News reports of a dog's planned euthanasia gone wrong this week led, inevitably, to my e-mail inbox being full of questions: How could that have happened? In what country do we live that a licensed professional can botch something as seemingly "simple" as an overdose of medications delivered by injection?
The story goes like this:
Mia, a ten-year-old Rottweiler from Michigan, had suffered long enough with her crippling arthritis when her owner agreed with her veterinarian that euthanasia would be the most humane option.
And so, the appointment was made and the deed was done. That two injections were administered in accordance with the two-injection protocol most U.S. veterinarians employ for euthanasia is not in dispute. What is in question is how Mia came to regain consciousness the next morning in her owner's garage (after her body had been brought home for a next-day home burial).
How could this have happened? When asked, her veterinarian deferred any comment on the subject until it could be verified that it was indeed Mia that was alive. Apparently, he was as flabbergasted as anyone, and I guess he was hoping that somehow there'd been some kind of confusion and it was not Mia but some other arthritic Rottweiler that had awoken from an extra-deep slumber. (Can't say I blame him for entertaining that kind of extreme wishful thinking though.)
Worse than the vet's stress, of course, was the angst of his owner, who is now forced to contemplate the idea of a second euthanasia procedure (inevitable, right?). And the kids! What do you tell the kids?!
The news of this occurrence wasn't just a problem for Mia's family, but for lots of Fully Vetted readers too. About a dozen of you wrote to inform me of this case and to ask the question that's on all of your minds: how???
It's a big deal, this story. More so because — let's face it — this is a big fear lots of us have. So much so that even a rational practitioner like myself, who's undertaken more than a thousand of these procedures during the course of my career, has experienced nightmares over the incomplete euthanasia of my own pets.
So I get it. I know the prospect of a "partial" euthanasia is nightmare worthy. But it's also far-fetched. Sure, it can happen. But it's rare.
Here's where you might well offer up a rational argument. You might say, "How would you even know? You just seal them up in plastic bags then put them into the freezer." And I guess you'd have a point. So here's what I'd offer in response:
When we euthanize your pet we offer you more than just a two-injection protocol. We also apply our expertise to ensuring that you're emotionally supported during this stressful time, and to the respectful observation of the death process and gentle confirmation of it's occurrence.
In case you ever have any doubt about this (and, as I said earlier, I can understand why you might), here's what I recommend by way of being sure your pet is truly deceased, whether it's in the wake of an unassisted death/accident or by veterinary euthanasia:
1) Absence of a pulse (by manual palpation).
2) Absence of a heartbeat (via stethoscope).
3) The absence of respiratory movements.
4) A change in coloration of the gums from pink to grayish.
5) The onset or rigor mortis ( I personally don't like to place a pet into the freezer until the onset of this unmistakable sign of death).
This is what your veterinarian offers by way of assurance that death has transpired. But lots of times, it's done quietly so that grieving pet owners do not have to suffer the potentially gory details. (You'd be surprised at how many people don't even want to hear an explanation of the process, flinching when I tell them their pet's eyes will remain open.) Yet if ever you feel the need to check for yourself, ask your veterinarian to visibly go through the above steps for your own peace of mind.
If you're in need of even more help on this issue, you may even ask for a pulse oximetry measurement or an EKG. It may not be part of the normal protocol but if you need this degree of confirmation, this technology is always there for you. The EKG and pulse ox will confirm that there is no longer any electrical activity in the heart and that the blood is devoid of oxygen, respectively.
As with everything in vet medicine, you deserve to know that things are as they should be, especially on such an important and final point as death. You deserve that closure. And it's your peace of mind that matters. So just ask!!
As for Mia, I feel for her and her family. Like her vet, I'm still hoping there was some mistake that could explain the experience. But short of the kind of miracle my son is taught about in catechism class, I'm fresh out of ideas for how this might have happened. The most obvious explanation is simple: Mia was under-dosed. And her vitals were not adequately assessed post euthanasia.
For now, I'm just hoping this situation sees a speedy resolution. In the meantime, perhaps this post will help restore any lost faith in my profession you might have suffered. But I wouldn't blame you if you had your qualms.
Dr. Patty Khuly