If you missed one of our last Facebook Live talks with Dr Gelderman, we have provided the transcript here so you don’t miss out on all of his great information and tips!

Good evening everyone, thanks for joining me. I’m Diederik Gelderman, and tonight’s topic is When is the Right Time?

We’re talking about ‘when is the right time for euthanasia?

This is a topic that’s fraught with a lot of emotion, and this topic is different for everyone.

I’ve made some notes that I want to go through, and I’ll just do this in no particular order. If you’ve got any questions, please put them in the chatbox, and Michele can read them out to me.

I want to present this topic from a number of different viewpoints, and the first viewpoint I want to put out there is the problem of ‘Convenience Euthanasia.’

Convenience Euthanasia

I know that you, the listener, reader, and viewer would not have any part in Convenience Euthanasia and wouldn’t even consider it.

But, we get, and I’m not just talking about ‘us’ at Highlands Veterinary Hospital, I’m talking about ‘us’ as vets in general. We see quite a number of people bringing their pets in for Convenience Euthanasia. It’s not nearly as often or common now as it was in the 70s and 80s.

But I remember many people coming in December of one year, bringing their pets in and giving us some sort of excuse for “It’s time to euthanize my pet,” and then in January, they’d come in with a new puppy or a new kitten for vaccinations.

Back then, to some degree (as an industry), we would tolerate that because we didn’t know any better. But now that’s just totally unacceptable, and if you’re bringing a pet into us for euthanasia, we’re going to sit down with you and work out ‘is this the right thing to do for both you and the pet’?

And it’s terrible that people will do this, but they’ll do it because they think that it costs too much to board the pet over Christmas while they’re going on holidays or some other feeble excuse.

As much as we’d like to believe that society is well and truly past this, Convenience Euthanasia for all sorts of reasons STILL does exist.

Personal Story

I need to be really careful how I phrase this, but I have a new acquisition in our lives at the moment, and this animal, and I’m going to be really careful because I don’t want to put my foot in someone else’s mouth.

But this pet came in for a procedure a little while ago; it’s a very simple procedure. We ran some pre-anesthetic blood tests as we do on all animals, which are over 15 years of age… there was a slight elevation in one of the kidney functions, which meant that this pet should go on medication.

But aside from that, this pet was perfectly healthy, and the procedure that the pet came in for was totally simple and easy, nothing to be concerned about.

The owners chose this slight elevation in kidney function meant that they would have to pop pills in this pet for as long as he or she was alive, and they elected euthanasia instead (as the easier option).

We asked them to sign a handover so that we could rehome this particular animal, and now he is living a perfectly healthy, happy, long life with me because I took him over, and he’s too old to rehome, and he’s living happily with me and popping some pills morning and night to help his kidney function.

That story is something that may be totally unheard of for good pet owners like you.

But unfortunately, we go through that and see this type of scenario on a fortnightly basis that we’ll get an animal in like that.

At Highlands, we’re fairly tough on this situation.

If there’s a pet to be euthanized, we will sit down with the client and discuss whether it is necessary or not, and if we don’t believe it’s necessary, then we’ll seek permission to re-home that pet or medicate it at no charge or whatever can be done.

Unfortunately, most practices don’t do this, and they will euthanize the animal.

Let’s get back to the topic, ‘When is the Right Time’?

Is NOW the Right Time?

If you’re not sure whether ‘this is the right time, then there are quite a number of things that you can get from us or online to help you answer this question.

I’m holding up a quality of life scale that we use with our clients.

If a client comes into us and says, “I’m not sure whether I should euthanize my pet or not,” then this is one handout that I can give them to help with that decision.

I had a client in today with a dog with a sore back, and she’s a really great client and really wants to look after their pet in all the best ways possible, but they’re not sure whether euthanasia is the right thing or not.

So I gave them this Quality of Life Scale that they could complete as a family to help them come to a decision.

This isn’t something designed by me; this is designed and validated by people who are much more intelligent than I am – and someone who is unsure of the ‘right’ decision can go home, fill out the answers and decide whether euthanasia of this pet is the right thing to do or not.

There’s another handout that we use a lot called, ‘How do I Know When it’s the Right Time’? Again, there is a whole heap of simple questions to help in making the correct decision.

There are plenty of those sorts of things available online.

…. if you’re not sure whether it’s time to euthanize your pet or not, then those sorts of things are available from us or go online.

The other thing that I like to look at is; I ask myself a very simple question – and previously we were talking about this pet who I saw today with these lovely owners, I used a phrase that I use a lot, it’s a very harsh phrase, so I’ve got to be careful how I deliver it but as I said to them….. “Does she want us to kill her?”

And that’s a very deliberate phrase, and it’s designed to make people really THINK – and their immediate reaction was, “No, of course not. She’s got a bad back, and she falls over a little bit because her legs aren’t functioning, but she doesn’t want us to kill her.”

In my mind, that’s a simple, direct question to ask with respect to what would that pet want us to do for his/her best welfare.

In some cases, the answer is “yes”; in some cases, the answer is “no.”

This ‘answer,’ I think is the same if you’re an older person or a person of any age who has some sort of serious or chronic disease….

Would you want to die at that point in time or not?

Let’s move on!

Price Shopping For Euthanasia

The other thing that we as a Veterinary industry run into is ‘price shopping’ for euthanasia. How inappropriate!

We get quite a lot of; I was about to say quite a lot of people, I’ll rephrase that; we regularly, now once a week or once a fortnight get people ringing us, and it happens with all practices, and the question is “How much is it going to cost to euthanize my pet?”

These people are price shopping euthanasia, which is, to my mind, incredibly inappropriate, and At HIGHlands Vets, we don’t go down that line.

But as I said a minute ago, there are plenty of practices that will just do that if someone rings up to find the lowest price to euthanizing a pet, which I think is just terrible.

As an aside, there are many different ways to euthanize a pet – some of them very unpleasant for the pet and even for the owners. And typically, they are also the cheapest ways to do it.

To make a ‘death’ pleasant (at least as pleasant as it can be) requires more in terms of drugs and therefore, in costs.

But most owners have no idea of the difference…

WE – we will just not go down the ‘cheaper’ road; compromise in HOW we perform that procedure will just NOT happen.

The other thing I want to talk about is terminology.

The terminology of ‘putting to sleep is just absolute, excuse me, crap.

Pets aren’t put to sleep; they’re being euthanized, they’re being killed….

This terminology is really important.

There have been plenty of studies done on children where their pet has been ‘put to sleep,’ and in many cases, these kids are scared to go to sleep at night because they believe they’re not going to wake up because their pet has been put to sleep and their pet never wakes up, never comes back because it’s been euthanized.

Please don’t ever use that term with your children.

The studies on these kids are quite horrendous with respect to the ongoing mental issues that many of these children have.

The term is euthanasia; it’s being killed, whatever term you’d like to use, and maybe being killed is not the right term, but certainly being euthanized is.

The other thing with respect to children is when and less so now than in the past when people bring their pet in during the day, and the pet will be euthanized, and they’ll tell us, “Oh, we were doing it during the day so that when our daughter, our son gets home tonight, the pet will just be gone and we’ll say, well we don’t know what happened it just disappeared or we had euthanized him or her euthanized.”

Again, totally inappropriate with children.

When children suddenly lose their pet like that, it creates a huge hole in their life or in their lives and creates mental issues for years and years and years to come.

If you’ve got a child and your pet needs euthanizing, all the right reasons, then involve them in that conversation, involve them in that decision-making, and they will cope with that decision of appropriate euthanasia much better than if their pet was suddenly disappeared out of their lives.

It’s a really important thing to involve them in the decision-making, even at a very young age, like four or five. They may not totally understand what’s going on, but it’ll set them up for a much better future without that pet than if their pet suddenly disappeared. Which is what some owners elect to do, or some parents elect to do.

With respect to the actual euthanasia procedure, there are quite a few things to think about (as I alluded to previously) and some practices are very ‘cheap’ with euthanasia, and some are more ‘expensive’ with euthanasia, and euthanasia can be done well, or it can be done inappropriately.

The euthanasia solution itself is a product called Phenobarbitone or Phenobarbital, and it’s simply a VERY concentrated solution of anaesthetic, and we give the pet an overdose of anaesthetic, and it’s a horrible way to die, being given on its own. It’s absolutely shocking.

Euthanasia is typical, in MANY practices, done just by an IV injection of Lethabarb, Phenobarb, and Valabarb-as it’s often called ‘green dream,’ whatever it’s called it is quite a terrible process for that pet.

To be done ‘nicely,’ it needs to be combined with a number of other (more expensive) drugs.

The way to do that is to sedate the pet with some form of opiate, some form of morphine, whatever you want to call it, then wait 10 – 15 minutes, and once that animal is zoned out with morphine with Buprenorphine, with some form of opiate then giving the Lethabarb, Phenobarb, and Valabarb whatever you want to call it.

It is not ‘literally’ going to sleep, but going under an anaesthetic exactly the same as we would do an anaesthetic for a desexing or a lump removal or a dental treatment or whatever, and that’s a very pleasant way. To drift off to ‘sleep.’

This way is very peaceful for both the family and the pet…

But just doing it without the appropriate sedation is terrible. But again, some practices elect to do it that way, because frankly, it’s cheaper and it’s quicker.

Then we get to the question of should it be done and where should it be done?

There is obviously doing it at home versus doing it in the clinic, doing it with the owners present or with the owners not present.

My personal opinion is that, and this is obviously debatable or arguable, but I will give you my personal opinion is, a pet would much prefer to pass on in the comfort of his or her pet parents and at home than on his or her own with strangers.

And also, he would prefer to pass on in the comfort of his or her surroundings at home rather than in a strange place. Those are some thoughts about that.

The other question becomes on one of timing, and I’ve shown you these handouts on, ‘When is the Right Time’?

There are lots of decisions to be made about that – but with respect to the actual details of timing, for example, is it better earlier than later?

I’ve changed my mind on this a little bit in the last few years, and typically I’ve always been someone who prefers to persevere as far as we can go maybe, the right term is to the ‘bitter end,’ or that’s the term I used to use is the ‘bitter end.

…leave no stone unturned

I’m still of that mindset, but it’s really important to relate that with; it’s far better, in my opinion, to euthanize a minute earlier than an hour too late, if that makes sense.

I never want to wake up as a pet owner or as a veterinarian and kick myself in the bum in the morning, saying, “Why didn’t I just try this before I euthanized? Why didn’t I just try that before I euthanized?”

But that’s got to be considered and balanced against the fact of having that pet suffer, and we certainly do not want any pet to suffer.

Therefore I believe that euthanizing a fraction earlier is a lot better than euthanizing too late.

The other aspect is physical versus mental breakdown.

Unfortunately, we see pets who are mentally fantastic and physically decrepit, and we can’t manage them anymore because they’re so physically decrepit, and that may involve issues like urinating and defecating on themselves, eliminating on themselves in the bed at night or in the house or whatever.

And if that was you or me, would you really want to stay alive if you couldn’t move out of your own excrement?

Even though you have a pet who is mentally 100 percent and physically decrepit, then would you want to do that to yourself?

If you’ve got a little pet like a 5 kilo Chihuahua you can move him/her around and carry around and clean up; that situation is a lot easier to manage than if you’ve got a 50-kilo Mastiff or Great Dane that takes two or three of you to wash and move around.

Those are the sorts of things to consider as well….

Then the other side of that coin is a pet who is mentally shot, but physically a hundred percent.

We’ll do a FB Live session in the future on dementia in pets, and pets do get a disease called CDS or cognitive dysfunction syndrome, call it Alzheimer’s, and there are some fantastic treatments for that now. My own dog, who has unfortunately passed away, Jack. If he wasn’t on his dementia medication, he would literally eat the garbage out of the garbage can if he could get to it, and he was like, just a dumb zombie. But on his three tablets a night, he was quite smart and quite ‘with it’ and doing really well.

NOW – there are progressively fewer and fewer reasons for us to have to euthanize pets for physical debility or mental debility because there are so many fantastic treatments around now.

The other thing I really want to talk about, and then then I’ll get to some of the questions, is the cost of euthanasia.

The mental cost and the mental impact of euthanasia to us as veterinarians, as veterinary nurses, as providers of that service.

Even though euthanasia, if we perform euthanasia on a pet and it’s appropriate, even when it’s appropriate, and you’re releasing that pet from ‘pain and suffering,’ it’s still emotionally draining on us!!

At some level, we’re all crying, and I’m talking about us as the practice when a pet’s euthanized.

Even though, in many cases, it can and definitely is the right thing to do.

We’ve got that responsibility to do it, and even though doing it is the right thing, you are taking away life, and that is terribly emotionally draining.

Because of having to perform that procedure so often and because of the stress in our industry, I’ve been down the road of having a breakdown because of that emotional overwhelm, overload of- there’s a word, and I can’t think of it at the moment.

Yeah, I just can’t think of the word I’m after, but it just gets to you after a while, and even as I said with a pet, when we’re doing the right thing at the right time, it’s challenging and difficult.

But when it’s inappropriate euthanasia, it’s much worse. At HIGHlands, we no longer do inappropriate euthanasia!!!

As I said, we’ll ask permission to rehome the pet, or we’ll find a way around it if we can.

But industry-wide, it is STILL a huge problem. When it’s inappropriate euthanasia, it’s even more debilitating, and we have even more emotional suffering in our teams.

Let me just go to some of these questions now.

Anne De Bono says, “You know when a surgery is required for a child, I would say they put you to sleep.”

Yes, you’ve underlined my point exactly, and the terminology in the community is “a pet’s put to sleep,” and I’m sorry, I just won’t go there, they’re not being put to sleep, they’re being killed, or they’re being euthanized, maybe euthanasia is the better term.

But please, for golly’s sake, don’t use that term with your children. It can have some horrible ramifications.

Gabby Cole, “You euthanized Daisy after doing everything you could; she had Cushing’s.” Yes, thank you, Gabby. That’s a situation in which it’s hard to do, but it was the right thing to do, and therefore, in a way, it’s sort of uplifting to help someone like Daisy pass on to a better and more appropriate life.

There are no other questions at the moment that I can see.

I hope that what we’ve talked about is- has been helpful, and I guess I’ll finish on this note which is;

if you’re if you yourself as a human have pain and suffering, whatever that happens to be

If you have dementia or some mental disability.

We all have different ‘pain’ points for ourselves.

If we have two people with horrible arthritis, one person may be happy being euthanized if it was legal in your state, and the other person would be happy to fight on with pain relief and all those sorts of things.

Just as there are differences within us, I believe that there are differences in our pets…

… and some of our pets, if we ask them that question ‘previous’ question – I literally- if I’m in this situation with a client’s pet, I literally ask myself that question to the pet and listen to what they say back to me, “Do you want me to kill you?”

…and I mean that in a nice way, it comes from a place of compassion, and then I listened back for that answer.

YOU as your pet- you, as a pet parent of your pet, have a lot better handle on that question than I would ever have with your pet.

That to me is the best indicator of, ‘when is the right time’?

The right time is when both you and your pet are in agreement that ‘now is the right time to euthanize, for whatever reason.

It may be just because it’s time, it may be for arthritic pain, it may be for dementia, and it may be for none of the above.

I hope that I’ve given you something to think about. I hope that you’ve got some answers to some questions.

If you have a pet and you need any of these handouts; Quality of Life handout, Quality of Life Scale, then just contact us at the practice.

…..that’s the ‘quality of life scale,’ and this is ‘how do I know when it’s time’ hand out.

If you want those, please drop in the practice or ring us and we can email them to you; you can also get very similar things online.

I look forward to catching up with you next month when we have another Facebook live about another interesting topic, so see you then, good night.