Euthanasia of Cats by Australian Veterinarians: A Survey of Current Practices
Abstract
:Simple Summary
Abstract
1. Introduction
2. Materials and Methods
2.1. Survey Instrument
2.2. Recruitment, Consent, and Ethics Approval
2.3. Data Cleaning
2.4. Descriptive Analysis
2.5. Outcome and Explanatory Variables
2.6. Univariable Analysis
2.7. Multivariable Analysis
2.8. Coding of Free-Text Responses
3. Results
3.1. Demographic Data
3.2. Euthanasia Methods Used by Australian Veterinarians
3.3. Factors Associated with the Use of a Premedication or Sedation in a Non-Emergency and Emergency Euthanasia
3.4. Free-Text Responses
4. Discussion
5. Limitations
6. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Demographic Parameter | Category | Number | Percentage (%) |
---|---|---|---|
Gender | Male | 97 | 16.6 |
Female | 485 | 82.9 | |
Other | 3 | 0.5 | |
Primary workplace | Animal shelter practice/charity/NGO | 16 | 2.7 |
Private companion animal practice | 430 | 73.5 | |
Private mixed practice | 103 | 17.6 | |
Research laboratory | 1 | 0.2 | |
Veterinary teaching hospital | 10 | 1.7 | |
Other (please specify) | 25 | 4.3 | |
Location | Metropolitan | 282 | 48.2 |
Regional | 257 | 43.9 | |
Rural | 45 | 7.7 | |
Remote | 1 | 0.2 |
Category | Non-Emergency Euthanasia | Emergency Euthanasia | |||
---|---|---|---|---|---|
Count/Denominator | Percentage (%) | Count/Denominator | Percentage (%) ** | ||
Did you use premedication or sedation? | Yes | 415/585 | 71 | 242/462 | 52.4 |
No | 170/585 | 29 | 220/462 | 47.6 | |
What was the reasoning behind using a premedication? | Chemical restraint | 242/415 | 58.3 | 139/242 | 57.4 |
(Participant could select multiple options) | Clinic protocols | 54/415 | 13 | 24/242 | 9.9 |
Reduce stress to owner | 327/415 | 78.6 | 163/242 | 66.5 | |
Reduce stress to patient | 388/415 | 93.3 | 218/242 | 90.1 | |
Taught to administer a premedication prior to euthanasia drugs | 32/415 | 7.7 | 11/242 | 4.5 | |
Other (please specify) | 26/415 | 6.3 | 24/242 | 9.9 | |
What was the drug used for premedication or sedation prior to the euthanasia you performed most recently? | Acepromazine | 120/415 | 28.9 | 43/242 | 17.8 |
(Participant could select multiple options) | Alfaxalone | 61/415 | 14.7 | 45/242 | 18.6 |
Inhalation anaesthesia | 2/415 | 0.5 | 7/242 | 2.9 | |
Ketamine | 31/415 | 7.5 | 21/242 | 8.7 | |
Medetomidine/dexmedetomidine | 61/415 | 14.7 | 35/242 | 14.4 | |
Opioids (methadone, buprenorphine, tramadol, butorphanol, pethidine) | 118/415 | 28.4 | 107/242 | 44 | |
Propofol | 20/415 | 4.8 | 13/242 | 5.4 | |
Tiletamine-zolazepam | 205/415 | 49.4 | 87/242 | 35.9 | |
Thiopentone | 10/415 | 2.4 | 8/242 | 3.3 | |
Xylazine | 9/415 | 2.2 | 5/242 | 2.1 | |
Other (please specify) | 15/415 | 3.6 | 1/242 | 0.4 | |
What was the route of administration for the premedication that you used? | Inhalation | 2/415 | 0.5 | 8/242 | 3.3 |
(Participant could select multiple options) | Intracardiac injection | 1/415 | 0.2 | 2/242 | 0.8 |
Intravenous injection | 115/415 | 27.7 | 92/242 | 38 | |
Intramuscular injection | 161/415 | 38.8 | 107/242 | 44.2 | |
Intraperitoneal injection | 2/415 | 0.5 | 2/242 | 0.8 | |
Oral administration | 4/415 | 0.95 | 0/242 | 0 | |
Subcutaneous injection | 148/415 | 35.7 | 45/242 | 18.6 | |
Other (please specify) | 0/425 | 0 | 2/242 | 0.8 | |
What was the primary method that you used in your most recent non-emergency euthanasia of a cat? | Pentobarbitone sodium | 584/585 | 99.8 | - | - |
(Participant could select multiple options) | Anaesthetic inhalation | 2/585 | 0.3 | - | - |
Potassium chloride | 1/585 | 0.2 | - | - | |
Thiopentone | 3/585 | 0.5 | - | - | |
Other (please specify) | 1/585 | 0.9 | - | - | |
What was the route of administration of your chosen euthanasia drug? | Intravenous injection | 536/585 | 91.6 | - | - |
(Participant could only select one option) | Inhalation | 0/585 | 0 | - | - |
Intracardiac injection | 15/585 | 2.6 | - | - | |
Intramuscular injection | 1/585 | 0.2 | - | - | |
Intraperitoneal injection | 7/585 | 1.2 | - | - | |
Oral administration | 0/585 | 0 | - | - | |
Subcutaneous injection | 0/585 | 0 | - | - | |
Other (please specify) | 26/585 | 4.4 | - | - | |
Was the euthanasia a house call or did it happen at the clinic? | House call | 49/585 | 8.4 | 13/242 | 5.4 |
(Participant could only select one option) | At the clinic | 531/585 | 90.8 | 229/242 | 94.6 |
Other (please specify) | 5/585 | 0.85 | 0/242 | 0 | |
Was the owner present during the euthanasia? | Yes | 513/585 | 87.7 | 197/242 | 81.4 |
No | 72/585 | 12.3 | 45/242 | 18.6 | |
How long do you schedule for a routine euthanasia? | 10 min | 22/585 | 3.8 | - | - |
(Participant could only select one option) | 20 min | 113/585 | 19.3 | - | - |
30 min | 345/585 | 59 | - | - | |
40 min | 28/585 | 4.8 | - | - | |
60 min | 23/585 | 3.9 | - | - | |
Other (please specify) | 39/585 | 6.7 | - | - | |
Unlimited | 15/585 | 2.6 | - | - | |
Were you assisted during the euthanasia? | Yes | 413/585 | 70.6 | 168/242 * | 69.4 |
No | 172/585 | 29.4 | 74/242 * | 30.6 | |
Who assisted?(Participant could only select one option) | Client | 3/413 | 0.7 | 5/168 * | 3 |
Veterinary nurse | 405/413 | 97.8 | 162/168 * | 96.4 | |
Other (please specify) | 5/413 | 1.2 | 1/168 * | 0.6 | |
What adjunctive measures did you take to minimise fear/anxiety/stress in the patient? | Away from other animals | 507/585 | 86.7 | 206/242 * | 85.2 |
(Participant could select multiple options) | Pheromones | 207/585 | 35.4 | 78/242 * | 32.1 |
Dim lighting | 128/585 | 22 | 48/242 * | 19.8 | |
Longer appointment time | 355/585 | 60.7 | 116/242 * | 47.7 | |
Soft bedding | 429/585 | 73.3 | 165/242 * | 67.9 | |
Soft music playing | 22/585 | 3.8 | 7/242 * | 2.9 | |
Treats | 81/585 | 13.8 | 24/242 * | 9.9 | |
Cat only consult room | 141/585 | 24.1 | 44/242 * | 18.1 | |
ISFM accreditation | 33/585 | 5.6 | 11/242 * | 4.9 | |
Other (please specify) | 42/585 | 7.2 | 14/242 * | 5.8 | |
None | 26/585 | 4.4 | 17/242 * | 7 | |
Did you dispense medication to the owner for the patient prior to the appointment? (Participant could select multiple options) | Barbiturates | 1/56 | 1.8 | - | - |
Clonidine | 0/56 | 0 | - | - | |
Gabapentin | 51/56 | 91.1 | - | - | |
Opioids | 2/56 | 3.6 | - | - | |
Oral acepromazine | 1/56 | - | - | ||
Trazodone | 0/56 | 0 | - | - | |
Other (please specify) | 0/56 | 0 | - | - | |
None | 529/585 | 90.4 | - | - |
Premedication or Sedation | Univariate | |||||
---|---|---|---|---|---|---|
Predictor | Category | Yes (%) | No (%) | Total | OR (95% CI) | p Value |
Gender | Male | 52 (53.6) | 45 (46.4) | 97 | 1.0 | <0.001 |
Female | 360 (74.2) | 125 (25.8) | 485 | 2.5 (1.6–3.9) | – | |
Workplace | Private companion animal practice | 304 (71.2) | 123 (28.8) | 427 | 1.0 | 0.006 |
Private mixed practice | 63 (61.2) | 40 (38.8) | 103 | 0.6 (0.4–1.0) | ||
Other * | 45 (86.5) | 7 (13.5) | 52 | 2.6 (1.1–5.9) | ||
Location | Rural and remote | 27 (58.7) | 19 (41.3) | 46 | 1.0 | 0.004 |
Regional | 170 (66.1) | 87 (33.9) | 257 | 1.4 (0.7–2.6) | ||
Metropolitan | 215 (77.1) | 64 (22.9) | 279 | 2.4 (1.2–4.5) | ||
Years since graduation | 0–4 years | 103 (71.0) | 42 (29.0) | 145 | 1.0 | 0.702 |
5–11 years | 101 (68.2) | 47 (31.8) | 148 | 0.9 (0.5–1.4) | ||
12–22 years | 107 (74.3) | 37 (25.7) | 144 | 1.2 (0.7–2.0) | ||
23+ years | 101 (69.7) | 44 (30.3) | 145 | 0.9 (0.6–1.6) |
Predictor | Categories | Adjusted OR | 95% CI | p Value |
---|---|---|---|---|
Gender | Male | 1.0 | <0.001 | |
Female | 2.6 | 1.6–4.0 | ||
Location | Rural and remote | 1.0 | 0.037 | |
Regional | 1.3 | 0.7–2.7 | ||
Metropolitan | 2.2 | 1.0–4.5 |
Premedication or Sedation | Univariate | |||||
---|---|---|---|---|---|---|
Predictor | Category | Yes (%) | No (%) | Total | OR (95% CI) | p Value |
Gender | Male | 34 (42.5) | 46 (57.5) | 80 | 1.0 | 0.055 |
Female | 207 (54.3) | 174 (45.7) | 381 | 1.6 (1.0–2.6) | ||
Workplace | Private companion animal practice | 177 (53.2) | 156 (46.8) | 333 | 1.0 | <0.001 |
Private mixed practice | 33 (36.3) | 58 (63.7) | 91 | 0.5 (0.3–0.8) | ||
Other * | 31 (83.8) | 6 (16.2) | 37 | 4.6 (1.9–11.2) | ||
Location | Rural and remote | 13 (32.5) | 27 (67.5) | 40 | 1.0 | 0.009 |
Regional | 112 (50.2) | 111 (49.8) | 223 | 2.1 (1.0–4.3) | ||
Metropolitan | 116 (58.6) | 82 (41.4) | 198 | 2.9 (1.4–6.0) | ||
Years since graduation | 0–4 years | 54 (50.9) | 52 (49.1) | 106 | 1.0 | 0.958 |
5–11 years | 68 (51.5) | 64 (48.5) | 132 | 1.0 (0.6–1.7) | ||
12–22 years | 57 (52.3) | 52 (47.7) | 109 | 1.1 (0.6–1.8) | ||
23+ years | 62 (54.4) | 52 (45.6) | 114 | 1.1 (0.7–2.0) |
Code | Number of Comments Coded | Examples |
---|---|---|
Premedication, sedation, and/or analgesia | 68 | “Often old cats have the worst veins, and they are also arthritic and hate their legs being handled. I think they need to be given sedation/pain relief.” (8) “In the ideal world. the cats would be given gabapentin prior to presenting—most times, it doesn’t happen due to the owners making the decision with not giving us much time to prepare—they seem to give more time for their dogs than their cats.” (37) “Less sedation for old sick cats.” (369) “…never use sedation.” (470) “I do not understand why some vets do not use sedation. I used to not due to lack of training and doing what others did. My eyes were opened by my previous boss. Now I would not do a euthanasia without it.” (607) |
Use of intravenous catheters | 47 | “Always place an IV catheter. This is done in a separate room before cat is brought back to owner.” (46) “I primarily use premedication to allow catheter placement with minimum stress. Most emergency euthanasias already have a catheter placed.” (151) “[I] find catheter placement in saphenous vein much better tolerated.” (335) |
Methods of euthanasia (including route of administration) | 29 | “I always try to go IV but warn owners that sometimes I have to go into the kidney.” (21) “If the cat is untouchable, I would use volatile anaesthesia in a box. If the veins can’t be catheterized, I would do a lethal injection intracardiac.” (35) “I often use a direct injection into the kidney (care to not inject into renal pelvis) which I find works well with no obvious pain or distress.” (376) “In my area, there are a lot of feral cats. The landowner catches the cat in a live-catch cage and signs appropriate paperwork. I check the cat is genuinely feral and not tame. (If tame I take it to the pound for desexing and rehoming). Euthanasia is instant loss of consciousness with a single 0.22 rifle subsonic (quiet) shot to the base of the brain. I try to minimise stress to the cat by keeping its cage covered and approaching quietly and slowly.” (696) |
Euthanasia of anxious or aggressive animals | 21 | “We use high doses of premeds to heavily sedate many unsocialised and feral cats presented to us.” (262) “Our clinic performs a lot of feral cat euthanasias. I always administer 0.5 mL xylazine IM prior to handling the cat. 1. For safety—have had too many nurses and vets bitten/scratched. 2. Reduce the stress to the cat when handling and going IC with Lethabarb [pentobarbitone sodium] injection” (357). “Sometimes I use Zoletil [tiletamine/zolazepam], particularly if in a hurry. For really aggressive cats I have dispensed gabapentin 100 mg capsule for the client to administer prior to doing the job. For feral cats I have sometimes used a Jabstick [a push-operated pole syringe] to safely administer anaesthetic. If no owner present then I don’t mind using xylazine to sedate the cat, they will always vomit with this protocol but it is a great drug and once anaesthetised, I have no issue with intracardiac pentobarbitone if no owner present (animal must be anaesthetised first).” (698) |
Communicating with clients | 15 | “I spend a lot of time prior to the injection making sure all present are in agreement, understand the necessity, humanity and what will happen.” (20) “Allow time to spend alone with the cat beforehand (presuming it is not an emergency euthanasia) explaining what the procedure is, and being compassionate.” (100) |
Minimising patient fear, anxiety, or distress | 13 | “We always use stress free handling techniques with cats.” (139) “Use of minimal restraint, medial saphenous vein.” (179) “I don’t normally give a premed but I think it was a good call and the cat fell asleep eating treats and I felt it was a good death.” (513) |
Approaches to euthanasia are unique or dependent on individual patient | 11 | “Every single one different” (276). “Every case is different and there is no one blanket treatment. I use a lot of medetomidine IM after hours to sedate the patient before I put an IV in. I don’t have access to nurses on call. Moribund cats I go intra-kidney often with the owners present.” (610). “Each cat’s character and nature is taken into account when determining the best approach to euthanise them. I always try to make it as stress free and caring as possible.” (646) |
Euthanasia of unowned or stray animals | 11 | “With shelter animals I try to treat them as if they are owned.” (117) “Our clinic routinely euthanises strays presented by the pound. These animals are in crush cages and are given intraperitoneal/intrarenal/intrahepatic injections of pentobarbitone without any sedation. The cages are covered with towels to provide shelter for them. This procedure is clinic policy.” (138) “Shelter euthanasias are very different to client directed euthanasia in my experience.” (623) |
Minimising owner stress | 10 | “Placing an IV canula in patient in a room away from owner minimises stress to owner then adding an extension tube so euthanasia solution can be administered at a distance and not between owner and cat at time of administering pentobarbitone.” (63) “Owner engagement important, allow owner to stay with cat after heart stopped.” (699) |
Assistance during euthanasia | 8 | “…decision to use or not use premed depends on condition/demeanour of cat, availability of assistant (not owner) for restraint if required.” (14) “IV catheter placed with vet nurse restraining. If cat fractious/distressed will admin IM or SC sedation before placing catheter.” (244) |
Adverse effects and their management or avoidance | 6 | “I buffer my premedication to reduce the sting.” (16) “May consider adding a sedation prior to any euthanasia to prevent gasping or reactions during procedures, not happen that often but it is very distressing.” (565) “I place the IV catheter out of the consult room in case the cat flinched, reacts to the needle. We also use EMLA cream to reduce feeling.” (630) |
Do not separate animal from owner at any point in the process | 5 | “Never take cat away from owner.“ (5) “Intraperitoneal route is my favoured route for cats. No pain, no restraint required, goes to sleep over a few minutes during which time many owners want to hold and cuddle their pet.” (82). |
Discussing aftercare of the body costs and paying accounts | 4 | “All the discussion of aftercare and payment is done prior.” (20) “I spend a lot of time before and after the euthanasia talking to owner (and family) about after-care options, grief support, memorial items and supporting their other pets.” (428) |
Time of appointment | 4 | “I try not to rush clients. I love home euthanasias but no longer work in a clinic that offers this.” (462) “I put everything I can in for the patient and the client in that 30 min.” (607) |
Location of euthanasia | 4 | “Would prefer cat only rooms.” (373) “I would prefer to perform all euthanasias in the pet’s home rather than a clinical setting.” (59) |
Indications and justifications for euthanasia | 3 | “I must convince myself there is nothing I could help the cat to alleviate the suffering and pain, also there is no quality of life.” (6) “Advise [that euthanasia is] a just act. Listen to their story.” (69) |
Need to be compassionate in general | 3 | “gentle hands & kind words.” (15) “do it well, smoothly kindly, with sympathy.” (705) |
Sympathy cards and memorials | 2 | “In our clinic we offer gold paw prints and hair samples and send sympathy cards. We send flowers to significant pets (long association with the clinic). I have also recently started to take photos before and after [euthanasia] with the client’s permission and have printed these out and given to the client. I have found this very well received.” (65) |
Minimising stress to veterinary team members including self | 1 | “I have to mentally prepare myself for euthanasia every single time.” (607) |
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Chan, H.; Pepper, B.M.; Ward, M.P.; Quain, A. Euthanasia of Cats by Australian Veterinarians: A Survey of Current Practices. Vet. Sci. 2023, 10, 627. https://0-doi-org.brum.beds.ac.uk/10.3390/vetsci10100627
Chan H, Pepper BM, Ward MP, Quain A. Euthanasia of Cats by Australian Veterinarians: A Survey of Current Practices. Veterinary Sciences. 2023; 10(10):627. https://0-doi-org.brum.beds.ac.uk/10.3390/vetsci10100627
Chicago/Turabian StyleChan, Hedia, Brianne Marlene Pepper, Michael P. Ward, and Anne Quain. 2023. "Euthanasia of Cats by Australian Veterinarians: A Survey of Current Practices" Veterinary Sciences 10, no. 10: 627. https://0-doi-org.brum.beds.ac.uk/10.3390/vetsci10100627