I walked away from rounds today feeling kind of raw and annoyed, and I'm trying to get it out of my brain in a coherent, nonjudgmental way. First of all, I love the clinician in charge of our emergency rotation and rounds. She's a very nice, helpful and instructive person. But tonight during rounds she said something that kind of got my back up a bit.
We were discussing euthanasia and situations where it would be appropriate to not put in a catheter and administer sedatives before the euthanasia solution. Fractious/aggressive animals, severe respiratory distress cats, bleeding risks, etc. were all brought up. But then one of my group mates said, "Exotics and small animals." Now, I agree about the catheter but I strongly disagree about not offering sedation for those patients, so I said so and gave an anecdote about how I was very unhappy with the euthanasia experience with my four rats, watching them struggle and fight the inhalant anesthesia with no pre-meds.
The clinician then said, "Well, exotic euthanasias are always going to be bad and I wouldn't let an owner back there to watch."
She undermined the exact point I was trying to make, and I felt sort of dismissed. I was trying to point out that owners of exotic pets want just as good of treatment for their snake/lizard/rodent/ferret as the owner of a shih tzu. We don't appreciate our animals being treated as something apart from "normal" pets. And I definitely didn't appreciate hearing her write off exotic euthanasias as "difficult" as though we shouldn't even try to make improvements so that the experience is less stressful. And then to go a step further and write off the client as just simply not allowed to be with their pet and see them out of this world... I was kind of flabberghasted, to be honest.
I've heard of exotic animals being given an IM injection of sedative and their owners sitting in a dim, quiet room for 15-20 minutes until the animal is sufficiently calm enough to take gas anesthetic without a struggle. Yes, that eats up time for your clinic where you could be taking other appointments. But it should say something to you that the owner of a $5 gerbil is willing to pay the additional expense for the injection and spend a half hour sitting alone in a dark room talking to and kissing and saying goodbye to their pet. These aren't cases you get to just dismiss as "difficult" and take in the back while the owner sobs their heart out in the parking lot. That is just lazy and not the best standard of care we can offer.
I was very distressed that I couldn't be with my zebra finch. She was the only one that I euthanized. The rest died suddenly and unexpectedly. She was the bitchiest of my females and the last of a group of four that I adopted together, and I really didn't want to abandon her.
ReplyDeleteAlso, I was afraid they were going to do something like snapping her neck. I have no idea if they did that but I'll never take a zebra finch for euthanasia again.
The only reason I was allowed back with my rats was because I was a vet student who worked with the veterinarian on several occasions. Normal clients were not allowed to be present for rat euthanasias.
DeleteI think if they would at least have promised that she wouldn't suffer I could have been okay with it.
Deletep.s. not a reply but have you seen this dolphin video yet? http://www.youtube.com/watch?v=CCXx2bNk6UA
DeleteThat attitude is really frustrating, and you will (sadly) encounter it throughout your career, both from colleagues and from clients.
ReplyDeleteI have the only clinic in a fairly large area that will see exotics - I'm not a specialist, but I do what I can.
With all of our euthanasias (large animal, small animal, exotic) I give the client the option of being present or leaving the room, and if they want to be present, I explain what I will be doing and what to expect. I do not place catheters or sedate most of our euthanasias, unless they are very fractious - ironically, one of the exceptions you made. Sedating a fractious animal allows me to give an IV injection safely with much less struggling on the part of the pet. But in most cases, we just give the Fatal Plus IV and everything is quick and quiet. For very small exotics (and some cats) where finding a vein (or restraining for venipuncture) is not feasible, we give the Fatal Plus IP (or intracoelimically) and allow the owner to sit with them until they pass, which is generally a very quiet 3-10 minutes in which the animal gets sleepy, falls asleep, and then dies.
I heard all the same horror stories I'm sure you've been told about IP injections being horrible, and was pretty leery about it when my boss just out of school suggested it, but I have honestly NEVER seen a patient freak-out, go through pronounced excitement, or do anything other than get progressively sleepier. If restraint is an issue, I may offer to take the pet in the back to administer the injection, and then bring it back to the owner.
Euthanasia is probably not the best time to be clinic shopping, but a little kindness, respect, and an explanation of what's happening during that experience can certainly make the difference in what clinic the go to with their next pet!
I did IP injections on feral/very old/very ill (dehydrated) cats or very small kitten when I worked at a shelter. I agree, we were always warned that there could be freak outs, but I never saw that. Usually one of us just sat with the cat (obviously not the feral ones) under a towel in our laps and talked softly to them until they were gone. I think it's a humane option for euthanasia of small exotics.
DeleteThe inhalant anesthesia I mentioned was for heart sticks. I think an IM sedative beforehand is the more humane option than just shoving their face in a smelly mask and holding them down while they struggle.
It takes a little longer, but they seem to struggle less if you box them instead of holding them - just get a small rubber maid box, cut a hole in it for the adapter to plug the anesthetic hose to, and put a towel over the box so it's dark and quiet. We have 3 different sizes of boxes for different sizes of patients.
DeleteWe have never been allowed to be with our birds when they were being euthanized. Just had to sit in the waiting room until they brought us the dreaded box. I have never appreciated the complete disregard from vet clinics for small exotics. Most just look annoyed when one of the birds needs care.
ReplyDelete