the horse up on Pain killers and sedatives to buy me a couple minutes to grab the euthanasia supplies. Because of the horrible weather, we chose to euthanize in the work-up stall. At this point, he was being restrained in a shoot (a mobile door that swings, and keeps horses against the wall.
I injected the euthanasia solution into the catheter I had placed an hour before. All was still, while I held the door and the resident held his head. It was 30 seconds later that he started buckling and then launched forward. He took a nose dive, and his hind end almost came over his head. He started kicking within the chute, and the resident was doing everything in her power to hold him back for fear if he broke lose, he could crash into anyone or anything. Then, he had what appeared to be a seizure…rhythmic banging within the chute. The only other thing I could hear aside from his grunting and kicking was the owners gasping and running out of the room. Then, he sighed and passed away.
We don’t know this happened this way, with an adequate dose and a patent catheter into the jugular vein. There are many theories, I’m sure. But unfortunately, we’ll never know and worse yet, is that these were the last moments the owners will remember forever. I cried as soon as I got in the truck, cried all the way home, and then cried as I told my roommates what happened. It was one of those moments that brings up a barrage of negative feelings and the sense of ultimate failure. Guilt, shame, disappointment, fear, regret, remorse, confusion and shock…all in the face of failure. And I definitely started asking myself if I should even be a vet if I cannot be a good one.
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