Guide to Dog Euthanasia

Summary:

"The hardest decision a pet parent can make is humane dog euthanasia (eu means good and thanatos means death). Good death summarizes the approach taken in pet euthanasia. It is part of the difficult emotional struggle that occurs when deciding if it is time to end the suffering a beloved pet. Many look to their veterinarian for advice or the guidelines from the American Veterinary Medical Association which states that "when animals are plagued by disease that produces insurmountable suffering, it can be argued that continuing to live is worst for the animal than death...The humane disposition is to act for the sake of the animal or its interests because the animal will be relieved of an unbearable burden." 

In general, pet parents of dogs with less than 3 months before quality-of-life concerns should begin discussions about end-of-life care options. Many owners choose palliative or hospice care which keeps a dog comfortable instead of pursuing painful or expensive treatments as part of an end-of-life (EOL) care plan. This continues until euthanasia is the more humane approach. Hospice care can give a family the time needed to say goodbye to a pet. It is not the veterinarian's job to determine when a dog should be euthanized. Pet parents should make the decision with input from the veterinarian. That said, it is the ethical responsibility of veterinarians to direct animal owners toward euthanasia as a compassionate treatment options when the alternative is prolonged and unrelenting suffering.

Many owners privately admit that the grieving process is more intense for a pet than for people. This is perfectly normal, with the feelings often more intense than we expected. The absence of a pet often feels more dramatic and the house even more empty.

Only 5% of Vets routinely recommend hospice and palliative care for pet patients diagnosed with life-limiting disease; this could be due to a lack of familiarity with this option. For additional information, The American Veterinary Medicine Guidelines for Euthanasia have been developed as a work in progress since 1963. The guidelines last updated in 2013 can be downloaded below."

AVMA Veterinary Dog Euthanasia Decision Matrix. Many Veterinarians suggest the use of a Quality of Life Scale (QOL) when determining the appropriate level of end-of-life (EOL) care.

Overview

Understandably, most pet owners are not comfortable with end of life decisions. The goal for most dog parents is to make the dying experience as peaceful and painless as possible. The AVMA publishes guidelines and advice on ethical decision-making and other matters beyond the actual procedure that would end a dog's life. A dog is considered to be terminally ill when the dog's life expectancy is 1 month or less.  The end-of-life care decision and the use of hospice care should be considered when a dog has 3 months or less before quality-of-life issues become a concern.

There are several questions that can guide an owner that can help to determine if a terminal illness has reduced the quality of life to the point where dog euthanasia makes sense. These include:

• Does your dog respond to you?
• Is your dog responsive to the environment?
• Are eating or drinking habits normal?
• Is the dog soiling the sleeping area?
• Does the dog have limited mobility?
• Is the dog unable to groom itself?
• If your dog comfortable?
• Can the dog experience joy?
• Is the dog content?
• Does your dog participate in his or her usual activities?
• Is your dog in pain?
• What do you think your dog would want?
• Do you have the financial resources to care for your dog?
• Are you keeping your dog alive more for you?

Another approach is to rate your dog's quality of life on a scale from 1 to 10, which is different for any dog. For example, if a dog no longer can do his or her favorite things like chase a ball or play, that would lead to a lower score. Download the dog quality of life scale here (PDF) to do your own dog euthanasia and end-of-life evaluation.

When using a quality of life scale, use it on a day when a dog is experiencing an average level of symptoms. Taking the test when a dog has had 3 to 5 bad days could unnecessarily depress any scores.

Some owners may not be able to care for a sick dog or one that requires expensive treatment or care for disabilities. In this case speak to your veterinarian about the possibility of finding someone to adopt your dog. Some veterinarians offer an all or nothing approach where a pet parent either has to accept complete care or dog euthanasia. If this is the case, consider getting a second opinion with a veterinarian that either offers hospice care for mid-ground palliative care options that might be lower in cost, yet still reduce any suffering.

When first learning of a veterinary recommendation for dog euthanasia, but sure to bring someone along to the visit if you can. It is difficult to remember what we are being told when worrying about the life of our pet.

End-Of-Life and Dog Euthanasia Discussions usually Begin 3 months Before Quality-Of-Life Issues Are Going to Reasonably Occur

Terminal Illness and End of Life Decisions

If you are told that your dog has a terminal illness, follow these steps when making end-of-life and dog euthanasia decisions:

• First, collect information on the illness and the latest treatments from your Veterinarian. Do some research online to see if there are any drug trials or studies being conducted by any of the Veterinary Research Hospitals.
  
  
• Have a conversation with your Veterinarian about options. Be sure to ask about any symptoms and how they will progress. Ask what can be done to manage those symptoms in order to maintain an acceptable quality-of-life for your dog.
  
  
• If you have any doubts, or if you feel you are not getting the answers, then be sure to seek a second opinion. Even hearing the same diagnosis from multiple sources affirms that you did the best you could for your dog.
  
  
• Do not avoid the inevitable. Better to have a plan and to think things through even if wrong.
  
  
• Download the quality of life survey at the bottom of this page. Take the survey as a decision making aid.
  
  
• Spend more time with your dog and celebrate his or her life. Capture the moments in pictures and words as best you can while you still can.
  
  
• When it is time, discuss what to do with your dog's remains.

Palliative Care

Hospice is different from palliative care. The goal of both is to keep your dog comfortable and pain free. 

Palliative care is designed to reduce or relieve the intensity of uncomfortable symptoms. Sometimes medications can be used to control problems such as urine that dribbles, panting or appetite loss. Alternative treatment options can also bring some relief including supplements (SAMe, omega-3 fatty acids), acupuncture, laser therapy and massage. 

Pain medications can also bring some relief, including injectable pain medications.

An example of palliative care is a dog that is getting radiation therapy for cancer. The goal of palliative care is to encourage the dog to drink and eat during treatment.

Dog Hospice

Hospice starts when the end of life is in site and treatment has stoped. For humans, hospice starts when the life expectancy is six months or less. For dogs, the goal is to keep the pet at home and comfortable until euthanasia or a natural death occurs.

A veterinarian can assist pet parents with end of life hospice care. The Vet will teach you how to provide the appropriate level of home care that keeps a pet comfortable and without pain.

That said, Veterinarians are often not equipped to support the emotional needs of your family.  This may require the involvement of other professionals who can care to your spiritual and psychosocial needs.

Hospice provides families with more time to come to grips with euthanasia or to enable your dog to die a natural death that is free from any suffering. In some areas mobile veterinary hospice care is available. This has the obvious advantage of keeping a dog at home in familiar setting instead of in a veterinary office or hospital.  The costs of hospice care are $30 to $40 for any technicians time. Veterinarians tend to charge $100 to $150 per hour spent in the home.

Other Pets and Dog Euthanasia

Some pet parents believe that if other pets are in the household, they should be able to witness the euthanasia. This prevents their searching for the missing pet. There are examples of inter and intra species grief that lead some to believe that offering other pets the opportunity to be present during euthanasia or being able to visit the deceased body afterward can be of benefit. We have all heard stories of pets gathering around a deceased house mate and not leaving for hours. Eventually, whatever was happening between the living pet and the deceased came to completion.

Our Deep Attachment to Dogs

Many owners feel a more profound form of grief than when a person passes away. These feelings are normal, since pets fill such an important and omnipresent part of our lives. The sense of emptiness in the house and the breaking of a caring mutual and loving routine can lead to profound sadness.

The author E.O. Wilson, a professor at Harvard, theorized that there may be a separate structure in our brain that may account for our deep attachment to animals.

Women and men tend to grieve for the loss of the pet differently. Women often grief early since they are often the primary caregiver. Men often have a delayed reaction that can appear as late as several months after the death.

Grief can be painful. Heaviness in the chest, tightness in throat, a feeling or emptiness or even guilt are all natural responses.

AVMA Podcast on Dog Hospice Care

Veterinary Procedure for Canine Euthanasia

Veterinarians perform dog euthanasia in a private room or in the home. They do their best to reduce any stress on the owner and the dog. There are several available approaches, with the most common a combination of a sedative followed by a barbiturate. The veterinarian will then need to advise the pet parent regarding the legally appropriate way to handle the pet remains. Each state and local municipality will have laws that govern the process. In most cases remains are incinerated or cremated, followed by burial.

The dog has no awareness that the end of life is near. To the dog, the process feels like it is going under general anesthesia.

Resources for Grieving Dog Owners

The ASPCA operates a Pet Loss Support program that can assist with all of the issues that surround dog euthanasia. It can help with the decision itself, in helping everyone (including other pets) cope with the loss and provide comfort.

The Pet Loss Hotline can be reached at (877) GRIEF-10 (in the United States).

There is also a Pet Loss Hotline available at the Washington State University College of Veterinary Medicine. The number is 1-(866) 266-8635. Hours are: Monday - Thursday, 7PM to 9PM and Saturday 1PM-3PM, Pacific Time.

Brochures

• AVMA Guidelines for the Euthanasia of Animals (2013 Edition)

  (PDF Download; Author: AVMA)
• Veterinary Hospice Guidelines

  (PDF Download; Author: AVMA)
• Dog End Of Life Care (EOL)

  (PDF Download; Author: Alice E. Villalobos, DVM)
• Dog Quality of Life Scale

  (PDF Download; Adapted from book by Alice E. Villalobos, DVM

Ask a Question or Share Your Story

Resources

Nikki Hospice Foundation for Pets

Hospice Care Overview
Guy Hancock, DVM, MEd
Veterinary Technology Program
St. Petersburg College, St. Petersburg, FL

Veterinary Hospice: Medicate, Meditate, Mitigate

Pawpice Pet Hospice Program

Helping Children Cope with Grief, A Guide For Parents

Supporting Pets That Have Lost a Friend

Supporting People That Have Lost a Pet

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