I write this with a very heavy heart. 1 of my professional colleagues – although I never knew him personally – has just been struck off by our regulator, the Royal College of Veterinary Surgeons (RCVS). And the biggest tragedy of all is that I think they were absolutely correct to do so. Information technology is profoundly pitiful that a vet could make such a massive error and not realise that what he had done was wrong – nosotros all make mistakes, but not accepting and learning from them is the cardinal sin in our profession. In this web log, I want to look at what he did, why he shouldn't have washed it, and what the ramifications are for united states as vets and as pet owners.

Simply so you're enlightened, this web log will go into details which some pet owners may find unpleasant, but which nosotros know others will desire to know about, and then as to understand all the things that may happen.

What happened?

The charges against this vet boiled down to the fact that he was called to put an elderly dog to sleep; he didn't take all the equipment that might have been appropriate for euthanasia, but the biggest issue was that he decided to put the domestic dog to sleep past an injection into the heart, without any sedation. When the owners complained, he told the RCVS disciplinary committee that this was his normal approach to euthanasia.

This, the RCVS agreed – rightly in my opinion – was completely unacceptable. Euthanasia means "a good expiry", and inserting a needle into the middle of a fully conscious animal is profoundly painful. It's also often much slower than people call up, equally the unsedated, frightened and in pain creature "fights" the anaesthetic.

What does this mean in hereafter?

Well, I'm sure that any vets who might have been tempted to exercise anything similar – mayhap for the best of reasons, such every bit trying to relieve the client money, or in an outdated belief that this procedure is non painful – will call back twice at present.

However, I besides remember information technology's an opportunity for us as a profession to take a chat with the rest of the pet-owning public (remember, nigh all of us have our own pets too!) well-nigh not just when information technology's right to put an animal to sleep, but how we do it – because there are lots and lots of options.

What are the options?

There are a number of questions the vet and the client need to consider.

Firstly, one-shot or multiple-drug euthanasia ?

Information technology is quite acceptable to use a unmarried drug – nosotros commonly utilize a potent anaesthetic agent called pentobarbitone (AKA pentobarbital). This is given past injection (encounter below), and the animal goes to sleep, gets deeper and deeper so only stops, peacefully and quietly.

Withal, there are a express number of places the injection can be given in a conscious animate being and if the patient is very stressed, or in hurting, the drug doesn't work as quickly. As a result, many vets prefer to give some sedation – or fifty-fifty a full anaesthetic – outset. In most cases, this will exist a small injection under the pare, that takes 10 minutes or so to kicking in. In some cases, it may be necessary to employ an inhaled anaesthetic amanuensis so the patient is completely unconscious before the pentobarbitone injection is given. The biggest concern is that sedatives may make it harder for the vet to find a vein afterwards; even so, this isn't normally a major trouble. Of course, this tin as well increase the price slightly – sedative drugs are unduly expensive – but in welfare terms, information technology is oft the best option.

Secondly, where can the injection be given?

As we've said, it is unacceptably painful and distressing to requite an injection into the heart in a conscious brute. However if the animal is unconscious, sedated or anaesthetised then these intracardiac injections can be useful, especially in very modest patients and those with very poor circulation or collapsed veins.

Most commonly, the injection is given into a claret vessel – "into the vein". This is the fastest and least painful option, simply not ever possible, for example in very small patients, or those in shock or with very low blood pressure level.

An alternative that is sometimes used in cats (if the vein is hard to discover or 'blows' when the injection is given) is to inject into the kidney. This is less painful than going into the center, and easier than finding a vein, but may take a trivial longer to work, specially in cats with kidney disease.

In some species, some vets will inject into the brain – this used to exist standard practice for birds, but again, we now think that birds should probably receive sedation or anaesthesia beginning in most cases.

In very small animals, it is often virtually painless to inject into the abdomen; all the same, this can exist very, very tedious to work, and needs very large amounts of the drugs.

If an injection into the vein is being used, needle or catheter?

This is a perennial debate amid vets! At that place really isn't 1 right answer to this, ultimately – it depends on the specific patient. Every bit a general rule, injecting "off the needle" is generally easier for the vet, and inserting a needle is less uncomfortable than placing a catheter; however, the needle is more than likely to sideslip out of the vein if the animal moves, and if so, the pentobarbitone is very irritant and can be severely painful to the tissues effectually the vein.

Finally, of course, we need to confirm decease .

In mammals or birds this is straightforward – a loss of normal reflexes and no heartbeat. In reptiles, however, it's much harder – some species tin can substantially "shut downwards" for hours, with no long-term ill effects. Therefore, it is usual to use additional measures to ensure that a tortoise, for example, is expressionless – stories of "zombie" tortoises are generally due to people burying a torpid but not dead pet. It is likewise unethical to freeze a reptile if you lot're not certain they've gone – they could theoretically be aware of the procedure. Pithing of the brainstem is the preferred choice once they are securely anaesthetised (and probably dead) afterwards the pentobarbitone injection.

Does it always go to programme?

Sadly, no – sometimes it may exist necessary to get to "program B" office way through – for case, if nosotros cannot access a vein, or something unexpected happens. However, in that location are always options, and our first priority volition ever be to make sure that the patient's welfare is not compromised during euthanasia.

The bottom line is that almost all vets are determined to give your pet the most humane, painless and stress-gratuitous finish that we tin can. How vets practice this volition vary depending on a broad range of factors, but if you have any concerns, please do talk to us! Any vet volition exist more than than happy to discuss your concerns and do anything we can to allay them.