Today, I made an interesting observation. I don’t cry that much any more at work. That may sound strange to you, but young vets cry…a lot (if my experience is any indication of the norm).
Sure, I still get misty-eyed at euthanasias (especially when clients do), but I don’t have that red-faced, nose-blowing kind of cry I used to when I was newer to the game.
My young tech couldn’t help but lose it when the obligatory, Saturday euthanasia came through the door this morning (yesterday to you). The male owner, a middle-aged guy with the family dog in tow, had spent a week trying to nurse his geriatric, downed Dalmatian back to orthopedic wellness, in spite of her pain and discomfiting disorientation.
It was a sorry sight. We had to pick her up and lift her emaciated frame from the waiting room onto the table in the exam room. She whimpered and complained as we did so.
As is my practice, I first offered my basic assessment of her condition, described her probable level of discomfort and discussed our potential remedies—in spite of the obvious.
Of course, it was clear that this dog was on her last legs. She’d had enough of the pain that would dog her for weeks (if not months) if her owners so chose. But I had to offer my best medicine. After all, that’s what this owner came for…wasn’t it?
As a vet, you’ve got not only to determine the animal’s needs and serve up the best strategy for treatment, you also have to know how to read the owner. My tactics include the word “euthanasia” and “letting her go.”
An owner’s reaction to my phrasing often tells me how to proceed. Does this owner need support in the decision he’s already taken or does he want, against all odds, to prolong his pet’s life?
It’s sort of like playing God—and I detest this role, as any feeling person would. But it’s nonetheless essential to how we deal with a pet’s last moments.
Unfortunately, this man was clear on his intentions…but torn on his feelings. He could barely stand to look at his suffering, beloved wreck of a dog. He so wanted to spend one more weekend with her—but he couldn’t bear to see her suffer any more. He was on the verge of tears and so clearly struggling for control that I thought he’d never bring himself to make the decision. Eventually, he managed to kiss her one last time. I promised to treat her gently and sweetly—and he said he knew we’d have it no other way.
As soon as he left the room (as men more often do before the final injections), my tech’s composure broke down. She’d been barely able to handle the conversation—and it reminded me of my early efforts to control the sobs that accompanied the administration of the anesthetic and euthanasia solutions.
My tech’s reaction was a sharp contrast to my own seemingly rational attitude—in spite of the emotional exchange that takes place under these circumstances. It’s obvious to me (and perhaps to my clients) that I’ve adapted to the emotionally taxing experience of euthanizing a pet. Somehow, the conscious me has turned it into an almost joyful occasion. After all, I’m offering a complete resolution of someone’s pain and suffering—and that’s one of the most concretely positive things I can do in this world.
That may sound weird (and it’s occasioned some guilt on my part in the past) but it’s what’s helped me survive the “compassion fatigue” that might very well have ruined my career. If I were unable to endure each and every euthanasia without crying (at least three or four every week) I’d likely go mad with sorrow.
So, as it stands, I cry less. And when tears do come to my eyes, it’s because I know that what I’m doing is the correct thing…a thing most people can’t do and one which brings relief. Call it cognitive dissonance, rationalization or wishful thinking, but I call it comfort…to the grief-stricken and the afflicted, alike.
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It's a necessary part of our jobs... we have to distance ourselves or we would go looney. Most people I work with will tell you I am hardened, cynical, and uncaring. I wouldn't do this job if I was. I care, but we can't allow ourselves to feel, or, like you said, we would be overwhelmed with sorrow. So instead, I bawl when I watch tv.... in the privacy of my own home.
Again, I couldn't do your job..... you have my respect.
agadore's mama June 24th, 2007 02:53:00 AM
As a client, I don't know what I'd do if my vet cried while putting my cat down (says me wiping a tear from my eye - I'm a big cry baby).
Laura
Laura Bennett June 24th, 2007 08:56:00 AM
When I put Angel down, my vet passed the time by talking about her German Shepard and what happened with her 14 month old yellow lab she lost to brain cancer. I don't know if there was any tears after we left, but the entire staff broke down ( including my vet) when my parents had their Jack Russell put down. Most of them held it together while my parents were there, but after they left, there wasn'ta dry eye in the "house".
We're still not allowed to talk about J.R when we go in there as everybody still gets teary eyed 3 months later. Who knew a Jack could make such a impression...
Stacy June 24th, 2007 09:35:00 AM
Thanks! I love your blog and I appreciate your honestly on these vet med issues. I didn't reapply to vet school after spending a year working fulltime ++ b/c I was so exhausted and sad and felt myself getting bitter, tired of crying over other people's neglected and abused pets. I still miss the good parts though and I'm working on toughening up so maybe I can go back. I wanted to be a vet since I was five, and life as a medical technologist just isn't the same. Thank you for all you do.
Sarah June 24th, 2007 09:42:00 AM
Back in high school I worked at a vet clinic (which, being a country practice in a rural area also functioned as the pound), and I participated in a lot of euthanasia, particularly strays. Sometimes, too, really heartbreaking cases, like people deciding to euthanize a nine-month-old puppy because she already had advanced hip dysplasia, or an ancient Chihuahua mix who was his owner's last "baby" with the kids grown up and moved away.
For a while, it tore me apart. I'd end up sobbing out in the kennels. And then it started to get "easier". To the point where holding that slackening body as the injection took effect, or taking the remains out to the freezer (animals were kept over the winter to bury in the spring) didn't even bother me anymore. That combined with near-homicidal rage at the idiots who intentionally or unintentionally made their pets suffer turned me into someone I really didn't like. And so I never went to veterinary college. It also took over a decade before I could bring myself to sign up to be a Humane Society volunteer.
All the parts of the job are necessary, certainly, but certainly not all people are suited to managing all parts of the job.
Melle June 24th, 2007 10:05:00 AM
Had to respond.Found myself in tears just reading.I am a counselor-in-pt. psych..I love animals,I am un-able to distance myself and due to this would never be able to do your work.It's not that I don't care or have compassion for the hardships of my clients.For me I believe the utter dependence of animals (and children) is a huge part of my emotional lability where animals are concerned.Keep up the good work!!
Linnea Johnson June 24th, 2007 12:00:00 PM
I've dealt w/plenty of euthanasias, but a few days ago was my first client-present assist, an 8-month old w/no vx history, well into the depths of parvo. The client didn't even have the money for the office visit, much less parvo treatment (as usual, it seems, w/parvo cases - as harsh as it sounds, it's almost always the poor clients who show up w/parvo-positive puppies, since they didn't have the money for "shots"). The owner wanted to be present - we had him step out for catheter placement and then let him come back in to hold his dog. He was wailing and sobbing and writhing on the floor - completely devastated. I managed to keep full composure throughout the entire ordeal, even during the few minutes after the pet had passed and we were still in the room w/him (the vet and I then excused ourselves, telling him to take all the time he needed) - but only b/c I was thinking about what I wanted for lunch. Seriously. I mentally ran through the menus of my favorite nearby restaurants, complete w/beverages and desserts. Sounds awful, but it was the only way for me to mentally remove myself from the tragic situation in front of me. I kind of felt guilty at first, but then I figured the last thing the emotionally distraught owner needed to see was the assistant coming un-glued, too.
anna June 24th, 2007 04:27:00 PM
I have dealt with numerous euthanasias too, however they have been wildlife and not pets. With wildlife if the animal is able to be captured, it is injured. Usually 25 - 35% or more of the animals were euthanasied or died within the first 24 hours. If the animal could not be rehabbed to where it could be returned to the wild or could not stand the stress of a lengthy recovery, then it was euthanasied. We shed so many tears over so many animals. It does get less difficult, but it was never easy! I think of euthanasia as the final gift to give an animal in pain or at the end of its life. I have never had to end the life of healthy but unwanted dogs or cats and don't even want to imagine doing that every day.
I was having a discussion with a vet tech friend recently. If the client asks, she recommends that they considering staying with the animal during euthanasia. I agree as long as the owner is not so distraught as to freak out the animal. I wonder how this situation is handled at other clinics?
Susan June 24th, 2007 06:54:00 PM
For Susan,
I've been involved with 2 euthanasias. One was my childhood dog, kept by my parents after I left for college. I made a deal with them that if they could not be present with him if/when he was euthanized, that I would come down (8 hour drive away) to be with him. This assumed it was not an emergency situation, of course. My parents called to say it was time, and I drove down the next weekend. My brother and I took the dog in. We cried so much the vet was in tears, too. We were present for the entire procedure. Eleven years ago, a friend had to have her 3yo dog put down due to cancer. I adored that dog and went with my friend for the euthanasia. Again, present for the entire procedure. (That dog is the reason I have my best girl now -- although I never thought I would own a pound dog, my friend's dog let me know that you can find a great dog in the shelter, so I listened to the voice that told me to go to the shelter 3 months after her death.) Neither vet had any issue with the owner being present.
One of my dogs is co-owned and elderly. She has lived with me for 8 years and regards the other co-owner as a dear family friend. I have asked the co-owner if she wishes to be present should euthanasia become necessary, and she says she would rather not be present.
I will be present if possible for a pet's euthanasia. If it's something that comes up during surgery or some such, or I'm traveling and I'm far away, then I will authorize the euthanasia from a distance and send my love rather than keep the animal on life support until I can get there. I think. I hope I never have to find out.
kabbage June 24th, 2007 09:58:00 PM
I have been a vet tech for 2 years now, and I will always remember how horrible that first PTS I had to assist on was. I remember I was able to keep my composure in the office visit...barely, but as soon as it was over I ran out the back door and cried my eyes out. Somehow I too find myself crying less when I have to assist on one. Every now and then however the realization sneaks back in there and suprises me. usually in cases where I just feel so awful for the especialy beraved client, or in a especially bad situation like a hit by car animal, or the lab we saw that got trapped in a house fire.
ed June 25th, 2007 04:36:00 AM
Very touching post Dr. Patty, I'm crying at my desk.
I was present for the euthansia of our family dog before I left for graduate school in Virginia. My mother and I were scared, sad, confused, distraught......but we stayed calm for Kasey. The procedure happened quietly and quickly and my mother and I had tears rolling down our faces. When she passed, the Vet left us in the room for over an hour - because we were sobbing and howling uncontrolably. I guess once she was at peace, that dam burst for us. This Vet was on a beautiful, large piece of acreage and had horses. 1 of the horses (a Mare with a young colt) came right up to the window right after Kasey passed. It was spooky and I will always wonder what the horse sensed/knew/felt that we maybe didn't know or see.
amy June 25th, 2007 08:49:00 AM
This is mainly to thank you and all Vets for being able to not only do what's neccessary but convince owners who are unable or unwilling to act, to end suffering. A thanks also to owners who do the right thing no matter how hard it is on them personally. Bawl if you need to (we did) but do what is best for the dog.
Scott Moore June 25th, 2007 11:49:00 AM
i've never had to have a pet euthanized, they all died naturally & peacefully. i don't know what i'd do if i had to face that situtation!
dog collar addict June 25th, 2007 05:54:00 PM
Beautiful, soulful, exceptionally poignant post.
Having been part of many euthanasias both as a pet owner, rescuer and veterinary assistant, I don't think I've ever heard it described so perfectly.
Thank you, Dr. Patty. I never thought that a story about euthanasia could make me smile while my eyes teared.
Kim June 25th, 2007 10:12:00 PM
I had to make the decision to have my 10 year old cat euthanized last February, when he had a malignant tumor on his jaw and it clearly wasn't in his best interest to let him suffer any more. I was going to stay with him until the last minute, and I just couldn't. I told myself I was so upset I would just frighten him. I'm sure they treated him kindly (as a matter of fact, I now take my other cats there because I was so impressed with the vet we saw that day), but I still feel guilty.
Diane June 25th, 2007 11:16:00 PM
Diane: Don't feel guilty. I always offer both alternatives. Not everyone needs to be with their pet at that last moment. If you trust your vet professionals you're always OK making this decision. Give yourself a break. Everyone's different.
Dr. Patty Khuly June 27th, 2007 06:41:00 PM
I see several uthanasia 's every week. As I am a new technician, I have come extremely abundant to them (which some times starttles me, I am very sensative). But occasionally we do get those cases where experience is just not enough.
In most of my cases of being emotionally attatched is because
1) The owner and its pet have such a strong bond, it almost seems as if they are loosing a child.
2) A very young case, that just doesn't seem to have enough.
and last but not least 3) A deadly diseases, such as cancer.
People go into animal medicine to help animals because they care (it's sad to say that their are many, not of this nature) and we are bound to give them everything they can to have a long healthy life. Going down the road we will encounter those heart breaking moments, and that! is what brings us back to why we do what we do, no matter what happens our professions will always be a positive reinforcement.
Shell June 27th, 2007 08:45:00 PM
I've been present for one euthanasia: my 11-year-old, FIV+ cat (whom I adopted from the local shelter in 1981, and was now having recurring infections and chronic pain that made it hard for him to even get up and use the litterbox). It was really hard to see it--I started crying as the vet prepared the injection--but it was harder yet to see my poor guy suffer so. I got in my car, drove home, and cried for half an hour. I've also been present for the death of two other cats who lived their full lifespans. It was hard then, too, but there was something about being with them in their last moments, in the home they knew and loved, that somehow made the transition less painful.
I'm fortunate to have a vet who's willing to make a house call if it ever becomes obvious that one of my present feline companions needs to be euthanized. I'd rather allow my beloved pets to die at home in the comfort of familiar surroundings.
Thank you all for the work you do. I can't imagine how hard it is to assist or perform a euthanasia, especially when it's on a healthy animal that simply ran out of time at the shelter.
JaneA June 29th, 2007 09:07:00 AM
I'm exposed to euthanasia from two sides. For my pets, if at all possible, I will be with them, and tell them both aloud and in my mind that they will be at peace now, no more pain, and that they move on with my love and support, because it's time. Then I go home and cry for the next two days.
For our wildlife patients, as Susan said, if they are not going to be releasable, then we generally euthanase. I have performed many myself, on small to medium birds - mammals and large birds are done by the vets. There are certain reasons that we euthanase for that I refuse to perform myself, because I don't believe they are morally correct, but when a bird comes in with an ancient injury, and is emaciated - it's a blessing to be able to help that bird. And I tell them the same kind of things, that they are moving on to a place where they will fly again, where they will be all that they should be, and that they are going with love and caring from me - I talk to them until they die.
I believe a timely death is a gift we can offer our animals, something that should be more freely available to the people we love as well. It's important to me though that it is done with love and respect, and for the right reasons. I admire the shelter techs who are forced to euthanase healthy animals for lack of a home, but I couldn't do it myself. I add them to my thoughts though when euthanasing myself, just an extra wish that peace will be given to all who die or help it to happen.
jcat July 1st, 2007 04:29:00 PM
As someone who has been on both sides of the euthanasia fence (as a vet tech student, I had the experience of euthanizing a shelter dog, and had to have my own cat put down at the E clinic a few months ago), I've done my fair share of crying on this subject as well.
I think that the fact you do still get weepy is a testament to what a good vet you are. When I had to perform the euthanasia at school, I ended up running to the nearest sink and vomiting as soon as I'd finished the injection. After the heaving and sobbing was over, my program director took me aside and asked if I was okay. My response: "I hope it never gets any easier."
I think if it ever does, that'll be the time to put away my scrubs and find a new career.
Lisa July 2nd, 2007 10:31:00 AM
Thank you so much for sharing this. Just last Thursday we had to have our precious Boomie Cat euthanized at the young age of six. He had been losing weight for about two weeks and had diarrhea for about the same amount of time. Our vet found a tumor last Monday and after blood work, x-rays and ultra sounds he felt that it was a single encapsulated tumor on the intestinal wall and their was a good chance it could be removed and little Boomie would be good as new in a few weeks. We were devastatated to learn that upon surgery that the tumor was malignant...it had destroyed his large intestine, most of his colon and was in the artery leading to his aorta. We knew that this little guy had been through so much so we asked our vet to let him keep on sleeping. It was one of the hardest decisions my husband and I had to make. Over the past 35 years we have had to make this decision for several of our pets, however we were always there to hold them. As much as we wanted to hold Boomie, we just could have him awakened merely to satisfy us when he had been deteriorating so rapidly...we had to do what was best for him. In reading your explanation, it helps to put some things in perspective. Our vet was very compassionate and we knew he was as shocked as we were. But through the last few days of Boomie's life they supported every decision we made. I believe though, that even though we know in our heart that we did what was best for Boomie, the fact that he was so young has just devastated us. Again, your story has helped me very, very much. Blessings to you and all those who serve only to help our beloved pets.
Carmen July 3rd, 2007 03:51:00 PM
It is a rare thing to have insight into the way that our dog care people perceive their daily tasks. To each of us who has spent years with the joyful companion, it is a daunting realization that we nearly always outlive our fur persons...it certainly doesn't make it any easier.
It was very refreshing to glimpse the cognitive dissonance that you quite obviously are aware of and how you most assuredly appreciate our companion animals and our feelings.
emmie July 5th, 2007 11:05:00 AM
I am only a couple of months into my job as a Veterinary nurse and have already seen many euthanasia cases.
The easier ones tend to be the animals that are not "owned" - I have had to assist with several pound dogs with severe behaviour problems (A weekly event...) and also with wildlife euthanasia. Although never fun... it is easier.
The hard ones are most certainly the ones that are dearly loved. I have had to restrain tears on several euthanasias as the owner sobs and says goodbye. The hardest was an old cattle dog, much loved, whose male owner had a home visit. It was very moving so see how open this "tough" man was with his overwhelming feelings at his buddy's passing.
It is, as you say, part of the job and must be accepted with grim determination - after all, the animals that are sobbed over tend to have had the best of life and the best of love.
I am an owner of a lovely 9mo black cat who is the joy of my heart. Vet nurse or no - if the time ever comes that she has to be euthanised I think it's going to be the hardest thing I will ever do - so kudos to the owners who have the strength and the soul to do so! I for one, know I will turn into a blubbing wreck.
Ally July 25th, 2007 04:06:00 AM
I sadly had to have my 14 year old dog Clyde euthanised, as an emergency. He had developed fluid around his heart and was clearly distressed and having trouble breathing.The vet was incredibly kind and explained he could drain the fluid but it would be dangerous and would not cure the problem just possibly extend his life by a week if I was lucky.I felt this was really his way of trying to say this would not be the kindest thing to do, I had already made my mind up anyway that I could not do that to him.
I decided to stay with him, but was not prepared for what happened, I had been with two cats before and they passed very quickly and peacefully. This was not the case for my dog he seemed to fight against it for a short while, which I found terribly distressing I managed to hold it together at the time as I did not want to upset or stress my dog out anymore. But afterwards I have never felt emotion like it I sobbed for hours I had mixed feelings of guilt, had I made the right decision,why had my dog reacted like that, and on it went.Even now I still find that last image very difficult to erase.
But for all of that I see the vet as amazing and compassionate, that would never be a job I could do,and it could not have been particularly pleasant for him either.Ultimately I know I made the right decision and my emotion is for me not for my beloved dog.
Debbie August 9th, 2007 02:33:00 AM
I was present when my beloved Golden Retreiver, Jesse, was euthanized after a 1 year fight against a nasal chonsdrosarcoma. We put off the decision 3 times, as each time we prepared to have him put down, he would seem to rally again and the decision about his quality of life was so hard. Finally the time came, I held him as he went on... I promise I will be there also for my current dog (who came home as an 8 week old fur ball) and my 2 cats when their time comes. (One was a 6 week old stray found on the roadside and the other a Hurricane Katrina rescue from New Orleans who live through god-knows-what as a kitten.) I feel it's the least I can do for their love and companionship, that I should be there with them on their final journey. It is a trip we must all take some day, and I think having a friend there might ease the way.
kate7047 August 12th, 2007 09:25:00 PM
Thank you for your essay on euthanasia. Cooper the dog was euthanized, and although my husband and I sat with him as he died we still cry for our loss. He was one of the best. He had twisted his stomach, vomiting from the cancer that was slowly killing him and making his life miserable. We had to decide whether to do the life-saving surgery, and nurse him back to some semblance of health so he could die slowly over the next few months of the cancer, or take his life to spare him any more suffering. He was game to go on - the tags jingled when I picked up his collar to put it in my purse, and he lifted his head and wagged. When we brought him in the poor vet diagnosed and stabilized him, and helped us reason through the situation, then left us along with him to figure out what we wanted to do. We chose to spare him the pain and drawn out death. I will never know that it was the right decision, but we did our best. I am crying now. Thank you for your essay.
Carol Nicolson August 19th, 2007 10:13:00 PM
Carol,
We can never truly know what is right...we can only do what our hearts tell us is best. Love and compassion take over when we are in doubt. Cooper is at peace and you allowed him to go with dignity.
I still cry for each of my babies who have left me over the years...yet I know that I did what was necessary for their peace and not my own...I see the tears as cleansing and nurturing. So I let them flow and then I pick up one of my other fur babies and pour my love into them.
Wising you peace and comfort. Cooper would want that for you!
Carmen September 11th, 2007 01:27:00 PM
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