Today’s VETgirl online veterinary continuing education blog is by guest blogger, Colleen Crockford, MSW, LICSW, a veterinary social worker at Crockford Consulting, LLC. She discusses how

Euthanasias are a challenging time for the veterinary client as well as the veterinary team. When euthanasia is conducted with attention to the human-animal bond, the client and care team can feel reassured of the decision and promote healthy grieving.

Preparation
Research show that increased preparation time given for decisions regarding death and euthanasia will increase comfort with the decision and can help mitigate prolonged grief. Prior to the appointment, the veterinary team can discuss the euthanasia procedure with the client, inquire about any special requests or rituals the client may want, who should be present during the procedure, and body care. This is also a good time to address paperwork and billing arrangements.

A dedicated space for euthanasia procedures is ideal. Consider soft lighting, comfortable places to sit with easy access to animal, including blankets and pillows for sitting on the floor. The décor in the room should be appropriate for the situation and include tissues, resources on normal grief, counseling services, and pet loss support groups. Some clinics use a portable doorbell or other simple mechanism for the client to signal the veterinary team. When dedicated space is not available, consider items that can be easily integrated into an exam room prior to the client’s arrival. Note which exam room was used for the euthanasia and avoid that room for future veterinary appointments.

Procedure
It is recommended that two veterinary professionals conduct a client-present euthanasia; one to focus on the medical procedure and one to support the client. This team could also consist of a veterinarian and a veterinary social worker. Alert the rest of the clinic that a euthanasia is in process and request their participation in respecting the client. Some clinics turn on an electronic candle at reception with an informational sign.

Escort clients into the procedure room immediately to avoid the waiting area. Complete preparatory work on the animal and return the animal to the room. Offer to leave the room for the client to have a final goodbye. Indicate when you will return, ‘in ten minutes time’ or explain the method the client can use to signal the team that they are ready. Ask permission to begin in a calm and quiet voice. The client support person should position themselves near the client to provide emotional and physical support if needed.

Verbal and non-verbal communication is important during the procedure. Be mindful of your tone, volume, and body language. Before beginning the veterinarian can state that they will be starting the procedure. This can be a very stressful time and a reassuring message from the team can be helpful – “This is a very challenging moment and we have all agreed this is what is best for Shadow. Let’s take a deep breath and say one last goodbye.” As each step is conducted, inform the client what is happening. After the last injection is administered the veterinarian can listen for a final heartbeat and pronounce death in a clear simple statement, “Michael, Shadow is dead.”

The client may react with sobbing, gasping, sighs of relief or little to no observable emotion. This can be a good time to provide reassuring messages to the client about their decision and reflect on their relationship with the animal, “I’m really going to miss Shadow too.” Clients may want to reminisce about their companion animal which is helpful in the grieving process. The team is encouraged to listen and share memories.

Offer to let clients clip fur, take collars, take photos, or make pawprints as final mementos. Encourage clients to take information on after care supports. Allow time for clients to grieve and leave the clinic on their own terms. Clients will appreciate an exit that doesn’t pass through the waiting area if available. Wait until the client has left to remove or handle the animal’s body. Once final care has been taken, check in with your team to debrief on the procedure and assess team wellness.

A thoughtful and well planned euthanasia can leave the client feeling comforted during one of the most challenging decisions in their animal’s life. Furthermore, the veterinary team can feel confident that they provided a supportive experience for their client.

References for this article and resources for further reading:

Colorado State University – Argus Institute. Making Decisions Resource Guide.

Lagoni, L., Butler, C. & Hetts, S. (1994) The Human-Animal Bond and Grief. Philadelphia: W.B. Saunders Company

Lagoni, L. & Durrance, D. (2011) Connecting with Grieving Clients. Lakewood: American Animal Hospital Association Press

Colleen Crockford, MSW, LICSW

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