Euthanasia: Making the Decision
Posted on  August 25, 2016 at American Humane

While some pets die of old age in the comfort of their own home, many others become seriously ill, get injured in some way or experience a significantly diminished quality of life as they grow very old. In these situations, it may be necessary for you to consider having your pet euthanized in order to spare it from pain and suffering. Here are some suggestions for dealing with this difficult decision, as well as some information about the euthanasia procedure itself.

KNOWING WHEN IT’S TIME
Talk to your veterinarian. He or she is the best-qualified person to help guide you through this difficult process. In some cases, your veterinarian may be able to tell you definitively that it is time to euthanize your pet, but in other cases, you may ultimately need to make the decision based on your observances of your pet’s behavior and attitude. Here are some signs that may indicate your pet is suffering or no longer enjoying a good quality of life:

• He is experiencing chronic pain that cannot be controlled with medication (your veterinarian can help you determine if your pet is in pain).
• He has frequent vomiting or diarrhea that is causing dehydration and/or significant weight loss.
• He has stopped eating or will only eat if you force feed him.
• He is incontinent to the degree that he frequently soils himself.
• He has lost interest in all or most of his favorite activities, such as going for walks, playing with toys or other pets, eating treats or soliciting attention and petting from family members.
• He cannot stand on his own or falls down when trying to walk.
• He has chronic labored breathing or coughing.

SAYING GOODBYE
Once you have made this very difficult decision, you will also need to decide how and where you and your family will say the final goodbye.

• Before the procedure is scheduled to take place, make sure that all members of your family have time with the pet to say a private goodbye.
• If you have children, make sure that you explain the decision to them and prepare them for the loss of the pet in advance. This may be your child’s first experience with death, and it is very important for you to help her or him through the grieving process. Books that address the subject, such as When a Pet Dies by Fred Rogers or Remembering My Pet by Machama Liss-Levinson and Molly Phinney Baskette, may be very beneficial in helping your child to deal with this loss.
• It is an individual decision whether or not you and your family want to be present during the euthanasia procedure. For some pet owners, the emotion may be too overwhelming, but for many, it is a comfort to be with their pet during the final moments. It may be inappropriate for young children to witness the procedure since they are not yet able to understand death and may also not understand that they need to remain still and quiet.
• Some veterinarians will come to your house, which allows both the pet and the family to share their last moments together in the comfort of their own home.

WHAT TO EXPECT
Making the decision to say goodbye to a beloved pet is stressful, and your anxiety can often be exacerbated if you do not know what to expect during the euthanasia procedure.

• Your veterinarian will generally explain the procedure to you before he or she begins. Don’t hesitate to ask your veterinarian for further explanation or clarification if needed.
• Small to medium-size pets are usually placed on a table for the procedure, but larger dogs may be more easily handled on the floor. Regardless of the location, make sure that your pet has a comfortable blanket or bed to lie on.
• In most cases, a trained veterinary technician will hold your pet for the procedure. The veterinary technician has the skill needed to properly hold your pet so that the process goes quickly and smoothly. If you plan to be present during the entire procedure, it is important that you allow enough space for the veterinarian and technician to work. Your veterinarian will probably show you where to stand so that your pet can see you and hear your voice.
• Your veterinarian will give your pet an overdose of an anesthetic drug called sodium pentobarbital, which quickly causes unconsciousness and then gently stops the heartbeat. Your veterinarian will draw the correct dose of the drug into a syringe and then inject it into a vein. In dogs, the front leg is most commonly used. In cats, either the front or rear leg may be used. The injection itself is not painful to your pet.
• Often, veterinarians will place an intravenous (IV) catheter in the pet’s vein before giving the injection. The catheter will reduce the risk that the vein will rupture as the drug is injected. If the vein ruptures, then some of the drug may leak out into the leg, and it will not work as quickly.
• Your veterinarian may give your pet an injection of anesthetic or sedative before the injection of sodium pentobarbitol. This is most often done in pets that are not likely to hold still for the IV injection. An anesthetic or sedative injection is usually given in the rear leg muscle and will take effect in about five to 10 minutes. Your pet will become very drowsy or unconscious, allowing the veterinarian to more easily perform the IV injection.
• Once the IV injection of sodium pentobarbitol is given, your pet will become completely unconscious within a few seconds, and death will occur within a few minutes or less.
• Your veterinarian will use a stethoscope to confirm that your pet’s heart has stopped.
• Your pet may experience some muscle twitching and intermittent breathing for several minutes after death has occurred. Your pet may also release his bladder or bowels. These events are normal and should not be cause for alarm.
• After your veterinarian has confirmed that your pet has passed, he or she will usually ask if you would like to have a few final minutes alone with your pet.

BURIAL AND CREMATION OPTIONS
Your veterinarian can offer you a variety of options for your pet’s final resting place.

• Cremation is the most popular choice, and you can choose whether or not you would like to have your pet’s ashes returned to you. Most cremation services offer a choice of urns and personalized memorials.
• Burial is another option. You may want to bury your pet in your own yard, but before doing so, be sure to check your local ordinances for any restrictions. There are also many pet cemeteries throughout the United States. To locate a pet cemetery near you, check with the International Association of Pet Cemeteries.

End of Life Care
Posted on  ASPCA.org

Coping with the impending loss of a pet is one of the most difficult experiences a pet parent will face. Whether your furry friend is approaching his golden years or has been diagnosed with a terminal illness, it’s important to calmly guide the end-of-life experience and minimize any discomfort or distress. As your pet’s health declines, you may elect to care for your pet at home—with the supervision of a veterinarian—or you may decide to end his suffering with euthanasia.
Read on to find out how to help make your pet’s final days peaceful and dignified.

Is Your Pet In Pain?
When cats and dogs are suffering, they may not show outward signs that we normally associate with pain like whimpering or crying. Sometimes an animal will continue to eat or drink in spite of pain or disorientation. Some physiological and behavioral signs that your pet might be experiencing pain include excessive panting or gasping for breath, reclusiveness, reluctance to move and food pickiness.

Caring for an Elderly Pet
The most important thing you can do for your elderly pet is to minimize any pain or distress she’s experiencing.

• Consult with your veterinarian and treat any health problems, since undiagnosed issues can cause discomfort and rapid deterioration.
• Surround her with her favorite things, like a warm blanket or special squeaky toy.
• Since pressure sores can develop in pets with limited mobility, it’s also essential to provide a warm sleeping spot with plenty of cushioning.
• Some older pets may develop incontinence, or the loss of bladder control, so be sure to check your furry friend regularly for any wetness or soiling. If your pet needs help getting up to urinate or defecate, you can purchase a sling or use a large towel to wrap under her body and assist her.

Pet Hospice Care
Pet hospice care, also known as palliative care, is an option if your pet is suffering from a terminal illness and a cure is not possible. The goal is to make a pet’s final days or weeks more pleasant with the proper use of pain medications, dietary strategies and human interaction. Pet hospice is not a place, but a personal choice and philosophy based on the principle that death is a part of life and can be dignified. When considering hospice care, pet parents should very careful not to prolong the suffering of pets who are in pain or experiencing poor quality of life.

A participating veterinarian will teach pet parents how to provide intensive home care to keep an ill pet as comfortable as possible. Hospice care requires an active commitment and constant supervision from pet parents, who work with their veterinary team to make sure their pet’s life ends comfortably. If you decide hospice care is the right course for you and your pet, you will become your pet’s primary nurse and caregiver, as well as the link between your pet and the veterinary team. Consult with your primary veterinarian and see if she recommends hospice care for your pet based on his specific needs.

Considering Euthanasia
Euthanasia provides a painless, peaceful end for a pet who would otherwise continue to suffer. Your veterinarian has special training to provide your pet with a humane and gentle death. During the procedure, your vet will inject your pet with a sedative followed by a special medication. The animal experiences no awareness of the end of life—the process is akin to undergoing general anesthesia for a surgical procedure and takes about 10 to 20 seconds.

Your veterinarian is the best person to advise you on when the time is right to euthanize—information from medical tests is often more accurate than what a pet owner can observe, and pet owners often delay the moment of euthanasia in anticipation of grief. Observing and keeping an accurate record of your pet in his daily activities can help you to decide. If you observe that moments of discomfort outweigh his capacity to enjoy life, it is time to euthanize, even if your pet still experiences pleasure in eating or socializing. If your pet is in pain, your main goal should be to minimize his suffering.

What to Do If Your Pet Has Died at Home
If your pet is under the care of a veterinarian at the time of his or her passing, he or she can guide you through next steps. However, if your pet dies in your home, there are options to consider. Whether you simply want the body to be removed from your home, or you wish to permanently memorialize your pet in some special way, the choice is yours.

• Depending on your decision, you may have to keep the body in your home for a short period of time. A well-cooled body can be held for up to 24 hours, but the sooner it can be taken somewhere else, the better.
• Placing the wrapped animal in a refrigerator or freezer is recommended, with one exception—if you plan to have a necropsy (autopsy) performed to determine cause of death, the body should not be frozen (refrigeration is still okay). It is essential that you contact a veterinarian as soon as possible if you would like a necropsy.
• If the animal is too big to be put into a refrigerator or freezer, the body should be placed on a cement floor or concrete slab, which is the best way to draw heat away from the carcass. Do not cover or wrap the body in this instance. Doing so will trap in heat and not allow the body temperature to cool.
• As a last resort, you may keep the body in the coldest area of your home, out of the sun, packed with bags of ice. In this case, the body should be placed in a plastic bag to prevent it from getting wet.

Pet Cremation and Burial
It is very common for pet owners to have their deceased pets cremated. You need to decide if you wish to keep your pet's ashes as a remembrance. If so, you will want to arrange an individual (or private) cremation, meaning that your pet will be cremated alone. Businesses that offer individual cremation commonly offer home pick-up/delivery of remains as part of their service packages.

Depending on local laws, it may be legal to bury an animal on your own property. It is typically illegal to bury an animal on public lands such as parks. If you desire burial for your pet but do not have land of your own, check to see if there is a pet cemetery or memorial park in your area.

Other Options
If you wish to simply have your pet’s body removed from your home, consult your local government to find out if your sanitation department picks up animal remains.

Dealing with Pet Loss
There are many forms of grief that are completely normal in the wake of the loss of a beloved pet. For support dealing with the loss of a pet, call our Pet Loss Hotline at (877) GRIEF-10.

When You Love An Old Dog, Managing Care Can Be A Challenge
by PREETI N. MALANI
Posted on February 25, 2017 on NPR.org


The notion of dog years stems from the common belief that one year for a dog equals seven years for a human. Although canine aging is more nuanced than a simple formula, any dog lover knows that dogs' lives pass far too quickly.

Even so, America's 70 million dogs, like their human companions, are living longer, on average, because of better medical care and nutrition. Caring for elderly dogs can be heart-wrenching. Many pet owners struggle to understand when to pursue aggressive care and when to stop and help a beloved pet pass on.

"Older patients are the biggest challenge veterinarians face," says Dr. Alicia Karas, an assistant professor of veterinary medicine at Tufts University. She argues for a holistic approach to older dogs, saying that "too often we focus on the affected body part or the results of an X-ray, not how an animal walks into the exam room."

Pain tops the list of common health concerns for older dogs, with causes ranging from the routine, such as arthritis, to the more serious, such as cancer. As in humans, pain management can be complicated by other conditions. A dog with weak kidneys, for instance, may not be able to take canine-specific pain medicine.

Karas looks beyond drugs to treat pain, sometimes recommending massage, therapeutic ultrasound and rehabilitation.

The benefits of a good rehabilitation program can be far-reaching. Older dogs may not make it outside for long walks, says Karas, but with rehabilitation, "three times a week the dog gets out and sees people who pet and love him."

Older dogs, like their aging owners, may experience memory loss. "When we work up a pet for urinating in the house, we tend to focus on the kidneys, bladder and endocrine reasons," she says. But it may be a case of "simply forgetting to go to the bathroom," she explains. Anxiety is closely linked to impaired memory, and even minor changes in the household can be hard on older dogs.

While specialized care may seem ideal, Dr. Stephen Steep, a veterinarian in Oxford, Mich., tries to present a menu of options and to set realistic expectations of what can and can't be done. "Here are some things you can do. If cost is not an issue, this is an option," he says. "Here is another less aggressive option." But the pet's comfort is paramount, and Steep says he always considers whether or not a particular decision will improve quality of life.

When it comes to end-of-life discussions, Steep recognizes they're inherently difficult. He likes to start with open-ended questions, noting that many owners aren't aware of subtle changes. "How is your dog's appetite?" he asks. "Is your dog sleeping through the night? How is he doing on long walks?"

Although Steep believes most owners understand there is a limit to their pet's life, he feels people don't always realize how old their pets really are. He tries to help them accept aging as a normal process, not a disease.

"People want to have dog pass away at home in their sleep, but that is rarely the case," Steep says. "You get into a situation where the pet cannot go outside to urinate or defecate. He may be gasping for air due to heart failure or incapacitated due to memory loss."

Still, some people just can't let go. When Steep gets the sense that someone is pushing too hard, he tries to emphasize the pet's comfort. "I'll pull them into clinical activities like checking heart rates, monitoring water intake, to try and open their eyes," Steep explains.

Most owners come to the realization that their dog is at the end of its life.

Although Karas recognizes the moral distress created by end-of-life decisions, she acknowledges the importance of euthanasia. "When I have no other options, I have a tool to alleviate suffering."

When Andrew Shepherd's 14-year-old English setter, Madison, developed seizures, he focused on maintaining her quality of life. Given her age and the lack of any obvious discomfort, Shepherd decided against an extensive work-up and instead focused on the dog's symptoms, a decision their veterinarian supported.

During the following months, the seizures become more frequent, lasted longer and the dog appeared to be in pain. "She would yelp," Shepherd recalls. "It was clearly not a pleasant experience."

One day Madison suffered a protracted seizure while traveling in the back seat of Shepherd's car. For him, this was the tipping point. "We couldn't sacrifice her quality of life just to keep her around," Shepherd explains. After that, it was about selecting the right moment to let Madison go.

Their final night together was a celebration of Madison's life. The family comforted their dog, took pictures, shared their favorite Madison stories and made a list of all the nicknames they had for her.

Shepherd recalls crying as he took Madison to the veterinarian's office for the last time. "Normally she hated going to the vet, but this time she didn't fight at all," he says. "She knew it was time."
​
Dr. Preeti N. Malani is a professor of medicine at the University of Michigan in Ann Arbor. You can follow her on Twitter: @PreetiNMalani.

Whether animals can experience romantic love is unknown. But there is some evidence that they are capable of experiencing the same range of emotions as we can. The brains of many mammals are surprisingly similar to the human brain. Take as an example the brain of a cat. A cat’s brain is small compared to ours, occupying only about one percent of their body mass compared to about two percent in an average human. But size doesn't always matter. Neanderthals, the hominids that went extinct more than twenty thousand years ago, had bigger brains than Homo sapiens, but they probably weren’t smarter than the Homo sapiens that beat them in the survival game. Surface folding and brain structure matter more than brain size. The brains of cats have an amazing surface folding and a structure that is about ninety percent similar to ours. This suggests that they could indeed be capable of experiencing romantic love. But we will probably never know for sure.

There is one thing we do know though: Your dog or cat doesn’t regard you merely as a food dispenser. Pets as well as zoo animals form strong attachments to their caregivers. As attachment is a form of love, animals are indeed capable of loving their caregivers.

Dogs have been reported to love their masters so deeply that they mourn their death for many years. Such was the case of Greyfriars Bobby, a Skye terrier in Edinburgh, Scotland. He served as Constable John Gray’s companion, until Gray’s death in 1858. After Gray’s funeral, Bobby was spotted sitting on top of his master’s grave in Greyfriars Kirkyard. The loyal police hound is reported to have spent every night at his master’s grave until his death fourteen years later.

The attachment of dogs to their owners has been confirmed in a study conducted by Daniel Mills, a British specialist in clinical animal behavior. The study used an adaptation of Ainsworth’s strange situation paradigm, in which the researchers observed the reaction of dogs and cats in response to their owners and strangers. He found that securely attached dogs tended to behave similarly to infants when their owners left, whereas cats tended not to do that. If anything, cats tended to have more of an avoidant attachment style, often ignoring their owners and happily greeting strangers. These results, of course, do not show that cats are incapable of attachment. While cats no doubt tend to have a more avoidant attachment style than dogs, most of us know from anecdotal evidence that there can be enormous differences in how attached cats are to their owners. My own two cats, Bertrand Russell and Roderick Chisholm (named after philosophers like my other cats) are undoubtedly anxiously attached, clinging tenaciously to me to the point of annoyance.

While it seems relatively uncontroversial that dogs can be attached to their owners, and that the owners assume the role of caregiver, there is also evidence that dogs can temporarily take over the role of caregiver. Dogs seem to be attuned to the emotions of their owners and are able to act as a loyal companion in times of need. In a study published in the September 2012 issue of Animal Cognition, University of London researchers found that dogs were more inclined to approach a crying person than someone who was talking or humming, and that they responded to crying with submissive behavior. According to the researchers, this contrast indicates that the dogs’ response to weeping wasn’t simply the result of curiosity but was based on a primitive understanding of human distress. These findings indicate that when a dog comforts his sorrowful owner, the caregiver-recipient roles are sometimes reversed. The dog temporarily becomes the caregiver, which suggests a more sophisticated attachment pattern in dogs than in infants.

These results have also been confirmed with brain scans. Gregory Berns, a neuroscientist at Emory University, used fMRI neuroimaging to test the brains of dogs. This is not simple feat. fMRI scans only work if the participants lie completely still, which dogs normally aren’t capable of. However, Berns trained his dogs to lie still in the tight compartment of the scanner, which made the brain imaging feasible. The results were astonishing. Berns’ lab team found increased activity in regions of their brain associated with attachment, empathy and a theory of mind in response to their owners. A theory of mind is a belief system about what others think and want that is continually updated. So, dogs apparently wonder what their owners are thinking about.

Animals also seem capable of experiencing attachment love for each other. The awe-inspiring story of Tika and Kobuk, two malamutes who had been companions for years, testifies to this. Together the two dogs had bred and raised eight litters of puppies. But Kobuk was a bit of a bully. He would eat Tika’s food and shove her away if he got the chance. He would also attempt to steal away any attention people gave her. But the bullying came to a complete hold when Tika developed cancer in her leg. Kobuk’s behavior changed entirely. He let Tika sleep on the bed, while he rested on the floor. He groomed her face and neck and would not leave her side. Tika’s leg eventually had to be amputated. In the beginning it was quite a challenge for Tika to walk on three legs. When she stumbled and fell Kobuk would try to help her. He even saved Tika’s life when she was going into shock during her recovery from the amputation. Kobuk was barking to wake up the owner, who rushed Tika to the hospital. Thanks to Kobuk’s attention and love, Tika survived. Kobuk continued to care for Tika while she was still recovering. But once Tika had fully recovered and had learned to walk on three legs, Kobuk was back to his old behavior.

Animals also sometimes form attachment relationships with members of other non-human species. The BBC documentary Animal Odd Couples features several unusual attachment relationships, among others that between Anthony, a giant lion, and Riley, a little coyote. When Anthony and Riley were brought to “Keepers of the Wild” animal sanctuary, they were only about a month old. They immediately bonded. They enjoyed playing and grooming each other. When they arrived at the sanctuary, they were the same size but that quickly changed. The lion rapidly outgrew the little coyote. Despite their extremely different physique, their early bond continued into adulthood.

Attachment love is not restricted to mammals. In his book Mind of the Raven biologist Bernd Heinrich argues that since ravens have long-term mates, they must feel a form of attachment for each other. Otherwise it is difficult to explain what keeps the couple together for a lifetime. Although not all birds mate for life, many do. Brant geese are no exception. The BBC documentary features a male Brant goose who has chosen a forty-five-year-old female Aldabra tortoise as his soul mate. He chases away anyone who tries to get near her, ensuring that she gets to eat her crisp lettuce without any interference. The hefty female tortoise contently puts up with his protection and care, in fact she truly seems to enjoy it. A truly kooky couple.

Brit has written over 100 peer-reviewed articles, some three hundred popular articles on neuroscience and health issues and three books: Transient Truths (Oxford), On Romantic Love (2015) and The Superhuman Mind (2015). She is currently finishing a third book with Oxford entitled Seeing and Saying. Her work has been featured in various public media, including Nightline, ABC News, the Huffington Post, Fox News, MSNBC, Daily Mail, Modesto Bee, and Mumbai Mirror. She is also an editor of the international peer-reviewed philosophy journal Erkenntnis, is the 100th President of the Southern Society for Philosophy and Psychology and was the first female President of the Central States Philosophical Association.

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