Euthanasia training in New Brunswick animal shelters — A cooperative approach

In an ideal world, euthanasia would not exist in animal shelters — there would be no stray or unwanted animals slated for a premature death due to a lack of available homes. In a near perfect situation, all animal euthanasia would be performed by licensed veterinarians, or registered animal health technologists under direct veterinary supervision. Controlled drugs would thus be available for use in the shelter setting, and everyone would be proficient in the handling of hazardous medications. Staff turnover would be non-existent. This is a utopia, which unfortunately does not exist in the animal shelters within our borders.

Our reality was not unlike that experienced by many rural and under-serviced areas across the nation. Volunteers or minimum wage earners staff most shelters in New Brunswick, which operate on a “shoestring” budget. Training was oftentimes that provided by local veterinarians who took it upon themselves to instruct the fundamentals of euthanasia to shelter staff before handing them T-61. There was no standardized training, no means of standardized evaluation, no checks in the system, and no means of ensuring that animals were being properly euthanized. Some attendants were extremely proficient in their ability to properly euthanize animals; others unfortunately were not. T-61, is a pharmaceutical specifically labeled for euthanasia. It is currently used in Europe, where animal welfare standards are high. Its use has been withdrawn in the United States, with the exception of Arizona, due to concerns about its administration. Used properly, death is quick; improper injection can result in possible asphyxiation before narcosis. Proper technique is essential for the use of this drug to result in euthanasia.

In 2005, the New Brunswick Veterinary Medical Association’s (NBVMA) Animal Welfare Committee was mandated to study the multifaceted issue of animal shelter euthanasia. To change the system, as it existed, a dispensing bylaw had to be passed by the NBVMA membership limiting the dispensing of hazardous drugs, including T-61, to certified individuals. This motion was passed, after lengthy discussion, at the 2005 Annual General Meeting, contingent upon the development of a certification program for shelter staff. There was consensus that veterinarians should ideally perform euthanasia, but logistics, manpower, and economics dictated that shelter staff would likely have to continue to perform this duty for surrendered animals. It was essential that they have sufficient knowledge to perform euthanasia properly. The NBVMA does not advocate the use of T-61, nor non-veterinarians performing euthanasia, but does recognize the limitations of the current manpower and economic situation. The certification program is a compromise to deal with a difficult problem with no easy solution.

Certification would entail developing a certification program, recognized by the membership as delivering adequate knowledge to perform euthanasia. The committee consulted many experts, but only Dr. Jamie Lawson of the BCSPCA offered his assistance by providing his training manual to serve as a template for the NB program.

There were several considerations that necessitated modifications of the BCSPCA format. As there are no veterinarians on staff, no controlled drugs such as ketamine and pentobarbital are available for use at NB animal shelters. There are no minimum education requirements for shelter attendants and there is a high manpower turnover.

The pharmaceutical section of the modified manual reflects the absence of controlled drugs. Acepromazine, xylazine, and T-61 are the only pharmaceuticals to be dispensed for the euthanasia of shelter animals in New Brunswick. The regulations as to the storage and the techniques for the safe handling of hazardous drugs are stressed. The manual was presented at the 2007 NBVMA Annual General meeting at which time legal concerns were addressed and further discussion of shelter euthanasia occurred. The NBVMA Council approved the manual for use in October of 2007.

The Provincial SPCA was notified months in advance that there was to be a certification course. The idea of standardized instruction was welcomed. It was understood, and accepted by the NBSPCA that once certification was in place “no certification meant no drugs.” All shelters were notified that a training session was being prepared and that there were to be no exemptions, no exceptions to certification.

In anticipation of the course, Dr. J.Goltz prepared a PowerPoint presentation of the manual. The manual was electronically transmitted to all participants a week in advance of the course to allow for familiarization with its contents. All NB animal shelters performing euthanasia were to send at least two attendants to ensure that there was backup at each facility in the event of illness or attrition. A repeat of the course was not anticipated for at least a year, and would be given depending on demand.

In order to facilitate participation, a grant was obtained from the Animal Welfare Foundation of Canada (AWFC). These funds were used exclusively to cover the costs of materials and travel/housing expenses of participants. All veterinarians participating in the workshop donated not only their time, but also paid their expenses so that the shelter attendants could have the bulk of their expenses covered. Oulton College of Moncton, NB, donated the lab and class space.

The theoretical session covered such topics as pharmacology, anatomy, safety, proper handling of medications, routes of injection, and injection technique. Regulations, as they pertained to the handling, storage, and use of the drugs were also presented. Throughout the session, safety was stressed. Compassion for the animals and stress reduction were two elements that were a constant theme. The “injection is done and so is the animal” was a mantra that summarized proper technique. “The animal deserves a pat, a kind word” and “How can you reduce stress to this animal” reflected the importance of not only efficiency but also empathy and compassion when dealing with euthanasia.

Participating shelters were responsible for providing animals for the wetlabs. These were exclusively animals that were slated for euthanasia. During the first wetlab, all animals were anaesthetized prior to intervention. The first wetlab covered injection sites, injection technique (SC, IM, IV, and IC) and anatomy. The student/vet ratio was 4:1.

At the end of the session, all animals were euthanized, with the participants identifying the different signs of death and demonstrating proper postmortem carcass handling. A necropsy was performed so that the participants could see the circulatory system and various anatomical landmarks. This activity was much appreciated by the shelter staff, as most had no prior instruction in anatomy.

The second morning session covered zoonosis, personal safety, staff stress reduction, and the recognition of the signs of “burn-out.” There was dialogue among the staff members of the various shelters and this provided the framework for further networking. Many compared notes and experiences and this served to enrich the information shared during the section on the emotional toll of shelter euthanasia on staff and how to deal with stress.

The second wetlab mimicked the shelter setting. Only those drugs to be used in the shelters were available. All animals were sedated using various combinations of the “allowed” drugs so that the participants could see the effect of dosage and drug interaction. When the animals were sedated, they were euthanized using T-61, and again the participants evaluated the signs of death. Those participants who were less proficient in their injection technique were identified, and extra instruction was given.

After the classroom and wetlab instruction was completed, candidates wrote an exam on the theoretical part of the course. A minimum of 70% was required for a pass. Questions included “You are faced with a man-eater of a dog. He weighs about 40 kg. Outline the steps that you would take to successfully euthanize this beast. Careful he bites!” The next question was “What is the first thing to ask before euthanizing the dog in the previous question?” The success rate in the written exam was 85%. There is a mechanism for a retake of the exam, which included 23 questions covering all aspects of the theoretical presentation. To achieve certification, however, participants also had to pass a technical and clinical evaluation; to be done at their respective shelters a month after the course. If the technique were lacking, the individual would not be certified until a satisfactory “in service” performance could be demonstrated.

There are other provisions in the program. Recertification is to be done every two years and will most likely be an “in service” evaluation of euthanasia technique and practical knowledge. Proper storage and record keeping is also to be monitored. The use of NBVMA practice inspectors to maintain surveillance is a viable option. A central dispensary to maintain inventory and access control is an idea that is being explored. This would not prevent a member from dispensing to a certified individual, but would encourage the use of a central source in order to further monitor access.

This is essentially a pilot project developed to respond to a need in our province, but potentially could be transferred elsewhere, subject to Dr. Lawson’s permission for the use of his material. Our goal was to improve our situation, which was untenable. We needed to ensure that shelter personnel use the drugs that are available to them in the best possible fashion. We had to ensure that animals are euthanized as compassionately as possible, and that the real concerns of staff safety and potential for accidents are addressed. Finally, we had to recognize the issue of staff stress and “burnout” and the impact both have on the ability of personnel to euthanize those animals that deserve a kind word and a pat in their final moments. These aims are universal and not limited to our borders.