Veterinarians and society may be starting to talk more openly about euthanasia. A dark difficult subject at best, it is fraught with the intense emotions of guilt and grief.

Euthanasia is the terminal event of most pet’s lives. Veterinarians claim to be “privileged” that they are “allowed” to do this. The act of euthanasia colours and distorts a veterinarian’s life, adding conflict to healing and life “at all costs”.

A 2015 veterinary presentation on the subject made the claim that euthanasia is not intended to kill – it is intended to end suffering and that death is the unfortunate unintended consequence of this.

This is indeed a weird mental pussyfoot around what we do as humans and as veterinarians. The human term for euthanasia is assisted dying. Death is most certainly intended as the final outcome. That is what is implicitly understood by both terms – we are killing to end suffering is the accepted justification.

Growing up with the constant admonition that Thou Shalt Not Kill may promote our guilt about what we really do as humans to survive, and what is absolutely prevalent in the natural world. I am not saying, run around and kill everything ad lib. But killing is a part of daily life. If you don’t think so, then you are very unaware of where your food comes from.

Socially, I think we have come a long way in reducing violence and unnecessary killing in the world. But we still have to rationalise our way through certain human actions.

Euthanasia is certainly intended to kill. Death is the desired outcome of euthanasia. It always was, and that is why it is such a touchy subject. Death is final. The life is gone and all that is left is grief.

We now openly recognise death should not be an unnecessary or even arbitrary event. The decision to kill is not light. Every life is precious. Veterinarians have moved on from the somewhat callous euthanasia events, now declining what we call “convenience” euthanasia, and only wanting to do euthanasia to end suffering. As pet owners and veterinarians, we are talking about what is suffering, and what really does constitute quality of life and how to make those judgement calls. We are now advocating that we do not extend suffering by performing medical or surgical intervention procedures that may not improve outcome in sick patients.

This is big improvement. Sixteen years ago, nobody was talking. Euthanasia, and the distress we feel around it, was almost a taboo subject. The unspoken, unaddressed grief and mental distress causes much suffering in itself, a major reason for the high depression and suicide rate within the profession; and probably the most stated reason for leaving the profession at that time. Now we are beginning to openly talk about “compassion fatigue”, of which euthanasia is only one contributing factor.

Convenience euthanasia used to be more common. This was the act of euthanasia, death intended, done because the animal was no longer wanted for a multitude of reasons. This started changing with society, when both animal shelters and veterinarians started voicing their distress. I used to tell people that I did not go to vet school just to kill animals.

The toll euthanasia takes on the people doing it is huge. Many clients will voice this – “This must be the hardest part of your job!” Yes, it is, actually. Whilst I say killing is a part of life, killing is never a pleasant act. It is done out of absolute necessity. How we define that necessity is part of our mental conundrum when we are faced with having to kill. Thus we have a plethora of spiritual, rational and irrational arguments around the subject. To end suffering is the most common veterinary justification, and one that appears to be emotionally and ethically acceptable to almost everyone. Humans can choose to die, but we make that choice for animals under our care.

This justification debate still rages in the human medical world – it must. The medical profession is aware of what happened in veterinary medicine, and must do all it can to prevent “convenience” euthanasia becoming a terminal event of a human life. The veterinary profession certainly showed how easy the mental traps were to make this justification! So whilst many people may consider that euthanasia should be an option for people too, we need to be discussing with an open mind the emotions surrounding this whole subject and what are reasonable controls and decision-making tools surrounding the euthanasia decision. Currently, only a few countries in the world are brave enough to be doing this.

Euthanasia intentionally causes death. The aim of euthanasia is a “good death”. What is a good death, then? Most would agree it is painless, stress-free and peaceful; a gentle slip away into oblivion surrounded by loved ones; preferably at home.

When I give that injection, I take a life. The entire day will have been coloured by the decision and the knowledge of what will be happening. I am already grieving and depressed when I give the pre-sedation. There is no going back after that pre-sedation. Watching the cat sink into the sleep is heart-breaking. All that I hope for is that it is rapid, and does not draw out into a woozy drug fight, that this will be a good death.” True compassion”, says Death,” is a sharp blade.” (Terry Pratchett). To achieve that, euthanasia is a skill practiced and honed and adapted for constant improvement on a daily basis.

As the barbiturate IV starts, I have to empty my mind, and accept the leaving life. You can feel the life leave, and there can be nothing more distressing than if it was not peaceful and gentle. The sense of finality is draining. Doing this almost every day leaves me living in a cloud of grief. All the veterinary staff experience this. There is no sadder event. Each time, I will be a little changed, altered. Almost like it is possible to lose a little of yourself; to tend towards a crueler, more callous person; to become inured to what is actually happening. It is important that death and the killing do not become routine, to keep each event unique, that each life has to be honored and cared for.

There is probably not a single veterinarian that went to vet school who is not a caring, sensitive and compassionate individual. This is a tough profession to be in, warts and prickles are inevitable. We are asked to accept the cognitive dissonances of factory farming, slaughter, doing everything we can to save a life, and euthanasia.

We can be talking more about how we feel, listening more to the owners about their euthanasia experiences, and teaching solid coping skills to our colleagues. Frank and open discussions with everyone about euthanasia, including our human medical colleagues, and in particular, what it feels like to be the killer, may help guide us into better procedures, ease the grief, provide better coping mechanisms and support groups, and guide us through the quagmire of ethics behind human and animal euthanasia.

Exploring societal attitudes to euthanasia, within cultures, during wartime, and how much (if at all) we have changed, may be a fascinating if dark topic.

Contribute to this discussion!

Edward(20) helps me study feline medicine

Edward(20) reviews current feline medicine

Joanna Swabe, in her book “Human-animal relations and the rise of veterinary medicine” (Routledge, 1999) has this to say:

“…perhaps one of the most interesting developments in veterinary medical science during the twentieth century has been the rise of feline medicine.”

We happen to think so too! There are a lot of contributing factors, societal changes and changes in attitudes in both veterinarians and cat owners that have made this possible.

I have opened a Facebook page for us to enter the discussion on what some of these changes have been. This forum is for us to comment on what we experienced growing up as cat owners, as feline veterinarians in the early days of the field, and as feline veterinarians and cat owners today.

Post your comments, and get your friends involved! Talk frankly about what it was like to be a cat owner and a cat vet 30, 40, 50 years ago….and now, what is the difference?

Back in my day – Cornell Summer 2013

 It was the last lecture on a Saturday night and a tired-looking old man in a blue suit took the seat next to me.

He listened attentively to the lecturer for a while, then leaned over to whisper.

“Back in my day,” he said, “it was different.”

He was Dr. Fred Scott – a pioneer in North American feline veterinary medicine. It made sense he would be there. We were sitting in a Cornell University lecture hall in Ithaca, New York at the 25th Annual Fred Scott Feline Symposium.

I knew it was him. I’d see him in the same blue suit two years ago and Dr. Scott had just accepted a plaque for 25 years attendance at his own symposium.

As I watched Dr. Scott accept his plaque, I realized that I actually had no real idea of who he was or what he had done. Most of the people in that room knew of him well, but the impact of the pioneers of feline medicine on recent veterinary development may be lost for the younger generation of feline veterinarians, many of whom have not been trained by these well-known personalities of faculty.

The Fred Scott Feline Symposium is a small gathering of feline veterinarians compared to the American Association of Feline Practitioners or International Society of Feline Medicine meetings that can see upwards 600 cat vets reveling in 5-star comfort. Rather than being held at an international hotel, it takes place at the oldest veterinary school in North America, set in a gentle bucolic summer landscape punctuated by ravines and waterfalls. It is an addictive setting, far different from where I studied.

In my vet school, (Onderstepoort, South Africa, 1998), I was the “crazy cat lady” of that year’s graduating class. I was open in my rampant specie-ism, unusual in a profession that is multi-species comparative and insists on multi-species competence. My professors certainly knew of my focus, and desire to practice only cat medicine. Some were reserved in their support – it was not a culture in which anybody really openly admitted how much they loved cats. Cats were considered vermin, animals best left to themselves in a barn, certainly not a creature to care about. Several of my colleagues left me in no doubt how much they hated cats. Nobody there and then really thought one could make a living and a profession out of cat-only practice.

So, I headed half-way round the world, to the continent where people were doing just that. Cat colleagues, then still few and far between, were active. It has been fascinating watching how these dedicated cat activists have been educating, motivating and activating the surge in feline medicine today. The roots of the current surge began well before I was born. Some of those people, like Dr. Scott, were in that small lecture theatre in July with me. 

I am interested in collecting and telling their stories. Entwined with their stories is the history of their technical and ideological achievements, of a rapidly changing culture, and some fascinating avenues of veterinary thinking. Explore with me, around the world, the recent history of feline medicine.

This is a broad scope, and will likely morph as the blog progresses. How far this goes, and how focused it gets, depends on funding. Eventually the material gathered may be collated into book form, and archived with the veterinary libraries and history societies. And if you are a feline veterinarian, with a story that starts “Back in my day….”- email me – I would love to talk to you!