Pentobarbital Shortage Concerns 2021; Have no fear

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Pentobarbital is almost back.  Where has it been you ask?  If you perform many euthanasias in your line of work, you know it’s been scarce for months, in the US and other parts of the world.  Due to complications from COVID at one overseas factory (affecting the US supply), and a reported explosion at another (affecting Canada’s supply), the chemical powder fell short of normal production levels and therefore did not reach the solution manufacturers as expected.  

Manufacturers like Virbac and Vortech Pharmaceuticals here in the US, and other companies around the world could not produce euthanasia solution to meet the demand.  Around mid March, veterinary hospitals and animal shelters alike found themselves beginning to worry.  In an effort to reduce drug hoarding, no formal announcements were made.  Pentobarbital is the #1 go-to drug for companion animal euthanasia in countries that allow it.  It is reliable with consistent dosing and minimal side effects leading to a peaceful death when performed properly.  If it were to disappear, the alternatives would feel foreign and down right scary for many professionals.  

It is still out there, but many have had to create accounts with new distributors to receive enough solution to support their appointment demands. Some veterinarians have had to transfer drugs between services, adding a layer of complexity for Drug Enforcement Agency (DEA) regulations. If COVID has taught us anything, it’s that we have to find ways to cope with adversity, especially when animal welfare is at stake.

To conserve euthanasia solution, a wise choice is to dial back how much is used.  When euthanasia is warranted to end patient suffering, only using the recommended dose is called for.  Many practitioners give a little extra to ensure death is complete, but it’s really not needed.  The typical dose of 1ml per 10#(4.5kg) of a 390mg/ml solution is appropriate for all companion animals.  Some countries have concentrations of 200mg/ml or 240mg/ml which requires even more for our 85mg/kg dosing in almost all species. And while the Companion Animal Euthanasia Training Academy (CAETA) is a big advocate for intraorgan injections as viable technique options, they do require more solution, sometimes triple the intravenous (IV) dose.  In a time of shortage, IV administration will help to preserve what minimal drug reserves there are.

Fortunately, word on the street is that pentobarbital is about to arrive on the doorsteps of many US manufacturers and soon return to the shelves for purchase. The veterinary distributors of the drug then have the monumental task of filling backorders.  Then and only then will most of us breathe easy.  Until that time, we keep the supportive conversation going through our Facebook group dedicated to companion animal euthanasia, including how to use the alternatives if push comes to shove.

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Dr. Kathleen Cooney

DVM, CHPV, CPEV, DACAW resident Founder, Senior Director of Education for the Companion Animal Euthanasia Training Academy

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