1. Euthanasia

2. Euthanasia From the Greek: From the Greek: “eu” meaning “good” or “well” “eu” meaning “good” or “well” “thanatos” meaning “death” “thanatos” meaning “death” A “good death” or “gentle death” is one that occurs with minimal pain and distress A “good death” or “gentle death” is one that occurs with minimal pain and distress The act of inducing painless death – AVMA Panel on Euthanasia The act of inducing painless death – AVMA Panel on Euthanasia

3. Ethical Issues A spectrum of reasons for euthanasia: A spectrum of reasons for euthanasia: Relieving suffering Relieving suffering Killing of unwanted, abandoned, stray, or undesired animals Killing of unwanted, abandoned, stray, or undesired animals Balancing conflicting interests: Balancing conflicting interests: “convenience killing” or compassionate termination of hopeless suffering? No easy or absolutely right or wrong answer No easy or absolutely right or wrong answer

4. The Decision One of the most difficult decisions that a pet owner will ever face One of the most difficult decisions that a pet owner will ever face Perceptions of animal suffering differ between individuals and from case to case Perceptions of animal suffering differ between individuals and from case to case The veterinary team can help by providing information: The veterinary team can help by providing information: Disease process Disease process Available treatments Available treatments Costs involved Costs involved

5. The Decision Veterinary professionals should lay out all the options available while being careful not to make the decision for the client Veterinary professionals should lay out all the options available while being careful not to make the decision for the client Veterinary professionals should help clients with euthanasia decisions by approaching the subject professionally with compassion and respect Veterinary professionals should help clients with euthanasia decisions by approaching the subject professionally with compassion and respect

6. Minimizing Pain and Distress Personnel who perform euthanasia must have: Personnel who perform euthanasia must have: appropriate certification and training appropriate certification and training experience with the techniques to be used experience with the techniques to be used experience in the humane restraint of the species of animal to be euthanatized experience in the humane restraint of the species of animal to be euthanatized to ensure that animal pain and distress are minimized during euthanasia.

7. Training and experience should include: Training and experience should include: familiarity with the normal behavior of the species being euthanatized familiarity with the normal behavior of the species being euthanatized an appreciation of how handling and restraint affects that behavior an appreciation of how handling and restraint affects that behavior an understanding of the mechanism by which the selected technique induces loss of consciousness and death an understanding of the mechanism by which the selected technique induces loss of consciousness and death

8. Selection of the most appropriate method of euthanasia in any given situation depends on the species of animal involved, available means of animal restraint, skill of personnel, number of animals, and other considerations. Selection of the most appropriate method of euthanasia in any given situation depends on the species of animal involved, available means of animal restraint, skill of personnel, number of animals, and other considerations. The following information focuses primarily on domestic animals, but the same general considerations should be applied to all species. The following information focuses primarily on domestic animals, but the same general considerations should be applied to all species.

9. Euthanasia Techniques A rapid loss of consciousness A rapid loss of consciousness Followed by cardiac or respiratory arrest Followed by cardiac or respiratory arrest Followed by loss of brain function Followed by loss of brain function With minimal pain, distress, and anxiety prior to loss of consciousness With minimal pain, distress, and anxiety prior to loss of consciousness Balance the ideal of minimal pain and distress with the reality of the many environments in which euthanasia is performed Balance the ideal of minimal pain and distress with the reality of the many environments in which euthanasia is performed

10. Animal Behavioral Considerations Gentle restraint (preferably in a familiar and safe environment), careful handling, and talking during euthanasia often have a calming effect on animals that are used to being handled. Gentle restraint (preferably in a familiar and safe environment), careful handling, and talking during euthanasia often have a calming effect on animals that are used to being handled. Sedation and/or anesthesia may assist in achieving the best conditions for euthanasia. Sedation and/or anesthesia may assist in achieving the best conditions for euthanasia. Preparation of observers should also be taken into consideration. Preparation of observers should also be taken into consideration.

11. Animals that are wild, feral, injured, or already distressed from disease pose another challenge. Methods of pre-euthanasia handling suitable for domestic animals may not be effective for them. Because handling may stress animals unaccustomed to human contact (e.g., wildlife, zoo, and feral species), the degree of restraint required to perform any euthanasia procedure should be considered when evaluating various methods. Animals that are wild, feral, injured, or already distressed from disease pose another challenge. Methods of pre-euthanasia handling suitable for domestic animals may not be effective for them. Because handling may stress animals unaccustomed to human contact (e.g., wildlife, zoo, and feral species), the degree of restraint required to perform any euthanasia procedure should be considered when evaluating various methods.

12. When handling these animals, calming may be accomplished by minimizing visual, auditory, and tactile stimulation. When struggling during capture or restraint may cause pain, injury, or anxiety to the animal or danger to the operator, the use of tranquilizers, analgesics, and/or anesthetics may be necessary. A route of injection should be chosen that causes the least distress in the animal for which euthanasia must be performed. When handling these animals, calming may be accomplished by minimizing visual, auditory, and tactile stimulation. When struggling during capture or restraint may cause pain, injury, or anxiety to the animal or danger to the operator, the use of tranquilizers, analgesics, and/or anesthetics may be necessary. A route of injection should be chosen that causes the least distress in the animal for which euthanasia must be performed.

13. Human Behavioral Considerations – In Veterinary Clinics Although many owners rely heavily on their veterinarian’s judgment, others may have misgivings about making their own decision. Although many owners rely heavily on their veterinarian’s judgment, others may have misgivings about making their own decision. When owners choose to be present during euthanasia, they should be prepared for what will happen: When owners choose to be present during euthanasia, they should be prepared for what will happen: What drugs are being used and how the animal could respond What drugs are being used and how the animal could respond Behaviors such as vocalization, muscle twitches, failure of the eyelids to close, urination, or defecation Behaviors such as vocalization, muscle twitches, failure of the eyelids to close, urination, or defecation

14. In Animal Care and Control Facilities In animal care and control facilities where unwanted, homeless, diseased, and injured animals must be euthanatized in large numbers: In animal care and control facilities where unwanted, homeless, diseased, and injured animals must be euthanatized in large numbers: Distress may develop among personnel directly involved in performing euthanasia repeatedly. Distress may develop among personnel directly involved in performing euthanasia repeatedly. Constant exposure to, or participation in, euthanasia procedures can cause a psychological state characterized by a strong sense of work dissatisfaction or alienation, which may be expressed by absenteeism, belligerence, or careless and callous handling of animals. Constant exposure to, or participation in, euthanasia procedures can cause a psychological state characterized by a strong sense of work dissatisfaction or alienation, which may be expressed by absenteeism, belligerence, or careless and callous handling of animals. Specific coping strategies can make the task more tolerable. Specific coping strategies can make the task more tolerable.

15. In Other Settings Laboratories Laboratories Researchers, technicians, and students may become attached to animals that must be euthanatized. The same considerations afforded pet owners or shelter employees should be provided to those working in laboratories. Researchers, technicians, and students may become attached to animals that must be euthanatized. The same considerations afforded pet owners or shelter employees should be provided to those working in laboratories.

16. Wildlife Control Wildlife Control Wildlife biologists, wildlife managers, and wildlife health professionals are often responsible for euthanatizing animals that are injured, diseased, in excessive number, or that threaten property or human safety. Although relocation of some animals is appropriate and attempted, relocation is often only a temporary solution to a larger problem. People who must deal with these animals, especially under public pressure to save the animals rather than destroy them, can experience extreme distress and anxiety. Wildlife biologists, wildlife managers, and wildlife health professionals are often responsible for euthanatizing animals that are injured, diseased, in excessive number, or that threaten property or human safety. Although relocation of some animals is appropriate and attempted, relocation is often only a temporary solution to a larger problem. People who must deal with these animals, especially under public pressure to save the animals rather than destroy them, can experience extreme distress and anxiety.

17. Public Places Euthanasia of zoo animals, animals involved in roadside or racetrack accidents, stranded marine animals, nuisance or injured wildlife, and others can draw public attention. Euthanasia of zoo animals, animals involved in roadside or racetrack accidents, stranded marine animals, nuisance or injured wildlife, and others can draw public attention. Human attitudes and responses should be considered whenever animals are euthanatized. Human attitudes and responses should be considered whenever animals are euthanatized. The primary responsibility is to use the most rapid and painless euthanasia method possible under the circumstances. The primary responsibility is to use the most rapid and painless euthanasia method possible under the circumstances.

18. Modes of Action of Euthanatizing Agents For death to be painless and distress-free, loss of consciousness should precede loss of motor activity (muscle movement). For death to be painless and distress-free, loss of consciousness should precede loss of motor activity (muscle movement). Loss of motor activity cannot be equated with loss of consciousness and absence of distress. Loss of motor activity cannot be equated with loss of consciousness and absence of distress. Agents that induce muscle paralysis without loss of consciousness are not acceptable as sole agents for euthanasia Agents that induce muscle paralysis without loss of consciousness are not acceptable as sole agents for euthanasia With other techniques that induce hypoxia (a deficiency of oxygen), some animals may have motor activity following loss of consciousness, but this is reflex activity and is not perceived by the animal. With other techniques that induce hypoxia (a deficiency of oxygen), some animals may have motor activity following loss of consciousness, but this is reflex activity and is not perceived by the animal.

19. Inhalant Agents Advantages— Advantages— Inhalant anesthetics are particularly valuable for euthanasia of smaller animals (< 7 kg) or for animals in which venipuncture may be difficult. Inhalant anesthetics are particularly valuable for euthanasia of smaller animals (< 7 kg) or for animals in which venipuncture may be difficult.

20. Inhalant Agents Disadvantages— Disadvantages— Animals may struggle and become anxious during induction of anesthesia because anesthetic vapors may be irritating and can induce excitement. Animals may struggle and become anxious during induction of anesthesia because anesthetic vapors may be irritating and can induce excitement. Ether is flammable and explosive. Explosions have occurred when animals, euthanatized with ether, were placed in an ordinary (not explosion proof) refrigerator or freezer and when bagged animals were placed in an incinerator. Ether is flammable and explosive. Explosions have occurred when animals, euthanatized with ether, were placed in an ordinary (not explosion proof) refrigerator or freezer and when bagged animals were placed in an incinerator. Induction with methoxyflurane is unacceptably slow in some species. Induction with methoxyflurane is unacceptably slow in some species. Nitrous oxide (N 2 O) will support combustion. Nitrous oxide (N 2 O) will support combustion. Personnel and animals can be injured by exposure to these agents. Personnel and animals can be injured by exposure to these agents. There is a potential for human abuse of some of these drugs, especially N 2 O. There is a potential for human abuse of some of these drugs, especially N 2 O.

21. Injectable Euthanasia Agents The use of injectable euthanasia agents is the most rapid and reliable method of performing euthanasia. It is the most desirable method when it can be performed without causing fear or distress in the animal. The use of injectable euthanasia agents is the most rapid and reliable method of performing euthanasia. It is the most desirable method when it can be performed without causing fear or distress in the animal.

22. Barbituric Acid Derivatives Barbiturates depress the central nervous system in descending order, beginning with the cerebral cortex, with loss of consciousness progressing to anesthesia. With an overdose, deep anesthesia progresses to apnea, owing to depression of the respiratory center, which is followed by cardiac arrest. Barbiturates depress the central nervous system in descending order, beginning with the cerebral cortex, with loss of consciousness progressing to anesthesia. With an overdose, deep anesthesia progresses to apnea, owing to depression of the respiratory center, which is followed by cardiac arrest.

23. Barbiturates Advantages— Advantages— A primary advantage of barbiturates is speed of action. This effect depends on the dose, concentration, route, and rate of the injection. A primary advantage of barbiturates is speed of action. This effect depends on the dose, concentration, route, and rate of the injection. Barbiturates induce euthanasia smoothly, with minimal discomfort to the animal. Barbiturates induce euthanasia smoothly, with minimal discomfort to the animal. Barbiturates are less expensive than many other euthanasia agents. Barbiturates are less expensive than many other euthanasia agents.

24. Barbiturates Disadvantages— Disadvantages— Intravenous injection is necessary for best results and requires trained personnel. Intravenous injection is necessary for best results and requires trained personnel. Each animal must be restrained. Each animal must be restrained. Current federal drug regulations require strict accounting for barbiturates and these must be used under the supervision of personnel registered with the US Drug Enforcement Administration (DEA). Current federal drug regulations require strict accounting for barbiturates and these must be used under the supervision of personnel registered with the US Drug Enforcement Administration (DEA). An aesthetically objectionable terminal gasp may occur in unconscious animals. An aesthetically objectionable terminal gasp may occur in unconscious animals. These drugs tend to persist in the carcass and may cause sedation or even death of animals that consume the body. These drugs tend to persist in the carcass and may cause sedation or even death of animals that consume the body.

25. Other Injectable Agents Pentobarbital Combinations: Pentobarbital Combinations: a barbituric acid derivative (usually sodium pentobarbital), with added local anesthetic agents or agents that metabolize to pentobarbital. a barbituric acid derivative (usually sodium pentobarbital), with added local anesthetic agents or agents that metabolize to pentobarbital. These combination products are listed by the DEA as Schedule III drugs, making them somewhat simpler to obtain, store, and administer than Schedule II drugs such as sodium pentobarbital. These combination products are listed by the DEA as Schedule III drugs, making them somewhat simpler to obtain, store, and administer than Schedule II drugs such as sodium pentobarbital.

26. Large Animals Horse euthanasia doesn’t always go as easily as for a dog or cat: Horse euthanasia doesn’t always go as easily as for a dog or cat: The horse is usually standing and can fall to the ground The horse is usually standing and can fall to the ground A 1,000 pound animal falling can be dangerous and unpredictable A 1,000 pound animal falling can be dangerous and unpredictable Sodium Pentobarbital is injected into a vein Sodium Pentobarbital is injected into a vein Horse’s eyes will glaze over in 10 to 20 seconds Horse’s eyes will glaze over in 10 to 20 seconds Horse no longer knows what’s happening Horse no longer knows what’s happening Horse drops to the ground Horse drops to the ground May have some reflex movements after heart stops May have some reflex movements after heart stops