Key words
Key: a thing that provides a means of gaining access to or understanding of something.
Therefore, key words are very important in order to understand a subject. If you don't understand the key words of a subject, you are liable to misunderstand things that people are trying to communicate to you and make mistakes or "appear stupid".
Euthanasia: See definition and description on website.
Common Abbreviations
| Euth | Euthanasia |
| ACO | Aftercare only (pet has passed and they want us to care for the remains) |
| QOL | Quality of Life |
| NAC | No aftercare, meaning the client will dispose of the body themselves |
| DSH | Domestic shorthair cat |
| Comm | Communal cremation |
| Priv | Private cremation |
| Hosp | Hospice |
| PP | Paw Print |
| HPESC | Home Pet Euthanasia of Southern California |
| Ind | Individual Cremation |
| EOL | End of Life |
| I/C | In Charge (the person in charge of an activity) ex: Aftercare I/C |
Keywords to Know and Understand
Palliative Care:
Medical care not targeted to cure a disease. Relieving pain or alleviating a problem without dealing with the underlying cause. It is used to “make things better” when a condition cannot be cured and is deemed permanent. Examples of this are “palliative radiation” which is targeted towards killing cancerous cells locally, thereby reducing the size of a tumor without removing it and knowing that it will come back. Another example of palliative care is caring for a pet who has lost the use of his hind legs and who is fitted in a wheel cart. We know he will never walk again, but the wheel cart may increase quality of life. Some drugs are considered palliative when they alleviate symptoms without curing. The difference between palliative care and hospice is that palliative care is not necessarily aimed at treating terminal conditions. A condition can be permanent and incurable without being fatal, such as the above example of a dog having lost the use of his hind legs.
Pet Hospice:
(You can read the section on Hospice on our website to clear this concept.) The difference between palliative care and hospice care is that hospice care is targeted towards End of Life patients. Palliative care can be part of Hospice care.
You will also want to know about some of the most common End of Life diseases that callers will mention. There are 20 brochures explaining the most common ones that clients mention. It is good to read these so you can have a concept of what the caller and their pet are going through.
Common medical terms you will hear:
Cancer:
A disease where a group of cells in the body become abnormal and lose their capacity to stop reproducing. Therefore they multiply indiscriminately and choke the normal tissue surrounding the cancerous mass. When cancer spreads to other parts of the body, we call the distant masses created “Metastasis”. A metastasis is a mass that is not at the primary site of where the cancer started. The most common tissues for metastasis to settle are the lungs, the lymph nodes, the liver and the brain, but metastasis can happen anywhere in the body.
Common types of cancer:
Sarcoma: A general term for cancer originating from cells that are not skin cells nor cells forming the lining of organs. Cells lining the skin or lining the organs are called epithelial cells. Sarcomas are “non-epithelial” cells cancers. Frequently referring to cancers originating inside an organ.
Hemangiosarcoma: Hemangiosarcoma (hemangio=blood, sarcoma=see above) is a type of cancer of blood tissue. The most common place where hemangiosarcomas are found is the spleen which is an organ in the belly that stores red blood cells and cells used by the immune system. Blood can pool in the spleen. When a hemangiosarcoma occurs, it renders the spleen very friable (easily damaged) and it can easily rupture, usually causing the body to bleed internally to death. Other common areas where hemangiosarcomas can settle are the base of the heart (near the aorta which is the biggest blood vessel in the body, the main one that comes out of the heart). Again, due to the nature of the tissue of origin, these cancers can easily rupture and the pet bleed to death internally. Hemangiosarcomas or hemangiosarcomas metastasis can spread anywhere, including the skin and the liver. It is VERY common, particularly in large breeds, and even more common in Golden Retrievers.
Osteosarcoma: Bone cancer. (osteo=bone, sarcoma=see above) It spreads extremely fast, is very painful and causes the affected bones to fracture spontaneously or upon minor trauma such as missing a step or falling.
Lymphoma: Lymph node cancer. Since the body as multiple lymph nodes and the lymphatic system is very well connected, lymphoma is not a localized disease. When lymphoma occurs, it is in all the lymph nodes. It usually responds well to chemo and frequently goes into remission when treated with chemo for 6-36 months. Sometimes, it does not respond. It causes lymph nodes to become very enlarged, particularly the ones under the throat which can cause difficulty breathing due to the constriction of the trachea, eventually leading to respiratory distress.
Mast Cell tumors: Common type of skin cancer frequently occurring in Boxers and Pitt Bulls (many other breeds as well, but these 2 are the most commonly afflicted). Mast cell tumors are graded depending on their relative aggressive behavior. A stage one would be rather benign; a stage IV is likely to spread and is deemed cancerous.
Carcinoma: A general term for cancer originating from “epithelial cells” (cells forming the lining of organs or skin.
Transitional Cell Carcinoma (AKA TCC): Bladder cancer. Transitional cells are a type of cells in the bladder wall. It causes a huge mass to form in the bladder, the sensation of the need to urinate constantly, blood in the urine and unproductive urination. It does not typically grow fast, but in the end stages of it, it is painful.
Squamous cell carcinoma: A common type of cancer in cats, particularly white cats exposed to the sun. Squamous refer to a type of cells on the surface of the skin, and that flake off. Those types of cancer are usually on the nose, lips or ears of cats and eat away at the skin. In advanced stages, the cat will be left with no ears, no nose or no lips and the underlying tissues exposed, resulting in a pretty scary picture.
Adenoma: A type of tumors of the glandular tissue (glands are organs that make hormones). A common site for adenomas are anal glands. When they get large, they cause pain, the sensation that they need to defecate constantly and obstruction of the anus.
Other common End of Life diseases
OA (Osteoarthritis): A fancy name for arthritis. (Osteo=bone). Also called Degenerative Joint Disease or DJD.
Renal failure (AKA Chronic Renal Failure, CRF, Kidney Disease, Chronic Kidney Disease (CKD): Failure of the kidneys to function resulting in dehydration and toxin accumulating in the body. Commonly leads to severe weight loss, weakness, vomiting and a general “shitty” feeling, to use scientific terminology. The kidneys consist of 2 major types of cells: those that filter OUT the toxin and discharge them in the bladder (urine) and those that filter IN (recycle) good fluids such as water, returning it to the blood stream. When kidney failure occurs, both types of cells are malfunctioning, resulting in an reverse condition/function. The cells in charge of discharging the toxins don’t work, so the toxins stay in the blood and the cells in charge of recycling water don’t work, therefore resulting in excessive water being discharged in the bladder. This is what causes extreme thirst, excessive urination and dehydration. Toxins accumulating in the blood result in byproducts similar to ammonia. These are caustic and cause ulceration of the lining of the mouth, tongue, oesophagus, stomach and intestines. This causes salivation, pain in the mouth, stomach ulcers, nausea, anorexia, vomiting, etc… It also causes a chronic “flu-ish” sensation, aches, weakness, headaches, joint pain, etc… This is due to increased toxins in the blood. This level of toxins can also cause seizures in the end stages. This condition is very common in old cats. The combination of extreme dehydration and weight loss led to the term “raisin cat”. This condition is also fairly common in dogs and can result from old age, poisoning and, sometimes congenital (born with abnormalities).
Liver Failure: Failure of the liver to function resulting in toxin accumulating in the body. Commonly leads to weakness, jaundice, vomiting and also resulting in a general “shitty” feeling, to use scientific terminology.
Dementia: A term describing brain degeneration due to old age and causing memory loss, disorientation, loss of training patterns, and gradual general loss of mental and bodily functions.
Canine Cognitive Dysfunction (CCD): A fancy term for doggy dementia.
Equipment
Catheter: Catheters are small devices used to insert in a body. An IV catheter (IVC) is a very small plastic tube installed by the use of a small needle to guide it inside a vein. It is then secured in place by the use of tapes. It is used primarily to administer fluids and drugs. In euthanasia procedure, it is used to administer euthanasia solution safely without having to worry about the pet moving thereby causing pain if the needle “slips” outside of the vein. Another common type of catheter is the urinary catheter, which is used to empty the bladder in the case of obstructions or during surgery/medical procedures. They are not used in the euthanasia procedure.
Butterfly: A butterfly (“winged infusion set”) is a type of catheter used to administer drugs intra-venously and to draw blood. It has little plastic “wings” on the sides and just above the needle that make it easier to hold stably, reducing the risk of “slipping” outside the vein when administering drugs. It is not as safe as the IVC but it is easier to hit a vein with it than it is with a regular IVC, especially on dehydrated patients or patients with poor veins.
Stethoscope: A devise used to listen to sounds originating from inside the body. It is most commonly used to listen to heart sounds, but can also be used to listen to lung sounds and bowel sounds.
Sedation: A procedure targeted towards reducing the awareness of a person or pet to a greater or lesser degree, usually aiming to make them more comfortable or more tractable in stressful situations. Unconsciousness may or may not result. If sedation is used prior to euthanasia, we are aiming at unconsciousness. In euthanasia, sedation is used prior to the IVC placement for pets who would find the IVC placement difficult or stressful. Adverse reactions CAN occur during sedation, which is why I prefer to avoid it whenever possible. When I assess a patient’s mentation and disposition prior to euthanasia, I make the decision to sedate or not to sedate. If the IVC placement is possible WITHOUT STRESS to the pet, then this leads to very peaceful, very smooth and rapid euthanasias without the pet going through a prolonged period of “in-between” consciousness and unconsciousness. See the Fletcher Video for an example of a smooth and peaceful euthanasia without prior sedation. Reactions to sedation are common and can range from subtle mental anxiety not necessarily noticed by an untrained eye, to vomiting, anxiety, difficulty breathing and blunt panic. They sometimes need repeated injections before finally falling asleep. The more severe reactions are RARE, but they can be atrocious. On the other hand, placing an IVC without prior sedation can also be atrocious on a nervous or aggressive pet. Sedation does not necessarily include pain control, but prior to euthanasia, we are using drugs against pain in the “cocktail”. Sedation differs from anesthesia as anesthesia implies absence of pain. General anesthesia the complete absence of pain and complete unconsciousness. Local anesthesia means absence of pain locally, usually on a conscious patient who may or may not be sedated.
Euthanasia solution: The drug used to humanely euthanize a pet. It consists of Pentobarbital (a strong barbiturate) and a drug called Phenytoin which relaxes the breathing muscles. It is usually pink. The reason why it is pink is because no other injectable drugs are pink (except for the rabies vaccine) and it cannot be confused with other drugs and injected accidentally, therefore accidentally killing a pet in clinic. It is a controlled substance.
Propofol: “The Michael Jackson drug”. It is an anesthetic which, in euthanasia procedure, can either be administered prior to euthanasia solution or mixed with it. It is white and milky in appearance. In medicine and surgery, it is commonly used to induce anesthesia (put a pet or person to sleep rapidly prior to installing a breathing tube and administering gas anesthetic) OR used as a single agent in SHORT procedures as it has a very short acting time.
Xylazine: A heavy sedative used in animals. It is not used in humans. It invariably causes vomiting in cats, which is why it is not used in cats. It is cheap and effective in dogs and usually brings about a nice, smooth sedation. Vomiting is seldom seen in dogs, but it can happen. In the protocol our doctors use for dogs, it is usually mixed with butorphanol and acepromazine. It is a clear liquid.
Butorphanol (AKA torb): A synthetic opiate. It is a pain killer and also has sedative properties. It is a clear liquid. It is a controlled substance.
Lidocaine: A local anesthetic. In the euthanasia protocol we use, it is injected in the IVC just prior to administering the euthanasia solution and propofol to “deaden” the lining of the vein because in some pets and some persons, propofol causes a brief burning sensation. The use of lidocaine nullifies this burning sensation. It is a clear liquid.
Acepromazine (AKA Ace): A tranquilizer. It is used in our dog pre-euthanasia protocol along with Xylazine and Butorphanol. It is bright yellow.
Telazol (tiletamine): a dissociative anesthetic. Dissociative means that it separates the perception of pain and sensation from the mind. It can produce hallucinations. Unfortunately, it is one of the only injectable sedatives available for cats that can be given subcutaneously and that produces a relatively smooth sedation without causing vomiting. It is a controlled substance. It comes in a powder that has to be reconstituted with a liquid (either sterile water or a liquid drug such as butorphanol).
Ketamine: a dissociative anesthetic. Dissociative means that it separates the perception of pain and sensation from the mind. It can produce hallucinations. Unfortunately, it is one of the only injectable sedatives available for cats that can be given subcutaneously and that produces a relatively smooth sedation without causing vomiting. Its dissociative effects are considered more severe than telazol which is why telazol is preferred). We do not use it except for reptiles. It is a controlled substance.
Other terms:
Rigor Mortis (AKA “rigor”): A condition that sets in after death (usually within an hour or 2) in which the muscles of the body become stiff and rigid. (Rigor=stiff; mortis is a latin name for death). It usually lasts for 1-4 days. It does not always occur. Sometimes, if death was violent and a lot of muscular activity occurred just prior to death (such as a drowning), it occurs very rapidly and the muscles are incredibly hard. Sometimes, it takes a long time to happen and the muscles are not as hard. It is important for you to know this term as families will frequently be concerned about this manifestation and they don’t want to see it. So they will often ask how long it takes before it happens and they want us to remove their pet’s remains from their sight before it happens. It is also important for you to understand this phenomena in cases where the pet parent wants to see their pet before the cremation procedure as in the case of Individual Cremation with Viewing. We strive to place the pet in a tasteful position prior to Rigor Mortis settling in, so that the pet is not in in a ridiculous or unsightly position when the family visits with the pet’s remains prior to cremation.
Subcutaneous (S/C or “Subcu”: Administered under the skin (sub=under; cutaneous=pertaining to the skin). Injections done S/C are less uncomfortable than those given IM. This is the way we administer the pre-euthanasia sedation injection when sedation is used in the protocol we follow. This is also the way that injections of fluids are administered in home settings, in dehydrated patients, for example in cases of Chronic kidney disease. Often times, people will mistakenly call S/C fluids “IVs”.
Intramuscular (IM): Administered in a muscle (intra=inside; muscular=pertaining to muscles). IM injections can be painful. We do not do IM injections in our pre-euthanasia sedation protocol.
Routing Form: A routing form is a form which “routes” people or things from place to place, ensuring that each step that needs to be done gets done in sequence and that no steps in a process are missing. For example, in our company, we have several routing forms such as the “Post Euthanasia Routing form”, the “Paw Print Routing form”, the “Cremains Delivery Routing form”, etc… Each of those forms has a series of steps, each step important to complete in order to make sure that nothing gets omitted.
Definitions of Compassion:
Deep awareness of the suffering of another accompanied by the wish to relieve it.
Compassion is the response to the suffering of others that motivates a desire to help. ... The etymology of "compassion" is Latin, meaning “co-suffering."
The meaning of compassion is to recognize the suffering of others, then take action to help.
Compassion literally means “to suffer together.” Among emotion researchers, it is defined as the feeling that arises when you are confronted with another's suffering and feel motivated to relieve that suffering. Compassion is not the same as empathy or altruism, though the concepts are related.
If someone shows kindness, caring, and a willingness to help others, they're showing compassion. ... When you have compassion, you're putting yourself in someone else's shoes and really feeling for them. ... When you feel compassion for someone, you really want to help out.
Define compassion: a feeling of wanting to help someone who is sick, hungry, in trouble, etc,…
compassion. /kəmˈpæʃən/ noun. a feeling of distress and pity for the suffering or misfortune of another, often including the desire to alleviate it. C14: from Old French, from Late Latin compassiō fellow feeling, from compatī to suffer with, from Latin com- with + patī to bear, suffer.
Euphemism:
a mild or indirect word or expression substituted for one considered to be too harsh or blunt when referring to something unpleasant or embarrassing.
the substitution of a mild, indirect, or vague expression for one thought to be offensive, harsh, or blunt. 2. the expression so substituted: “To pass away” is a euphemism for “to die.”
Euphemism is from Greek euphemismos, meaning "good speech," and it's a way that we paper over uncomfortable things with more pleasant-sounding words.
A euphemism /ˈjufəˌmɪzəm/ is a generally innocuous word or expression used in place of one that may be found offensive or suggest something unpleasant.[1] Some euphemisms are intended to amuse; while others use bland, inoffensive terms for things the user wishes to downplay. Euphemisms are used to refer to taboo topics (such as disability, sex, excretion, and death) in a polite way, or to mask profanity.[2]
You will learn more about using euphemisms in the policy entitled “Choice of words”.