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Vet Talk

What do we Tell the Kids?
August 26, 2013 (published)

A fragment of conversation anchored my feet to the floor, over-filled laundry basket perched on my hip. My two oldest children were playing with their plastic horses. One horse had a bandaged foreleg. My ears caught the syllable “—ize” come from my oldest daughter, then about six.

Her younger brother, about three at the time, said “What’s that mean?”

Caitlin replied, “We’re going to have to give her a shot so that she’ll die.”

My maternal brain glitched. “Caitlin, you’re going to euthanize your horse?”

“Yes, Mom. She isn’t going to get better. It’s unavoidable.”

Most kids aren’t given the lowdown on the how, what, and why of euthanasia while sitting in a booster-seat in the backseat of their mother’s vet truck. Had I my druthers, I would not have given a quick “Why mommy is about to give this horse a shot that will kill her” spiel to my kindergartener who had been having an otherwise lovely spring break seeing the cool animals. But, an emergency colic had turned out to be far worse than expected, and I was forced to acquaint my daughter with the reality that sometimes Dr. Mom can’t fix the animals, sometimes they won’t get better, and all we can do is make their pain go away faster. Meanwhile, I frantically drew pentobarbital into two large syringes.

I was sure I’d scarred her for life.

After all, aren’t we supposed to tell children that their dog retired to a farm in the country, or that the hamster escaped and is living a life on the lam in the French Riveria? Surely kids are too fragile for the realities of death, and especially for the knowledge that sometimes veterinarians cause death.

Many euthanasias, and many explanations to children later, I’m convinced of the opposite. Most kids handle a direct discussion of the end of life pretty well. It’s grownups who struggle to cope.

Not only was Caitlin apparently undamaged by the knowledge of euthanasia, but she found a way to role-play it and process it herself. A few months after the plastic horse episode, my grandfather lay dying of leukemia. After I explained that Grandpa Bligh was very sick and that the doctors couldn’t make him better, Caitlin asked me, “Mom, can’t they just give him that shot? The one you give the horses when they won’t get better? The one to make him die sooner so he won’t hurt anymore?”

We had the conversation again a few years later, this time with her younger siblings. Our 16-year-old German shepherd had developed a severe hind-end neuropathy and had lost any measurable quality of life. I explained that Jasmine was very sick, and that I couldn’t make her better, and that even the dog doctors I worked with could only give her medicine that might make her live longer, but wouldn’t fix her. My son was in tears. “I don’t want Jasmine to die.”

“I don’t either, honey, but she’s very old, and she’s in a lot of pain, and she can’t even control where she poops, and she hates that. Do you want to keep her feeling that way just for us?”

He thought. And being a methodical child, he thought some more. “No. That wouldn’t be fair.” Aidan is big on fair.

I do still periodically hear “I miss Jasmine. I wish you hadn’t had to kill her.” It’s only been five years. I’m sure they’ll stop soon.

Maternal guilt aside, some tactics work better than others for explaining death and pet loss to children. I’ve euthanized animals in the presence of children, with children around for one last goodbye, in emergency situations where there was no time to take the kid out for ice cream, and I’ve found certain things that help – or seem to. Many of these things aren’t just veterinary communication. Parents, grandparents, neighbors, aunts, uncles, and random friendly aliens can all facilitate this process. It takes a galaxy.

  1. I always ask the child to tell me about the animal. What is your favorite thing about Lucky? How old were you when you guys got him? What do you love to do with Lucky? 
  2. I always explain the process of euthanasia if the parents give the okay. The unknown is scary when you’re a kid. Think back. Were you afraid of the things your parents and teachers told you about, like fire drills? Or were you afraid of the stuff where you knew grownups were leaving something out? It’s the monster under the bed that haunts our childhood nightmares. The childish imagination can invent bogies far worse than information.
  3. I use the word euthanize. I explain what that means. I never, ever say “Put to sleep.” Really, folks. Isn’t bedtime hard enough? Also words are powerful, and when you’re small, knowing a big word gives you power. If you can’t control the loss of your pet, it’s pretty cool to have at least one new word that your friends might not know.
  4. I ask the child if he or she likes to draw. Almost all do. A few have told me that they’d rather write stories. I once had less than five minutes to give the entire euthanasia speech to a little boy whose pony was suffering from an agonizingly twisted gut before our eyes. I wanted to get him away from his dying pony as soon as I could, so I asked him to go to the house with his mother and draw me a picture of Ben the pony the way he most wanted to remember him. A few days later the mail brought a crayon picture of Ben in better days and an effusively grateful note from the mom for helping her son and his pony. When we euthanized Jasmine, Aidan drew me a picture. I firmly believe that re-creating those good memories imprints something other than the stamp of death.
  5. If the child isn’t to be home or present, and the parents ask my opinion, I always suggest they tell the truth. Kids are great lie detectors. Telling them that the dog ran away or that the horse suddenly joined the circus, or that the goldfish is living on a farm in Connecticut is a great way to kill your parental credibility. Don’t go there. If you’re uncomfortable telling your kid that you had the vet give Fluffy a death shot, at least say that Fluffy died painlessly.
  6. I always, always ask if the child has any questions, and I always answer them. Folks, don’t be embarrassed by your child’s curiosity. This is big stuff. Kids need to know the answers. I never found questions a burden. I always believed that I was building a new generation of good veterinary clients.
  7. I let the child and the parents know that it’s okay to be sad. It’s okay to cry when we lose a friend. I’ve been known to cry with them. We live in a culture that often tries to deny, minimize, or sensationalize death. Death is a part of life. A loss is a sad thing. The mind needs to absorb and process that loss. And for children, the loss of an animal is often more real than that of a human. My kids have cried far more over our pets than they did over any of their great-grandparents, despite being fairly close to the latter. To them, the pets were more real.
  8. Every child is unique. And every situation is unique. Parents sometimes ask if their child can/should be present for euthanasia of a family animal. The best answer I have is: “It depends.” Emergency colic episode aside, none of my kids has been present when I’ve euthanized an animal, particularly our own. When it was Jasmine’s time, they said their goodbyes and went to the movies with my husband while I took care of the rest. Some children are scientifically curious and process facts better than the unknown. Those children may benefit by seeing euthanasia all the way through. Other kids, such as my son, are much more sensitive to emotion or may be a bit squeamish. For those children, it’s probably best to say goodbyes in a controlled setting. Also, while euthanasia is painless, it is essentially an anesthetic overdose, and animals may react unpredictably or show a variety of end-stage physiologic responses, such as gasping, paddling of legs, and loss of bladder and bowel control. Horses, for instance, rarely sink quietly to the ground, so even a “smooth” euthanasia can look dramatic to someone who is unprepared. A teenager may want/need to be present, but a pre-schooler would be unlikely to understand the situation, and monitoring a young child might further stress already grieving parents.

Your veterinarian may or may not have the time or temperament to do any or all of these things with your child, but as someone special in a child’s life, you can help give them the tools to better understand the loss of their animal.

Just don’t be shocked if the teddy bear or plastic horse meets with a humane demise. It’s all part of the process.

12 Comments

Liz
September 7, 2016

So true to tell the truth.  why would you lie to your kids and let them not trust you ever again. As a volunteer in Pet Bereavement Support we learn never ever to say to a child that a pet was put to sleep....how can we expect a child to go to sleep again if they worry they may be dead when they wake up (so to speak). Also if kids get to know about losing pets, you can use it when a grandparent or someone close dies. You can say 'Do you remember how sad you were when fluffy died - and how you eventually felt better?'.


Wes 
September 18, 2013

The bigger issue is that we live in a death denying culture, where the only people who see real death are professionals -- doctors, vets and people working in an abattoir. Meat is something that comes on a styrofoam tray wrapped in plastic. Death in our experience is something that happens only at one step removed, on a screen, with music playing and frequently violent. Very few get to see their own grandparents or elders die (much less the elderly relatives of their neighbours). Comforting, truthful handling of death is something that is sorely lacking from our everyday experience.


Louise 
August 29, 2013

I was sort of joking about the whole 'sending him to a farm' thing with another vet and her husband, not a vet, was in the room. He chimed in with 'when I was a kid our dog went to a farm'. We both sort of looked at him and you could see the penny drop, right then and there, at 30 something years old. His dog did NOT go to a farm. He parents lied to him. I've never seen someone look so shocked. It's a bad lie to tell. Eventually the kids will work it out and feel betrayed and hurt, even years after the fact. Knowing the dog died would have been way easier than having to confront the lie all those years later.


Sandy Lee 
August 27, 2013

It is hard even for adults to accept the truth. I  have had to help my wonderful dogs and cats cross the rainbow bridge always feeling sad and guilty, even knowing there were no other options. I think children do better than adults with accepting things that need to be done.


Christy Corp-Minamiji, DVM 
August 28, 2013

Hi Cynthia, thank you for your feedback.  I'm glad that your experience with an equine euthanasia went so smoothly.  It is a blessing when it happens that way.  From the hundreds (probably close to a thousand or more, realistically) of euthanasias that I have performed or witnessed over my years in equine practice, I can say that, as with many things in biology, the outcome is variable regardless of the method used.  You are absolutely right; when correctly performed, lethal gunshot is as humane as chemical euthanasia.  Most veterinarians in the U.S. tend to use pentobarbital because it is usually preferred by the clients, and as the urban/rural divide narrows in many areas of the country, euthanasia by injection is perceived as less disruptive and concerning to the public than gunshot.  However, as far as children are concerned, horses are big animals, and regardless of the method of euthanasia used, watching one fall to the ground can be unsettling to many people.


Cynthia 
August 27, 2013

You wrote:  "Horses, for instance, rarely sink quietly to the ground, so even a “smooth” euthanasia can look dramatic to someone who is unprepared."  The only horse euthanasia I've ever seen was done by my husband, with a bullet placed in just the right spot.  The horse DID sink quietly to the ground, apparently dead instantly. If that doesn't happen when a vet does the deed, maybe vets should consider using this method.


Carol 
August 27, 2013

Truth. always. I learned last week that the untruth is tough on everyone.  as a 6 yo (50 yrs ago) my parents took the family calico cat, Muffin, and kittens "to the vet" but we never picked her up. I asked for years to go and get her. Just last week a nearby feral rescue had a pretty calico girl for adoption (apparently abandoned after she had kittens). I sent her pic to my 82 year old mom, who immediately said 'go get her, I'll pay the adoption fee, but can you name her Muffin?' I did. That guilt and anxiety can stay with people for decades. Would I have been happy at 6 with the truth? hard to say, but I am pretty sure I would have absorbed it better than the years of wondering. Great article!!!


Barbara
August 27, 2013

In late January 2005, I got a call from my mother who immediately put my 10-year-old niece on the phone. Sarah started crying and told me about finding her goldfish Domino floating at the top of the bowl. She had had her two fish, Sunset and Domino, for over two years. It was nothing like what I remember from my childhood, a series of unnamed fish that each died after a couple of weeks. She related to them like I had to dogs and cats, which her mom (my baby sister, Gillian) won't allow her to have. She then described making a little box for the fish digging through nearly frozen ground to bury it in the front yard, and putting up a cardboard "headstone" with "Domino – the best fish ever" written on it. Sarah wanted to talk to me because I'm the only other "animal person" in the family. What she didn't know was that, her great-grandmother, my grandmother, was in the process of dying. Grandma was 93 years old and, like most older people, occasionally ended up in the hospital for things like wound care and tenacious colds. Up until this time, she had been essentially healthy. She couldn't keep food down, had a feeding tube put it, was in a lot of pain, and was drifting in and out of a lucid state. Sarah hadn't been told how serious the situation was with her great-grandmother. The two of them were very close. My thought was, "What bad timing." Less than a week later, my grandmother died. Sarah's response was to take charge. She wanted to be the one to call my other sister and me to break the news. She said she wanted to pick out the headstone because, she said, "I've got taste." We all got ready for the wake, she spent several minutes packing the purse she'd bought to match the black funeral dress. While we were sitting there waiting for the guests, she pulled out a little bag with a marble in it. Her mom scolded her (mildly) and told her to put the marble away before she lost it. I heard her say, "See where that cloud is in the marble – that's a piece of Great-Grandma's soul and Domino's soul. Just a piece, all mixed together." So, I guess Domino the fish had good timing after all.


michele 
August 27, 2013

So true about telling the truth. Our family went on vacation, and when we came back, our dog was gone. He was "living on a farm". I knew they were lying.  After all, if he was living on a farm, wouldn't we get to see him once in awhile, or get a card to know how he's doing? Before my dad died, and now that I'm a senior citizen, I asked for the truth, My mom still won't give me the details of the farm, or what happened, and she just screams and tells me to let it go. I just want to know what really happened--I don't hold it against her. If I knew, I could rest more easily. These lies go on forever.


Rhainy Carter 
August 27, 2013

Thank you so much for such a wonderful article about an oftentimes painful and avoided subject.  My feelings have always followed the same path as yours, as I was a vet tech for many years, and preferred honesty to the usual parental explanations.


Dee Lee 
August 27, 2013

Excellent article.


Judy Sutterfield, LVT 
August 27, 2013

When my son was 4, my sister made the decision to have her old dog euthanized.  I explained to my son that the vet would help Jazzy die, and that she won't feel any more pain.  He asked if Jazzy would go to heaven.  I believe she will, and told him so. I said she'll be able to run and play and chase squirrels all day long.  My son thought for a minute, then he said, "I think dog heaven must be the same place as squirrel hell."



 
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