PTS

[ester]

Pony dies quietly = correct drugs were used. PTS without sedation is poor practice.
The signing out of the food chain was correct, and signing a disclaimer seems pretty usual to me (and depending on the circumstances reasons to sedate asap before doing so).

 

[mary pearce]

So, thanks for your opinions, but I also have my own, so lets leave it there because as you say I am new and you don't know me or the anything surrounding the decisions made that day.
So thank you all again.

 

[ycbm]

No the horse did not suffer, but the paperwork is pitted with mistakes and I see no reason not to answer simple everyday questions as a polite paying client.

You haven't described anything which would suggest that the paperwork is incorrect, though.

What do you expect to achieve?
.

 

[ycbm]

So, thanks for your opinions, but I also have my own, so lets leave it there because as you say I am new and you don't know me or the anything surrounding the decisions made that day.
So thank you all again.

OK, I hope you can come to terms with your loss. You did the last act of a caring owner.
.

 

[ester]

We can only go from the information that you have given.

 

[Mrs. Jingle]

I am so sorry you are finding the aftermath of PTS so stressful. Of all the horses I have had to PTS all bar one were given an initial sedative and then a different dose of the 'final' stronger heart stopper, in one horse they did need a larger second dose of the heart stopper as he was not going quietly unfortunately. So in those cases just two different sedatives were used for the whole process.

My last horse PTS was not given the initial sedative, just straight in with immediate lethal heart stopper and I always regret I did not insist on an initial sedative as it was very distressing to watch him trying to fight the drug.

You do not answer if the horse/pony was an emergency PTS - I think if it is not a pre arranged PTS but an emergency then it could be a vastly different criteria your vet used for PTS than would be under normal end of life circumstances.

Perhaps take a few days to digest everything then write a very clear and concise letter to the practice manager, pointing out that you would just appreciate if someone could take the time to clarify the points that are still concerning you. I would word it very carefully to show that at this stage anyway, you are not trying to apportion any blame but just trying to understand the sequence of events on the day to help you come to terms with it all, if this is your first PTS of a large animal it could be worth pointing that out to your vet too.

Edited to say all my horses have drugs administered noted on their passport and signed signed by my vet. This is normal practice.

 

[mary pearce]

Thank you x

 

[ycbm]

Spoiler: euthanasia details

The heart stopper is potassium chloride and it is sometimes given if the lethal dose of anaesthesia is not working quickly enough to kill the horse, it's not the same drug. The horse must be heavily anaesthetised before it's used. That's what happened when the one I was with was PTS, it simply wasn't dying, even though it was right out of it, so the vet stopped the heart with potassium chloride. This was a few years back, there may be better drugs now.

 

[Chianti]

Thank you x

I'm sorry you're so upset. My last horse was PTS but that was nearly ten years ago. I didn't have to sign any paperwork but things may have changed as I expect vets now feel the need to protect themselves by having a record of the client's agreement. I would be very distressed if the form was produced during the process rather than before. It's possible that it should have been done earlier but the vet simply forgot but didn't like to say that they had. My horse couldn't be PTS by the senior vet in the practice as he was away so one of the younger vets came out to do it. I was so focused on my horse that I hadn't realised that her hands were shaking badly as she did the last injection. Someone else who was there noticed it and told me afterwards. I did wonder how many she had actually had to do- she did do it as well as it could be done. I would put everything in writing to the practice manager with copies of any paperwork you have. I think you need to do that to help you come to terms with what's happened. If you don't you will always be questioning it. You are a client and they should have a clear complaints process. If you feel that their response doesn't answer your concerns then raise it with the RCVS. Losing a horse is awful and however it happens there will always be things that you wish could have been done differently.

 

[paddi22]

Watching a loved animal being PTS causes a massive amount of grief and emotion. That emotion is an energy that has to be channelled somewhere and it's very easy to channel it towards the different target (if that makes sense) instead of really sitting and processing the grief. We put a lot of horses to sleep here at the rescue and nothing the vet has done seems out of the ordinary at all. They should have explained the consent form to you beforehand as that has distressed you, but it makes sense that the first thing they would do when they arrived was sedate the pony, as animals can get worked up and increase their heart rate when the smell vets and the drugs don't work as well, so it makes sense the first priority was to calm the pony and then deal with paperwork. it is an awful situation for you, and I'd imagine if it was a pony you have to deal with the emotions of younger family members. but please please for your own sake, don't get too obsessed on paperwork and cause more distress with potentially legal situations or falling out with a vet you normally use. it all genuinely sounds like normal process and a vet who did a professional job and gave a kind end to your much loved pony. grief is a powerful thing and it's very natural not to think clearly after such a traumatic thing. take a few days before you do anything and change your focus to maybe getting a nice memorial for the pony.

 

[mary pearce]

I'm sorry you're so upset. My last horse was PTS but that was nearly ten years ago. I didn't have to sign any paperwork but things may have changed as I expect vets now feel the need to protect themselves by having a record of the client's agreement. I would be very distressed if the form was produced during the process rather than before. It's possible that it should have been done earlier but the vet simply forgot but didn't like to say that they had. My horse couldn't be PTS by the senior vet in the practice as he was away so one of the younger vets came out to do it. I was so focused on my horse that I hadn't realised that her hands were shaking badly as she did the last injection. Someone else who was there noticed it and told me afterwards. I did wonder how many she had actually had to do- she did do it as well as it could be done. I would put everything in writing to the practice manager with copies of any paperwork you have. I think you need to do that to help you come to terms with what's happened. If you don't you will always be questioning it. You are a client and they should have a clear complaints process. If you feel that their response doesn't answer your concerns then raise it with the RCVS. Losing a horse is awful and however it happens there will always be things that you wish could have been done differently.

Thank you x

 

[mary pearce]

Pony dies quietly = correct drugs were used. PTS without sedation is poor practice.
The signing out of the food chain was correct, and signing a disclaimer seems pretty usual to me (and depending on the circumstances reasons to sedate asap before doing so).

Correct or not, we should have been informed of any signature going into his passport, we were not. thank you.

 

[ester]

It's interesting you think so, I don't think I ever was as it had to happen to have the treatment.
Very sorry for your loss and hope you get some more closure.

 

[brighteyes]

You haven't answered our repeated question about whether their end was calm and peaceful, Mary.

Assuming that it was, because you haven't said not, can't you see that is far more important than an asterisk by a name or how many syringes drugs were given in?

You're a new poster and we know nothing about you, but I'm going to make an assumption that you are displacing your grief at the ponies' deaths into anger at the vet who carried it out, and it's helping none of you.

Are you challenging the cost? Because unless you are, I can't see what it matters what drugs are on the invoice. If you are, just pay what you think you owe and ask in writing for an explanation of the rest.

Are you planning to sue for negligence? If so, then I can see why your vets won't take your calls, they will need everything in writing for their insurers.

If it wasn't for knowing how grief can affect people, I would be baffled about being upset that the vet records have an asterisk against a horse name. If the horse was treated correctly what on earth does it matter? It doesn't, but you need something to fight at the moment to assuage your own grief. That's a completely normal part of the grieving process and I'm very sorry you are going through it.

Many vets have a hard time being asked to kill animals. If your ponies had a kind and peaceful end, please consider the effect of your actions on the veterinary practice and the vets who have to do a job must of us would not countenance.
.

THIS x 1000

 

[milliepops]

It's interesting you think so, I don't think I ever was as it had to happen to have the treatment.
Very sorry for your loss and hope you get some more closure.

no I've never been expressly asked about that, latest one was my homebred when they came to give her first vaccinations. Vet filled that bit out at same time as filling in batch details etc. I guess it's been a requirement for so long now they don't think it needs mentioning.

 

[brighteyes]

Correct or not, we should have been informed of any signature going into his passport, we were not. thank you.

And here, any sympathy I have lies solely with the vets. They turned up and performed what must be, singly and cumulatively, the hardest of procedure of all and you are moaning about a signature in a passport...

I always thank my vets for their attendance and help after a PTS because I know that while it was hard on me, they have the awfulness of the upset and sadness and loss multiple times a week. We have often cried together.

 

[teddypops]

Correct or not, we should have been informed of any signature going into his passport, we were not. thank you.

Why is this an issue?

 

[brighteyes]

Why is this an issue?

I'm struggling to see, too. And am actually upset for the vets involved.

 

[MiJodsR2BlinkinTite]

Mary, I have been present at one where three drugs were used, a sedative, a lethal anaesthetic dose and a heart stopper. The consent form is normal-ish, and signed before any irrevocable step is taken, so after initial sedation (done as much to prevent the owner's upset from disturbing the horse as anything) is the right timing. I'm sorry the vet was brusque, but I'd rather they got the horse bit right and the human bit wrong than the other way around.
.

^^^ This is what was done for mine.

I would respectfully suggest to you OP that perhaps, just perhaps, your vets are not the best at doing paperwork!! This is often the case; a vet perhaps will be rushed and/or harried, and trying soooh incredibly hard to be a "good vet" and treat the (animal) patient respectfully and well if it is a PTS event, as well as looking out for the owner, that perhaps the paperwork is less than desirable. I would much much rather have a damn good vet who does a difficult (and sad) job well, but who's paperwork is a total disaster, than t'other way round.

I rather think this might be the case with your vet here on this sad occasion.

May I, as respectfully and gently as possible, and alongside the wisdom of others on here, encourage you to move on from this........ I feel you are causing yourself unnecessary distress by dwelling on what you perceive as a "paperwork" and/or "billing" issue. I would also very gently suggest that you might be deflecting your very natural feelings of loss and sadness, and grief, by focussing on this issue.

I feel you would really benefit from talking through your feelings with a professional; seriously, grief whether over a human friend or an animal one, is a very real thing and I think you would find it helpful to share this with someone. I have seen posters up in vets about this, and recommending an organisation, but can't remember what it is (sorry). Whatever, I would gently but firmly urge you to seek help............ sending hugs.

 

[Mrs. Jingle]

I believe BHS do have an end of life bereavement service for horse owners. Here is the link to the Blue Cross one that encompasses all pets small or large, hopefully you might get some help to resolve any issues that are preventing you from moving on from you sad experience. https://www.bluecross.org.uk/pet-bereavement-and-pet-loss

 

[Redders]

Is there a cost implication for disposal if signed out of food chain? I chose not to go into equine vet practice so don’t follow costs for disposal, but if it’s more expensive to dispose when signed out of food chain, maybe OP was expecting one method of disposal and found out that couldn’t happen due to PTS by injection and previous medications given and hadn’t realised this was the case?
if it doesn’t make a difference then I’m just making leaps and I apologise

 

[ester]

Excellent point MrsJ

 

[milliepops]

misunderstood redders - ignore!

 

[Murphy88]

OP, I'm an equine vet and would be happy to answer questions re the drugs used to help put your mind at rest. I would standardly use 2 syringes for euthanasia, one with sedative (either one drug or a combo of 2-3) and one with euthanasia solution. There are a couple of main euthanasia drugs and choice of which to use depends on vet preference.

Re the passport - as others have mentioned, it is now standard to sign it and is a legal requirement. Basically every horse has had a sachet of bute at some point in their life, and if you don't know their full history you have to assume they have. It is our legal responsibility to sign that section of the passport, and isn't actually up to the owner whether it is signed unless the owner can guarantee the horse has never received drugs that make it ineligible for the food chain (ie owned the horse it's whole life and it has never needed veterinary treatment).

Also re the consent form (which I would guess is what the disclaimer was). Unfortunately, in the current litigation culture, vets have to cover themselves against all eventualities - gone are the days when those older male vets could do whatever they wanted, those of us now in the profession sadly live our life in fear of being sued and it is reflected in extra paperwork. One part of this is signed consent for procedures including euthanasia. Now, there are definitely cases where some vets may choose not to do this, perhaps where they have a long term relationship with clients, but even if they do ask for a form, it is not meant to cause distress or as a suggestion that you are not a "good client" but simply as part of protocol.

 

[brighteyes]

I have always asked that they please do not send me a bill as I can't bear to look at the details. I call up later or first thing the following day and settle in full. The amount I have paid always seems very fair.
Also, as we bury ours, nobody signs anything, but that bit would be the least of my worries or sadness.

 

[paddy555]

Yes they did refuse, they have said there is nothing more to say or conclude. Yet there are many unanswered questions. Valid questions regarding conduct, paper work and drugs, drugs that my old vet said are not used to PTS, merely sedatives.
Why the little pony was marked up. Why was his passport stamped at the back without our knowledge in January when he had his injections. (regarding exclusion from human consumption) No vet has ever signed this prior.
Why was there only mention of two drugs in the conformation email received afterwards at my request, but now after asking questions yesterday a third drug, being the correct one, has now been added on new paperwork.
It is soul destroying to say the least x

there are so many explanations to your questions and none of them are sinister.
Why did you have to sign to allow PTS? I have looked online and it does seem to happen for horses.

This is a quote from one vet firm, Priors farm. Just one I picked at random
Once the decision has been made we will need a consent form signed by the owner to allow us to carry out the procedure. In certain circumstances this may not be possible so if this is the case a signature of consent from an agent present will be needed.

Possibly this should have been produced at the start but then again the vet may have thought sedation was the most important thing. Possibly he wondered if you would want to change your mind and gave you a chance to do so after sedating. I suspect some people may have done when they really had to sign the form. (that of course may well not have been in the best interests of their pony)

Why 2 doses of sedation? I have had several horses where the vet has given the normal dose based on the weight (both PTS and just to operate on the horse) and has then seen it is not enough so they top it up. They cannot always tell how a horse will react to sedation, some need sufficient to sedate an elephant, some are just within normal guidelines. They could well have used the 2 syringes for the sedative if they had to top it up.

The final injection.This appears not to have been included on your e mail/bill to start with. It was obviously used. It could simply have been omitted from the paperwork, vet didn't note it down and presumed the clerical staff would do as it would obviously have been required. Why only 2 syringes? Possibly vet reused one of the syringes for the final injection.

I can see one explanation for the asterix and that could simply be to note a sadly deceased animal. It could well be their practice after PTS that vet notes the record with an asterix. Possibly this is known in the practice so that no one inadvertently talks to the owner as if the horse is still alive. Another reason could be to note that passport has been signed out of the food chain.

As for signing and stamping the passport this is really nothing sinister and not even something I would think they would need to discuss or even ask you. It is a requirement for certain drugs. Some vets have been very lax about this. My old practice had a panic about this and rang quite unexpectedly and asked me to get all my passports down that day to get the vet to sign them. No choice, bring them or none of the drugs you want. I picked them up the next day and from the receptionists comments I guessed they had previously been lax in this department. Your vets may simply have been given the instruction when you go out to vaccinate make sure the passport is signed out. When I got a new horse that needed vaccinating vet not only filled in the tetanus he also signed it out. Just standard practice.

I'm really sorry you are still so distressed. Like many on here my criteria for PTS are that vet turns up asap, he gets sedative in and the horse calm asap and then it is PTS as calmly as possible with no struggle or upset from the horse. If that happens it has been a good day at a terrible time.

If you are paying for a call out, possibly examination and 3 injections then that seems to be in order. I'm not sure why it matters about the paperwork unless of course they charged you for anything over and above the PTS injections and associated costs.

We all feel for you (and everyone else ) when a horse has to be PTS but it is really difficult to see what particular part is causing your distress. Of course your vets should provide the info you want but maybe they are struggling a little as well?

 

[piglet2001]

In all honesty I don’t know what all the fuss is about. It seems your vets have done everything by the book and your horse had a peaceful end. I genuinely cannot see any problem. Personally I can see why your vets are no longer communicating with you.

 

[MadJ]

Yes they did refuse, they have said there is nothing more to say or conclude. Yet there are many unanswered questions. Valid questions regarding conduct, paper work and drugs, drugs that my old vet said are not used to PTS, merely sedatives.
Why the little pony was marked up. Why was his passport stamped at the back without our knowledge in January when he had his injections. (regarding exclusion from human consumption) No vet has ever signed this prior.
Why was there only mention of two drugs in the conformation email received afterwards at my request, but now after asking questions yesterday a third drug, being the correct one, has now been added on new paperwork.
It is soul destroying to say the least x

If it helps you in anyway regarding the passport being stamped, my vet informed me at the last visit that they were having to clamp down on that particular part of the passport being signed. This is orders coming from above so I was told. I found out I had missed filling in that part for one of mine.

Regarding the pts issue, I can sympathise as I've have been in a similar position and although my horse also passed peacefully once it was completed, the unnecessary delay from the vet after the sedative was administered made the whole experience much more traumatising for me than it needed to be. I knew what the procedure entailed and was mentally prepared so to have a spanner thrown in to the works at such an emotional time was horrific. I totally agree that once the vet had started, ie sedated your horse, they should not have then pulled out paperwork for you to sign. This should have been done either before or after.

 

[Red-1]

I think the one thing the vet did wrong was not answer your queries after the event. I suspect that is because they fear a complaint of some sort and their advice from insurers will be to not talk with the client in that case.

When Charlie Horse was PTS, he had a sedative as soon as the vet arrived, and was then left in peace while we did paperwork. He was led down the yard to the lawn, swaying a bit, and the vet did a final "are you sure" before the injection went in.

I had made a special request, to have 6X the dose required available to give. My old vet had told me of a time when he had 3x the required amount and it was the worst day of his working life as the horse fought it and was plunging round the driveway, refusing to go down. Needing a top up isn't as unusual as you may think.

TBH, I don't remember the details of what I signed, my attention was on my horse. I just signed. It needed signing for PTS to happen, I wanted PTS to happen, so I signed. I can well imagine people, in the past, have watched the administration of the final injection and changed their minds. I can see why the vet feels the need to protect themselves. I did value the kindness of the vet, the peaceful passing and the efficiency with which they had arranged collection.

I have no idea what the asterix was for, it could simply be for a pony. My passports have all had to be signed out, the vet won't give any treatment without.

TBH, it sounds like you have now lost the trust with this vet, I would change vets to a new practice. I don't think they have done anything wrong, but at times of grief, we can put meaning on stuff. Changing vets would mean a fresh start for you and your other horse.

I can't see that pursuing this vets will get you anywhere. The relationship has broken down. I don't think they owe you money, as you wanted PTS and they did, with a calm end for the horse. The horse is PTS, the bill (presumably) paid, but the relationship broken. A new vet, new start would be in order, I think.

 

[mary pearce]

If it helps you in anyway regarding the passport being stamped, my vet informed me at the last visit that they were having to clamp down on that particular part of the passport being signed. This is orders coming from above so I was told. I found out I had missed filling in that part for one of mine.

Regarding the pts issue, I can sympathise as I've have been in a similar position and although my horse also passed peacefully once it was completed, the unnecessary delay from the vet after the sedative was administered made the whole experience much more traumatising for me than it needed to be. I knew what the procedure entailed and was mentally prepared so to have a spanner thrown in to the works at such an emotional time was horrific. I totally agree that once the vet had started, ie sedated your horse, they should not have then pulled out paperwork for you to sign. This should have been done either before or after.