The Right Time to Euthanize a Pet | Dr. Lisa Walling Interview

Hi! I’m Michelle. I’m Joe. We’re here with
VetMedics and today we have a special guest with us, Dr. Lisa Walling of
Comforting Care Veterinary Services. We work in conjunction with some services
that we provide including in-home euthanasia, hospice, palliative care, and
she also provides acupuncture services. So I work with VetMedics on a regular
basis and we kind of work as a team to go to homes to help people out at the
end of life for their pets either for hospice or palliative care. So as long as
I set up a client relationship and meet your pet, then Michelle can go in and
help out with doing some technician services at the home being giving sub-q
fluids, helping with treatments helping keep your pet
comfortable at home and then getting back to me with what’s going on and how
the pet is doing especially if I can’t get to a pet she can come and evaluate
your pet until I get there. And hospice care, I guess I’ll explain.
Hospice Care is generally kind of guidance toward the end of life helping
people once their pet has either a terminal illness or a very chronic
illness that is not going to get better and just going to kind of progress. I can
help by coming to your home, evaluating your pet in your home, which gives us a
lot more information than that you can get being in the hospital so I can see
the environment where you have your food dishes, what your floors are like…All
those things can kind of help you keep your pet most comfortable at home as
well as prescribing medications and then offering also acupuncture can be very
helpful for pain especially with arthritis and back pain and neurologic
issues. Acupuncture is excellent for that.
That’s why hospice I think is so important to offer and it’s an
awesome service. I mean we get a lot of calls and automatically people ask, you
know, is it time for euthanasia? Mm-hm And I don’t think a lot of people know that
veterinary hospice care exists. So it’s an awesome service that she provides and
yeah, we work right in conjunction one another and we help prolong
the life of a lot of pets. Yeah we can and kind of guide people toward the end
of life if they’re not quite sure if it’s time we can give them a lot of
information to help them figure out when it is time and I can help them make that
decision when it is time to finally euthanize. So there’s things like pain
charts so we know so pet parents can kind of look and see certain
positionings and certain behaviors that they’re doing at home to
know if their pet is in pain. And you monitor respiratory rates. I can give
them all kinds of things that they can do at home to know if their pet is
getting worse which can really help you the owners know if their pet is
worsening if their pet is suffering and then once they make the final decision
then we can also help them at that point with the euthanasia in the home. Right,
yeah. And that’s another reason why we work in conjunction with Dr. Walling
again we get a lot of calls for euthanasia or how do we know when it’s
time to euthanize our pet? And being a licensed tech, which is awesome, but very
limited as what we can do medically so that’s why you know you need a doctor such as yourself who is awesome and offers all these great services that, again, I
don’t think a lot of pet parents know. They don’t they don’t know that
these options exists, you know, to certain medications and changing certain
things in the home. Yeah and also just coming to see one of us, it doesn’t
necessarily mean that you have to cut off communication with your regular
veterinarian. What’s great about hospice care is it’s this whole team
effort. So the team includes me as the hospice veterinarian, your regular
veterinarian, possibly your oncologist, Michelle as a vet tech coming
to your house to help, and then we can even get people, we can even get help
with social workers if you’re having a lot of trouble. That’s where Joe comes in! Right. It’s helpful. Yeah it is a whole kind of holistic
approach to helping the client. In hospice care my patient is basically
considered the owner and the pet so I help the owner not just the pet so
that’s part of it is kind of helping people and guiding them through this you
know to watch for things that their pet may be it’s ready for euthanasia and you
know. Things that I think are most common to watch for are decreased appetite a
big one is decreased socialization that your dog is normally sitting on a couch
with you when you’re watching TV and now they’re off in the kitchen where they
never are alone. They don’t want to go outside, they’re having more trouble
getting up, they’re falling frequently… Those are all kinds of things that we
can kind of help them and you can also do a quality-of-life assessment which is
just kind of going into the home and checking and helping people figure out
if their dogs quality of life is good enough to you right keep going and
keeping them medicated or if it is maybe time for euthanasia. Right. And Joe
actually talks to quite a few clients too, you know, when we’re in an emergency
type situation or even at the hospital and owners are really still having a
hard time whether to decide if this is it or not. You know, they kind of look to
us because we’ve already made that connection with the owner and the pet at
their home going into the hospital and then they kind of look to us as if like
to still help or give answers or just to be there. Because I think you know it’s
always a hard decision and it’s never a decision that we can make for the owners
or pet parents but we can listen to what’s going on and help them to really
look at some of the things that we know are significant factors and it’s you
know, it’s always helpful just that as you said it’s a team approach and that
the owners and parents are part of the team too and when everyone works
together it makes even a hard situation a little bit easier. Yeah Yeah
Yeah So, you know, with the hospice, you know we
kind of went into all the things you can offer and stuff but again we get
phone calls–how do we know it’s time you know. I think we have to euthanize our pet…
Yeah, I usually, you know, can figure out is usually pretty well on the
phone by talking to them about like you know like I said like appetite, activity
levels, socialization, breathing, if they’re having trouble breathing, or
coughing, or bleeding, or you know, if they already have a previous diagnosis from
their veterinarian that we know is a terminal diagnosis like cancer then we
can kind of tells by some of the things they tell us on the phone if it sounds
like it’s time. And then the nice thing is once we go to the home for the
euthanasia if they set it up, if we get there which Michelle knows, if we get
there and it seems that oh there’s still some more that we can do to keep their
pet comfortable a little bit longer if that’s something that they’re interested
in doing then we can turn it into a hospice evaluation. We’ve shown up to
people’s houses and yeah expecting to euthanize their pet and we walk
away giving them an extended life. Yeah and even if it’s only a week longer I
think it’s nice to have your pet there as long as they know that someone has
come to evaluate their pet and there’s tells us your pet’s not
suffering and there’s more that we can do. So that that is a nice thing to be
able to offer. Mm-hmm yep I mean what’s your feeling? And you know you know we
always say nobody wants to play God and you know we just recently had a case not
too long ago where the owners were definitely in stress with the bigger dog
and you know she kind of looked to you for some guidance as to… Yeah and you
know again like you know I say right that it’s never right to make a decision
for people, can help them to look at what’s going on I tell what I’m seeing
with the dog, the dog appears to be in distress and what the options are. Which
I think a lot of people aren’t aware of the hospice care as an option yeah
that’s this other piece of it but I know that the this recent case that I worked
with and the option at the time was either to euthanize the dog or
for us to transport the dog to a specialty center. I said we can certainly
do that well it knows there were no guarantees with that that it would be
stressful for the dog that we would do our best with the dog but it was just
something for her to think about. That it didn’t guarantee an outcome that was
gonna be an added stress and I think that enabled her to make the decision
that she didn’t want to go through with that. People just need a little help. Yeah
We always say you know we can’t make that decision for you. We’re
here to help and help guide you yeah definitely guide people and make them
feel comfortable with whatever decision they make one way or the other. Another thing
that people probably don’t know about hospice care is that once in a while we
have people that due too like religious or ethical reasons they don’t want to go
euthanize at all yeah so a lot of veterinarians at your hospital, if you’re
in their hospital there’s nothing you can do you kind of have to know that pet
is going home to potentially suffer until it does pass away. And with hospice
care I can come into the home and actually help guide people through
what’s called a natural death so it’s not that common. But if something like,
especially for religious reasons, if someone doesn’t believe in euthanasia I
can help keep them medicated with pain and that’s something that sometimes we
may need to stop in daily. I might have to have Michelle stop in everyday or
myself to check on that pet and make sure that they’re not suffering and that
we kept them medicated. But that’s why it’s great to have you know
that like with human medicine a doctor directs the treatments a technician or
nurse is able to carry some of the treatments out that consists with certain
things. But it’s all those options. I think a lot of times you know people
have their reasons why they do or don’t want to euthanize at a given time
and sometimes it’s just validating for them what they’re seeing what they’re
feeling and that yes you know this is why maybe you want to keep going a
while or maybe this is why you want to move to euthanasia now.
Even if someone does choose to kind of try and have a natural death for their
pet at home if things really change for the worse
obviously that can change everyday. They can change their mind and say that now
their pet is suffering too much and we can’t keep it comfortable and then we
may say this you know we’re recommending euthanasia for your pet. But it is an
option for people to have that I think no one knows it’s available they think
they just have to go home and wait by their poor pet to die at home.
And that’s when your pet is definitely going to suffer if you don’t have
someone helping you through it. right yeah so why don’t you touch on
acupuncture also. okay I mean it’s a practice that’s been around for quite
some time Easter, Western out yeah yeah the Chinese developed it and I
learned it from more of a scientific perspective than from the Chinese
perspective. It’s all the same points and the Chinese figured it out somehow and
it works right so how how acupuncture is actually scientifically proven to work
it’s not just you know hoping that it works but so it’s its points on the body
So I know Chinese and Chinese medicine they talk about meridians and Qi flow
but more I’m I’ve learned it from the perspective of I know more I later from
the perspective of the points run along where nerves and vessels run and so it
stimulates those nerves that can kind of help kind of you know your
fight-or-flight response the sympathetic nervous system it could kind of decrease
that a little bit and it can help with the parasympathetic nervous system was
just more calming. It can help with pain inflammation just because it’s around
all those nerves and vessels and so there’s different points that so
basically the nerves go out of the spinal cord and they go to different
organs and that’s how some of them help different organs like the kidneys or the
liver so we can make a difference we can make a difference with appetite and pain
and and and anxiety too so yeah it can really help with anxiety if you have an
anxious pet acupuncture may be enough – What’s your most I’m done I guess what’s
the word I’m looking for what do you get called for most to do acupuncture for
what you know arthritic pain kidney disease? Yes most often it is arthritic
big old arthritic dogs but actually, or neurologic so if you have a dog that has
disc disease you know like if you have a ruptured disk and then the you go you take them to the specialty center and they
recommend surgery to remove that disc material and that can do we see a lot of
those very that can be like yeah six to eight thousand dollars I think and so if
something a lot of people cannot afford to do that so another option if is
either doing the surgery and then having acupuncture afterwards but if you can’t
afford the surgery it’s worth trying acupuncture as long as we can keep your
medicated for pain while we’re trying to get their neurologic function back but
it could make a big difference just acupuncture without surgery for backs
yeah I actually do with someone as She’s busy with. Some cat patients too. I have a
little kitty cat that has neurologic weakness to his back legs and we’ve been
doing acupuncture now for a few months he’s the super chill cat he sits on his
owners lap and just lets me put the needles in and then hangs out on her
that’s awesome for 15 minutes we just leave the needles in and he’s now like
jumping up onto his cat tree like he’s doing great they’re happy he’s like 18
years old Wow he’s doing very well. Yeah and she
notices when the acupuncture starts to wear off so you know going to him every
a couple weeks now well you performed it on one of my past
Oh Poli You know towards his and he had some
neurologic issues kidney disease and arthritis and definitely after yeah I
could definitely tell a difference. Yeah sometimes they’re really sleepy after
the first treatment after each treatment but then it can really help them. Do you
ever get good results from just primary anxiety maybe a dog with
thunderstorm phobia or separation anxiety or right I mean it could
potentially work I haven’t had a patient that has come to me just that usually
the patients that are coming to me are for arthritis oh by the way he has
really bad anxiety and so it kind of help kind of calm them down a little bit
I haven’t tried one that’s just totally behavioral yeah yeah but I think it
could really help there’s a bunch of points that can really help calm down
the sympathetic nervous system so I think it really would make a difference
yeah. Yeah Doctor Walling I think it might be helpful for people to hear a
little bit more if they’re not familiar if whether or not they’ve been through
hospice care the actual process of euthanasia in a
what that looks like especially when it’s done at home. Right so I only do
euthanasias in the home for people and it’s so much nicer at home I gotta say
and Michelle knows this we go together a lot and at home your pet can be kind of
wherever they’re most comfortable on the couch on your bed on their bed in the
backyard we’ve done that you know it’s kind of done it front yard we’ve been
definitely in the front yard and kind of anywhere that they’re comfortable and
you’re comfortable the whole family can be there and be around them and it you
know we can be there kind of as long as people need and what the procedure is
usually it’s two injections the first injection we give is a very heavy
sedative and a pain medication and an anti-anxiety medication so that’s all in
one syringe that one they do sometimes feel and react to but that’s all. If they’re eating well we usually can distract them when the treat if they
still like something so some people make bacon for them or I have had a family
give them chocolate cause they’re like yeah a meal fit for a king we you know
whatever they wanted always trying to steal chocolate chocolate yes ice cream
I had one eat the whole gallon of ice cream. We had a pizza party for Remy. Oh
yeah so you can offer them anything like that
and then the sedative takes anywhere from 5 to 15 minutes to take full effect
and how I know is I kind of touch their feet and see if they have any reaction
and if they are no longer feeling anything then the second injection
usually goes intravenously. There’s other routes that we can use as well but that
second injection is just an overdose of anesthesia so it’s not painful it’s not
stressful. I don’t think a lot of people know that either what right yeah–Some people say
oh you’re gonna stop his heart no that’s not my medication that we use we use a
medication that is an anesthetic and it said high concentrate so it goes goes
right through the veins up to the brain and the brain quiets as if it’s under
anesthesia and then the rest of the body follows and so it’s usually quite fast
usually before I even finished injecting here most of them have already passed
they’ll stop breathing and then their heart will stop and then afterwards one
thing that can be a little upsetting to people is that their eyes stay open
right that’s just the muscles relaxing that’s not stressful for them or
anything there their brain is gone and then and they’ve
totally passed and then afterwards they also can urinate or defecate so I
usually put something behind them and then afterwards what’s so nice is once
they’ve passed we usually let the family be alone with their pet for a bit so
they can say goodbye and then once they’re ready we can take the pet and
arrange aftercare services so we can arrange cremation if that’s what
people want and then we can get the ashes back to them. It’s just overall you
know a very humane peaceful environment and being able to have family around if
they want yeah you know I mean we’ve been at homes for as little as 20
minutes a half an hour to two hours yeah no more yeah – one has three hours
I’ve been noting that someone’s house for three hours kind of helping them and
guiding them and being with the pet and helping them make the decision and then
you know the sedative taking effect and yeah and then afterwards if they need
some time with the pet and then we can you know a couple nice things we can do
for them afterwards I can clip a little fur if they want to keep that right we
can make a little paw prints that they can keep yeah so we try and make it as
pain-free as we can make it and it is right it is so much nicer at home
because the pet literally has no idea what’s happening they think they’re just
with their family and having a special treat and yeah. Like we had a case
we went to a house a few weeks back and you know they were still kind of
undecided they made the decision we came out to the home you know the cat has an
illness, kidney disease yeah I think I’m not mistaken. But you know the cat was
having a better day. You know it always seems that a client calls they make the
decision or you know to come to we’re gonna euthanize yeah and then we get a
call back oh you know we’re doing better now. We call it rallying or yeah, last
anywhere from a day or two to a couple of weeks right yeah and that’s one thing
that I think people think once they make the appointment with me the
they have to keep it but I’d much rather you cancel, you know I’d
rather than cancel and you have your pet with you a little bit longer as long as
your pets doing well and then call me when you’re ready. And it comes to
the saying and you said it to these clients you know letting them go on a good day
wait I forget what yeah but a minute too soon rather than yeah yeah so I tell
people it I’d rather euthanize my pet a day too soon then I’m in it too late
yeah so like you don’t want to wait until your pet is in distress at home
and your veterinarian as well as we can kind of help you decide what that point
might be right so hopefully we avoid that you panic and calling around to try
to get someone in you know in the middle of the night and you know I’m
having to go into the emergency hospital and you’ve already had you know right
relationship with us but yeah it is it’s better to do it just a little bit…
and they ended up being so they were very happy they did it yeah yeah a good
last day right and that’s a good memory so they have a good memory of his last
day he was eating and he didn’t feel anything and then he didn’t even notice
the sedative and he peacefully passed away at home and so now they have that
memory of a good day and a peaceful passing. It’s very important
yeah and very important yet and then another nice thing is people can react
however they want so you know I see right big man like freaking down and
crying over it which they may not do in the hospital in the hospital
yeah so I think it’s good they can let out all their emotions and they can hug
their parent and not feel like they’re trying to hold it in and I think they’re
a little more willing to do that with just one person or two people there.
Like I see what a lot of hospitals do now is if they have a candle and that’s
planned please be respectful that someone’s saying goodbye there but at
home that’s not even necessary you’re worried about that people notice the
candle it’s in your home and you react however your ring and everyone is
different and so everyone asks me oh is it
yeah just it okay to cry I don’t you know I’m you know I’m sorry I’m just
being so loud or whatever and it’s like the nicest thing I just do whatever
would everything is badly you and feels right for you after you say goodbye.
Absolutely yeah fantastic well thank you for being here today so yeah of course
if you have any questions Dr. Lisa Walling Comforting Care Veterinary
Services, you can say your website and oh yeah it’s just

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