Things I Wish I knew

What veterinarians wished you knew before euthanizing your pet

At 14 years old, Barky, our family dog, had survived cancer and blood disease thanks to a combination of heroic veterinary efforts and just plain good luck. Then, she developed congestive heart failure.

Congestive heart failure is a terrible condition. The dog's heart can't pump blood through the body very well. It leads to coughing, exhaustion, a swollen belly — and eventually, the dog's lungs will fill with fluid, and she will essentially feel as if she is drowning in her own body.

Courtesy of Arin Greenwood
Barky at the author's parents' house in Rhode Island

We didn't want Barky to experience a terrifying, painful death. We thought it was kinder for the veterinarian to end her life before that happened — peacefully, at home, surrounded by the people who love her.

My family and I were devastated to lose Barky, devastated to think of her dying, and unsure about whether we were making the right choice. Should we wait? Had we already waited too long?

This is the price we pay for loving animals, and for living with animals: being responsible sometimes for deciding when and how to end their lives.

But how do we know how and when to do it, so that we have done right by our pets, and honored their places in our family? TODAY reached out to veterinarians for guidance to help answer some of our deepest — and, frankly, sobbiest — questions about pet euthanasia.

What actually happens during euthanasia, and does it hurt?

Generally, the veterinarian will give your pet two shots. The first is a sedative.

"This provides for a gentle transition from consciousness to unconsciousness, and the only sensation a pet will experience following this injection is falling into a deeper and deeper sleep," explained Dr. Shea Cox, a hospice and palliative care specialist with Bridge Veterinary Services in Northern California.

This period will likely last between five and 10 minutes, with the pet falling into a deeper and deeper sleep, "at which time they become no longer aware," said Cox.

When the family is ready, the veterinarian will then administer the second injection. The most common drug used during that stage is pentobarbital, another anesthetic that will cause the pet's heart to slow and then stop.

The injection is given either intravenously, which will bring on death in seconds, or directly into the abdomen, which may take up to 15 minutes and "is more gentle and slow," said Cox — but in either case, the pet, having been sedated, will not be aware of this part of the process.

The only discomfort the pet should experience throughout is a possible pinch when the first injection is given. This is in keeping, Cox said, with the true meaning of the word "euthanasia," coming "from the Greek word euthanatos, which means 'good death.'"

How do you know when it's time?

People often ask Dr. Dani McVety, founder of the home-based veterinary hospice and euthanasia service Lap of Love, when is the "right" time for euthanasia. She prefers the term "best," instead.

McVety feels this word better encompasses the truth, that there is usually no 100 percent, objectively correct time for euthanasia. Rather, "we, together, are making the best decision that we could make," she said.

Courtesy of Arin Greenwood
Barky was very loving and patient even when some people insisted in dressing her up like a babushka.

Deciding when to end a pet's life involves the owner and their veterinarian weighing a number of factors: the animal's current quality of life, what type of disease he or she may be suffering from and how it is likely to progress. Another consideration is what the family is able to endure; if they want every possible second with their pet and will undergo expensive or uncertain treatments, or if they want to forestall their pet's suffering.

If the pet has a condition like congestive heart failure, or untreatable brain cancer — a disease that will, unchecked, lead to a painful death — the recommendation may be for euthanasia sooner instead of later.

Even then, by and large, your pet won't tell you for sure that it's time; don't expect a clear-as-day sign to let you know. "There’s a subjective period of time in which euthanasia is a good decision," said McVety.

It's important that you and your vet can have open, honest conversations about euthanasia, to help guide this hard part of the process.

"In general, I also tell people to trust their instincts. They know their pets better than anyone," said Dr. Lisa Lippman, a house-call veterinarian in New York City. "Are they eating? Do they get up to greet you like normal? No matter what any veterinarian says, they know their pet best."

It's normal for your pet to have good and bad days toward the end. Texas veterinarian Dr. Fiona McCord, founder of Compassionate Care Pet Services, stresses that owners shouldn't feel as if they have done something wrong if the euthanasia takes place on a day their pet is feeling well.

"I would much rather somebody plan — we had a good day, went to the park, came home, had the ice cream sandwiches and we let that pet go — than to say, 'OK, let’s play it day by day,' and suddenly I get a call, 'My dog is in distress, can you come today?'" she said. "It’s OK to be a good day. There is no perfect time. Nobody will ever know the perfect time."

What can we do to make this process easier for our pets?

Some veterinarians specialize in at-home euthanasia, or incorporate that into their practice. Being at home means not having to get a sick pet into the car, not having to bring them to the veterinarian's office, which may be associated with anxiety or pain.

"Allowing a pet’s final moments to be spent in their familiar home setting, surrounded by the comforts and smells they have known all their life, is a final gift we can give," said Cox.

The price varies widely among veterinarians and clinics. Some vets may not charge at all for euthanasia, only for cremation services. Lap of Love's Tampa Bay location charges $250 for the euthanasia itself, with additional costs for cremation. Other veterinarians have quoted prices of double and even triple that amount. You'll have to ask your vet about prices.

When the procedure cannot be done in your home, your veterinarian may have a back entrance and quiet room set aside for euthanasia so you and your pet can avoid the loud waiting room. In that case, Dr. Michael Dix of the Jacksonville Veterinary Hospital in Oregon suggests bringing along "their favorite toy, bed or blanket with the pet when the actual euthanasia is taking place."

"It is also nice for people to give special things to their pet as the time nears," Dix said. "This may be a special treat, like ice cream or hot dogs — not too much, though, as they can get uncomfortable."

The most important thing is to help your pet feel calm and not increase their stress, says Dr. Katy Nelson, a veterinarian with Belle Haven Animal Medical Centre in Alexandria, Virginia, and host of "The Pet Show With Dr. Katy."

For example, if your pet wears a collar, leave it on until they have passed, since "taking it off can be excitatory," Nelson said.

And stay with your pet through the process and to the end. "While it may be hard, it would be harder knowing that the last face that your precious one saw was that of a stranger," said Nelson. "They’ve always been there for you in life. Be there for them in death."

What can we do to make it easier for us, too?

You may feel comforted by being able to celebrate and honor your pet at the different stages of this process.

For example, perhaps you have sufficient opportunity to prepare, create and then go out and fulfill a bucket list of experiences for your pet. Or revisit their favorite places, and give them their favorite foods.

Then on the day of, you can try to have people and things around you that will foster a peaceful and meaningful experience. McCord recalls an elderly Labrador retriever whose owner invited several friends to come to her house to be there for the dog's euthanasia.

The group had flowers, lit candles and sang. The owner's friends "read a couple of really awesome poems. They did a little prayer," said McCord. "This then allows that person to deal with this death in whatever way is appropriate for them."

Is this process also hard for the veterinarians who do it?

Your veterinarian may cry with you. In fact, it's common enough for this to happen that there's a kind of rule of thumb that the vet should ensure not to cry harder than the pet's owner.

For McVety, even with the sadness, what she mainly feels is that it is "an honor" to be part of a family's life during this time.

Cox shares this perspective. "While it is true that the nature of the appointment is a situation of sadness and loss, there is no other time in my relationship with that pet and family that is more impactful and meaningful than those moments we spend together," she said. "To be able to make a final journey as meaningful as the life lived is not just a gift to the pet and family, but a gift to me."

What happens after euthanasia?

You have a lot of options as to what you want to do with your pet's body after euthanasia.

Your veterinarian can tell you about pet cremation services available in your area. You will generally have to specify if you want your pet cremated alone, and for their ashes to be returned to you.

There are countless urns and other specialty memorials you can buy for containing your pet's ashes. A chain of pet funeral homes called The Pet Loss Center is currently expanding through Texas and Florida; other similar operations may be opening in your city. In some jurisdictions it is legal to bury your pet in your backyard, and in some others, you can even make arrangements for you and your pet to be (eventually) buried together in a cemetery.

But before all that, many veterinarians will allow you to spend time alone with your deceased pet — in the room at their animal hospital if that's where the euthanasia occurred, or in your home before the veterinarian takes away their body. McCord said she's even had pet owners ask for their pet's body to be left at home overnight.

"That’s OK; we don’t have to push bodies away or hide them or cover them up the minute they passed," she said.

McVety recommends saving a lock of your pet's fur, and keeping their collar, especially if you have other animals at home. They will smell these tokens, and it will help them grieve, too.

"They don’t grieve in a human way, so we can’t expect them to act the same way that we do. But they get the circle of life better than we do," she said. "They understand this. We’re the ones that have a problem with it. So even watching your pet and how they get through the process is, I think, such a great example for us humans on how we can continue moving forward in life in a moment-by-moment basis."

Be sure, finally, to give yourself time and space to grieve. Consider joining a pet loss support group. A pet's death can be as traumatic and difficult as the loss of a human family member.

"It is not a sign of weakness to love a pet," Nelson said. "And it’s certainly not a sign of weakness to mourn their loss."

Courtesy of Arin Greenwood
Barky was spoiled rotten until her last day.

It was about five years ago now that I flew to Rhode Island — where my parents live, and where they had taken such good care of our beloved dog — to see Barky one last time.

Barky's final day was bright and sunny. We spent hours outside with her in her favorite spot in the yard, so she could keep a good eye on all invading squirrels. Her face was white with age; her fur was warm from the sun. We gave Barky as many biscuits as she wanted to eat.

When the vet arrived that afternoon, my parents and I sat with Barky on the couch — where she'd napped so many hundreds of times that there were dog-sized white spots worn into the otherwise tan leather. My brother and his wife, who were living in Turkey at the time, joined us by Skype.

After a long time of saying goodbye, while my family and I cried into Barky's fur, the veterinarian administered the shots. We hugged her and told her we loved her as she left us. Maybe there are things we might have done differently today, given the chance. We did our best.

My mom claims to still hear Barky walking around the house from time to time. I still think of her daily. Sometimes I sit my other pets down and tell them about their Auntie Barky.

They never really pay attention, but it makes me feel better to say it.

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