Sunday, February 13, 2011

Euthanasia Day

Euthanasia is so depressing that at my school, they just teach you about it all in one day to separate it from the rest of the curriculum. Apparently it was originally students who came up with the idea for Euthanasia Day; the curriculum at the time did not directly address these issues. Students organized and ran the first several euthanasia symposiums before the school subsumed it into the core curriculum as a requirement. There will be no tests on what we learned on Euthanasia Day, but attendance was taken.

We started the day with the definition of euthanasia, according to the Animal Welfare Act: “the humane destruction of an animal accomplished by a method that produces rapid unconsciousness and subsequent death without evidence of pain or distress, or a method that utilizes anesthesia produced by an agent that causes painless loss of consciousness and subsequent death.” I wish that we had addressed the current debate about use of the term “euthanasia” for anything other than the destruction of an animal for relief of pain or discomfort. I try to refer to “sacrifice” when I am talking about the destruction of research animals in pursuit of research, and “slaughter” when I am talking about the destruction of food animals for food. I have read a book by a dog trainer in which she insists that destruction of a dog for aggression should be called “execution,” which I think is an interesting argument but an awfully charged choice of word.

Next up was the pharmacology of euthanasia: which drugs to use and how. We covered the debate about human execution by lethal injection as it related to veterinary medicine: the AVMA’s euthanasia guidelines have been used in court cases about lethal injection, to the extent that the AVMA chose to edit its guidelines to point out that they were intended for discussion of animal euthanasia only and not human execution. The issue seems to be the difference between mixing three drugs, including a sedative and a paralytic, in one syringe, which the AVMA finds unacceptable for animal euthanasia (what if the paralytic took effect before the sedative? That would not be humane), and the triple injection used in humans, which uses similar drugs. In humans, the three injections are given separately, so there is no chance of the paralytic taking effect before the sedative. However, the AVMA statement that this particular approach is not humane has been taken out of context.

Then we covered the issues in euthanasia in various species.

Horses: It is alarming when they go down! They are big animals, have a long way to fall, and do not often do so gracefully. Do you want the owner to be present for that? Secondly, what do you do with the body? It takes a backhoe to bury it. There are disposal options, but they are expensive and limited. My school lives in fear that the single disposal option available to us will disappear if that company goes out of business.

Wildlife: If you find an injured wild animal on the side of the road, do you bring it in to the clinic knowing that it is too badly injured and will be euthanized there? Is it better to leave it, so as to avoid the stress of being handled by humans? (The veterinarian mentioned all the things you might want to take into account, such as, predators probably won’t come finish it off until evening, so what time of day is it?) We also discussed the emotional difficulty of being a wildlife veterinarian and having to euthanize a wild bird for a damaged wing. If the wing can’t be repaired, the bird can’t be released, even if saving the bird’s life would be easy. Some birds can be placed in educational facilities, but no educational facility is interested in a red tailed hawk, an incredibly common species in this area which makes up the bulk of the birds coming in to our wildlilfe clinic.

Exotics: I almost hesitate to relay this tidbit, as I feel like I must remember it incorrectly. We were told about research in which brain activity was measured in turtles up to 72 hours after decapitation. (Did I remember the number wrong? But you know, even one hour would be pretty incredible.) So how do you humanely euthanize a turtle? Another issue is their extremely slow respiration rate, so that euthanasia in a gas chamber takes a long time too.

Cows: We got to see a video of a cow dying by gunshot and another of a cow dying by injection. Both appeared extremely quick to me. Farmers do often choose the gunshot route, because they like to dispose of the cow’s body under the manure pile. It is obviously not a good idea to have a carcass full of euthanasia medication on your farm: one of our faculty members says that he had to return to one farm after injection euthanasia of a cow to treat the farmer’s dog for pentobarbitol toxicity.

We also had a talk by a certified animal grief counselor. She asked us to do a little role playing. Now, I have been in role playing games for fun and profit (okay, not the profit part), and I had some issues with how poorly structured this role playing was. This has been a recurring issue for me in vet school. I should start a gaming group for faculty.

Finally, we had a panel discussion with local small animal practitioners, which was completely open ended: we just asked questions. As we were wrapping up for the day, the final question was “Can you tell us about the best euthanasia experience you had?” The practitioners sort of looked at each other blankly. Then one volunteered, “I have an experience to tell you about.” She relayed the story of the euthanasia of a long-term patient, an older dog whom she had treated for years. She got a little smile when she said his name; she was clearly very fond of this dog. The owner chose not to be in the room, so it was just her and her tech. They injected the solution and the dog relaxed and was gone. They waited to see if his body would have any last reflexes; sometimes you see a last gasp for breath after the animal is already really dead. And what they saw was a tail wag, a thump thump thump in the same rhythm, she said, as when you come into the room and your old dog greets you. The tech said in amazement, “Did you see that?” And the vet replied, “I think he likes where he’s going.” It was the perfect end to an interesting but emotionally difficult day.

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