CAETA Euthanasia Case: Patches the egg-bound chicken

The Companion Animal Euthanasia Training Academy (CAETA) invites you to consider the following fictional euthanasia case and reflect on how to proceed. After reviewing the case, read the questions and consider your answers before continuing on to CAETA’s suggestions. This case is designed to test your knowledge of companion animal euthanasia and be a conversation starter among your veterinary team. Case outcomes are enhanced when following CAETA’s 14 Essential Components of Good Euthanasia.

Euthanasia Case: Patches the egg-bound chicken

Patches, a 9-month old, 2.5kg, chicken has become egg-bound and is very uncomfortable. Her owners are a retired couple that have begun rearing a backyard flock. This is the first time one of their chickens has had this condition, and they have never euthanized before. Based on the severity of straining and now cloacal prolapse, euthanasia is chosen at the local mixed-animal veterinary practice. Patches travels in a small pet carrier and they bring her into the exam room. She is pulled out and placed on the table, and the veterinarian can feel how swollen her belly is. Patches is young and reluctant to handling, which her owners are aware of and are hoping to keep things gentle. The veterinarian describes their typical euthanasia approach of giving an intracoelomic injection of pentobarbital, but that in this situation, another method may be better. The veterinarian has recently learned that giving transmucosal pentobarbital euthanasia solution to absorb across mucous membranes in the mouth/beak is a euthanasia method in some birds. Patches is given 600 mg/kg of pure pentobarbital via syringe (no needle) into her mouth/beak, and placed back in the carrier rather than holding her. She flaps a bit, lays down after one minute, then goes completely limp at four minutes. The veterinarian removes her from the carrier and places her on the table to listen to her heart. Patches has stopped breathing but her heart continues to slowly beat. The owners are invited to pet her and be close. Another listen to the heart at ten minutes reveals that Patches has died. The owners elect communal cremation.

Discussion Questions

1. The veterinarian chose to use a new euthanasia method with owners watching. Is this advised and what are the risks?
2. It takes up to ten minutes for Patches to die. Why do you think this happened?
3. There are a few euthanasia techniques that can be used with chickens. What else could the veterinarian have done if transmucosal administration of pentobarbital was not an option?

CAETA Euthanasia Case Suggestions

1. Sometimes veterinarians need to reach for techniques and procedures that are novel to them. While it can be a bit scary to try something new with people watching, if it’s in the patient’s best interest, and the veterinarian has confidence in a successful outcome, it should be attempted. Patches did not want to be touched and the owners wanted to keep things gentle for her. Giving medication into the mouth rather than administering a potentially painful injection has advantages. When trying new things with owners watching, they should be told what to expect (without overwhelming them) and invited to remain present if they wish.
2. Patches took around ten minutes to succumb to the effects of pentobarbital. A 2023 study looking at transmucosal administration in wild birds found the average time of death to be around four minutes or longer. Other pentobarbital euthanasia injection techniques (e.g., intraperitoneal and intracoelomic) can take ten minutes or more. Pentobarbital has to be absorbed into the blood stream, circle through the body to reach the brain where anesthetic overdose is achieved. As long as the correct dose is given, and signs of death of presenting (e.g., unconsciousness, apnea), it is likely the technique will lead to permanent death. The veterinary team should always have extra drug on hand and be ready to give more if they feel it is necessary. 
3. If the transmucosal administration of pentobarbital did not lead to euthanasia for Patches, the veterinarian could have given more pentobarbital into the heart or liver. Patches was rendered unconscious with the transmucosal dose making it safe to give more drug into an organ with good perfusion. If the transmucosal route was not possible at all, the veterinarian could have given an intramuscular injection of anesthetics/sedatives (e.g., tiletamine, butorphanol, acepromazine) to induce anesthesia, then proceed to give pentobarbital or some other euthanasia agent into the vein, heart, or liver. It was a good decision to avoid the intracoelomic route because it could have been extra painful for Patches and lengthen the time to cardiac arrest due to her egg-bound condition. 

This case highlights the following Essential Components: D=Deliver Proper Technique, I=Inclusion of loved ones, and A=Avoid pain and anxiety. These examples are just a few of the ways euthanasia can be enhanced. Consider what else might be done to ease the client’s emotional burden and support the patient’s needs for a gentle death. The Companion Animal Euthanasia Training Academy is here to boost your euthanasia expertise.

Reference
Gardhouse, S., Beaufrere, H., Hawkins, M. G., Sanchez-Migallon Guzman, D., Jajou, S., & Paul Murphy, J. (2023). Evaluation of Oral Transmucosal Administration of Pentobarbital for Euthanasia of Conscious Wild Birds. Journal of applied animal welfare science : JAAWS, 26(1), 4–14. https://doi.org/10.1080/10888705.2021.1911655