An increasing number of practitioners are making it their business to ensure pets can enjoy more dignified deaths outside of traditional treatment rooms, as Tracey Porter discovers.
The veteran veterinarian remembers each one as if they were her own—Fluffy, Simba, Maggie, Bugsy and Beau. Different species and contrasting characters but bound together by the affection in which they were held. But these were no ordinary pets and they required no routine treatment. Instead, the good doctor was there to perform what would prove the ultimate in compassionate acts, allowing these moribund animals to draw their final breath in the comfort of their own surrounds.
While euthanising animals is often cited as one of the least favoured tasks required of practising veterinarians, it is a space in which specialists such as Dr Marie de Lint are more than happy to operate.
Since launching her in-home pet euthanasia service, LetMeGo, nearly a decade ago, the Dutch-born, Adelaide-based vet estimates that she has assisted more than 580 families with the mercy killing of their pets.
Home is where the heart is
Dr de Lint believes that as with their human counterparts, all adored family pets deserve a peaceful passing in their own “comfort zone” surrounded by their loved ones. Being home means there is no enforced time limit, but there are other advantages too, she argues.
“There is no need to transport a fragile or anxious animal and no need to go to a ‘scary’ vet clinic. There is time for telling funny life stories, remembering adventures, allowing the patient to ‘fall asleep’ (via subcutaneous anaesthetic) first to the point of total relaxation or [sometimes even] snoring. It is my experience that a home euthanasia of the pet makes for a much healthier grieving process for the owners.”
Perth-based Dr Cameron Mortlock, who operates his own in-home euthanasia service, Farewell My Friend, is also adamant that there are many advantages to be had by permitting a favoured dog, cat, rabbit, sheep or goat to die with dignity at home.
There is often an assortment of ailments driving an owner’s decision to end their pet’s life, but most commonly these are associated with old age and poor health, in particular cancer, as well as behavioural-related euthanasias (usually related to aggression) and young pets with congenital defects.
Being forced to visit a clinic or animal hospital for end-of-life care adds anxiety to both owner and animal when emotion is already highly charged and at a time when owners just want their pet’s last moments to be as peaceful and stress-free as possible.
Performing the procedure in their home surrounds goes a long way to achieving this, Dr Mortlock says.
“I can recognise [compassion fatigue] if it is concerning myself… that’s when it’s time to have some time out or go on a long bush walk. I sometimes suspect it in others when they sound harsh, bitter or uncompassionate.”—Dr Marie de Lint, founder, LetMeGo
“There is also a much higher degree of privacy especially for owners when they know they are going to be upset. Owners can choose exactly where and when their pet is going to pass—on their pet bed, in their owner’s arms or lap, or in their favourite place outside. The majority of owners who have experienced a well-performed in-home pet euthanasia would not consider in-hospital euthanasia for any of their future pets.”
Preparing to let go
Dr de Lint says while each specialist operates differently, in most cases text or email contact is usually initiated by the pet owner as he or she attempts to get to grips with their decision. Once contact is made, the specifics behind the request are discussed in detail to determine urgency before the visit is confirmed. At this time, a quality-of-life assessment is also undertaken.
Upon arrival at the scene, Dr de Lint says a “feel-good” cocktail is administered to the pet (the effects of which are easily reversible) before the animal is cocooned in a favoured blanket or alongside a favourite toy. The decision of when to administer the final barbiturate injection intravenously into the hind leg is made by both owner and vet with the final breath usually taken around 10 seconds later.
“I always ask if people would like a paw print or keep a lock of hair. I always have paint, a brush and paper with me and kids especially love to assist with this. Before I leave I check that the family is comfortable with the position the [animal] is in or if they would like assistance wrapping them in a blanket or moving them to another place. It’s very important to me that the deceased patient looks very comfortable, as if they are in a very deep, relaxed sleep.”
At first Dr de Lint says she used to send every family a handwritten homemade sympathy card with a sachet for forget-me-not seeds, but as she is now attending to around 50 clients per month, this is no longer sustainable.
Dr Mortlock, who estimates that he has been involved in around 400 at home euthanisations in the past 12 months, says that clients find his service via a variety of sources including internet searches and a “growing component of word-of-mouth”.
But by far the majority of his clients come to him via referrals from other vet practices, he says. “I imagine this is because many vets don’t actually like having to provide euthanasia services for pets they have known for very long times. I think private practice vets also recognise the value of pets being able to pass comfortably and stress-free in their home and actively want to foster this.”
The cost of caring
The very nature of veterinary work means most vets are immersed in suffering and loss daily, and with ready access to injectable drugs such as Lethabarb are more likely than most to suffer from compassion fatigue.
Registered psychologist Anastasia Goussios, who routinely facilitates awareness workshops designed for the vet profession through her business Compassion Fatigue Australia, describes the insidious illness as “the cost of caring”.
Individual symptoms manifest themselves in an assortment of ways, she says. Signs include emotional exhaustion, an inability to refuel and regenerate, a reduction in empathy, detachment from the work they once loved, absenteeism, presenteeism, sadness, lack of interest in self-care, addiction and persistent physical ailments.
“The majority of owners who have experienced a well performed in-home pet euthanasia would not consider in-hospital euthanasia for any of their future pets.”—Dr Cameron Mortlock, owner, Farewell My Friend
“If compassion fatigue is not addressed, it can lead to depression, which can drive wonderful vets from the profession feeling damaged—and for some who feel hopelessness, suicide becomes an option.”
A statement backed up during the 2013 inquest into the death of dog groomer Donna Cowley-Persch which found the drug commonly used in pet euthanasia, also known as Nembutal, had been used for 293 suicides since 2000.
Goussios says those at the coalface often place the needs of others before their own, resulting in them becoming “immune from their own humanity” and ultimately placing them at a very high risk of developing the traumatic stress disorder. “The irony is that the most conscientious and effective workers are the most vulnerable.
“For veterinary professionals and their teams, the work is not just caring for the animals. It is also about caring for the people who are bonded with the animals they treat. Vets are not trained counsellors and yet sometimes daily, they courageously deal with the emotional fallout of owners who are devastated and overwhelmed by the loss of their animal companions.”
Dr de Lint says despite the fact she performs more euthanasias than most of her peers, her resilience means she has yet to be touched by work-related depression or compassion fatigue.
“I do sometimes get tired when it’s been a big day with more home visits than average but the minute I walk into a client’s home, that family and their very sick pet are the only things that exist.”
Dr de Lint says she also refuses requests to euthanise from those with young, healthy pets—a fact she believes allows her to maintain a healthy perspective about her role.
“I can recognise [compassion fatigue] if it is concerning myself… that’s when it’s time to have some time out or go on a long bush walk. I sometimes suspect it in others when they sound harsh, bitter or uncompassionate when talking about their clients having to deal with [the decision of] their pet’s euthanasia.”
Dr de Lint says it is testing for vets to deal with this in a clinic setting where there’s so much else going on. For She advises colleagues to refer their most demanding, difficult and time-consuming clients to her.
Dr Morgan also believes he has a healthy attitude towards his work. He concedes the cases he finds most difficult are his own pets as well as those that he has been seeing for many years as a mobile vet and formed a bond with. The most heart-wrenching, he says, are pets belonging to “old people living by themselves. You know how much their pet means to them.”
Almost by accident, Dr Morgan believes he has found an effective way to handle the pressure of this line of work by holding firm to the belief that the work he does in this field “makes a difference to both owners and their pets alike.
“In general, I think a degree of emotional detachment is essential and I think you also have to have the right personality for this line of work,” he adds. “You need to be able to work under immense pressure but remain calm and focused on providing what the owners need under often very difficult emotional circumstances.”
In June and September, Anastasia Goussios is running Train the Trainer workshops on compassion fatigue prevention. Visit compassionfatigue.com.au/compassion-fatigue-prevention-train-the-trainer-programme/