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The euthanasia procedure.

Species: Cat
Breed: Mixed
Age: More than 15 ye
I had to euthanize my 18.5 year old cat Quincy on Monday. He suffered from CRF and hyperthyroidism. He was quite dehydrated at the end and he was quite constipated over the Christmas weekend, poor thing. It was clearly "time". I live in NYC.

My concerns have to do with the way the euthanization went, because it was not nearly the "peaceful" experience I had been expecting.

When Quincy was given his first of the two shots in the euthanization process, the Dr. and tech/assistant quickly left the room to give me privacy with him. I was very broken up, of course, given that I've had him a long time. But I vowed I would be with him throughout this process.

Shortly after the Dr. and tech left, Quincy began to quiver a bit. Within another minute or so, his whole body was shaking. He was breathing very shallowly and rapidly, and he struggled mightily to lift his head. He succeeded after a struggle in raising his head for a moment, before exhaling heavily (like a sigh) and putting his head down. After another couple of minutes, he went through this process again where his body would just start shaking and he was struggling. This time, he couldn't lift his head, but it was clear to me he wanted to.

He had one more convulsive fit like this a couple of minutes later, and then finally just laid there, eyes wide open all throughout and his tongue somewhat extended.

In the last couple of minutes before the Dr. and tech returned to the room, Quincy was fairly motionless. I would say he looked like he was in a state of "conscious paralysis", what with his eyes open and still having a blink reflex. He did not appear to be anywhere close to a "sleep state".

Now I've heard that it's not uncommon for pets to keep their eyes open during this process, although given the amount of time cats, in particular, like to sleep, I found that quite odd. But I'm much more concerned with the convulsions/spasms that he was experiencing during the sedation process.

The tech was the first to return to the room and I mentioned what had happened and that Quincy didn't appear to be "sleeping", and she said "why didn't you let us know?". I replied that I -- like any layperson-- don't have a frame of reference as to what is "supposed" to happen during a euthanization. I just wanted to be with him and comfort him during the process, not leave him alone in his last few minutes to go summon help. I'm not convinced they could have done anything, anyway.

The tech summoned the Dr. back in, and the Dr. mumbled something to the effect that he didn't respond well to the sedative (or some such) and quickly prepared/administered the final lethal dose. Within moments after the second injection, Quincy had passed.

I'm so glad my wife wasn't with me as she intended to be, because had she seen this convulsive behavior, she would have freaked out. Again, it was not nearly the experience I was expecting. I do feel guilt that as Quincy's "protector", I ended up leading him into a very uncomfortable end to his life.

I've written to the Vet's senior doctor (it's a regional group of vet facilities) to ask for some kind of plausible explanation as to why this occurred, not in an accusatory tone but for my edification. As of this question to you, they have not responded to my inquiry. It's only been a couple of days, though.

I expressed to the Vet that while everyone there (Dr., tech, and receptionist) were very nice and compassionate, I was concerned about the "process". While I understood them leaving me for my private time, I said that perhaps in the future they should alert people to summon them if they see anything unusual, or even better, to remain in the room post-sedation for a minute or two to be sure that there are no "complications".

Dr. Marie, I'm hoping for candor here, no matter what that entails. If this sounds highly "unusual" to you, I'd like to know that. If you've personally witnessed this before, I'd like to know that, too.

Thank you so much.

Rick Buser

Online vet, Dr. Marie

Dr. Marie replied:

Hi Rick,

I'm sorry to hear of your difficult experience. I can tell by the way that you have written your question that you are not out to villainize anyone but rather to get some peace about the situation.

In my almost 13 years of practice and 12 years before that of working at veterinary clinics I have seen and done a great number of euthanasias. I would say that 95% of them have gone extremely peacefully. Here is what normally happens in a "normal" euthanasia:

  • We give an injection of sedative. Sometimes there can be a tiny amount of discomfort when we give this injection.

  • Within 5-10 minutes the cat gets quite sedated. The goal is to give enough sedative that the cat is calm and quiet but not so much that they are completely comatose. But, sometimes this doesn't go as well as expected. If an animal is quite ill then they may get more sedated than we expect. (I will come back to this later to answer your question better.)

  • Once the animal is sedated I usually have my technician put in a catheter and then I administer the intravenous drug that will stop the heart. Some vets will skip this step. I have learned from experience that this helps make the final injection more peaceful.

  • Usually that injection is extremely peaceful. The animal usually dies by the time the injection is done, but sometimes can take a minute or two longer. They almost never close their eyes.

I have occasionally seen a similar reaction to Quincy's after sedation is given. It sounds like the tremors/convulsions that you were seeing were Quincy's body going through the dying process. Sometimes if an animal is really unwell then the sedation can be the final straw in the body's fight to stay alive. When this happens, the good news is that it is extremely unlikely that Quincy was consciously aware of what was happening. He likely was completely unconscious. It was probably much harder on you than it was on him.

It's a tough call sometimes on whether or not to sedate animals that are really unwell. One one hand, we can possibly cause an animal to start to die like Quincy did. On the other, if we don't give sedation (or give too little) we can have an animal that struggles and fights against the final injection. It's a fine balance and we do our best to get it right, but I can tell you that even with all of the experience that I have, I still occasionally have euthanasias that don't go as well as I would like.

The one issue that I have with what happened to you was the technician's comment that you should have alerted the staff to what was going on. You are correct in thinking that this was not your responsibility. How are you to know what is normal?

We learn from every situation though. Part of the reason why I created this website was to make myself a better vet. Now, I will have my staff explain to people, when they are given their pet after sedation for euthanasia, that if anything seems uncomfortable or unusual to please open the door and alert us.

I'm very sorry that this happened. If this were in my hospital I would likely make a gentle suggestion to the technician that what she said was not appropriate. (With that being said though, it's often very hard for staff to know how to react during a euthanasia and around grieving clients.) I don't feel that the doctor did anything wrong and I don't feel that this was a case of negligence.

I hope that helps you to understand. I'm so sorry for your loss.

Dr. Marie.

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Disclaimer: Although Dr. Marie is a qualified veterinarian, the information found on this site is not meant to replace the advice of your own veterinarian. and Dr. Marie do not accept any responsibility for any loss, damage, injury, death, or disease which may arise from reliance on information contained on this site. Do not use information found on this site for diagnosing or treating your pet. Anything you read here is for information only.

Customer reply:

Thank you so much for your thoughtful and detailed response, Dr. Marie. The thought had occurred to me that perhaps the sedative, itself, was more than his failing body could handle.

Of course, that makes me wonder if I waited too long before making the decision to euthanize him when I did, but up until last weekend he was still doing fairly well (in the relative sense). I mean, it was obvious that he was in decline, but with sub-Q fluids I was giving him and the pet stairs we bought for him, he seemed comfortable enough. We always knew his time was growing short.

It can be a painful judgment call as to the euthanasia timing, as I'm sure you know.

I can't imagine that euthanizing pets as "part of the job" can be routine, even for a physician. There's no way to get around the palpable grief and angst that pet owners arrive with. For that, alone, I applaud people who do what you do.

Thank you again for your thoughts on what happened. Your opinion seems to be the most plausible. You seem like a great vet. Best of luck in your practice.


Online vet, Dr. Marie

Dr. Marie replied:

Thanks for your kind words in your feedback Rick.

It sounds to me like the timing of the euthanasia was exactly as it should be.

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Dr. MarieDr. Marie is a veterinarian who practices in a busy animal hospital in Ottawa, Ontario. She created Ask A Vet Question as a resource for good, accurate veterinary advice online. Dr. Marie treats dogs, cats, hamsters, guinea pigs, and rats. She has been a vet since 1999.

Is an online vet visit just as good as a trip to your veterinarian? No! But, many times, asking an online veterinarian a question can help save you money. While Dr. Marie can't officially diagnose your pet or prescribe medications, she can often advise you on whether a vet visit is necessary. You can also ask Dr. Marie for a second opinion on your pet's condition.