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September 26, 2011

1:34
P.M.

How kind is at-home pet euthanasia?

Total Responses: 18

About the hosts

About the host

Host: Dr. Krisi Erwin

Dr. Krisi Erwin

Dr. Krisi Erwin has lived her entire life in Loudoun County, Virginia. She received her Bachelor of Science degree from Longwood College in 2000 and her Doctorate of Veterinary Medicine from the Virginia-Maryland Regional College of Veterinary Medicine in 2003. She became a Certified Veterinary Acupuncturist through the International Veterinary Acupuncture Society in 2008 and a Certified Canine Rehabilitation Therapist through the Canine Rehabilitation Institute in 2009. Dr. Erwin belongs to several professional organizations including: the American Veterinary Medical Association, the International Veterinary Acupuncture Society, the International Association for Animal Hospice and Palliative Care, the International Veterinary Academy of Pain Management, the Association for Pet Loss and Bereavement and the American Holistic Veterinary Medical Association.

About the topic

Chat with Dr. Krisi Erwin, a veterinarian who performs end-of-life house calls for those who want more for their pets' last moments than a frightened scrabble on a cold steel exam table. Ask questions about the procedure, the growing popularity of these house calls and more. Also discuss if you think euthanasia at home is "kinder" than euthanasia in a veterinarian's office.

Related: At-home pet euthanasia grows in popularity
Q.

Dr. Krisi Erwin :

Hello everyone! I just wanted to let you know that I am now logged in and will take few minutes to read everybody's questions and respond. Thank you all in advance for your interest and I will do the best I can to help!

Q.

Thank you!

This is a great idea, and I thank Dr. Erwin and the other vets who offer this service. It must be heartbreaking work, but it is necessary. Most of the pets we've had to euthanize (small mammals) have been so out of it that they were unaware of where they were, but our rabbit was a different story. He was terrified the entire time. He hated any sort of change, and car rides and vet visits most of all. I felt awful that his last moments were filled with deep fear that made him cower. If we had been able to utilize this kind of service, I would have jumped on it.
A.
Dr. Krisi Erwin :

Hi there,

I am so very sorry for the loss of all of your critters in past years, but especially for the experience with your bunny. I think that, as pet parents, we have to give ourselves some credit for making the best decisions that we could at the time with the information you had at hand. I believe that our bonds with our pets is so deep and we easily forgive them for any "mistakes" that they may make during their time with us. It then seems logical to assume that forgiveness would flow from them to us if there was indeed a mistake. We just put a lot of pressure on ourselves to be perfect in the decisions we make for those we care for. I am thankful that more services are out there to help you prevent another situation like this in the future but I am sure that your bun is frolicking away waiting at Rainbow Bridge and any last minute fears have been long forgotten.

– September 26, 2011 1:39 PM
Q.

Home Euthanasia vs Vet's Office

I can see the benefits to home euthanization. But isn't there also a benefit to having it performed by the vet who has seen my pet for its entire life?
A.
Dr. Krisi Erwin :

Absolutely! In my perfect world, the regular veterinarians would be the ones to come to the home and perform the euthanasia for those who want it done at home. Unfortunately, as my 8 years in private practice have shown me, it is sometimes very difficult to have time and staff avaialable to do this. Also, some veterinarians aren't comfortable performing euthanasia away from the clinic. In these cases, it is best to find someone who is comfortable performing euthanasia at home and it may be worthwhile (if time permits) to set up a "consult" in advance so that way you can meet the doctor ahead of time and work out a plan. This would make it a lot less scary and help you to feel more in control when the actual event happens.

– September 26, 2011 1:42 PM
Q.

TK PK MD

No question just a comment: I find it highly ironic that I just made a round on phone calls to veterinarians on this very subject last week. I have a cat that has been hit with two untreatable conditions. Although his quality of life is good today, his health is very fragile and could deteriorate on a moments notice. He is very reticent about anything outside his realm of familiarity. And he utterly despises going to the animal hospital. I just couldn't bear the thought of that being the last experience he would have of life. With any luck he will pass away in his sleep, but it is good to know that there are alternatives that are far less traumatic if they become necessary. Thanks for the article.
A.
Dr. Krisi Erwin :

I am very sorry that your cat has been diagnosed with such difficult conditions. I believe that you are being very fair in your assessment of what to do, as sometimes the treatment (if there is one available) truly can outweigh the disease. I find this especially true in cats that get very stressed with doctor visits. I hope that your kitty is able to stay comfortable for as long as possible, and don't be afraid to lean on one of the housecall vets if you need support, have questions, or do need help with his final transition. You'll be in my thoughts!

– September 26, 2011 1:44 PM
Q.

When going to a vet's office is the only choice...

Reading the article was difficult, to say the least. I noticed in the comments many complaining that scheduling on short notice was often a problem and that the only alternative seemed to be to wait a few days, thus extending the animal's agony, or to to deal with the clinical, cold environment of the vet's office. I don't know how common this is among vet offices in the area but two years ago, when we said goodbye to our beloved cat, I was very grateful that the VCA in Gaithersburg had a lovely, private furnished room in which we were able to hold her and spend as much time as we wanted with her before, during and after. Not quite as comforting as home, but a far cry better than the "cold steel exam table." I was grateful for that option and am grateful for the service you provide. Hope it is a long, long time before I have to think about it, but will definitely consider this when that time inevitably comes.
A.
Dr. Krisi Erwin :

I am very thankful for you that the VCA was able to provide you the service you needed in a compassionate and comforting manner. One of the hopes, among the hospice and home euthanasia vets, is that we can get the word out there to help educate other day practices and emergency facilities on how to take care of the whole family during this time. This means providing flexible scheduling (nobody should have to wait for days when it is time for euthanasia), comfortable environment, and having a staff that is prepared to help families when they are in the midst of acute grief. This is not a fun situation, but it can be so much less scary and so much more comfortable if people will just take the time to give families and their pet just a bit more TLC.

– September 26, 2011 1:46 PM
Q.

Logistics

I think the idea of at-home euthanasia is lovely, and we've done it for a couple of my mom's cats over the years. Unfortunately when the time came for our beloved Leonberger (about 100 lbs) we just couldn't get past one logistical hurdle: the notion that my grieving husband would have to carry the body of his beloved dog to the car and drive it to a 'funeral home'. No one else (including the vet who offered the in-home service) could carry a 100 lb animal, but it just seemed too cruel to force my husband to do that. Instead we went to the vet's office and lay on the ground with our boy until he passed, then lay there some more until we were ready to leave. It was brutal and we miss him every day. Just wanted to share that sometimes it's not so logistically easy to do what is our emotional preference.
A.
Dr. Krisi Erwin :

I am sorry that you guys had to deal with that "hurdle" and I can only imagine how much you miss your boy. I hope that this situation will change in the future for families as more veterinarians are probing deeper into the realm of recognizing the "4th stage of life" as a pets end of life and how we can make that time and transition as gentle as possible. At our practice, Wholistic Paws Veterinary Services, we have made arrangements so that we can transport all of our pets to a local crematory ourselves, pick them up when the cremation is finished, and then take them home when the family is ready. Even with a small pet, the drive to the crematory can be brutal and we would rather take on that responsibility for our families to provide that last bit of comfort care and respect for their pet. I hope more home euthanasia practices will pick up on this trend to help avoid this situation for other families. Thanks so much for your in put and keep loving your boy. The bond isn't broken just because he is no longer physically here!

– September 26, 2011 1:50 PM
Q.

Thanks for this. (No thanks for other things.)

I sincerely appreciate all you do with this at home end-of-life service. My problem is with vets who convince someone to spend thousands and thousands of dollars on hip surgery or cancer treatment on 15 year old dogs. Your job (vets in general) is to convince the pet's caretakers that this is a really bad idea and just adds suffering for all those concerned.
A.
Dr. Krisi Erwin :

Hi there,

Thanks so much for your input and view point. In veterinary medicine, we have typically been looking at a pet's lifespan in 3 stages: puppyhood/kittenhood, adult, and senior. There is a movement amongst the hospice veterinarians to introduce a 4th stage to account for end of life. I am hoping as this becomes more widespread and more veterinarians accept this, they will be better able to have conversations with families about their pet's quality of life and condition so they can come to the best decision for their pet and their family. However, these conversations are very personal and individual and care does need to be tailored to that specific scenario. I hope these conversations become more fluid and helpful to families as the end of life care movement has a chance to blossom.

– September 26, 2011 1:57 PM
Q.

Acupuncture

I have a question on a separate topic. I have been fascinated by acupuncture ever since a neighbor spent years seeking treatment after a stroke. It was acupuncture surgery in China that restored much of his functions. How common is acupuncture for animals? What types surgeries are done with acupuncture?
A.
Dr. Krisi Erwin :

Thanks so much for a great questions! Acupuncture is becoming increasingly more common for animals and can help many conditions, including arthritis, disc disease, kidney disease, asthma, and acute strains and sprains. It can also be very helpful for conditioning athletes as well. I am alittle bit confused about the term "acupuncture surgery," however. Pets do not need to be sedated or anesthetized for acupuncture treatments and most seem to really enjoy it. You can check out the website for the International Veterinary Acupuncture Society (www.ivas.org) or my website (www.wholisticpawsvet.com) for some frequently asked questions about acupuncture as well if you would like to learn more!

– September 26, 2011 2:03 PM
Q.

Euthanasia

Our lurcher hated going to the vets. Then we found a vet who made housecalls in a mobile clinic. When our dog got sick (he was 15) and clearly was not going to recover, out vet came to our home to euthanize him and for that we are eternally grateful. He died with us around him in a familiar place. We should all be so fortunate.
A.
Dr. Krisi Erwin :

I am so very thankful that a tough situation was made a bit better for you by being comfy at home with your dog. Celebrate him...I am sure he was and is a huge part of who you are today and I appreciate all you did for him.

– September 26, 2011 2:04 PM
Q.

How to know when it's time

Hi Dr. Erwin - We recently had to put one of our two elderly dogs to sleep. Our family was able to come to the house to do the procedure, which was nice. Our other dog is blind and deaf, but other than that seems physically pretty well for a 15 year old pug. Do you think keeping a blind and deaf dog around is cruel, if otherwise she seems well?
A.
Dr. Krisi Erwin :

The decisions surrounding quality of life can be very tricky. As her pet parent, you should trust yourself that you know her better than anybody else on this planet. However, sometimes it is hard to maintain objectivity when we are in the midst of dealing with a failing pet. I would encourage your family to make daily or weekly (whichever seems appropirate) assessments of how your puglet is doing. I would pick 5 things that she likes to do and that you feel give her good quality of life. When you are making your assessments, keep these things in mind as well as some basic things such as: Is  she eating and drinking well? Can she go outside to potty or is she soiling in the house? Does she show interest in the family and what is going on or does she separate and isolate herself from you? Based on looking at these things, you can then give her a grade (i.e. 1-10 with one being poor quality of life and 10 being fantastic or by using a smiley face/straight face/sad face). Keep track of her grades, if they begin to slip down below 6 or so or if she is mostly having straight faces and sad faces, it might be time to think about making a decision.

Here are some resources for you as you navigate these tricky waters:

Dr. Alice Villalobos' Quality of Life Scale:

http://www.veterinarypracticenews.com/vet-practice-news-columns/bond-beyond/quality-of-life-scale.aspx

The book: Living with Blind Dogs is available through Amazon.com and is a great resource for families.

Also, my website has a lot of links and articles surrounding end of life issues and might shed some light as well:

www.wholisticpawsvet.com

Good luck and please don't hesitate to contact me, or another veterinarian who is "tuned in" to these issues if you need some back up!

– September 26, 2011 2:10 PM
Q.

Teaching kids

I think the location of euthanasia is up to the pet parents and I'm glad this is available for those who want it. I'd just like to state that whether it be at home or the clinic, it's good for proper-aged children to see the completion of the cycle of life (and none of this "the pet is living on a farm now" stuff). However, I think all involved should know how to deal with kids. Recently, we had to put down our pet. The lab tests came back Monday and we scheduled it for a Saturday (so the kids could get closure). One child (a bit over 8 years old) asked to come with me to the vet's. We explained what was going to happen and the child was ready. However, at the clinic, the vet tech said "The doctor is going to put some medicine in the pet's vein and the pet is going to go to sleep." Come on, medicine is for healing and sleep is what you do at night. Fortunately, this didn't cause any problems at home but it so could have.
A.
Dr. Krisi Erwin :

Thank you so much for this input! Eveyone seems to get a bit "squeemish" when it comes talking with our children about death. However, for families with children, your pet's final gift to you is to provide a platform to safely and compassionately teach your children healthy ways of grieving  and coping with loss. This will help them to deal with the losses that we all will face during our lives in a much more healthy manner. Parents, remember, you don't have to perfect in how you explain things to your child and it is certainly ok for them to see you cry. It helps to normalize what they are feeling. Also, please don't hide what is happening as your pet may be a special confidant and companion and your child (based on age and maturity) should have a chance to say goodbye. The following websites have some excellent information on helping children cope:

The Association for Pet Loss and Bereavement:

www.aplb.org

The Argus Institute:

www.argusinstitute.colostate.edu

Wholistic Paws Veterinary Services:

www.wholisticpawsvet.com

Thanks again for your input and I appreciate that you included your children in what was happening. I do agree that the term "put to sleep" or "special medicine" should be avoiding when speaking with children as it can sometimes lead to fears about going to bed or taking medicines for themselves in the future. Again, I am so sorry for your loss as well.

– September 26, 2011 2:16 PM
Q.

Possible Problems

What are the risks of having an at-home euthanasia? It seems to me it would be easy for unqualified practitioners, which would increase the risk that the euthanasia would fail.
A.
Dr. Krisi Erwin :

In terms of risks, I think that ultimately the end outcome would be the same regardless of "qualification." However, the middle part of the journey may vary drastically if you are using a veterinarian that is not comfortable with performing euthanasia at home. The whole process of performing an in home euthanasia revolves around caring for the humans as well as the pet. Obviously, you want your pet to exit from this world in a dignified, comfortable, pain free manner. However, as a pet parent, it is ok to need some "hand holding" as well. I encourage you to discuss these concerns with your veterinarian or have a consult (either in person or over the phone) with a home veterinarian that you might consider using. These conversations should be a safe launching ground for you to express your concerns and questions that you might have about the process. Also, it will give you an opportunity to see if that person is a good mix for you in regards to personality. Outside of care of the human, some logistical issues that can come up during a home euthanasia might be something as simple as finding a vein for the final injection. It is definitely worth asking your veterinarian to make sure they are comfortable and experienced in doing this in a home setting.

– September 26, 2011 2:22 PM
Q.

How kind is at-home pet euthanasia?

Thank you what a wonderful idea. When we had to put our beloved Cisco dog to sleep, we had had 17 wonderful years with him. We were very fortunate to have a very kind and understanding vet and he gave us time with Cisco before and after, but it was still very difficult to leave him there. We received his ashes several weeks later with a wonderful letter, but... So when it came time for our beloved Midnight cat, 16 years, we went to our vet again but this time we brought Midnight home and my most wonderful brother built a fire and we cremated her with a very loving and moving ceremony. The next morning my son and I (he was very close to her) gathered her ashes. It was very helpful to know we actually could do this.
A.
Dr. Krisi Erwin :

That is very beautiful what you were able to do for both Cisco and Midnight and I am thankful that the cremation at home went well. However, I would warn the general populace that fires at home typically do not burn hot enough to provide a complete cremation, especially for a larger animal. An alternative option for families might be to transport their pet to one of the local crematories that can do the cremation while the family waits or within a few hours of taking your pet to them. How things went with Midnight is great and I am sure it was healing to provide for her care the way that you did. I would worry, though, that it may not always go so smoothly. Thanks again for sharing Midnight and Cisco's stories with us- all of our relationships are about just that...honoring the story.

– September 26, 2011 2:25 PM
Q.

At-home euthanasia

Thank you for doing this for families. We had to take in a beloved little pug last year, and it's actually still very difficult for me to go back to the vet with our other dogs, and I have asked to no longer go to the room where it happened. I have a feeling that we're going to be losing a second dog soon, and I'm thinking this will be our preferred way - he loves one chair in particular.
A.
Dr. Krisi Erwin :

There really is no right or wrong when it comes to the location of the euthanasia. It truly depends on the pet, the families wishes, and their relationship with the veterinarian. Your difficulties about going into the veterinary clinic after a euthanasia are very common and many people wrestle with the same thing. I would encourage you to try and repaint your perspective a bit and try to think about the exam room where your puglet passed away as a sacred place. It is where his or her spirit moved on to be free from a body that was no longer working. That may help to alleviate some of the aversion to being in that area. For your current dog, trust your instincts and I encourage you to scope out your options ahead of time so that you can be as prepared as possible for when that inevitable, heartbreaking time comes. The more informed and prepared you are, the more empowered you will be to make it the best possible situation for your dog and your family.

– September 26, 2011 2:29 PM
Q.

Woodbridge

I wish I had known about this last year. I had to get my own self together before taking one of our cats to the vet for the last time. Driving and crying don't go well together.
A.
Dr. Krisi Erwin :

I totally understand. Hopefully by getting the word out that this is an option for families, it will help to avoid the devastating drive home and also provide the families with the privacy and dignity they deserve as they say goodbye to their pets. I am sorry for your loss.

– September 26, 2011 2:30 PM
Q.

Beloved pets

Really just a comment. Thank you for getting this topic out there. Our 11 year old beloved chocolate lab is slowing down and the inevitable is around the corner. It is such a comfort to know that there is an option out there. We are devoted pet parents and would not deny him the extra expense for a dignified end in his home. Keep getting the message out there!
A.
Dr. Krisi Erwin :

Thank you for the encouragement and keep loving your furbaby!

– September 26, 2011 2:31 PM
Q.

The best choice

We were fortunate to have a mobile vet who routinely treated our dogs at our home in Helena, Mt. When it was time for Tubbs, he died quickly and peacefully. Our dog Theo was an emergency euthanisa and it had to be performed in a clinic in Louisville. A third dog, Star died peacefully on her bed with a wonderful vet performing the proceedure. She then removed Star for cremation. Much to our suprise, when we went to pick up Star's ashes, the staff had made and painted gold, a plaster paw print of our special critter. If at all possible we will always use the in-home option for our pets final act of love.
A.
Dr. Krisi Erwin :

That is so beautiful. Thanks for sharing your stories with us all. Unfortunately, there will always be times when emergencies happen and to do the euthanasia at home is not an option. However, I appreciate your commitment to giving your fur kids the best comfort that you can.

– September 26, 2011 2:37 PM
Q.

Hope your practice is more than euthanasia

Dr Erwin- I inferred from the article that the vets mentioned do only euthanasias- if that is the case, I hope you incorporate wellness and treating the sick as well or you will soon grow depressed and burn out. I am a housecall vet in Stafford VA since 1990. There are times that there are so many euthanasias, it truly gets overwhelming. You are very young, take care of your spirit! Carole Nicholson DVM - Home Vet Care of Stafford
A.
Dr. Krisi Erwin :

Thanks very much for the words of caution! I truly do recognize the risk of compassion fatigue and have tried to balance things out so that I don't get burned out. I cannot speak for the other doctor in the article, but my practice is limited to acupuncture, rehabilitation, hospice and euthanasia. While the hospice and euthanasias are emotionally "heavy", the acupuncture and rehab cases tend to be a lot of fun and allow a good chance to bond with pets and their families under "happier" circumstances. However, it has been an honor and a privelage to walk beside my families during the final leg of their pet's journey as well.

– September 26, 2011 2:39 PM
Q.

Worth the extra $$

Hi Dr. Erwin, we just lost the second of our PBGVs last month. When we lost our first one three years ago, we did it at the vet's office, and it was very well done. This time we were offered the option of doing it at home. We decided it would be better than making her take one last ride to the vets, probably terrified. We chose a spot in the back yard where our sweet dog (age 15) used to go regularly to visit with our neighbor's Labs. It was really nice, the weather cooperated and we got to carry her to our vet's car where she was wrapped tenderly in a blanket. She just looked like she was sleeping. We were very pleased we chose to do this at home.
A.
Dr. Krisi Erwin :

I am sorry for you loss but I am very thankful that you were able to allow your girl to pass in a manner appropriate for you all. I hope that you are able to plant some flowers or place a bench in that area so it can become a place of reflection and remembrance!

– September 26, 2011 2:40 PM
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