Small Animal Euthanasia, Care of Body Remains and Fees

Purpose/ Applicability: The purpose of this SOP is to describe the guidelines for Euthanasia and care of the body remains along with the associated fees. Euthanasia at the Veterinary Teaching Hospital (VTH) should be guided by compassion, respect, and sensitivity to the needs of the clients and patients. 

Scope: This SOP shall be applied within the Small Animal Clinic.

Definitions:

• Disposition: The way the remains of a deceased animal are handled. 
• General Disposal: the disposal of a deceased animal by group cremation. 
• Group Cremation: the disposal of a group of deceased animals by burning them to ashes. Cremains are not returned to the client. 
• Private Cremation: the disposal of a deceased animal by burning it to ashes separate from other bodies. The cremains are returned to the client. 
• HIS: Health Information System the electronic medical record with the client account and patient medical record 
  
  

Estimates for Euthanasia:

• Current VTH patient (seen within the last year)

o Private cremation total estimate: $198-336 + $240-260 if necropsy package wanted

• • Fee per size of patient below
    • 0-5# $141
    • 6-35# $172
    • 36-75# $188
    • 76-100# $209
    • 101+# $260
  • Other fees included: euthanasia procedure (no charge), IV catheter supplies ($25-30), euthanasia solution ($6-20), after death care ($26)= $57-76
  • With necropsy package + $240-260

o Group cremation total estimate: $135-154 + $240-260 if necropsy package wanted

• • Other fees included: euthanasia procedure (no charge), IV catheter supplies ($25-30), euthanasia solution ($6-20), after death care ($26), group cremation ($78)= $135-154
  • With necropsy package + $240-260

o Taking body home total estimate: $57-76 + $385-405 if Cosmetic necropsy wanted

• • Other fees included: euthanasia procedure (no charge), IV catheter supplies ($25-30), euthanasia solution ($6-20), after death care ($26)= $57-76
  • With Cosmetic necropsy $385- 405

o Undecided other private cremation company total estimate: $135-154 + $240-260 if necropsy package wanted

• • The client must contact the VTH to inform us of the cremation provider they have selected with in 10 days of the pet death. After 10 days, the pet will be sent for group cremation and no animal cremains will be returned.
  • Other fees included: euthanasia procedure (no charge), IV catheter supplies ($25-30), euthanasia solution ($6-20), after death care ($26), care of remains hold ($78)= $135-154
    • Once the remains are retrieved by the selected cremations provider or client picks up the body, the client will be refunded the Care of Remains HOLD $78
  • With necropsy package + $240-260

• Not a current VTH patient (not seen within the last year)

o Private cremation total estimate: $301-451 + $240-260 if necropsy package wanted

• • Fee per size of patient below
    • 0-5# $141
    • 6-35# $172
    • 36-75# $188
    • 76-100# $209
    • 101+# $260
  • Other fees included: new patient ($15), euthanasia- new patient ($88-100), IV catheter supplies($25-30), euthanasia solution ($6-20), after death care ($26)= $160-191
  • With necropsy package + $240-260

o Group cremation total estimate: $238-269 + $240-260 if necropsy package wanted

• • Other fees included: new patient ($15), euthanasia- new patient ($88-100), IV catheter supplies($25-30), euthanasia solution ($6-20), after death care ($26), group cremation ($78)= $238-269
  • With necropsy package + $240-260

o Taking body home total estimate: $160-191 + $385- 405 if Cosmetic necropsy wanted

• • Other fees included: new patient ($15), euthanasia- new patient ($88-100), IV catheter supplies($25-30), euthanasia solution ($6-20), after death care ($26)= $160-191
  • With Cosmetic necropsy $385- 405
  • Undecided other private cremation company total estimate: $238-269+ $240-260 if necropsy wanted
  • The client must contact the VTH to inform us of the cremation provider they have selected with in 10 days of the pet death. After 10 days, the pet will be sent for group cremation and no animal cremains will be returned.
  • Other fees included: new patient ($15), euthanasia- new patient ($88-100), IV catheter supplies($25-30), euthanasia solution ($6-20), after death care ($26), care of remains hold ($78)= $238-269
    • Once the remains are retrieved by the selected cremations provider or client picks up the body, the client will be refunded the Care of Remains HOLD $78
  • With necropsy package + $240-260

Prior to Euthanasia:

• Give the client honest, straightforward information about the animal's condition, treatment options, prognosis and cost. 
  o Strive to communicate clearly and prevent misunderstandings.
• Let Client Services know when a client is coming in for euthanasia of their pet so Client Services may greet them appropriately.
• Respect client privacy. 
  o Get clients into an exam room, comfort room (Molly’s place) or private space, as soon as possible, to discuss euthanasia and care of remains, not in a public space such as the hallway, lobby or parking lot.
• Give clients the choice to be present for the euthanasia.
  o Be respectful of clients who choose not to be present.
• Explain the procedure, including possible agonal breaths, vocalizations, movements, eliminations and the eyes may remain open. 
• Explain the options for care of remains
  o Client to take the body- the client must retrieve their pet’s remains within 10 days or the remains will be sent for group cremation with no return of animal cremains.
  o Group cremation- no return of animal cremains
  o Private cremation- animal cremains will be returned to the owner via Endearing Pets.
  • Arrangements for shipping or other services such as choice of urns, must be made directly with Endearing Pets- 309-828-2422. 
  • If the client chooses a different cremation provider, they will need to notify us of those arrangements.
    • They may choose to have the other provider pick up the pet’s body. 
    • VTH may make pick up arrangements for 2 other private cremation providers that have a scheduled weekly pickup at the VTH. The client is welcome to utilize these providers. 
    o Cherished Like Family – 217-949-2402
    o Sunset Funeral Home – 217-239-2874
  • The client must retrieve their pet’s remains or arrange private cremation within 10 days or the remains will be sent for group cremation with no return of animal cremains. 
  • All arrangements will be between the client and that provider. 

o Necropsy: when an owner requests or when the clinician feels there is medical value, explain the value of a necropsy, both in terms of the need to expand medical knowledge and in closure for the client. Pricing may be found in the HIS.

• • There are funds available to offset the cost of a necropsy performed for teaching purposes. Check with your service’s supervising faculty for funds available. 
  • Follow the SOP for Requesting a Necropsy if the client chooses this option.
• Ensure the client understands process and ask if they have questions. 
• Complete the Euthanasia/Care of the Remains Authorization and Release form. (See SOP for Completing the Euthanasia/Care of Remains Authorization and Release form)
  o Answer all questions on the form clearly. 
  o Ensure the form is signed by the client and witness appropriately, after being completed. 
  o Ensure you provide the yellow copy to the client. The white and pink copies will go with the body or returned to medical records if the owner took the body. 
• Ask client if they would like a clay paw/ print or lock/ braid of hair.
• Give the client the choice to have time with their pet prior to the euthanasia.
• Input and check charges in the VTH HIS.
  • Enter Euthanasia fee -
    • Euthanasia code related to the service the patient was seen on
    • If new patient, add SAC new patient fee (NPSF) and ER Euthanasia New Patient (AI009)
    • Died at U of I (GS500)
    • Entering a code related to died/euthanasia will auto populate a GM After Death Care fee (GM010)
    • Entering died/euthanasia in the HIS, acknowledges the patient has died by putting an asterisk next to the patient’s name. It will generate an initial communication sent via fax to the rDVM listed notifying them that the patient has died.
  • Prescribe Euthasol in HIS to obtain from medical dispensary or obtain from Cubex.
    • This will also cause acknowledgment in HIS, the patient has died, by putting an asterisk next to the patient’s name. It will generate a pop-up note reminding you to enter a patient died or patient was euthanized charge.
  • Enter fees for any ward supplies used such as the IV cathether
  • Body disposition choices
    • Client to take body home (GS205)
    • Group cremation fee (GM009)
            • Must be entered if the body is not taken home or privately cremated. It must be entered even if a necropsy is performed.
    • Private cremation- Endearing
      • 0-5# (GM013) 
      • 6-35# (GM014)
      • 36-75# (GM015)
      • 76-100# (GM016)
      • 101+# (GM017)
    • Private cremation but undecided on cremation provider
      • Enter Care of Remains HOLD fee (GM012)
        • This fee will be returned to the client once the remains have been picked up by the cremation provider or client.
      • Client has 10 days after date of euthanasia to decide and inform VTH of the selected cremations provider or the body will be sent for group cremation.
    • Enter Necropsy fee if one is requested
      • See SOP for Requesting a Necropsy
• Help clients pay their bill before the euthanasia is performed, when possible.
  • You may escort the client to Client Services, take the client invoice to the client and bring their payment to Client Services, or they may call the VTH cashier to make payment by phone.
  • The hospital accepts Visa, MasterCard, American Express, Discover, CareCredit, checks and cash.
    • Clients with a Care Credit account need to sign the credit slip and select a payment plan. 
  • The University of Illinois cannot provide financing or payment arrangements.

Euthanasia:

• Try to make the client's last image of their pet a pleasant one. 
• If the client has chosen to be present: 
  • Ensure you have all the supplies needed before entering the room with the client and pet.
  • Ensure the pet is as clean and presentable to the client, as much as possible.
  • Again, explain the procedure, including possible agonal breaths, vocalizations, movements, eliminations and the eyes may remain open. 
  • Ask the client if they are ready for you to inject the euthanasia solution, doing so when they are ready.

After euthanasia:

• Express sympathy for the client’s loss. 
• Ask the client if they would like to have more time to spend with their pet before we prepare the body.
• Offer grief support materials to the client. Located in the SAC 102 Comfort Room (Molly’s place) and in the SAC and LAC waiting rooms.
• When they are ready for you to prepare the body, you may have the client remain in the private room or you may escort them outside to their vehicle to await the pet’s body or other items they may have, such as pet carriers, blankets, toys, collars, clay paws, lock/braid of hair, etc.
• Document the procedure including the drug and dosage on the Euthanasia/Care of the Remains Authorization and Release form (see Hospital Use Only portion).
• Sign a sympathy card and make it available to others involved with the case. Make sure the card is mailed to the client within a week. Cards to be mailed may be placed in the outgoing mail receptacle at Client Services.

Handling of Body after death:

• Remember to be respectful in how you handle the pet’s body.
  o Avoid areas with clients and cover the body with a blanket if necessary.
• Remove collars and any IV catheters, tubes, etc. 
• Make clay paw and snip lock of hair if the client would like them.
• Fill out 2 sets of appropriate color-coded body tag(s). There may be more than one tag choice depending on if the owner elected to do a necropsy or not.
• Ensure the tags have the doctor’s name, type of animal, owner’s name and pet medical record number. You may place patient labels on these tags. 
  o Necropsy = RED
  o Private Cremation = PINK
  o Group Cremation = BLUE
  o Owner Pick Up = GREEN
  o Rabies Suspect = YELLOW
  o Owner undecided = GREEN tag with HOLD written on it
• Place appropriate color-coded body tag(s) on the pet’s hock securing with a plastic zip-tie
• If client decides to take the pet’s body home
  • Line a coffin (available in SAC 90) with disposable pad(s) to collect any bodily fluids.
  • Place body in coffin and arrange respectfully.
    o  Avoid allowing the client to see the pet’s body being placed in a bag or coffin or walking through the lobby with a coffin.
  • Cover body with disposable pad(s).
  • Place lid on coffin and tape shut.
  • Affix 2nd color-coded body tag to the coffin (green)
  • Present the coffin to the client
    • you may use the door by ER for more privacy rather than going through the lobby to the front door.
  • If the client is not present, put coffin in the walk-in cooler in SAC 90 for client to pick up later. 
    • Avoid stacking and attempt logical placement.
    • The case clinician is responsible for ascertaining the owner’s wishes and communicating with Client Services. 
    • The case clinician shall post an alert in the HIS regarding the client’s wishes.
    • The case clinician is responsible for scheduling a time for the client to come pick up the pet’s body. 
      
      • When the owner is coming to pick up the animal's body, the doctor on the case will inform Client Services when the owner is coming and meet with the owner in the privacy of an exam room. 
      • If the clinician cannot meet with the owner, they will arrange for someone else to assist, such as a student, technician or client grief counselor. This should not be a caretaker or client services staff member. 

• For private cremation

• Ensure the patient weight is accurate on forms at the time of death. Do not estimate the weight.
• Place the pet in body bag.
  • Utilize 2 bags if patient is too large for a single bag.
• If Zoonotic suspect double bag and label accordingly
• Use tape to secure the bag closed.
• Affix the 2nd color-coded tag(s) to the bag (pink-private)
• Place body bag in walk-in cooler in SAC 90. 
• Place the Euthanasia/Care of the Remains Authorization and Release form (white and pink copies) in the file folder along the wall by the door in SAC 90

• For private cremation with necropsy

• Ensure the patient weight is accurate on forms at the time of death.
  • Do not estimate the weight.
• Place the pet in body bag.
  • Utilize 2 bags if patient is too large for a single bag.
• If Zoonotic suspect double bag and label accordingly
• Use tape to secure the bag closed.
• Affix the 2nd color-coded tag(s) to the bag (pink-private and red-necropsy)
• Place body bag in walk-in cooler in SAC 90. 
• Place the Euthanasia/Care of the Remains Authorization and Release form (white and pink copies) in the file folder along the wall by the door in SAC 90
• The caretakers will take the body to the Veterinary Diagnostic Lab (VDL)
• Once done in the VDL, the body is returned to the VTH by a caretaker and sent for cremation.

• If client elects Group cremation

• Place the pet’s tagged body (blue tag) (no bag) in the red barrel in the walk-in cooler in SAC 90
• Place the Euthanasia/Care of the Remains Authorization and Release form (white and pink copies) in the file folder along the wall by the door in SAC 90

• If client decides Group cremation with necropsy

• Place the pet in body bag.
  • Utilize 2 bags if patient is too large for a single bag.
• If Zoonotic suspect double bag and label accordingly
• Use tape to secure the bag closed.
• Affix the 2nd color-coded tag(s) to the bag (blue and red)
• Place body bag in walk-in cooler in SAC 90. 
• Place the Euthanasia/Care of the Remains Authorization and Release form (white and pink copies) in the file folder along the wall by the door in SAC 90
• The caretakers will take the body to the VDL for necropsy.