euthanasia roundtable - the iwrc

1/9/2015

1

Lethal LoveDignity in Death

How Euthanasia Can Save Lives (Including Your Own!)

Main Goal

• Release!

Stress Goals• Minimize stress

• Balance suffering with probability of release

• Take care of ourselves!

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Compassion Fatigue

• What is it?• Form of secondary PTSD; also

called secondary traumatic stress (STS)

• Secondary traumatic stress from witnessing the suffering of others

• Compassion fatigue can reduce caretakers’ empathy which can decreases the quality of care given to patients

Effects of Compassion Fatigue

• Normal displays of stress!

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Individual Symptoms• • Excessive blaming

• • Bottled up emotions

• • Isolation from others

• • Receives unusual amount of complaints from others

• • Voices excessive complaints about administrative functions

• • Substance abuse used to mask feelings

• • Compulsive behaviors such as overspending, overeating, gambling, sexual addictions

• • Poor self-care (i.e., hygiene, appearance)

• • Legal problems, indebtedness

• • Reoccurrence of nightmares and flashbacks to traumatic event

• • Chronic physical ailments such as gastrointestinal problems and recurrent colds

• • Apathy, sad, no longer finds activities pleasurable

• • Difficulty concentrating

• • Mentally and physically tired

• • Preoccupied

• • In denial about problems

Organizational Symptoms

• High absenteeism• • Constant changes in co-workers relationships• • Inability for teams to work well together• • Desire among staff members to break company rules• • Outbreaks of aggressive behaviors among staff• • Inability of staff to complete assignments and tasks• • Inability of staff to respect and meet deadlines• • Lack of flexibility among staff members• • Negativism towards management• • Strong reluctance toward change• • Inability of staff to believe improvement is possible• • Lack of a vision for the future

• Including suicide

Cuteness Interlude

How do we cope with compassion fatigue?

• ?• Ignoring the problem/bottle

it up poor standard of care

• Become detached from our patients

• Loss of motivation ( loss of productivity...b/c less productivity means experiencing less secondary trauma)

• BURNOUT

How do we avoid/treat compassion fatigue?

• ?• Awareness!• Processing the secondary

trauma• By setting limits

– So we have time to fully process (grieve) the trauma

• Taking breaks• Balance caring with the

rest of your life

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Bottom Line

• If you stretch your limits, the quality of care you give ALL your patients will be LOWER

• WRC

– Independent non-profit located in St Paul, MN

–One of the largest wildlife rehabilitation centers in the country

–Admit ~ 9000 animals/year

–Over 160 species

–2 full-time DVMs and 2 CVTs

–8 full-time staff members

–>500 volunteers

WRC Example

• ~1500 TOTAL ECTR/yr

• 500-600 <50g/yr

0.0%

10.0%

20.0%

30.0%

40.0%

50.0%

60.0%

70.0%

80.0%

90.0%

100.0%

2003 2004 2005 2006 2007 2008 2009 2010

eoa

dic/e

released

How do we set limits?• Dedicate time to the rest of your life know

how much time AWAY from wildlife allows you to work optimally

• Analyze your past data (in the off season) to find your limits

Guidelines for analyzing data

• Do NOT compare yourself to other centers/rehabilitators– Variables are usually not the same

• Different types of facility (home vs center)

• Different budgets

• Different access to resources (volunteers, veterinary services, etc)

• Different amounts of available time.

• Different areas of the country

• Different seasons

• Different species

• Release rates are calculated differently!!!

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0.0%

10.0%

20.0%

30.0%

40.0%

50.0%

60.0%

70.0%

80.0%

90.0%

100.0%

2003 2004 2005 2006 2007 2008 2009 2010

eoa

dic/e

released

The Release Rate Riot“ReleaseRate”

Carolina Raptor Center 75% -EXCLUDES those that die/euth w/in 24 hrs of admission-INCLUDES placed raptors (100+ on site)-admit 700/year

UK Paper 42% -EXCLUDES those that died w/in 48 hours of admit

WRC nursery ECTR 35% -INCLUDES ALL ECTRs admitted

WRC nursery ECTR 60% -EXCLUDES ONLY EOA and DOA

E wild again- rehabber avgrelease rate

67% -based on each rehabber, regardless of admit size

E wild again-overall avgrelease rate

52% -based on ALL animals admitted

E wild again numbers-ex. of calculations# patients/year

Jane Doesaver 35 80% -only does baby mammals

John StudebakerMcrehabberschmidt

67 70% -does everything

TE HS(TakesEverythingHumane Society)

5000 45% -contract with city and has to take all widlife

Total # admitted: 5102

AVG per rehabber:(80+70+45)/3= 65%

AVG per animal: (0.8*35)+(0.7*67)+(0.45*5000)=2325/5102=45.6%

28, 47, 2250

0.0%

10.0%

20.0%

30.0%

40.0%

50.0%

60.0%

70.0%

80.0%

90.0%

100.0%

2003 2004 2005 2006 2007 2008 2009 2010

eoa

dic/e

released

Guidelines for analyzing data

• Do NOT compare yourself to other centers/rehabilitators

• Compare YOUR past statistics to YOUR current statistics

• Very easy and quick to do based on an electronic state/fed report....hint hint....*coughwild-onecough*

EuthanasiaThe “How-To”

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“Euthanasia”

• From the greek ‘euthanatos’ (Merriam-Webster, 2008):– Eu= good– Thantos= death

• Ideal euthanasia (AVMA, 2007):

– rapid loss of consciousness – cardiac or respiratory arrest – loss of brain function.– + minimize distress and anxiety experienced by the animal

prior to loss of consciousness

**With out these requirements ‘termination of life’, NOT euthanasia**

Indications (companion animals)

• Terminal disease

• Overpopulation

• Laboratory testing

• Herd health

• Slaughter

Indications (wildlife rehabilitation)

• Illegal

• Low chance/will not be able to survive in the wild

• Low chance/will not be able to reproduce in the wild

• Too much pain/suffering

• Lack of time/resources

Methods

• How do we know which are “best”?

Standards

• American Veterinary Medical Association) (AVMA) reviews euthanasia in the scientific literature every few years and states which methods it considers humane

• (FREE)https://www.avma.org/KB/Policies/Documents/euthanasia.pdf

AVMA• Ability to induce loss of consciousness and death

WITHOUT causing pain, distress, anxiety, or apprehension =sufferinghappens in cerebral cortex

• Time required to induce loss of consciousness• Reliability • Safety of personnel• Irreversibility • Compatibility with purpose• Emotional effect on observers or operators• Compatibility with species, age and health status• Ability to maintain equipment in proper working order• Safety for predator/scavengers should the carcass be

consumed

https://www.avma.org/KB/Policies/Documents/euthanasia.pdf

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Euthanasia

Methods

Euthanasia

METHODS

OF

MURDER

EUTH...

ETHICS

PLANS

FOR

PULLING

THE PLUG

SKILL OF

THE KILL

ENDING

THEIR

AGONY

POTPOURRI

This procedure

involves first

rendering the

animal unconscious

and THEN stopping

the heart....

Euthanasia

• Steps:

1. Render animal unconscious

2. Stop heart

Euthanasia Methods

• Physical– Captive Bolt

• Penetrating• Non-penetrating

– Gunshot– Manual blunt force trauma– Cervical dislocation– Percussive stunning

• Chemical– Injection – IV, IP, intra-liver, intra-kidney

• Barbituates, Tributame, T-61

– Inhalation• CO2, anesthetics, nitrogen, argon, helium

– Lethal dose of intoxicant to food or water

Adjunct:ExsanguinationPithingKCl

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METHODS

OF

MURDER

EUTH...

ETHICS

PLANS

FOR

PULLING

THE PLUG

SKILL OF

THE KILL

ENDING

THEIR

AGONY

POTPOURRI

This method of

euthanasia is

NOT “aimed

between the

eyes”

Euthanasia Methods- Physical

• Target (Gunshot, Captive Bolt)– Line from the base of the

horns to the lateral canthus of the opposite eye where 2 lines cross Angle so bullet will exit foramen magnum (brainstem)

– NOT “middle of the eyes”

– Chart of calibers online

NAHEMS 2011

Gunshot

Pros

• Rapid and Humane Death

• Target cerebral region and brainstem for immediate unconsciousness

• Good for hoofstock

• No carcass residues

• Distance or close proximity

• Silencers available

• <400# = 300ft lbs ; >400# = 1000ft lbs muzzle energy

Cons

• Skilled in technique

• NEVER in contact with skull

• Appropriate equipment– Varies by species and distance

– hollow pointed bullets; frangible iron plastic composition bullets; or powdered iron missiles

• PPE – head and eye gear

• Potential for collateral damage large

Penetrating Captive Bolt

Pros

• Rapid and Humane Death


• Good for hoofstock

• No carcass residues

• Energy required is 200 J

Cons

• Skilled in technique

• Appropriate equipment– Seals and stop washers

replaced regularly

• Must be in contact with skull

• Only more recent bolt guns kill without second step (extended length penetrating bolt)

Non-penetrating Captive Bolt

Pros

• Concussive trauma to brain


Cons

• Must be prepared to use adjunct method to ensure rapid death

• Neonatal animals only without adjunct method

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METHODS

OF

MURDER

EUTH...

ETHICS

PLANS

FOR

PULLING

THE PLUG

SKILL OF

THE KILL

ENDING

THEIR

AGONY

POTPOURRI

This method of

euthanasia

requires no

special

equipment...

Cervical Dislocation

Pros

• Immediate unconsciousness

• Quick death

• No tissue contamination

• No special equipment or supplies

Cons

• Technique requires practice

• Aesthetically unappealing

• Continued muscular movement undesirable

• Limited to small birds, mice, immature rats, rabbits

Blunt Trauma by Manual Force

Pros

• No equipment

• Single sharp blow delivered to the central skull bones in the region over the brain

• Neonates ONLY

Cons

• Aesthetically objectionable

• Skilled technique

• Requires practice

• Requires strength

• Requires resolve

Remember...

• Although Physical Methods of Euthanasia render unconsciousness immediately...

– Should drop to the ground instantaneously

– Muscles may continue to convulse

METHODS

OF

MURDER

EUTH...

ETHICS

PLANS

FOR

PULLING

THE PLUG

SKILL OF

THE KILL

ENDING

THEIR

AGONY

POTPOURRI

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These methods

of euthanasia

are not physical

in nature...

Euthanasia Methods – Chemical

• Injection – IV, IP, intrahepatic, intrarenal– Barbituates, KCl, Tributame, T-61

• Inhalation– CO2, anesthetics, nitrogen, argon

• Lethal dose of intoxicant to food or water– None identified without risk to humans or

environment

• Consider cost and disposal of contaminated carcasses

• May need chemical restraint beforehand

Euthanasia Methods - injection

IC – AVMA 2013

Intra-hepatic – AVMA 2013

Intra-renal – AVMA 2013

METHODS

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EUTH...

ETHICS

PLANS

FOR

PULLING

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SKILL OF

THE KILL

ENDING

THEIR

AGONY

POTPOURRI

This is the most

common type of

chemical

euthanasia...

Barbituates

Pros

• Rapidity, effectiveness

• Chemical restraint generally not needed

• IV injection preferred

• IP, intra-liver, intra-kidney

• Sodium Pentobarbital – 1cc per 10 lbs mammals

– 1cc per 2 lbs birds

Cons

• Controlled substances– Beuthasol, FatalPlus

• Carcass contaminated

• MUST absolutely determine that death has taken place (vs deep anesthesia)

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T-61

Pros

• Rapid, humane death

• Terminal gasps not seen

• Works similarly well in birds

Cons

• Not available in the US

• Must be slow IV injection to avoid dysphoria

• Controlled substance

• IV only

METHODS

OF

MURDER

EUTH...

ETHICS

PLANS

FOR

PULLING

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SKILL OF

THE KILL

ENDING

THEIR

AGONY

POTPOURRI

These options

do NOT require a

controlled

substance

license...

Alcohols

Pros

• Readily available

• Inexpensive

Cons

• Dose-related irritation to tissue

• Large volumes required for most animals

CO2

Pros

• Not controlled

• Easily administered (chambers)

• Nonflammable

• Nonexplosive

• Use gradual increases in concentrations to avoid stress from hypoxemia

• Analgesic and anesthetic properties

Cons

• Safety equipment for gas

• Oxygen must rapidly decrease to <2%

• AVMA recommends heavy sedation prior

• Carefully regulate gas so does not freeze animal

• Time to death longer, may exhibit stress

• Drastic species differences

CO

Pros

• Loss of consciousness without pain, with minimal distress

• Rapid death with concentrations of 4-6%

Cons

• Danger to humans

• Potential for explosions

• Aversive to rodents

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N2, Ar

Pros

• Readily available compressed gasses

• Nonflammable

• Nonexplosive

• Nonaversive to poultry

Cons

• Must combine with CO2 to make heavier than room air

• Aversive to rodents

• Exposure times up to >7min

• Even 6% O2 before death will results in immediate recovery

Helium

Pros Cons

METHODS

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These

euthanasia

agents work by

inhalation...

Anesthetics

Pros

• Easily administered (chambers)

• Minimal risk to handlers vsphysical or injectable methods

• ether, halothane, methoxyflurane, isoflurane, sevoflurane, desflurane, enflurane

Cons

• Methoxyflurane and halothane not available in the US

• Enflurane can cause seizures

• Breath holding, esp. aquatic or diving species

• Aversive vapors

• Special equipment –vaporizers

• Human abuse potential

METHODS

OF

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EUTH...

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These

euthanasia

agents can be

dissolved in

liquid...

Tricaine (MS222)

Pros

• Soluble in fresh water

• Soluble in salt water

• Commercially avaiable

• Not controlled

Cons

• Expensive

• Species variability

• Retinal toxicity to humans

• Cannot inject (rapid excretion)

• Possible detrimental environmental effects

Benzocain Hydrochloride

Pros

• Not controlled

• Fast acting, effective for fish and amphibians

• Low toxicity to humans

• Little environmental risk

Cons

• Does not dissolve in water

• Cost

• Must be buffered

• Impact on scavengers not determined

Clove oil

Pros

• Eugenol, isoeugenol

• Widely available

• Not controlled

• Inexpensive

• Short induction time

• Effective at wide range of water temps

Cons

• Carcass disposal

• Some derivatives are potential carcinogens

• Impact on environment not studied

METHODS

OF

MURDER

EUTH...

ETHICS

PLANS

FOR

PULLING

THE PLUG

SKILL OF

THE KILL

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AGONY

POTPOURRI

These

euthanasia

agents are ONLY

secondary

means...

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Euthanasia Methods - adjunct

• Animal must first be rendered unconscious by other means

– KCl injection

– Exsanguination

– Pithing

KCl

Pros

• Not controlled

• IV or IC = cardiac arrest

• 75-150mg/kg, 34.1-68.2mg/lb

• Also Magnesium chloride or magnesium sulfate

• Carcasses less toxic

Cons

• No analgesia

• Adjunct method only, MUST be unconscious first

• Muscle fasiculations, spasms can be violent

Pithing

Pros

• Immediate unconsciousness

• Can be used as secondary method

Cons

• Technique

• Practice

• MUST be rendered unconscious first

• Involuntary movement post-procedure

Exsanguination

Pros

• Not controlled

• Carotid or brachial arteries

Cons

• MUST be rendered unconscious first

• Aesthetics

METHODS

OF

MURDER

EUTH...

ETHICS

PLANS

FOR

PULLING

THE PLUG

SKILL OF

THE KILL

ENDING

THEIR

AGONY

POTPOURRI

These species

large size can

make euthanasia

difficult...

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Euthanasia Methods By Species

• Bovidae (deer)

– Gunshot

– Penetrating Captive Bolt

– Injectable

• usually impractical

NAHEMS 2011


• Ovidae, Caprinae


– Gunshot (no contact!)

NAHEMS 2011


• Ovidae, Caprinae, cont

– Pithing – acceptable after anesthesia (30-50mg Xylazine IV or IM, wait 20min)

– KCl – acceptable after anesthesia

– Chloral hydrate (900mg/kg) - acceptable after anesthesia (difficult to obtain)

– Injectable – usually impractical

– CO2 – generally impractical due to required chamber size

– Electrocution – conditionally acceptable (equip)


• Equidae

– Gunshot


– Injection (barbituates)

– KCl with anesthesia first:

xylazine 0.5mg/lb IV or1mg/lb IM

NAHEMS 2011


NAHEMS 2011

• Wild Boar

– Gunshot (slug)

• 1” above brow line

• Thicker skull

– Penetrating Captive Bolt (.25 caliber)

– CO2 for <70 lbs (32kg)

• See AASV ; concentration 80-90% for minimum 5min


• Wild Boar, cont

– Electrocution (specialized equipment required)

– Injection

• usually impractical

• Xylazine does not work

– Adjunct methods

• Pithing

• KCl

NAHEMS 2011

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METHODS

OF

MURDER

EUTH...

ETHICS

PLANS

FOR

PULLING

THE PLUG

SKILL OF

THE KILL

ENDING

THEIR

AGONY

POTPOURRI

These methods

are preferred for

canine and

feline-type

species...

Euthansia Methods By Species

• Coyotes, fox, bobcats, raccoons, skunks, ferrets/ermine, mink...

– Injection of barbituate preferred method

– Injection of non-barbituate anesthetic

• Ketamine/xylazine

– Tributame, T-61 – not currently manufactured in US

– Inhaled anesthetics, <7kgs

– CO, CO2

– Gunshot, Penetrating Captive Bolt


• Canidae/Felidae, adjunct methods

– KCl

– N2, Argon

– Electrocution (specialized equipment required)

METHODS

OF

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EUTH...

ETHICS

PLANS

FOR

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SKILL OF

THE KILL

ENDING

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AGONY

POTPOURRI

These species

make up the

bulk of our

rehabilitation

mammals...

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• Rodentia/Lagomorphs (muskrats, woodchucks, squirrels, mice, bunnies...)

– Injectable (barbituates, barbituate derivatives, dissociatives agent combinations)

– Inhaled anesthetics (not N2O alone)

– CO2, CO (CO not rabbits)

– Tribromo-ethanol (not currently avail in US)

– Cervical Dislocation, <200g

– Decapitation


METHODS

OF

MURDER

EUTH...

ETHICS

PLANS

FOR

PULLING

THE PLUG

SKILL OF

THE KILL

ENDING

THEIR

AGONY

POTPOURRI

The preferred

method of

euthanasia for

birds is...


• Avian

– Injection (barbituates, barbituate derivatives, dissociative agent combinations)

• IV preferred

• IP if necessary – prolonged time

• Intrahepatic in small birds

– Cervical dislocation, decapitation (<200g)

– Manually applied blunt force trauma (<200g)

– Gunshot (larger birds, use appropriate shot)


• Avian, cont.

– CO2, CO, N2, Argon

• Latter 3 with CO2 combinations only

– Adjunct Methods

• Exsanguination

• KCl

• Thoracic compression

METHODS

OF

MURDER

EUTH...

ETHICS

PLANS

FOR

PULLING

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SKILL OF

THE KILL

ENDING

THEIR

AGONY

POTPOURRI

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These

difficulties

present when

under water...


• Aquatics

– Tricaine (MS222)

– Benzocaine

– CO2-saturated water

– Ethanol (concentrations of 10-30mL of 95% ethanol per Liter)

– Eugenol, isoeugenol, clove oil

– Isoflurane, sevoflurane liquids added to water


• Aquatics, cont.

– Injectable (barbituates, barbituate derivatives, dissociative agent combinations)

– Decapitation followed by pithing

– Cervical transection followed by pithing

– Manually applied blunt force trauma followed by pithing

– Captive Bolt (larger fish)

– Electrocution

– Percussive stunning


• Marine Mammals

– Injectable anesthetics (barbituates, barbituatederivatives, dissociative agent combinations)

– Gunshot

– Implosive decerebration (not practical)

– Adjunctive

• KCl or succinylcholine

– Unacceptable

• Inhalant anesthetics (remember they’re divers)

• Exsanguination

End of Jeopardy Cuteness Interlude...

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Chelonian Euthanasia “Euthanasia” (review)

• From the greek ‘euthanatos’ (Merriam-Webster, 2008):– Eu= good– Thantos= death

• Ideal euthanasia (AVMA, 2007):

– rapid loss of consciousness – cardiac or respiratory arrest – loss of brain function.– + minimize distress and anxiety experienced by the animal

prior to loss of consciousness

**With out these requirements ‘termination of life’, NOT euthanasia**

Why am I concerned?

• http://www.youtube.com/watch?v=6_8p8sg3rSk

• http://www.youtube.com/watch?v=lmhBEeEMqYo

Why am I concerned?

• “Evidence suggests that biochemical and electrical activity persists within an anoxic turtle brain for some considerable time. This means that euthanasia with some agents could result in unexpected recovery due to the ability of chelonian brains to survive prolonged anoxia.” (McArthur et al, 2004, page 398)

Why am I concerned?

• Google search “how to kill a turtle”

– Drowning: “check on it every hour-MAKE SURE IT’S DEAD”

– Freezing: “I’ll have to make room in the deep freeze”

– “a .44 mag to the head will quickly incapacitate the critter”

Why am I concerned?

TURTLES ARE HARD TO KILL!

http://www.youtube.com/watch?v=lmhBEeEMqYo

http://www.youtube.com/watch?v=lmhBEeEMqYo

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Outline

• Basics of euthanasia

• Turtle physiology

• Analyze suggested methods of euthanasia

Turtle Physiology

• Turtles can tolerate anoxia for longer periods of time than other vertebrates

• Not all turtles tolerate anoxia to the same degree (not much is known)

• Painted turtles and sliders (Chrysemys picta, Pseudemys scripta/Trachemys scripta)

tolerate exceptionally long periods of time without oxygen and have been studied the most

(Lutz, 1992, Johlin & Moreland, 1933)

Turtle physiology

• The brain of the freshwater turtle Trachemysscripta [slider] is able to withstand anoxia for days at room temperature (Lutz et al., 2003; Bickler et al.,

2002)

• The anoxic turtle suppresses brain activity to such a degree that it becomes virtually comatose (Nilsson, G.E., and P.L. Lutz, 2004)

– Via releasing GABA (and conserving adenosine receptors)

EEG in turtles

• EEG of turtles does not fluctuate throughout the same range across states as in mammals (declining in frequency and amplitude during sleep)…spikes and sharp waves during sleep (Eiland et al 2001)

• Anoxic turtle brains had 3-8Hz EEG (~human sleep), about 20% of normoxic control with mixed bursts of activity

• =turtle brain down-regulates in anoxia

• Can the anoxic turtle brain feel pain????

Physiology summary

• Apnea alone may not be enough to cause death (McArther, 2004)

• Whether the brain is actually conscious and/or feeling pain in the anoxic state is still unknown

Questions so far?

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Methods of Euthanasia

• Volatile anesthetic (ie isoflurane)

• Freezing

• Captive bolt

• Decapitation

• Pithing

• Sodium Pentobarbital injection

• Combo

Volatile Anesthetic

• Turtles will hold their breath for a loooooooong time doesn’t work (Mader, 2006)

(AVMA, 2007)

Freezing

Rapid freezing:

• (ie dipping in liquid nitrogen) for turtles less than 40 grams (AVMA, 2007)

Putting turtles in the regular freezer:

• Animals may experience pain as ice crystals form within tissues and skin (Cooper et al 1984) (AVMA, 2007)

• This is not an acceptable or humane method of euthanasia, even if combined with other methods (ieanesthesia, stunning, etc) (AVMA, 2007) (McArthur, 2004) (Mader, 2006)

Captive bolt

• Diagrams and manuals exist for landmarks on where to place a captive bolt gun

• Should only be performed by a trained individual (Mader, 2006)

• Only penetrating should be used

Decapitation

• Because the central nervous system of reptiles, fish, and amphibians is tolerant to hypoxic and hypertensive conditions death is not immediate Cooper et al (1989) believes decapitated reptiles may still be able to perceive pain for up to an hour after the spinal cord has been severed

– Must be followed by pithing (AVMA, 2007)

– Needs to be preceeded by anesthesia (Mader, 2006)

Pithing

• Definition: to destroy the brain or spinal cord by passing a pick or wire into it

• Because the animal may still be conscious, pithing should only be performed by trained individuals (National Research Committee on Pain and Distress in

Laboratory Animals, 1992)

• No other source talked about pithing as a sole method

• Personally, pithing without prior anesthesia is inhumane

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Pithing sites Sodium Pentobarbital• Action: GABA-like

– Mammals: (Rhoades, R., 2002, Lumb & Jones, 2007)

• CNS is more sensitive, so causes unconsciousness first

• Then acts on the medulla oblongata to depress vital signs stops breathing BP drops heart stops

– Turtles: ???

• Heart often beats for considerable time after administration of euthanasia agent (Frye, 1991)

possibility of metabolism of agents and recovery (McArthur, 2004)

• If the heart does stop since their brains can tolerate anoxia, are they feeling pain??

Sodium Pentobarbital

• If dehydrated, cold, or moribund circulation may be poor delay/inhibit absorption (Mader,

2006) (try placing the animal on a heating pad to increase circulation)

• Site: – Intracardiac (only if anesthetized first) (Mader, 2006)

– Intracoelomically (slow acting)

– Dorsal tail vein

– Subcarapacial sinus

Combo Euthanasia

Ideal

• Anesthetic plus pithing/intracranial injection of formalin

• Anesthetic plus sodium pentobarbital plus pithing

• Sodium pentobarbital plus cardiotoxic agent plus pithing

Small?

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Cuteness Interlude... Questions?

Pre-fabricated topics Nonindigenous Species

• Allocation of resources

• Euthanasia on admission

• Specialized individual rehabilitators

Obtaining Euthasol

• Vet relationship

• ALL VETS CAN EUTHANIZE ANYTHING

– Can choose not to

Dealing with Volunteers

• Who are very attached to specific animals

• Being able to explain reasons for euthanasia

• Being confident that euthanasia IS an appropriate treatment option

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Dealing with the Public

• Nuisance species

– “please euthanize this healthy raccoon”

• Animal rights groups with problems that you euthanize at all

Dealing with the Emotion

• Compassion Fatigue

• Coping Mechanisms

Struggling with when…

• How long do you “give them a chance”?

• Who do you decide to “give a chance”?

• Why?

• Why not?

Specific Injuries

• Go to Triage lecture on Saturday...

• No orthopedic vet nearby, to rehab or not?

Keeping the Goal in Mind…

• Remember why you’re doing what you’re doing

• Learn from euthanasias

• Learn from successes

• Learn from mistakes

• Use that knowledge to help the next ones…