Who Should Euthanize Leia?

"Leia's owners are ready for euthanasia. Who do you want to do it?"

It really was a sad situation. Leia, a 12-year-old Jack Russell, had been losing weight over several weeks. She was vomiting and anorexic.

Laparotomy confirmed exactly what the referring vet's ultrasound had indicated: a small intestinal mass and enlarged mesenteric lymph nodes. Jejunal resection and anastomosis, as well as biopsies of a lymph node and the liver were uneventful.

The following day, Leia remained lethargic and anorexic.  She continued to vomit and became hypoglycemic.  Hypoglycemia strongly suggested cancer, with lymphoma high on the differential list.

Despite intensive care, she didn't improve. The next day, the "stat" biopsy confirmed the suspicion of lymphoma in all three locations: jejunum, lymph node and liver.

The owner visited and eventually elected euthanasia. Without any doubt, they were doing the humane thing.

Because I was in the middle of a splenectomy, I couldn't perform euthanasia myself, and there was no reason to prolong the owners' agony – and Leia's.

"Leia's owners are ready for euthanasia. Who do you want to do it?" asked my nurse.

I answered: "Whichever technician is the least emotionally attached."

Dr. KL, who was observing surgery for the day, later inquired about my answer.

"Well, before, I would have asked any available technician to do it. But VPN's very own Dr. Alice Villalobos suggested this concept to me a few months ago. I asked her how she and her staff could deal with terminal cancer patients and "Pawspice" patients all day long without too much burnout.

Her suggestion was to ask a technician who hadn't treated this particular patient, or who had interacted with the patient less than other co-workers. Of course, the same concept applies to bonding with the pet's owner.

"Doctors and technicians become attached to patients and bond with clients" explains Dr. Villalobos.  Performing euthanasia, although it offers pain relief, can be emotionally draining. It can break your heart."

I thought it was a great suggestion, and I will implement it in my practice.  I won't ask a nurse who has bonded with the client or the patient to perform euthanasia on that pet.

Do you have other suggestions to avoid being emotionally drained?

01/04/2010 - Changing the world, one patient at a time

12/21/2009 Would you have euthanized this patient?

12/07/2009 - Spay a pet, save a life

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