Daily Archives: June 28, 2017

It is important to understand what the body does when death occurs. Not in an attempt to be morbid, but so that you will not experience unpleasant surprises and so that you will be prepared to witness the passing of your pet.

In the process of a quiet, peaceful home euthanasia, it is unlikely that you will witness anything very upsetting or unsettling. In about 95% of the cases, you will not see anything else than the cessation of breathing and of motion. Body reactions can occur however, and in the event that you see something it is important for you to understand that these body reactions do not equate suffering and are part of the natural event of dying.

The genetic entity is geared towards survival. Cells and bodies are reluctant to let go of life and when death occurs, the body may attempt to stay alive even though the spirit is leaving the body. This is not an indication that your pet was not ready or anything of the sort.

The most surprising of those reactions is the agonal breathing. This looks like sudden or convulsive breaths which do not actually lead to oxygenation. They are more or less a reaction of the nerves in the body trying to kick start the body back into life again. There can be only one "shudder" or several in a row (4 or 5 or rarely more). When those occur, there is not enough oxygen to the brain for the pet to be conscious. Agonal breathing occurs as the body is dying and the pet has no consciousness of this and certainly does not feel like "he can't breathe". Most of the times, those are silent, but occasionally, breathing noises can accompany them. Some people describe it as a shudder or a grunt, I've also heared the term "death rattles", but the pet has no consciousness of this occurring. They do not always occur. As a matter of fact, they are unlikely to occur because we use a drug that calms the body and that helps to prevent agonal breathing. In addition, injecting the euthanasia solution slowly also helps to prevent agonal breathing. However, sometimes, despite the use of this drug and despite the slow injection of the euthanasia solution, agonal breathing cannot always be eliminated. It is important to understand that agonal breathing does not mean that the pet is suffering and that pain is experienced. Remember, if and when they do occur, the pet is already unconscious and chances are that the heart has already stopped. For all intents and purposes, the pet is already gone.

Other reactions that can be seen are little twitches of the muscles or skin. These can sometimes last for several minutes after the pet has passed away. They are normal nerve reactions but do not always occur either. They are very subtle and not always observed. When observed, they are most often seen around the lower part of the shoulder or around the muzzle, but they can be seen anywhere on the body.

The normal relaxed position of the eyes after a pet (or a person) has passed away is open. Eyes will likely remain open. Rarely they close and sometimes they are in a sort of a neutral position, neither open or closed. Pet owners often ask me to close their pets eyes. Unfortunately, even if we close the eyes, they will inevitably re-open unless a little drop of surgical glue is put under the eyelids. Some people find it particularly unsettling to see their pets eyes open and prefer that I use that little drop of surgical glue. If this is the case for you, please do let me know.

In addition to the eyes remaining open, the cornea (the clear part of the eyes) will take on a glassy or blurry appearance within a few minutes.

Bodily fluids and gas will leak out. If the bladder is very full, there will be a large puddle of urine under your pet, so it is important to prepare for this and to have towels readily available to slide under your pet after his passing. Even if your pet has recently urinated, it is likely that there will be a little bit of urine leakage. It is not as common for feces will leak out, but it can happen, especially if your pet has had diarrhea. If your pet has been very ill with severe diarrhea or bloody stools, it can be quite messy after his passing. Again, better be prepared. Out of respect for your pet, we will never force your pet to lie down on something unusual that he may be uncomfortable with. But if towels are nearby, as soon as your pet has passed away, we can slide those towels underneath him before leakage occurs.

Sometimes, particularly in cases of congestive heart failure, chest bleeding due to a ruptured tumor, pneumonia or trauma, blood tinted fluid can escape the nasal cavity or mouth. This can look scary, but as your pet has already passed away, his suffering has ended and this will be of no consequence to him and is a normal part of such disease process. If your pets illness did not involve the conditions named above, this nasal or oral bleeding will not occur.

Other normal occurences include the ears becoming pricked, the tail can curl up, the hair (hackles) along the spine (particularly at the base of the spine and on the tail) can become raised. Very rarely, the entire body can stretch during the death process or immediately after.

After the passing of your pet, when his body is moved or lifted, sometimes, the air empties out of the lungs and as this happens, you may hear something what sounds like a breath or a grunt. This does not mean that your pet is still alive or is still breathing. It is just the leftover air leaving the lungs.

With all the above said, you should not worry yourself unduly that the passing of your pet will be traumatic to you. A home euthanasia is usually very peaceful and the reactions described above are benign and not very scary or traumatic to a pet owner. Being aware of what can occur will find you prepared for all eventualities and will minimize the upset and trauma you will inevitably feel at the loss of your beloved pet. The most important thing to remember is that your pets spirit left peacefully and the body reactions which can be considered potentially unsightly by more sensitive people are just body reactions and they do not indicate suffering upon euthanasia. If you know that you are very sensitive and likely to be very upset in the unlikely event that you see any of these reactions, you may want to consider not being present for the final injection and may want to choose saying your final goodbyes beforehand.

Death occurring naturally, unaided by euthanasia is usually more dramatic to a greater or lesser degree. Agonal breathing is likely to occur and may last for several seconds and even minutes. Twitches are usually more evident. If your pet is experiencing pain, he may vocalize. The manifestations of death vary depending on the disease process causing death.

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At 14 years old, Barky, our family dog, had survived cancer and blood disease thanks to a combination of heroic veterinary efforts and just plain good luck. Then, she developed congestive heart failure.

Congestive heart failure is a terrible condition. The dog's heart can't pump blood through the body very well. It leads to coughing, exhaustion, a swollen belly and eventually, the dog's lungs will fill with fluid, and she will essentially feel as if she is drowning in her own body.

Barky at the author's parents' house in Rhode Island

We didn't want Barky to experience a terrifying, painful death. We thought it was kinder for the veterinarian to end her life before that happened peacefully, at home, surrounded by the people who love her.

My family and I were devastated to lose Barky, devastated to think of her dying, and unsure about whether we were making the right choice. Should we wait? Had we already waited too long?

This is the price we pay for loving animals, and for living with animals: being responsible sometimes for deciding when and how to end their lives.

But how do we know how and when to do it, so that we have done right by our pets, and honored their places in our family? TODAY reached out to veterinarians for guidance to help answer some of our deepest and, frankly, sobbiest questions about pet euthanasia.

Generally, the veterinarian will give your pet two shots. The first is a sedative.

"This provides for a gentle transition from consciousness to unconsciousness, and the only sensation a pet will experience following this injection is falling into a deeper and deeper sleep," explained Dr. Shea Cox, a hospice and palliative care specialist with Bridge Veterinary Services in Northern California.

This period will likely last between five and 10 minutes, with the pet falling into a deeper and deeper sleep, "at which time they become no longer aware," said Cox.

When the family is ready, the veterinarian will then administer the second injection. The most common drug used during that stage is pentobarbital, another anesthetic that will cause the pet's heart to slow and then stop.

The injection is given either intravenously, which will bring on death in seconds, or directly into the abdomen, which may take up to 15 minutes and "is more gentle and slow," said Cox but in either case, the pet, having been sedated, will not be aware of this part of the process.

The only discomfort the pet should experience throughout is a possible pinch when the first injection is given. This is in keeping, Cox said, with the true meaning of the word "euthanasia," coming "from the Greek word euthanatos, which means 'good death.'"

People often ask Dr. Dani McVety, founder of the home-based veterinary hospice and euthanasia service Lap of Love, when is the "right" time for euthanasia. She prefers the term "best," instead.

McVety feels this word better encompasses the truth, that there is usually no 100 percent, objectively correct time for euthanasia. Rather, "we, together, are making the best decision that we could make," she said.

Barky was very loving and patient even when some people insisted in dressing her up like a babushka.

Deciding when to end a pet's life involves the owner and their veterinarian weighing a number of factors: the animal's current quality of life, what type of disease he or she may be suffering from and how it is likely to progress. Another consideration is what the family is able to endure; if they want every possible second with their pet and will undergo expensive or uncertain treatments, or if they want to forestall their pet's suffering.

If the pet has a condition like congestive heart failure, or untreatable brain cancer a disease that will, unchecked, lead to a painful death the recommendation may be for euthanasia sooner instead of later.

Even then, by and large, your pet won't tell you for sure that it's time; don't expect a clear-as-day sign to let you know. "Theres a subjective period of time in which euthanasia is a good decision," said McVety.

It's important that you and your vet can have open, honest conversations about euthanasia, to help guide this hard part of the process.

"In general, I also tell people to trust their instincts. They know their pets better than anyone," said Dr. Lisa Lippman, a house-call veterinarian in New York City. "Are they eating? Do they get up to greet you like normal? No matter what any veterinarian says, they know their pet best."

It's normal for your pet to have good and bad days toward the end. Texas veterinarian Dr. Fiona McCord, founder of Compassionate Care Pet Services, stresses that owners shouldn't feel as if they have done something wrong if the euthanasia takes place on a day their pet is feeling well.

"I would much rather somebody plan we had a good day, went to the park, came home, had the ice cream sandwiches and we let that pet go than to say, 'OK, lets play it day by day,' and suddenly I get a call, 'My dog is in distress, can you come today?'" she said. "Its OK to be a good day. There is no perfect time. Nobody will ever know the perfect time."

Some veterinarians specialize in at-home euthanasia, or incorporate that into their practice. Being at home means not having to get a sick pet into the car, not having to bring them to the veterinarian's office, which may be associated with anxiety or pain.

"Allowing a pets final moments to be spent in their familiar home setting, surrounded by the comforts and smells they have known all their life, is a final gift we can give," said Cox.

The price varies widely among veterinarians and clinics. Some vets may not charge at all for euthanasia, only for cremation services. Lap of Love's Tampa Bay location charges $250 for the euthanasia itself, with additional costs for cremation. Other veterinarians have quoted prices of double and even triple that amount. You'll have to ask your vet about prices.

When the procedure cannot be done in your home, your veterinarian may have a back entrance and quiet room set aside for euthanasia so you and your pet can avoid the loud waiting room. In that case, Dr. Michael Dix of the Jacksonville Veterinary Hospital in Oregon suggests bringing along "their favorite toy, bed or blanket with the pet when the actual euthanasia is taking place."

"It is also nice for people to give special things to their pet as the time nears," Dix said. "This may be a special treat, like ice cream or hot dogs not too much, though, as they can get uncomfortable."

The most important thing is to help your pet feel calm and not increase their stress, says Dr. Katy Nelson, a veterinarian with Belle Haven Animal Medical Centre in Alexandria, Virginia, and host of "The Pet Show With Dr. Katy."

For example, if your pet wears a collar, leave it on until they have passed, since "taking it off can be excitatory," Nelson said.

And stay with your pet through the process and to the end. "While it may be hard, it would be harder knowing that the last face that your precious one saw was that of a stranger," said Nelson. "Theyve always been there for you in life. Be there for them in death."

You may feel comforted by being able to celebrate and honor your pet at the different stages of this process.

For example, perhaps you have sufficient opportunity to prepare, create and then go out and fulfill a bucket list of experiences for your pet. Or revisit their favorite places, and give them their favorite foods.

Then on the day of, you can try to have people and things around you that will foster a peaceful and meaningful experience. McCord recalls an elderly Labrador retriever whose owner invited several friends to come to her house to be there for the dog's euthanasia.

The group had flowers, lit candles and sang. The owner's friends "read a couple of really awesome poems. They did a little prayer," said McCord. "This then allows that person to deal with this death in whatever way is appropriate for them."

Your veterinarian may cry with you. In fact, it's common enough for this to happen that there's a kind of rule of thumb that the vet should ensure not to cry harder than the pet's owner.

For McVety, even with the sadness, what she mainly feels is that it is "an honor" to be part of a family's life during this time.

Cox shares this perspective. "While it is true that the nature of the appointment is a situation of sadness and loss, there is no other time in my relationship with that pet and family that is more impactful and meaningful than those moments we spend together," she said. "To be able to make a final journey as meaningful as the life lived is not just a gift to the pet and family, but a gift to me."

You have a lot of options as to what you want to do with your pet's body after euthanasia.

Your veterinarian can tell you about pet cremation services available in your area. You will generally have to specify if you want your pet cremated alone, and for their ashes to be returned to you.

There are countless urns and other specialty memorials you can buy for containing your pet's ashes. A chain of pet funeral homes called The Pet Loss Center is currently expanding through Texas and Florida; other similar operations may be opening in your city. In some jurisdictions it is legal to bury your pet in your backyard, and in some others, you can even make arrangements for you and your pet to be (eventually) buried together in a cemetery.

But before all that, many veterinarians will allow you to spend time alone with your deceased pet in the room at their animal hospital if that's where the euthanasia occurred, or in your home before the veterinarian takes away their body. McCord said she's even had pet owners ask for their pet's body to be left at home overnight.

"Thats OK; we dont have to push bodies away or hide them or cover them up the minute they passed," she said.

McVety recommends saving a lock of your pet's fur, and keeping their collar, especially if you have other animals at home. They will smell these tokens, and it will help them grieve, too.

"They dont grieve in a human way, so we cant expect them to act the same way that we do. But they get the circle of life better than we do," she said. "They understand this. Were the ones that have a problem with it. So even watching your pet and how they get through the process is, I think, such a great example for us humans on how we can continue moving forward in life in a moment-by-moment basis."

Be sure, finally, to give yourself time and space to grieve. Consider joining a pet loss support group. A pet's death can be as traumatic and difficult as the loss of a human family member.

"It is not a sign of weakness to love a pet," Nelson said. "And its certainly not a sign of weakness to mourn their loss."

Barky was spoiled rotten until her last day.

It was about five years ago now that I flew to Rhode Island where my parents live, and where they had taken such good care of our beloved dog to see Barky one last time.

Barky's final day was bright and sunny. We spent hours outside with her in her favorite spot in the yard, so she could keep a good eye on all invading squirrels. Her face was white with age; her fur was warm from the sun. We gave Barky as many biscuits as she wanted to eat.

When the vet arrived that afternoon, my parents and I sat with Barky on the couch where she'd napped so many hundreds of times that there were dog-sized white spots worn into the otherwise tan leather. My brother and his wife, who were living in Turkey at the time, joined us by Skype.

After a long time of saying goodbye, while my family and I cried into Barky's fur, the veterinarian administered the shots. We hugged her and told her we loved her as she left us. Maybe there are things we might have done differently today, given the chance. We did our best.

My mom claims to still hear Barky walking around the house from time to time. I still think of her daily. Sometimes I sit my other pets down and tell them about their Auntie Barky.

They never really pay attention, but it makes me feel better to say it.

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Pet euthanasia: Veterinarians on when it's time, cost and more ... - Today.com

The three women who took their own lives in an apparent suicide pact in a Gold Coast unit were part of controversial euthanasia advocate Dr Philip Nitsches group Exit International.

Mother Margaret Cummins, 78, and her daughters Wynette and Heather, aged 53 and 54, were found dead in a unit on Ephraim Island on Tuesday afternoon.

Dr Nitschke released a statement today confirming the trio were members of the pro-euthanasia group, and had subscribed to the online Peaceful Pill eHandbook.

He said the triple suicide pact was unusual but the "planning and research by the women that took place over a number of months indicated that this was a rational decision".

He told AAP he did not personally know the women but confirmed they had joined his Exit International group.

"It was a bit over six months ago," he said from Amsterdam.

"They were not terminally ill people but on the other hand, they were not in the best of health either.

"They were obviously working out what they wanted to do."

Dr Nitschke said three members had never ended their lives at the same time before.

But the man known as 'Dr Death' said it appeared to be a "rational and informed choice" and their decision to end their lives because of their health problems was a matter only for them.

"It needs to be respected, it doesn't mean you need to be enthusiastic about it," he said.

9news.com.au has approached Dr Nitschke for further comment.

A Gold Coast man returned to the luxury residential estate of Ephraim Island at Paradise Point on Tuesday to find his wife, mother-in-law and sister-in-law dead.

Detective Senior Sergeant Mark Procter told News Corp Australia the husband was shaken, but not completely surprised.

It's believed all three had medical problems and police aren't treating the deaths as suspicious.

Neighbours have expressed sadness over the deaths in the upmarket residential community is joined to the mainland by a bridge.

Ephraim Island is an artificial island developed in the mid-200s as a resort and holiday destination.

Rental villas and holiday homes in the area can cost more than $1500 a week, while many other holiday-goers prefer to tie up luxury yachts in the marina.

Euthanasia is illegal in Australia, although Dr Nitschke led a successful campaign to allow assisted suicide in the Northern Territory in 1996.

Four people committed suicide through the laws provisions before it was overturned by the Federal Parliament in 1997.

Dr Nitschke founded Exit International following the ban.

In 2014 he was suspended from practising medicine, but this was overturned in 2015.

The Medical Board of Australia nonetheless prohibited him from providing information about euthanasia as part of his conditional return to practice.

In response, Dr Nitschke publicly burned his medical certificate and moved to Holland, where he currently resides.

*Readers seeking support and information about suicide prevention can contact Lifeline on 13 11 14.

*Suicide Call Back Service 1300 659 467.

*MensLine Australia 1300 78 99 78.

*Multicultural Mental Health Australia http://www.mmha.org.au.

Nine Digital Pty Ltd 2017

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Gold Coast suicide pact trio members of 'Dr Death' pro-euthanasia group - 9news.com.au

A vocal member of the QandA audience expressed her own feelings on euthanasia in Australia. Courtesy: ABC

William Toffler is touring Australia campaigning against euthanasia. Picture: Facinglife.tv/Youtube

AN ultraconservative, anti-euthanasia campaigner with extreme views on abortion and contraception is this week touring Australia and meeting with senior MPs.

US doctor William Toffler believes abortion can lead to breast cancer, contraception is against Gods plan and suicide is a sin. Now hes here on the dime of a Liberal politician to convince some powerful people not to legalise assisted dying, which has been legal in his home state of Oregon for 20 years.

Im here to educate people its probably not great to make Oregons mistake, he told news.com.au. Theres a shroud of secrecy, its corrupted the practice of medicine, violating the trust between doctors and patients.

The paradigm of situational killing is anathema to end-of-life care.

This is the perfect murder. Its very flawed, very dangerous and impossible to circumscribe.

William Toffler is touring Australia campaigning against euthanasia. Picture: Facinglife.tv/YoutubeSource:YouTube

Dr Toffler who is this week addressing MPs in Melbourne, Sydney, Adelaide and Perth says there are no adequate psychiatric tests for people who want to end their lives and that they are not asked whether they have life insurance or who the beneficiary is.

He lists a number of anecdotes about people who did not have appropriate mental health checks, about a woman absconding with her euthanised partners $25,000 and about medical staff failing to administer lethal doses properly.

While the statistics from Oregon indicate all is well, Dr Toffler says thats because cases are not properly investigated.

Victorian MP and Leader of the The Australian Sex Party Fiona Patten told news.com.au Dr Toffler was providing a lot of misinformation and misrepresenting the situation in Oregon.

She said she supported his right to free speech but that he had no evidence to support his theories and she felt he was trying to force his views on others.

Ms Patten said she had visited Oregon, where there had not been one case of litigation, and gained a very different picture from doctors and patients.

Im hoping people look at the evidence and listen to the experts in this area and vote on its merits, she said. I dont think Professor Toffler is very helpful in that respect.

Sex Party leader and Victorian MP Fiona Patten said Dr Toffler was trying to force his views on others. Picture: Mark StewartSource:News Corp Australia

The Catholic Church and Right to Die are very well funded. I know privately an enormous number of MPs would like to see physician assisted dying approved.

We received over 1000 submissions to our inquiry. I dont think anyone with compassion could have heard them and not want to give patients at the end of their lives and suffering some kind of autonomy.

She said the alternatives to assisted dying were often violent suicides, unregulated euthanasia or Dr Tofflers recommendation of sedation, in which patients died of starvation or dehydration.

Polls show around 80 per of Victorians and, it is believed, Australians nationwide support a law for voluntary assisted dying.

Shayne Higson, Vice President of Dying with Dignity, told news.com.au that the law in Oregon had been working safely and effectively for 20 years, supported by the public and medical profession, which was why similar laws are now in place across six states in America.

Hopefully the parliamentarians of Victoria and NSW will not be persuaded by scaremongering, she said. It is a challenge when groups like Right to Life bring people here and put them forward as experts. I dont think Dr Toffler would be considered an expert in Oregon.

Hes Catholic and represents a very small minority of people.

His views are not really credible. Its disappointing that Australians, especially the Victorian Parliament, are going to be exposed to his views. We deserve a better, evidence-based debate.

There is no slippery slope, and no evidence of widespread abuse.

Dr Toffler says that while the law currently only allows assisted dying for terminally ill, mentally competent patients, there is no reason this would not be extended if people were suffering for longer periods of time.

Andrew Irving, holding a photo of wife Marilyn, who passed away after a long illness, at a rally supporting a voluntary assisted dying bill. Picture: Luke BowdenSource:News Corp Australia

Claiming dignity by taking a massive overdose is specious, he said. I was married for 40 years my wife died 13 months ago with cancer of the uterus.

The reality is because my wife and I knew she was going to die there was suffering, but also great joy. Our days together all more special because we knew they were numbered.

I wouldnt trade it for a nanosecond. To say an overdose is dignified, what does it say about my family, my wife, who chose to live her life fully with support from family and doctors?

Many advocates for assisted dying have spoken out against Dr Tofflers visit, which comes as the debate heats up in Australia, particularly in Victoria and NSW, where Voluntary Assisted Dying Bills have been tabled to the state parliaments.

While Premier Daniel Andrews, most of his ministers, the Sex Party and the Greens are in favour of reform, some are not, including such as Deputy Premier James Merlino, Opposition leader Matthew Guy and socially conservative Liberals and crossbenchers.

Anne Gabrielides from NSW is terminally ill and campaigning for the right to die on her own terms.Source:News Corp Australia

A spokesperson from Go Gentle Australia told news.com.au in a statement: Dr Toffler is a controversial member of the religious right and was part of a very small minority in the Oregon Medical Association who opposed a womans right to choose abortion and did so because God told him so. He has publicly aligned himself with the discredited view that there is a link between abortion and breast cancer, a view opposed by, among others, the Australian Medical Association, the Cancer Council of Australia and the Breast Cancer Network, Australia.

Toffler is being sponsored in his visit to parliament by Liberal MLC Inga Peulich. Ms Peulich was one of two dissenting votes on the Cross-Parliamentary Inquiry into End-of-Life Choices Committee. Their recommendations (6-2 in favour) laid the groundwork for the voluntary assisted dying bill to go before Parliament later this year.

Along with the other dissenting voice Labor MP Daniel Mulino Ms Peulich chose not to travel with the Committee to Oregon, or other jurisdictions where assisted dying laws exist, to learn how they work.

Instead, she has chosen to sponsor a speech to MPs by a doctor with extreme religious views. A doctor whose opposition to Oregons Death with Dignity law not only predates its existence, but also flies in the face of its widespread acceptance after more than 20 years of operation.

The people of Victoria deserve better from Ms Peulich than the introduction of a religious extremist into this important public health debate.

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Anti-euthanasia campaigner touring Australia with some very extreme views - NEWS.com.au