under the skin [ 19 ]. Intramuscular injections can be given into the triceps, quadriceps and gluteal muscles.
It is worth noting that although intravenous cannulas can be placed, they are usually dislodged if the patient curls up. Pentobarbital can be administered via an intravenous cannula if one has been successfully placed, or pentobarbital can be given by intracardiac injection following adequate sedation.
Administration of a volatile anaesthetic agent such as isoflurane can be performed to induce anaesthesia so an intravenous cannula can be placed or to allow intracardiac injection.
Pithing
Following euthanasia of certain species, the VS may choose to pith the patient. Lizards, for example, have a high tolerance of hypoxia, and it is therefore theoretically possible for a lizard to be injected with pentobarbital as part of the euthanasia process but then survive hypoxia [ 20 ].
Pithing will substantially destroy both the brainstem and the spinal cord tissue, ensuring that the patient is dead, not just anaesthetised [ 21 ]. However, this process should not be done in the presence of an owner, so careful communication will be required.
Communication
Clear and transparent communication with the owner is key to ensure a smooth euthanasia process. Agreement to remove the patient from the owner needs to be discussed in advance, as the patient may need to be taken from the owner for the injection of the sedative agent and again for the pentobarbital injection.
With species such as reptiles and hedgehogs, once the alfaxalone has been administered, the patient can be placed back with the owner until an appropriate level of sedation has been achieved.
With knowledge and practice, the VS may feel confident in giving these injections with the owner present, if the owner wishes. Minimising the time the owner and patient are apart can maintain the owner – patient bond and help the owner ' s grieving process [ 5 ].
Conclusion
Euthanasia of NTCAs requires species-specific knowledge, careful planning and a compassionate approach. By planning procedures ahead of time, using appropriate sedative agents to minimise fear and distress, and maintaining patients within their POTZ, veterinary professionals can significantly improve the welfare of these patients during the process.
Clear, empathic communication with owners, allowing them to be involved, where possible, and maintaining the human – animal bond at the end of the animal ' s life will have a positive effect on the wellbeing of the veterinary team. Combining these clinical techniques with a fear-free, owner-inclusive approach will enable the veterinary team to provide a truly compassionate and stress-free euthanasia experience for all.
Acknowledgements
The author would like to thank Caoimhe Hodgins MRCVS for reviewing and contributing to this article, and Matthew Reed RVN for allowing use of the photo of the bearded dragon.
Assessment of learning
1. In 2023, which veterinary association released a policy on NCTAs?
a) BVA b) RCVS c) AZEVN d) BVNA
2. Injecting into which location in a lizard can cause slow uptake of a drug?
a) Triceps b) Fat pad c) Ventral tail vein d) Longissimus dorsi
3. What concentration of alfaxalone can be added to water to achieve sedation in fish?
a) 2 – 10 mg / l b) 20 – 100 mg / l c) 5 – 10 mg / l d) 50 – 100 mg / l
4. When giving snakes an intramuscular injection, where on the body should the injection be given?
a) Caudal third b) Cranial half c) Mid-thorax d) Tail
32 Veterinary Nursing Journal