Hospice veterinarian Dr. Jessica Vogelsang became acutely aware of her communication shortcomings when she had to explain euthanasia to her own childrenan experience that completely transformed how she now counsels parents in the same situation.

My favorite situations are when you have kids whove been prepared early on and who want to go through some sort of ceremony beforehandmaybe theyll write a letter or light some candlesand youll just see them really involved in the process. Its beautiful for them, and its absolutely astonishing to watch the calming effect it has on the parents. Jessica Vogelsang, DVM (Shutterstock.com)As a hospice veterinarian at Paws into Grace in San Diego, California, Jessica Vogelsang, DVM, is an expert when it comes to end-of-life veterinary care. But until somewhat recently, she wasnt so skilled at having euthanasia conversations with kids.

My shortcomings were revealed when I had to explain euthanasia to my own upset and confused kids, says Dr. Vogelsang. I had no idea what I was doing. Pulling from my Catholic school background, I tried to explain the concept of heaven, to which my son responded, Whos Kevin, and why does he have our dog? (Dr. Vogelsang later drew on that experience when she published her first book.)

It became painfully clear to Dr. Vogelsang that she wasnt doing clients any favors by giving them her default how-to-tell-the-kids advice: Tell them whatever feels right. Her clients didnt know what was right. They didnt know where to start or what was appropriate. They needed more concrete guidance.

Dr. Vogelsangs first piece of advice is to start early. As soon as you know a pet has a terminal illness, start talking about the end-of-life process, she says. Plant the seed by saying, I know you have kids. Have you thought about how you want to handle telling them? Most people wait until the day of the euthanasia to talk to their children, which is a difficult time to start laying the groundwork.

The next step is to provide tools, like this handout on general communication tips, age-specific advice and ideas for celebrating and memorializing pets. Help parents see they have an opportunity to teach and model appropriate grieving to their children, who may be encountering bereavement for the first time.

My favorite situations are when you have kids whove been prepared early on and who want to go through some sort of ceremony beforehandmaybe theyll write a letter or light some candlesand youll just see them really involved in the process. Its beautiful for them, and its absolutely astonishing to watch the calming effect it has on the parents, says Dr. Vogelsang.

You dont always have the luxury of planting a seed early on, but you can still be ready to provide advice and support on the day of the euthanasia. If you end up being the one to break the news to a child, the same general communication tips from this handout apply. Dont sugarcoat whats happening with vague expressions like, Spot is going to sleep for a long time. Say, Ive done everything I can do, but Spot wont get better. I will give him a shot that stops his heart from beating. He wont feel any pain.

Explain to parents that up until almost age 5, kids are typically more in tune with their parents emotions than their own, says Dani McVety, DVM, owner ofLap of Love Veterinary Hospice and In-Home Euthanasiain Lutz, Florida. They may not want their child present during the euthanasia so they can experience their emotions in full without worrying about their childs interpretation.

Dr. Vogelsang has a box of crafts on hand for every euthanasia appointment where children are present. Its full of things children can do to express themselves and stay occupied, like collage, drawing and letter-writing materials and bubbles. I let them pick what feels most comforting, she says.

A peek into Dr. Jessica Vogelsang's box of crafts for euthanasia appointments. (Image courtesy of Dr. Jessica Vogelsang.)According to Dr. McVety, Teenagers can be one of the most difficult age ranges to talk to because they have an altruistic view of society and want to fight through whats happening. I try to talk to the teenager directly because you can see parents get very defensiveparticularly when theyre already grieving.

Dr. McVety tries to meet teenagers where they are by saying something like, I understand you feel like were giving up. But lets talk about what we cant do and what we can do. We cant keep coming back to the emergency room. We cant risk a potentially difficult passing. We can provide the most peaceful euthanasia, and thats why Im here.

Helping parents and children in this way may seem difficult to juggle in addition to your other tasks, but Vogelsang sees it as a veterinarians duty: If we are asking people to take on the responsibility of making this decision for their pets, we owe it to them to provide tools to manage the emotions involved. (We also owe it to clients to help them know when it's time. Here's a client-facing video that can help owners navigate this difficult decision).

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When a child's BFF can't live up to its title: Talking to kids about euthanasia - dvm360