Gentle In-Home End-of-Life Care
The Euthanasia Appointment - What to expect
1. Planning What Service You and Your Pet Need
It is best to touch base with Dr. Cushing by sending her an email (email@example.com) and fill her in on what has been going on with your pet. Dr. Cushing will make her best effort to respond to your email with detailed appointment information (that does include pricing) as soon as possible.
Often times it is very clear to the family /pet owner that it is time for their pet's euthanasia. If that tough decision has already been made it is ok to proceed directly to planning the Home Euthanasia appointment with Dr. Cushing.
If you are undecided about the euthanasia decision please let Dr. Cushing know as there is the option to arrange a Quality of Life Phone Consult prior of the home euthanasia appointment or schedule the appointment as a Palliative Care Assessment. A Palliative Care Assessment is an in-person hands-on exam and consultation time with Dr. Cushing about palliative care options that may be available to your pet. A Palliative Care Assessment can be the beginning of on-going hospice care or often times it can clarify the euthanasia decision. This service can be added on to a possible Home Euthanasia appointment. Advanced notice is needed to arrange enough time for a palliative care assessment in conjunction with possible euthanasia and there is an additional fee.
2. Planning The Euthanasia Appointment
After the decision for euthanasia has been made, you will be asked to sign a consent form. This is now offered as a convenient online google.doc that will be emailed in advance of the appointment. The form contains all the information Dr. Cushing needs to prepare for the appointment and after-care. The form indicates that you give your consent 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).
Once Dr. Cushing has your completed consent form she will email you a confirmation email that includes total cost of appointment and after care. Payment is handled at the time of the appointment. Payment by cash/check is preferred, however any major credit card can be processed at the time of the appointment too.
3. Day of The Euthanasia Appointment
Prior to the appointment keep feeding, outing and medication schedule as usual for your pet. It would be good to reserve a few tasty treats for your pet to have during the appointment. If you would like to prepare a blanket or sheet for them to lay in their favorite comfy spot that would be helpful especially if it is a large pet that may need to be transported afterwards.
On the day of the appointment Dr. Cushing will arrive at your home within a 30 minute window of the scheduled appointment time. Precision of arrival time varies due to the unpredictability of house calls and traffic. 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. This discussion is usually 5 or 10 minutes to fill Dr. Cushing in on what has been going on with your pet recently. After that she will go over details of the process with everyone present.
4. Pre-Euthanasia Process
It is very important to Dr. Cushing that your pet not be anxious or in pain, prior to and during euthanasia. Dr. Cushing starts with a medication that is special combination of a sedative, pain reliever and anesthetic. That medication is given by injection under the skin by the neck or by the lower back and induces deep sleep. Pets usually don’t mind this injection, but as with any injection there may be a momentary discomfort. A food distraction for the moment of the needle poke is greatly helpful. This combination of medication induces a gentle drift into pain-free unconsciousness. Drowsiness and a full snoring anesthetized 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 Dr. Cushing has confirmed that the pet is fully asleep with the first medication she will then 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 a quiet spot in the yard. 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). Your pet will not feel any pain or discomfort with this injection. The medication will stop all brain activity then in a very short while the breathing stops and then the heart will stop too. 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. Dr. Cushing can also make an air-dry-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 or pass some stool (pee-pads will be in place in preparation for this).
Dr. Cushing can take care of cremation for you too. She works with a wonderful pet crematory Forget Me Not Crematory in Northboro.
Forget Me Not Cremation options are either:
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
Communal cremation, where your pet is cremated in a group along with other pets and their ashes are cannot be returned
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 stretcher for carrying them to her car.
Recently Dr. Cushing injured her back and is restricted from lifting heavy pets. 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 (private cremation)
If Private Cremation is selected, your pet's ashes are returned in about 7-10 days. They are presented in a beautiful complimentary wooden container. The crematory also has a selection of specialty urns are available for an additional charge. We can arrange to have ashes hand delivered to your usual veterinary hospital (except for Shawsheen Animal Hospital, VCA Wakefield and the emergency referral hospitals), 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 barcode with an identification number by Dr. Cushing. This identification is scanned with 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 local legalities (check with your town). It does require the endeavor of digging a very deep hole. In general it is recommended to have a minimum of 4 feet of earth covering your pet to prevent wild-life activity disturbing your pet. In order to achieve this depth avoid tree roots, areas of ledge, areas near well water or where there has every been standing water. It is advised to call 1-800-DIG-SAFE to make sure you won't be disturbing any buried utilities. It is best to dig the hole in advance of the home euthanasia appointment to make sure you are able to prepare a suitable grave that you pet will be secure in.
Other Pet Crematory Options
It is also an option for you to make your own cremation arrangements with Forget Me Not Crematory or any other pet crematory of your choosing. Rainbow's End in Danvers can offer very personalized service. This option does require that you transport your own pet there and make arrangements in advance of the home euthanasia appointment as Dr. Cushing does not offer body storage.