Gentle In-Home End-of-Life Care
The Euthanasia Appointment - What to expect
1. The Euthanasia Consultation
Dr. Cushing will arrive at your home at the scheduled appointment time. If you have a mobile phone she will text you when she is on the way with an accurate estimated time of arrival.
After greeting your pet, they can relax while you discuss with Dr. Cushing their symptoms and health and whether euthanasia is suitable on this day. If your pet has recently had an appointment (with us or your regular vet) and the decision for euthanasia has already been made, a detailed or repeated consultation may not be necessary, but some discussion and reassurance for your decision is available. If your pet has not been seen by a vet for some time, a consultation regarding their quality of life is needed prior to any final decision. This discussion may be brief or lengthy, taking your and your pet’s situation into consideration. Dr. Cushing will answer questions and offer guidance in helping you make the decision. The euthanasia process will be explained and any further questions that arise will be answered. Naturally, if your pet is in a crisis situation when Dr. Cushing arrives, attending to their welfare takes immediate priority.
It may be clear that euthanasia is the kindest thing to do. However, sometimes the situation is that your pet can benefit from medications or further palliation, or you feel that you are not ready to go through with euthanasia that day. If, after a detailed consultation, you are still uncertain, it may signal that you, or your pet, are not quite ready for euthanasia now. As long as your pet will not needlessly suffer, we can further discuss how you can continue to support their quality of life, and we will arrange to come back for euthanasia another time.
It is important that you are comfortable (as much as possible under such difficult and upsetting circumstances) with your decision. You will not be under any obligation to proceed with euthanasia if not necessary, or to engage in a lengthy consultation when it is clear that euthanasia is required.
2. Consent Form
After the decision to put your pet to sleep has been made, you will be asked to sign a consent form. Your consent gives permission to euthanize your pet, and if you already know, indicates your choice for body aftercare. The consent form also affirms that your pet has not bitten within the last 10 days (a requirement of state rabies law).
Customarily, this is the point where payment for service occurs. Cash, check and credit card payment is accepted.
It is very important to Dr. Cushing that your pet not be anxious or in pain, prior to and during euthanasia. A pre-euthanasia injection to induce sedation is thus routinely given.
The sedative injection is given under the skin by the neck or by the lower back. Pets usually don’t mind this injection, but as with any injection there may be a momentary discomfort. Drowsiness and a full snoring sleep usually happens within 5 to 15 minutes in dogs. Sedation occurs more rapidly in very frail patients, and may take longer in robust or very anxious pets.
Once you have said your good-byes and feel you are ready, Dr. Cushing will proceed with preparing to put your pet to sleep.
Dogs will have an intravenous catheter placed in a vein, usually in the hind leg. A small patch of fur over the vein is clipped. The catheter is placed into the vein and a saline solution is injected to confirm placement.
Cats may or may not require an intravenous catheter. Your pet can be in their favorite resting spot – their bed, on your bed, or the sofa, by a fireplace or in the garden. Sometimes we decide not to disturb your pet from their resting place after sedation. You may hold or hug your pet on your lap or in your arms, or sit next to them gently stroking or just touching them.
When you feel that you are ready, the euthanasia injection is given. This injection is a concentrated barbiturate (a type of general anesthetic) and induces a gentle drift into unconsciousness within seconds. If you yourself have ever had an anesthetic, you will probably recall that the drifting off to anesthesia was rapid and no pain or distress was experienced. Similarly, your pet will not feel any pain or discomfort with this injection. In a very short while the heart and breathing stop. The breathing may suddenly stop, or a few deep breaths may occur before ceasing. The last breath usually happens within seconds, but can take up to a minute from the start of the injection. The heart will then be checked that it too has stopped, after which Dr. Cushing will confirm that your beloved pet has passed away. You may, however, already have sensed that this has occurred.
You will be offered time alone with your pet at this stage, should you wish it. Some people like to keep a tuft of fur as a memento. We can also make a clay paw print mold for you.
The eyes usually remain open (unless they were naturally closed prior to the final injection) and after a few minutes they may void some urine (we have absorption cloths in preparation for this).
If you have a private backyard, and it is legal to do so, you may choose to bury your pet at home. After euthanasia most people choose to have their pet cremated. Dr. Cushing can provide after-care (cremation) arrangements for you.
Cremation options are either:
Communal cremation, where your pet is cremated in a group along with other pets and their ashes are not returned
Private cremation, where your pet is cremated separately from other animals (your pet is the only one in the cremation machine) and his or her ashes are returned to you.
Witnessed cremation, where you make an appointment with the crematorium to be present during your pet's private cremation.
If you would like Dr. Cushing to arrange your pet’s cremation, she will respectfully transport your pet’s body away at the end of the visit. Cats and small to medium dogs are placed in a cozy bed. Dr. Cushing will carry cats and small to medium sized dogs to the vehicle; however some people like to carry their pet themselves.
For larger dogs Dr. Cushing has a sturdy stretchers for carrying them.
If your dog weighs over 35lbs Dr. Cushing will require assistance in carrying them to her vehicle. If you (or any other household or family member) are unable to assist in this, please do let her know in advance as she may need to hire an assistant (there may be an additional fee).
Return of ashes (individual cremation)
If Private Cremation is selected, your pet's ashes are returned in about 7 days. They are presented in a beautiful complimentary wooden container. A selection of specialty urns are available for an additional charge (please let Dr. Cushing know and she can order this for you). We can arrange to have ashes returned to your usual veterinary hospital, your home address by UPS or you can drive to Forget Me Not Crematorium in Northboro MA to personally pick up your pet's ashes. Your pet is assigned a metal tag with an identification number by Dr. Cushing. This identification tag follows your pet through the entire cremation process. This highly organized system ensures your pet's identity every step of the way until your pet's ashes are returned to you.
If you wish to bury your pet at home, you may do so pending practicalities and compliance with general and local legalities (check with your town). In general it is recommended to have a minimum of 4 feet of earth covering your pet and to keep away from trees or areas near well water or standing water.