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The procedure is made as comfortable as possible for the animal, too. Technicians insert an IV catheter into a front leg so they won't cause discomfort by searching for a vein. Syringes are then used to inject two drugs into the catheter. The first literally puts the pet to sleep. The second contains a powerful narcotic which stops its heart.
A vet walks up and presses a stethoscope to the orange cat's rib cage. She can still hear the occasional fibrillation from the heart--leftover electrical activity that might or might not indicate that the euthanasia isn't quite finished. When the sounds stop a few minutes later, a tech carefully cuts away the surgical tape holding the IV line.
No one can explain why, but the company that cremates animals for the hospital wants the bodies stripped of all foreign matter. The tech discards the tape and the miniature catheter into a special trash barrel destined for a medical-waste incinerator. The cat will be reduced to ash separately.
Everyone here stops to pet everything lying on these gurneys, animate or not. The staff spends a lot of time helping pet owners let go, but they're no more sure than anyone else what happens at the moment of death. Brain activity may have ceased for the orange cat. But you just don't know when the soul slips away, the techs say.
When "end-of-life" decisions are made about human beings, the first thing usually considered is the patient's wishes, says Kahn, the bioethicist. But there are cases when a patient can't speak for him- or herself. When that happens--in both human and animal medicine--care providers suggest family members consider the degree of suffering and the prognosis. "If the answer is that someone's not ever going to get better and they are suffering, then it's pretty easy to say, 'Yes, let's stop life support.'"
Predictably, that equation isn't always so clear. When the biopsy results came back on Kayla, Mark Farmer's geriatric black Lab, they were inconclusive: The dog didn't have the osteosarcoma originally suspected, but another form of cancer. The suggested course of treatment remained the same--amputation, followed by chemotherapy.
Back home, Farmer told his wife everything he had learned at the veterinary hospital. If Kayla were younger, they agreed, they'd be more likely to take advantage of the cutting-edge care. But between her age and the fact that the tumor was just the latest in a long string of ills, they couldn't see opting for chemotherapy. Urbanz suggested amputating the cancerous toe, but even that was too much for the Farmers. The cost of the treatment didn't even enter into the discussion, he explained later. It simply seemed best to keep Kayla at home until she visibly suffers, at which point she'll be euthanized.
A few days later, Urbanz called to find out what the couple wanted to do. Farmer says the only concern she voiced after hearing that they didn't want further treatment was making sure they kept Kayla comfortable. Nonetheless, Farmer says he feels a little guilty. He's pretty sure the kids would want to try anything that might keep the dog with them longer.
"In the past, we didn't have so many options or choices. And we wouldn't have given so much second thought to putting this animal to sleep. We've done more for this dog than we would have in the past." Partly, he says, that's because unlike the animals on the farm where he grew up, Kayla lives in the house and interacts with the family all day long.
"You want to try to save the pet," he says. "That's something that tugs at you, too. Especially with my kids. If they thought I wasn't going to do something that would help or fix the dog..."
He lets the thought trail off, adding after a brief pause, "I'm not going to have that discussion with them. We thought a lot about what we're going to tell the kids, and we're just going to tell them that Kayla got old and died."
Intern Miki Mosman contributed to this story.