Welcome to this webinar on euthanasia of exotic animals. My name is Emma Keeble. I work at Edinburgh Vet School.
We have a first opinion and referral exotic animal practise, as well as teaching final year veterinary students on clinical rotation. I know this is a, a difficult topic for us to be talking about in a webinar, but I think it is something that when I talk to vets and vet students, gives rise to anxiety and concern as to how they're actually going to manage this in all this array of exotic species that we now see in clinical practise. So I felt really, it would be a good idea for us to sort of go through the humane ways of euthanizing exotic species.
So just thinking about this, what sort of general advice would we be giving to people, about sort of euthanasia techniques? And this can be very daunting when you're starting out as a new graduate in practise. And I do think talking, with colleagues about how they approach these difficult conversations with clients is very, very important.
We all are learning on a daily basis, and it's what keeps us excited and interested in our job as veterinary surgeons. And so I think sort of improving on your technique, your approach to clients, and what you actually, say to clients can be very, very helpful to, to try and sort of fine tune that and, and perhaps reflect on your own clinical practise and how you approach these cases. I think it's always good to think what was, what went well, what could we do better next time.
And hopefully that will help you, develop and improve on your clinical practise. And, you know, every case is different, and obviously owners vary greatly as well. What are the sort of considerations really, I suppose, well, these would apply to any euthanasia that you're performing, but very important at the start to have that quality of life discussion with the owner.
And what is this animal's welfare? And unfortunately, with exotic pets, reptiles, birds, we do see a lot of welfare issues and a lot of things that potentially could be avoided through appropriate husbandry and nutrition. And this is a difficult conversation to have with the owner because obviously, they're gonna be feeling a little bit guilty, you know, if it is something that that husband and wives perhaps could have been improved on.
So it is a very delicate and difficult conversation that you're going to be having. I feel like listening to owners is, is absolutely essential. And sometimes actually talking through the different potential choices that could be made at this stage for that patient care can help you determine what the owners are actually thinking about and what their, their wishes might be, really, in terms of how they react to those different options, and, and what sort of body language there is as well.
I think it's important to give owners time, and these things can't really be rushed. It's very important to to allocate appropriate time and perhaps a quiet area or space, to have these discussions as well. And many of our owners want to actually spend time with their pet before, to say goodbye.
So having that sort of quiet space is really important. The other thing that I often do is actually talk owners through what I'm going to do, because I think there's an element of feeling worried and perhaps a little bit scared and and mistrustful if you're taking that animal away. And unfortunately with exotic pets, a lot of the time, we, when we don't have the option to perform the euthanasia with the client present because we're using a lot of anaesthetic gas, and obviously there are health and safety issues surrounding that.
So, I think it's very, very important to outline, what you're going to do, what the process will be, what to expect, and to be as open as possible. So basically, remaining calm and explaining every aspect that's going to happen, I think is really, really important. Just trying to break this down into to different stages so that we can consider every part of that.
And obviously we'll come on to different species later in the, in the webinar to sort of go through how each might be approached. But the, the general stages and discussion is the same for every different animal. We obviously do need to get signed consent, so hopefully that's part of your owner discussion.
That I feel like a period of time to say goodbye is very important for some owners, and I always offer this. We do want to have as ethical an approach to, euthanasia of this animal, so that it is pain free and quick and appropriate. In some of these, it's very difficult to confirm death.
So I just want to talk, I'll talk through a few of the, the things we can look for, particularly with reptiles, this is where it can be quite difficult, and I'll come on to explain why that is later on. I also think it's quite important to have a chat about what the owner's wishes might be for after the event. So have a chat before you've actually, performed the euthanasia because they will probably be quite upset afterwards.
So trying to talk through their wishes, you know, would they like to take the animal home for burial or would they prefer a cremation is really important. Another thing that I think we, we sometimes forget as vets is that obviously there is going to be a charge for this. And how is that going to be given to the owner?
And sometimes getting an email or a letter in the post can be really upsetting, especially if it's a few days later. So I always talk to the owner and say, listen, you know, you can pay now, but if you don't want to go out to reception, there is this, this, You know, we, we could basically send it out to you. But, but obviously expect that and, and don't let that be a shock to you when it arrives.
I think that's quite important. And I think another thing that we sometimes forget to do, and, and there's absolutely essential, I think, particularly with exotics, we do need to make accurate, concise clinical notes afterwards. I think that's important, so that we've documented that discussion with the owner.
We've documented what they wish. Would be, we've documented what's going to happen afterwards to the body. And, and making sure that happens, it basically helps avoid any upsets or misunderstandings occurring and obviously there's a a clinical record of that conversation.
So what are the challenges with exotic animals? And I, and I think this is a, really key because there are so many challenges. We can't always extrapolate from dog and cat medicine.
I mean, a fish is very, very different to a dog and cat in terms of how you're going to euthanize it. We do have to ensure staff safety so that handling and restraint is, is, carried out carefully. And quite often in these species, we're thinking about a sedation or general anaesthetic before actually performing the euthanasia.
So this is why it's not always possible to have an owner present. And I, I explained this to owners because obviously, we don't want to expose them to any anaesthetic gases. Often, if we can't find an actual vein, we might be considering doing an intracardiac injection, and that can be very upsetting for an owner to have to witness.
Then with the reptiles, we are usually pithing the animal, if it's going to be going home to ensure that it's brain dead. And I'll talk you through that in a bit. But, you know, that is not something that I would want an owner to to see.
So, for all these reasons, and mainly the the health and safety one with the anaesthetic gas, we're often not having owners present. Also, there are very wide variety of species you might be seeing in clinical practise. Some of these are tiny, so it can be really challenging.
If you've got just a little 40 gramme lovebird trying to find a vein on that is going to be difficult. I do want to know throughout this webinar that I have used doses that I've given you for sedation, that are much higher than I'd normally use for an anaesthetic, because this is obviously an end stage sedation. So, we're going to be euthanizing that animal.
We want it to get very sleepy quite quickly. Some of the other challenges I mentioned about venous axis, this is a little tortoise having a bath, you know, quite difficult to get a vein, potentially if it's a bit dehydrated. And it can be challenging, obviously, in species that you're not fully, used to.
We might also have problems with drug metabolism, certainly with reptiles, they need to be kept at their preferred optimum temperature zone. And this is the zone of temperatures within which their metabolic processes will be optimal. And if we don't have them in that preferred optimum temperature zone.
The drug won't be properly metabolised. So, you know, a, a, a little tortoise like this needs to be kept warm before you give the sedation so that it actually works. If it's cold, what might happen is that it'll metabolise that drug very slowly, and it won't actually fully anaesthetize.
And you might even potentially, with your barbiturate, not give a lethal dose. So it's quite important. A lot of these will take more time, perhaps than than a dog and cat euthanasia, which can be more straightforward, because again, you're perhaps sedating an animal, you're waiting for that to take effect.
And certainly trying to confirm death can be more challenging, particularly in reptiles, where it's very difficult to auscultate and we generally tend to use a Doppler, to listen to the heart. There are some species that can actually death vein, just to sort of keep you on your toes. Certainly, hognose snakes are quite popular as pets these days.
I've got a picture in a, in a while to show you of one of those, but they can actually death hane. So if they're very, very stressed, they might suddenly, Writ and, and go onto their backs and then look dead, but this is actually a mechanism that they have developed so that they aren't eaten by predators. And it's not that they truly are dead.
They can also bleed from their mouth as well. So, you know, some species can be a bit challenging. And then I mentioned about pithing, this is particularly in reptiles to ensure brain death.
And that is important if the owner is taking the body home. Obviously we want to ensure that that the process has been, performed. So I thought I'd try and go through the main sort of groups of animals that I see as exotic pets in practise and and talk through how I would manage these in terms of euthanasia.
We use a lot of local anaesthetic cream in rabbits, which is really wonderful because it means it numbs the air and you don't get the animal jumping, and reacting to placement of a cannula. I would always place an IV catheter in these cases, and, and usually we can do this even in quite collapsed animals. And we tend to, favour the vets called the marginal ear vein.
What we can then do is give a slow IV sedative. But if we didn't already have an IV cannula, we could give this subcutaneously, giving you some doses of, the types of sedative we could use there. And if it's given subcutaneously, then the animal can sit with its owner, be cuddled.
It might take about 20-30 minutes, for it to get sleepy. Once it is sleepy, again, if the owner wishes to be present, having placed an IV cannula, you can then administer the barbiturates. And as a general rule of thumb, it's pretty much 1 mL per kilogramme body weight as a rough guide for any animal.
I tend to prefer to place the cannula away from the owner, because, again, it can be a little bit upsetting for them to see blood, and you do get a bit of flashback. So I think I'd explain and just take the animal away. I'd do the the cream and the sedation first, let the owner have a cuddle, take the animal to put the catheter in, and then bring it back to the owner and, and talk them through the actual euthanasia.
And rabbits are fairly straightforward for confirmation of death. We can auscultate the heart as we do in dogs and cats at a similar anatomical place. As I mentioned, we often have owners present for this, and, I'd usually ask for a nurse to come and help me as well.
Rabbits can be quite difficult in terms, they, they can do agonal gas, they can jump. So do warn owners of this prior to administering the barbiturate. And the other thing that I find is, once they have passed away, often the guts can continue to peristyle.
So you'll see these sort of rippling movements across the body, and it can look like the animal's still moving. So again, I talk owners through this and say that's totally normal and that is everything relaxing. And I think that's quite important to say.
It's also common for them to, go to the toilet. So if the animal is being held by the owner, perhaps having a vet bed underneath it, just to avoid any upsets could, could be a good idea. This isn't something that we should be rushing, so have the consultation time.
And one thing I do do, if there, is an inpatient that we're going to be euthanizing. And permission has been given by telephone conversation, I would usually always ask the owner to repeat that over the phone to another member of staff and keep medical notes that that has happened as a witness, just to be 100% certain that those are exactly the owner's wishes. One thing I think we do need to think about is grief for companion animals, because rabbits obviously shouldn't really be kept on their own.
They're social animals like guinea pigs, and they do usually have a companion. So we want to be ensuring that that we talk to owners about the sort of grief process that might be occurring in the companion animal. We know that animals can feel grief.
Certainly they, . Have observed in elephants, burial rituals, of a matriarch that's passed away. So we, we know that there is some sort of emotional response to an animal, or partner animal dying.
In rabbits, it can be very varied, so often talk to owners about this and it can be really quite strange, the behaviour of an individual that's lost a companion. And I've listed some of the common things that we have reported by owners there. One thing can be actually increased aggression.
Whether the rabbit should see its partner once it's been euthanized is a difficult decision, and I think it needs to be done carefully. Some rabbits just ignore the companion, that's been put to sleep, and others, can actually have, have had hypersexual behaviour towards the dead animal, which is obviously quite upsetting for owners. So I think it needs to be supervised and, and perhaps, you know, the, the companion rabbit, is taken to the body which is being held by, yourself or a nurse or the owner.
And I think that way might be, a better way to, to introduce them. If a rabbit is left on its own, then we obviously, really don't want it to be kept on its own because they are social animals. So talking about perhaps getting a new companion at a later date, might be important.
Moving on then to our small mammals, you know, particularly the small rodents like rats and mice and hamsters. Also our little guinea pigs and chinchillas, and we, we see quite a few African pygmy hedgehogs as well. For these little guys, I much prefer to use a chamber induction, pre-oxygenating first and then using sevoflurane, to actually induce anaesthesia.
I still have students who come back and tell me that in general practise, they have seen intraabdominal barbiturate being given to these little guys. And I really feel that we shouldn't be doing this. It's not best practise.
It is going to be very, very painful. That barbiturate is going to, crystallise, inside the, the abdominal cavity on the wall, and that will be painful. And also, it's a very slow way of euthanizing these little guys.
So I really don't think we should be doing that at all. I would really advise against it. It's not a humane euthanasia.
So considering a gas anaesthetic, and then a face mask or even just the end of the T piece placed over the nose of these little guys, and then either an intracardiac or perhaps an intravenous injection. And we use the cranial vena cava in these little guys. And actually, it's, it's a really good way because we also take blood samples from this site.
So you can actually, Perfect your technique doing euthanasias in the first instance before considering taking a a blood sample. Also, if you're going into cardiac field for the apex beat, it's usually on the left side at the level of the electronon. And always confirmed death with cardiac auscultation afterwards, really important.
So that's how, how I would consider putting to sleep a little small mammal patient. I have a video just to show you here because this is the this is the cranial vena cava technique. We're actually taking a blood sample, but it would be exactly the same.
Consideration if you were, going to be euthanizing this animal. And I'll talk you through in a bit more detail what our anatomical, landmarks are, just in a second. But you can see there, we're taking the blood sample.
If we were euthanizing, it would be the same technique, but, obviously injecting rather than aspirating. So, with these small mammal anaesthetics, we, we are not really wanting an owner to be present because of health and safety. So what we sometimes do in these cases, particularly with the the bigger ones like the guinea pigs and the chinchillas, is that we might give them a, an injection of a sedative while the owner's actually there so that they get really sleepy, and they can cuddle that animal until, it's gone to sleep.
What we could do then is place an IV catheter away from the owner with a nurse present and then perform the euthanasia back with the owner, once that cannula has been placed. So that is an option. I wanted to just to show you the landmarks here, for the.
Cranial vena cava, we have. The trachea, which is ventral and midline, and that's what I normally feel for. And then to the side of the trachea, just at the thoracic inlet, there's a little notch, and that is easily palatable by a single finger.
Once you found that knot. You're then going to be directing your your angle of needle insertion at about 45 degrees and towards the contralateral hind leg. So aiming it towards the opposite back leg.
And this is really, how you'd be performing the, the vena caval injection of barbiturate. So thinking about moving on to avian euthanasia, and obviously, birds can get very distressed easily. And often owners are very bonded to their birds, particularly if they're really long-lived birds like parrots.
And it can be very difficult talking through euthanasia in these situations, because often we are going to be taking the bird away from the owner, because we want to anaesthetize it to reduce stress. So I would, always pre-oxygenate and gently wrap the bird in a towel, and then using a face mask, gradually increase the anaesthetic gas over time. And ivofluorin, you do have to have quite a high percentage, to induce.
And it seems to be less irritant than iso in birds to the mucous membrane. So I much prefer Civo if you've got it available. Once they're anaesthetized, you can feel, for the cardiac beat, apex beat is usually on the left side between ribs, and you can feel that.
You could go for an intrahepatic injection. And this is usually with the bird lying, in dorsal recumbency and you feel along the, the keel of the bird to the edge of it, and then direct your needle again at a sort of 45 degree angle underneath that keel into the, where the liver will be. And you should be aspirating blood if that is in the right place.
If you get air, you're probably in an air sack and you'll need to reposition. Alternatively, you could go for an intravenous route. And again, this is perhaps something that would be helpful for perfecting your blood sampling technique as well, if you start performing euthanasias intravenously.
The right jugular vein in birds is usually quite large. There is also a basilic vein on the ventral aspect of the elbow, and also a vein on the inside of the leg, the medial tarsal vein. We're going to be confirming death through cardiac auscultation.
You can auscultate on the left side of the pectoral area or actually over the dorsum between the scapula to hear for that beat. And hopefully, if your euthanasia has been performed successfully, obviously, there won't be a cardiac beat auscultated. With birds, I mentioned that I prefer Siva fluorine rather than iso.
If you've got a big bird, I probably would place an ivy cannula first. So you can see the picture here. We've got a swan's foot, and that's using the medial tarsal vein.
And that has, had an indwelling catheter placed, so that we can perform, our euthanasia using that. I'm just gonna show you, if I can, the outline. Of the vein, so you can just about see it it's coursing here along there.
It's quite a big vein, so when you've got it raised, you can see it really nicely on the medial aspect of that bird's leg. This is a little budgie gar, you can see the right jugular vein, really descended and obvious there, you do have to wet the feathers to see it. And then you've got this featherless tract called anapuary that is a really nice place where you can part the feathers and usually the jugular lies directly under that.
I also mentioned the brachial vein on the underside of the elbow. Again, having wet the feathers here, you can see that this is causing over that elbow joint. Moving on to reptiles, I think reptiles are the most challenging of all our, exotic animal patients to euthanas, and this is where we, we have the most difficulties.
I would always go for a sedation first, usually intramuscular. And I've given you some sedative doses at the top there. After doing that, I would leave the animal for at least 20 minutes, maybe longer, in a quiet warm area.
We've got vivaria that we can use, but you could use an incubator that was, you know, safe and they couldn't escape from. It's really important for reptiles to be kept warm so that they can metabolise that drug. Once they're fully asleep, then you're going to be giving an intravenous or potentially intrahepatic, injection of barbiturate.
In lizards, we can use the cordal tail vein. You can also use that in snakes. In Shelonia, we can use the jugular vein on either side, or they have a subcarapacial venous sinus as well that can be used, which is under the shell, the carapace at midline.
In snakes and lizards, we could go intracardiac if the animal is fully anaesthetized. And what I'd usually do is actually, get our little Doppler and listen to the heart and gauge the rate before actually performing the euthanasia. So I know what I'm listening for and where I'm going to be placing that Doppler probe, to check that the animal has actually, been euthanized.
With reptiles, we always pick them if they're going to be going home, and if owners are taking the bodies away, then we can ensure that they have actually You know, they are actually brain dead. For, intracardiac landmarks, . I, with, with, with the little, lizards, I usually lie them on their back, and then draw an imaginary horizontal line between the forelimbs.
If you then envisage, a vertical midline, where these cross the heart, that's where it's, these cross, that's where the heart is located. So draw a line between the, pectoral limbs and then Put across midway in that line, that's exactly where you're going to be going to access the heart. And you insert your needle perpendicular to the patient.
You have to be doing this with the animal fully anaesthetized. So owner is unlikely to be present because it takes a bit of time, but we can, let the owner hold the animal, while it's getting sleepy, perhaps have them on a little heat pad so they don't get cold. If we're going to give inchcardiac, as I, as I've described, then, really only in small lizards and snakes, and you can use the Doppler to listen to where the heart is first, so you know where to place your needle.
It's very important to check that the heart has stopped, because these little guys can actually continue to metabolise the barbiturate. So, I would either use a Doppler to auscultate, or you could actually ultrasound scan the heart to check that it's no longer beating. Another thing you can look for, the glottis usually remains open when the animal's deceased.
So you could just gently open the mouth and have a look and see if that little, airway is open. What I would then do is probably leave that animal at room temperature for a couple of hours, just to ensure that it is dead and that you fully metabol, it's fully metabolised the barbiturate. And once it has rigour mortis, then obviously, potentially the, the owner can take it home.
This is a picture on the bottom of the screen here of a little hognose snake. They, they tend to bury, so they've got this little sort of, funny shaped nose because they use that to dig. And these are the little guys that can death feign, and also they can bleed from their mouths.
It's, it's, it's a normal response to stress or threat. One thing that we need to be aware of is that reptiles, have got a high, high tolerance for hypoxia. So it is possible for a reptile that you think you've put to sleep, to actually survive and to metabolise that drug.
So really, this is why we talk about pithing in reptiles after euthanasia. In tortoises, it's quite straightforward. Once you've confirmed that the heart has stopped, you can basically insert your needle through the one of the nostrils through the cribriform plate, and aim it up, towards the back of the skull.
And you can basically move the needle backwards and forwards, and that can, That can help with the pithing, or you could try and inject a very tiny amount of barbiturate into the actual brain and that also will hopefully ensure that the animal is brain dead. In lizards and snakes that tend to go through the roof of the mouth, again, aimed towards the back of the skull. And again, you can either insert your needle multiple times to destroy the brain or perhaps inject a small volume of barbiturate as well.
The reason we quite worry about reptiles is that that in reptiles, skeletal muscle undergoes rigour mortis before the cardiac muscle. So you can actually get an animal that's in rigour mortis but still has a heartbeat, which can be very, very disconcerting, but it is actually cortical dead and cortically dead and has been for some time. So just be aware of that.
And I think that's why we, we talk about using this pithing technique in reptiles. Just to show you in these pictures here, the top picture with our little leopard gecko. This is where we're going into the heart.
So we've drawn a line between those pectoral limbs, and midline straight down the animal. And, and where those two lines cross, we're going straight in and you can see we've got a little bleb of blood, in the hub of our needle, so we know that we're in the right place. This is at the bottom pitch is actually taking a blood sample from a bearded dragon, but if you want to inject into the caudal tail vein, this would be the exact site that you would do so.
So moving on to fish euthanasia, this is something that we quite regularly do, unfortunately, have to perform. We have many owners who are really dedicated to their fish, and some of these little goldfish can live for a very, very long time. Time and be quite a well loved family pet.
So it's really important that we do this process, you know, with with compassion and as pain free as possible. And again, this is something I would talk an owner through and explain what I was going to do. I probably wouldn't want them to be present just because, you know, it can look a bit unsettling once you've added the anaesthetic to the water, it can increase.
Thepercular movements and open mouth breathing of that fish. So I think it's something to talk through with the owner, explain what you're going to do. And then you'd be taking the, the fish away.
And obviously, if they want to take the animal home after to bury, that would be fine to wait. Another reason for not perhaps having an owner present is that some of these anaesthetics that we're using have to be very carefully used, and shouldn't come in contact with the skin and have to be disposed of very carefully as well. So, it's quite important, that perhaps owners don't come into contact with those anaesthetics.
So what we would do is sedate them in the water, and there are a couple of products there that, I think are quite helpful to have if you're, you're seeing fish in practise, particularly, Aquice by Vet Ark is quite easily available. And actually, fish keepers themselves can get this product, and, and purchase it, for, for sedation or euthanasia. We do tend to buffer the water, so add a bicarbonate buffer, and we're basically looking until there's no writing reflex.
We can give an intracardiac injection of barbiturate. So, what I would do is place the Doppler first and listen to the heart, so I know I'm in the right place, and then put my injection into that little space. And in fish, it's quite straightforward where the heart is.
In this middle picture here, there's almost a triangle formed between the edge of the gills and this pectoral fin, and the heart lies in that in that little triangle. And again, you can see it here. This is our Doppler and we're placing the edge of it into that little triangle so that we can auscultate the heart and ensure that we place our injection in the right place.
You can actually also euthanize a fish by overdose of anaesthetic. So giving 5 to 10 times the concentration you'd use for an anaesthetic, to actually, kill the fish with, with an overdose. And you need to make sure the animal's left in there for at least 10 minutes after it stops breathing.
And what we're looking at there obviously is mouth and a percular movements. Again, we're going to confirm death using the Doppler like I talked through in the the previous slide. And we can also pi goldfish as well.
So similar technique, as for our little snakes and and lizards. Again, just being careful, our cardiac ACD typically lags behind brain death, because fish myocardial cells use local g glycogen stores for energy and don't need blood glucose. So rigour mortis can be present, but the heart can still be beating.
And again, this is something that's quite disconcerting as a vet to, to see. So just be aware of that. And if the animal has got rigour mortis, it's not still alive.
Technically, it's brain dead. I mentioned Acquice, which is available commercially. You do have to be careful what you do afterwards with the, solution that you've actually, euthanized the fish in, .
They usually are instructions on the bottle that can tell you how to do this. Owners are able to get hold of this product as well, so some fishkeepers may already have this. And so I've, I've listed what the Aquis website says on how to euthanize using that product.
You can't tip this down drains, so it's supposed to be, disposed of on, on ground, and it has to be as disposed of as a hazardous waste as well. So it's quite difficult what to do with these after, particularly the Trian, S, which you can see there. So I think it's probably better to to have the Aquis in practise.
I tend to wear gloves and overalls, and sometimes also goggles and masks because I don't really want to inhale or, or, absorb this product through, through skin. So I've got some interesting extras really towards the end of this talk, because you never know in practise what you might be presented with. And certainly one of my worst experiences ever was trying to euthanize an axolotl.
You can see a picture of one that has been anaesthetized floating on its back at the bottom of the screen on the right there. It was just awful because, I was only anaesthetizing the animal and not actually euthanizing it. And so every time I went to put my hand back in to pick it up, thinking it was dead, the animal would start moving, which was really quite not very nice process.
So, you know, I think it's quite good to talk. Talk through how we might go about euthanizing these particularly unusual animals as well. Amphibians usually we we treat quite similarly to fish.
So we can use the same products that we talked about with the fish, euthanasia. And again, Aquis is quite a useful product to to have available. The other thing that's quite cool about amphibians is that drugs can be, absorbed across their skin.
So you can actually use topical sevofluorine. You can mix it, with, with a jelly, and also, dilute it in water. And then I've given you a, a recipe there if you like for your frog, anaesthetic or actually for a euthanasia dose as well.
We're going to be checking these animals with our usual sort of responses, particularly the toe pinch seems to be quite a good, reflex to, assess depth of anaesthesia or whether the animal's actually been euthanized. If you think that there still is a, a, a heartbeat and you can auscultate this using a Doppler, then I would, inject an intracardiac, barbiturate as well. We're confirming death using the cardiac Doppler and the anatomical lion marks are exactly the same as in lizards, between those pectoral limbs.
And we're going to be pithing these animals as well to ensure that they are brain dead. Sometimes we might be asked to euthanize invertebrates, and this has happened to me on a few occasions. And these little guys are not actually really covered by animal welfare legislation, which is quite, interesting, I think.
But I still feel, obviously, as vets that we have, an important job to perform this as quickly and as humanely as possible. And we tend to overdose them with anaesthetic. I do think it's worth thinking about because obviously insects becoming much more popular and farmed situations for protein sources, both for pet food, fish feed, and human consumption now.
And there's very little research and and very little sort of published on euthanasia techniques in invertebrates. But, obviously, in a sort of farm situation, often these animals are frozen. But, you know, is that really an ethical process?
And, and personally, I think it probably is quite inhumane way to to euthanize them. Certainly with with arthropods, you can use either the fluorine in a little a plastic bag that's sort of got a a clip shutter so that you can actually seal it off and place the tube just in one corner. You can then give them an inch cardiac injection of, pentobarbitone, and I'll just show you, us doing that.
I've got a little video of giving fluids. The heart in these guys, you can see from the picture there at the bottom, lies over the abdominal part midline. So that's where we're going to be going, to give our injection of barbiturate.
With the gastropods, we're going to be using our fish anaesthetics. We can use a, a, a topical bath of pentobarbital as well. And we're going to be using the Doppler to confirm death.
You can with these little guys actually immerse them in a fixative to ensure that they have actually, been euthanized. So that is a possibility, as well, or you potentially could freeze the animal once it's been euthanized to ensure it definitely has passed away. So I've got a little picture here just to show you this was a very dehydrated, collapsed, little tarantula.
And actually this is a video. It's just really to show you, listening with a Doppler. And then there's our Doppler, so we can actually hear where the heart is on this individual.
And if you want to then, inject either fluids, or maybe we're going to give up barbtrip via this, approach, that's how we would be performing it. Wildlife is, an interesting, situation. Obviously, there's so many different types of wildlife that you might encounter in practise.
Often it's middle of the night that you're called away to a road traffic accident, for example. And so it's going to be very variable how we euthanize these animals. But really, a lot of our techniques that we've talked about with our avian and reptile and and small mammal euthanasias are going to apply.
With the really big mammals, though, I think we would be wanting to consider sedation first because obviously, we need to be safe ourselves. So for deer, badgers, foxes, seals, I would definitely give them an intramuscular sedative first, usually based on, dog doses and extrapolated, so that that animal is sleepy, and then we'll place an IV cannula and we'll euthanize it very similarly as we would a dog or a cat. Seals might be the exception.
I don't know how many of you might see seals in practise, but just in case, this is just to show you exactly where you'd be going. We'd be sedating it first and then placing an IV cannula and then giving a slow IV injection of barbiturates. You need a very long needle for this.
I've got some diagrams there just to show you what you Feeling for the white dots represent the last rib on this animal. And, and the most cranial ones are the ribs and the most cordal ones represent the edge of the the pelvis, and you can palpate those landmarks and then go midline on the spine, about a 45 degree angle. And we're going to auscultate to confirm death.
With cetaceans, this is very specialist and, and, really, I would be consulting, books to have a look at that if you're likely to be called out to a stranded whale or dolphin. So just really think about our 5 key points. Listening to the owner, very important, have everything ready beforehand, make sure you've got everything signed.
You've talked about what's going to happen afterwards. Give the owner time to say goodbye to their pet, and perhaps after the actual process, would they'd like to see the body afterwards. I think that's quite important.
Explain what you're going to do, talk them through it and act calmly as well. And I think hopefully, with all that, things will go well for, for you for the process. I have a couple of quick cases just to talk about at the very end of this webinar.
I thought it might be interesting to think about some real situations that you might encounter. So case one is an elderly African grey parrot, and it's been presented with open mouth breathing. It's collapsed.
And the owner had the bird for 30 years. She recently lost her husband, and the husband was very bonded to the bird. So how are we going to approach discussing euthanasia in this case?
Well, I think the most important thing is to actually, notify the owner that this bird is critically ill. It's open mouth breathing, which is a really, really bad prognostic indicator. So rather than standing and talking through things while that bird's open mouth breathing and gasping, ask if you could take it away, put it in some oxygen, give it warmth, quiet, explain that even handling that bird could, could, cause it to pass away due to the stress.
And then after you've done that and the birds, you know, somewhere warm, quiet in oxygen. I think talk about the age. This is a, you know, an older animal.
Not really old. I mean, birds can live up to sort of age 70, but often we see things like atherosclerosis and heart disease, you know, from 30 years onwards. They can hide illness.
So I think this is probably likely the big differential to be Aspergillus granuloma, which might have formed and, and is actually blocking the trachea or it could be a seed inhalation, but, Obviously, this animal is pretty unwell, and we don't want to prolong things, if the animal is open mouth breathing. Is it fair to, to continue? Now, it might be that there are other clinical signs that this is something you can treat, but obviously, I do think sort of the age and, and the prognosis given the open mouth breathing need to be talked about.
What sort of important factors should we think about prior to putting this bird to sleep? And I, and I hope you sort of picked that up from our history. This animal really is a member of the family and the owner has had a recent bereavement and that, It's very important to think about because, there will be a very close bond.
There'll be an association with this bird, with the death of, of her husband. And, and there can be a lot of other things ongoing that can cause quite a lot of upset in that owner. So it's likely that all these sort of memories will be brought back.
And, and often the owner can feel quite emotional about the euthanasia of this, this loved pet. So how would we actually go about it? The owner really insistent that she wants to be present.
What are we going to do? Well, again, I think talking through the process very carefully is important. I do think explaining that just going to sleep gradually with an anaesthetic gas, is probably the most peaceful and stress-free thing for this bird.
But unfortunately, You can't have an owner present there because of anaesthetic risks. So I think that's quite important. Do reassure them that you'll be there.
You'll talk to the bird, ask if she'd like to spend some time with it before saying goodbye, and obviously talk about what, what she would like afterwards, whether she wants to see the bird, and take it home. And then we'd go through the process as we discussed for our avian patients, pre-oxygenating, mask inducing, possibly giving a pre-med, perhaps, of midazolam innasally. I probably wouldn't do that with the owner present just because it, you know, it can be a little bit irritants the bird, and then obviously we're going to be giving an injection of barbiturate.
Important obviously also to confirm that the bird has passed away after. Our second case, out of 3 cases, is a very grumpy elderly chinchilla. It's 10 years old.
It's got a history of chronic dental disease and weight loss. The owner's wondering about his quality of life and is thinking about euthanasia. How are we going to talk about this with the client?
Well, again, this is an old animal. It's got a chronically painful condition, that is requiring repeated anaesthetics and probably dental work. And therefore, I think, welfare wise, It is quite compromised and and euthanasia is a valid thing to be considered.
I do think the owner knows the pet best and knows her concerns best. The animal is probably already on palliative care and, and long term analgesia. So I think agreeing with the owner in this situation, and especially since the animal is starting to lose weight, is probably the right decision.
And obviously then we're going to talk through the process and get a signed consent form. If the owner wishes to be present, how would we accommodate this request and how would we euthanize this animal? Well, I think, I would go with a subcutaneous injection of a sedative first, probably quite a high dose of alfaxone, and let the owner hold the animal and stroke it, until it gets very sleepy.
We might want to give that injection away from the owner if he's very, very grumpy and we could get a nurse or, another vet to help hold. And then once sleepy, we can take him away. Hopefully, the owner will be happy with this plan.
We can offer for the owner to see him afterwards, reassure that I, you know, you will personally be there, and it will be a calm and peaceful way to go. If you wanted, you could alternatively think about placing an IV cannula, and then, euthanizing the animal with the owner present. But obviously, that depends on your, how you feel about, placing that cannula, and perhaps you could do that away from the owner.
Our third and final case is a tortoise. This is a pet tortoise been missing for a few days from the owner's garden, and they've phoned from the car saying they're coming straight away to the vet hospital with the tortoise. They've just found it in the neighbour's garden.
It's very cold, it's not moving. Its eyes are closed. When we see it, the animal is hypothermic, it's moribund.
There are no reflexes that you can see. How are you going to determine that this animal is still alive or perhaps it has already, passed away? And sadly, this is actually quite a common scenario, a collapsed tortoise that appears to be dead or a poorly tortoise that's actually already died.
So really important for us to confirm whether that animal is alive or not. So we're going to listen to the Doppler carotid pulse so we can place that at the thoracic inlet against the neck about 1/3 of the way up. But do you remember that rigour mortis and brain death can occur before the cardiac muscle death.
So you can still have a beating heart. If you've got rigour mortis, it's most, it, you know, the animal is likely to be brain dead. Another thing you could do is, actually warm that animal up first so that you know it's not just hypothermia and it's reduced the heart rate massively.
Alternatively, I mentioned before that you can actually ultrasound scan the heart. So we tend to use the left thoracic inlet to place the probe and you can see the heart beats. Do you remember I mentioned in reptiles that if they are dead, then the glottis is usually held permanently open.
So you could open the mouth, have a look inside and just see what that glottis is doing. Is there any movement there? We can also see if we pull one of the limbs.
Are there any spontaneous limb movements observed? Is, is the animal trying to pull that limb back into the shell? If there's no pulse on the Doppler, you can't see any heartbeats on the ultrasound scan, it's likely the animal is dead.
I would, obviously, once you, you're sure that this is the case, I would also pick the animal report if it was going to be taken home for burial. And I think that's quite important to, to do. I would never do that with a present though.
If the Dopplerpa is present, and then we're unsure if the animal is dead, that there are two options. You can discuss, with the owner, explain why, even with a heartbeat that their pet may have already died. And I think also, you know, explaining that skeletal muscle undergoes the rigour mortis for the cardiac muscle.
So. A reptile can be presented in rigour mortis, but still have a heartbeat. But it has actually been cortically dead for some time.
So I think it's important to talk to owners with that. And certainly, if you've got no other reflexes, I would just continue to monitor that, perhaps make sure the animals properly warmed up. And obviously, if that continues over time, you might consider, euthanizing via our techniques that we talked about perhaps finding a vein to do so.
If you can detect heartbeat and you think the animal's still alive, it hasn't got rigour mortis, then I would admit it and do some very gentle warming. You might want to intubate it and start some, an IPPV, but obviously, there's still going to be a very poor prognosis for this animal. And again, you're going to be explaining the heart can be there, but the animal is still brain dead.
The other option is that you actually put the animal to sleep, having discussed it with the owner, and ensure that the heart has stopped beating. So, as I mentioned just now, giving a pentobarbital injection. And I think probably in this case, you might not be able to get a jugular vein.
So the subcaripacial venous sinus might be your best, bet. And then I mentioned pithing of reptiles, particularly, tortoises through the nostril, aimed towards the back of the head. And we can do that.
And obviously, I, I also mentioned that the process of pithing and, explanation of pithing. I tend not to actually talk owners through that because it's quite distressing. But I think it's important to do so that we ensure, you know, that, that the animal has definitely, passed away.
So, thank you so much for listening to this webinar. I hope it hasn't been too, upsetting to have a whole webinar on euthanasia techniques, but I, I think it's a really, really important topic that we don't talk much about, and we should do. And I really hope that this has given you a bit More confidence in your small exotic pet, euthanasia.
And please do go and talk to colleagues about it. The more we all talk and the more we we perfect our technique, the the better these things will go. Thank you so much for listening.
Goodbye.
