Monday 17 June 2019

Euthanasia is a sad but essential part of pet care

Pete Wedderburn - Animal Doctor

Euthanasia - the deliberate ending of the life of a pet - is one of the most stressful aspects of the job as a vet. Pets are often seen as family members, so when they die, the grief felt by their owners is often immense. And because animals have relatively short lives - perhaps only a fifth as long as humans - vet clinics frequently witness the death of pets, arguably over five times more often than doctors experience the deaths of their patients. Typically, a vet may need to carry out a euthanasia once a day, and sometimes even more often. Every case is a different family, a new set of emotions and a separate type of grief. As well as being upsetting for the pet's family, it's difficult for vets too, on many levels.

The first and most obvious challenge is emotional; simply witnessing other people's grief. It's rare for most people to see another person cry. Tears are shed with nearly every euthanasia, and sometimes the grief is intense to the point of being distressing to witness. As a vet, you desperately want to help people who are so visibly upset, but at the same time, in some ways, nothing can really be done to help. Their pet's life is ending, they have to say goodbye, and it's a painful, difficult time. Nothing you can do can change that.

I often find that the observation of C S Lewis helps: the grief of loss is the other side of the coin of deep love. One cannot exist without the other. If people did not care about their pets so much, they would not mourn their deaths so deeply. So the fact that they are so upset at losing a pet is a direct consequence of the fact that they have had so many happy years with the animal. When grief is seen in this light, it is easier to see the distress as something positive, in a roundabout way. It is still upsetting, but at least the origins of the distress have their roots in something good and noble.

Nobody trains you at vet college for dealing with human grief, and every vet has their own way of trying to help. Some vets offer words, some physical solace (handshakes or even hugs), and some just give people the space that they feel they need. Whatever happens, it is never easy.

The second challenge of euthanasia is the fact that as a vet, you are the one who carries out the physical procedure which ends an animal's life. You are the one who inserts the needle and presses the syringe plunger. You've been trained to save animal lives; that's why you became a vet in the first place. Yet here you are, ending a life. There is some degree of cognitive dissonance here: even when you know that you are doing something which is helping to ease the animal's discomfort or distress, you are still ending their life. It is always profound and upsetting. But as a professional, you need to project a calm, reassuring presence, so you need to try to keep any of your own unhappy feelings inside, which isn't always easy.

Having said this, the process of euthanasia always involves discussions with owners, and this usually includes talking about the reasons why euthanasia is being considered. There is nearly always a sound, rational reason for the procedure: the animal is in pain, they may have a terminal diagnosis, they may be very elderly.

Euthanasia is almost never carried out on a young healthy animal; the only exception would be a dog with such aggressive behaviour that they could not safely be kept in the vicinity of humans. And even in these rare cases, justification is possible: you know that if the dog was not euthanased, they would spend a life of misery, being continually locked up and being treated brutally because people would be afraid of them. Still, these are the most difficult cases, and the only consolation is that they are exceptionally rare.

The vast majority of euthanasias happen to elderly or terminally ill animals, and the act is the ultimate in palliative care: it takes them away from the pain of their unwellness. This is the only reason why vets are able to carry out euthanasia: we know that it is in the animals' best interests.

It can be even more upsetting not to be allowed to carry out euthanasia. I have never been in this position myself, but I have friends who have witnessed animals in obvious distress whose owners refuse to allow euthanasia to be carried out. There are many possible reasons for this, including religious, philosophical and even simply because an owner cannot bring themselves to choose for their much loved pet to die. My friends will always try to act in the best interests of the animals, but ultimately, the choice does lie with the owner. And if they refuse euthanasia, it is very difficult to insist on it, short of reporting a case to the ISPCA. You can understand how this can be a serious dilemma for a vet who has the animal's interest closest to their heart, yet who also wants to help the owner.

My own experience has been that most owners do listen to the advice of a vet: they recognise that vets act as independent arbiters, helping to objectively assess whether or not euthanasia is the kindest choice for a pet.

My job as a vet would be easier if I never had to euthanase pets. But a world where pets were never euthanased would mean that pets suffered more. It's a tough, but very essential, part of a vet's life.

The Argus