Plus-Hex CLINICAL
Introduction
‘ Euthanasia’ is a word that has negative connotations; hearing it may evoke images of a pet ' s last moments, or of death in general, and we can lose sight of what the word means.
Those with an interest in linguistics and etymology may better understand the word. Babbel, an online language education provider, describes etymology as‘ the study of the origin of words and how the meaning has changed over the course of history’.
When looking at the word‘ euthanasia’, we begin with‘ eu’, which derives from the Greek for‘ well’ and can also mean‘ good’.‘ Thanatos’ means death; for example, thanatology is the scientific study of death. The ending of euthanasia, the‘ ia’, is an abstract noun ending. So, we have come to understand that euthanasia means‘ good death’ and, as veterinary professionals, this is something we hope to give patients requiring the procedure.
Managing expectations
To provide a good death, we need to first look at the process of euthanasia. We deliver the barbiturate pentobarbital sodium into the bloodstream of a patient and, depending on the patient, death is usually swift and painless.
The process is not particularly drawn out and it does not take long for the cessation of life to occur. However, there are those patients that, due to underlying medical conditions, may have a death that seems to be prolonged or distressing.
As veterinary nurses( VNs), we may have had some patients that required more barbiturate than others, or patients that may have displayed behaviours that led us to think they were in distress, for example, vocalising, pacing, thrashing, vomiting, or releasing faeces or urine. Such situations are not commonly witnessed by veterinary professionals, but neither are they unheard of; however, they may be disturbing for a client to witness and may have a lasting effect on them.
From the start of a euthanasia consultation to the end, veterinary professionals are responsible for managing the client ' s expectations of what is to happen, and to ensure that the patient passes with peace and dignity, providing a genuine euthanasia, or‘ good death’, for the patient.
Dysthanasia is the opposite of euthanasia, with‘ dys’ being derived from the Greek for‘ bad’ or‘ difficult’. Although there are processes in place to reduce the chances of this occurring, patients can be unpredictable and it does happen. Should such a situation arise, our reaction will be crucial, not only for the patient but for the owner, too.
Predicting the unpredictable
Knowing the patient ' s history can reduce the risk of unexpected situations arising. This may be easier to obtain if we are the primary care provider, but if we are the emergency service provider, we may not have all the information, or time to obtain it.
Even if the patient ' s history is known, there may be an unknown issue that becomes apparent only at the time of euthanasia. Neurological issues may cause a patient to react in an unpredictable way when the pentobarbital sodium is administered, which may then lead to a death that is not peaceful or does not appear so.
Furthermore, the way the euthanasia is performed may play a role in how the patient reacts, and this may turn a euthanasia into a dysthanasia. For instance, if there is no intravenous catheter in place before the pentobarbital sodium is administered, the drugs may need to be injected. This process may not go smoothly, for example, if a patient ' s blood pressure is low and venous access is difficult.
Similarly, consider a patient that receives enough pentobarbital to achieve a plane of anaesthesia, but with a loss of inhibition or loss of motor control; the patient acts erratically and has to be restrained so the vein can be re-accessed. Such a scenario could be very distressing for the owner to witness.
Understanding the process
The drugs we use to euthanise patients essentially provide an overdose of anaesthetic. As such, they depress the central nervous system( CNS) and, in quick succession, cardiac and brain functioning ceases and death follows.
Due to the nature of pentobarbital sodium and its effect on the CNS, there may be a reduction in awareness and a loss of inhibition, which can lead to behaviours that look distressing but are not necessarily distressing to the patient itself.
The primary author has witnessed patients scrambling on the table, wide-eyed, staring and looking as if they were trying to‘ fight for their life’ – a phrase she has also heard owners use to describe their pet ' s last moments. It is understandable that, to a layperson, an animal acting in this manner may look as if it does not want to die. It is likely that an owner witnessing this would remember the moment and it could affect their grief and bereavement, especially if they already had doubts about their decision and were left with the impression that their pet was fighting to live.
Whether it would help to explain to the owner, in the moment, that this is normal and their pet is not aware of what is happening, would depend on the individual
Volume 40( 5) • October 2025
47