During the most heinous rotation of my senior year in veterinary school, my horse developed laminitis in all four hooves. It is an acutely painful condition with an extremely poor prognosis. Emmy was 32, beloved beyond words, and I agonized over the decision before me. Four sleepless nights later, I chose to end her suffering. Truly, I was not certain I would be okay without her.
Little did I comprehend, Emmy, who had taught me so much during her life, would mold me into the veterinarian I became the day she died.
Euthanasia became hallowed ground for me. While most of my colleagues treat these appointments as jarringly sad interludes in an otherwise busy day of saving or improving lives, I view them as the highest purpose of my training and the most significant act I could ever perform for the family. Why? Because euthanasia would only ever happen once in the animal’s lifetime, and nothing intensifies the preciousness of the human-animal bond like imminent separation. I was present during the worst days of my clients’ lives—and humbled to have seen so many at their very best.
For me, this realization occurred before the term “human-animal bond” officially entered the veterinary vernacular, before hospice gained popularity, and well before COVID turned this most sacred responsibility of the veterinary profession into a minefield of client anxiety and unmet expectations.
I am out of private practice now—partly due to my refusal to erect a barrier between myself and the raw grief of clients—but in my current position with a veterinary triage provider, I still witness the chaos reigning in our profession over this very issue. Whether euthanasia results from financial constraint, grave prognosis, or the tender knowledge the joy has gone out of an animal’s life, clients asking for this service are typically driven by one overriding emotion and, thus, have one supreme need the veterinary team must address.
Illness and death slam all of us with the realization we do not have full control over life (we never did, of course, but this is a topic for philosophy class). Lack of control breeds fear: fear of what to expect with the euthanasia itself. Fear the pet will be scared, will suffer, or will struggle. Fear of taking a pet’s life away too early (or too late). Fear of not knowing how we will cope with the loss of this animal. Fear of not knowing if mornings or evenings will be worse. A young boy’s fear over how he will grieve his first and best friend. An elderly widow’s fear she might not survive the loss of her constant companion. Fear is the emotion behind every thought and the engine driving every client’s euthanasia experience.
When the veterinary team meets a client’s fear with compassion, effective communication, and predictable action, the pet owner’s emotion transforms into gratitude. If any of these components are missing, if the complex dance of describing the euthanasia process, responding to the client’s body language, modifying tone and posture, and showing affection for the animal at the center of the visit falls apart, client fear easily escalates to fury. Why? Because in a tangible or intangible way, the client feels abandoned—and this is the single and absolute unforgivable sin of our profession.
COVID’s unintended consequences
Curbside care converted face-to-face heart-to-hearts into constrained phone conversations, which could easily degrade into a listing of facts delivered with thinly veiled impatience. This hardly happens on purpose, but each day’s flood of patient cases dictates less time on each pet. Compassion suffers at the hands of expediency. Without compassion, rapport evaporates, trust crumbles, and communication falters. Additionally, in most cases, clients could not be present during the euthanasia itself due to social distancing. This introduces a level of unpredictability in this emotional procedure, heretofore unimagined by most pet parents.
Veterinary professionals do their best to slow down and treat euthanasia with the kindness and respect it deserves, whether the client is with the pet or not; all the client sees, however, is a crammed parking lot, a wait time defying logic, and a clinic too busy to answer exhaustive questions. Many pet parents feel their final and greatest responsibility is to be with their four-legged friend to the very end, to pour out the kind of love only they can give when the pet needs it most. Curbside care wrenched the inviolable duty away from them.
As mask mandates subside and clinics return to more normal workflows, our profession is still grappling with unmanageable patient loads. To mitigate burnout, many practitioners who were once on-call for afterhours care now refer all clients to emergency clinics. In some cases, the nearest emergency facility is three hours away, and we all know the wait times for emergency care have skyrocketed. Clients calling in the middle of the night expecting their veterinarian to be available are stunned to find themselves sent to a distant stranger instead.
During regular business hours, same-day euthanasia requests are either worked in at the cost of staff sanity or are scheduled out to a different, hopefully less busy, day. We all know this is not always the case. Clients told they must delay euthanasia wonder how to trust a practice, which, to their thinking, is making their pet suffer needlessly. Mobile veterinarians are now answering nonstop calls from new clients requesting same-day euthanasia, while dealing with limited staff support and impractical driving distances.
The way forward
The veterinary profession’s ability to end suffering humanely and peacefully is at the heart of what makes us different from every other medical profession. It is a heavy and delicate responsibility, which can determine if the heart of veterinary medicine is noble or tarnished. As we emerge from the strictures of the pandemic, let us own that client trust in our profession has decreased.
Meet this challenge by renewing your commitment to compassion. Put yourself in the client’s shoes. Even a brief glimpse of life through their eyes can reset your emotional temperature. Effectively communicate any changes in your after-hours services to pet owners through social media, pet portal announcements, invoice notes, hold time messaging, and, most importantly, in-person interactions. Go out of your way to acknowledge client fear and explain what to expect throughout the euthanasia process. Never let a client feel abandoned.
Your extra effort will not only rebuild client trust, but enhance team satisfaction, magnify the human-animal bond, and restore the beating heart of this most honorable profession.
Holly Sawyer, DVM, Human-Animal Bond certified, is a 1999 graduate of UC Davis School of Veterinary Medicine. After 19 years in private practice, she became a regional director for GuardianVets, a veterinary communication company that helps practices streamline access to patient care, strengthen client bonding, and alleviate professional burnout through live, 24-hour triage service, call overflow support, and user-friendly telemedicine access.https://www.veterinarypracticenews.com/the-pandemics-impact-on-veterinary-medicines-most-sacred-responsibility/