Lecture 29: Euthanasia - Physical Modalities

What are the three mechanisms for euthanasia?

1. Direct depression of neurons necessary for life function

2. Hypoxia

3. Physical disruption of brain activity

What are the acceptable methods of euthanasia?

• Inhaled anesthetics – conditionally acceptable in small animals(< 7kg)

• Carbon monoxide or CO2 – conditionally acceptable

• Argon or nitrogen – conditionally acceptable in chickens and turkeys

• Barbiturates – acceptable

• KCl, MgSO4, MgCl2 – unacceptable unless animal is unconscious (under GA)

What is the major active ingredient in several euthanasia solutions?

pentobarbital

What type of animals is pentobarbital not to be used in?

animals intended for food purposes

How is death confirmed after a euthanasia?

• Death must be confirmed before disposal of body

• Lack of pulse/breathing, corneal reflex, or response to firm toe pinch

• Inability to hear breath or heart sounds with stethoscope, graying of mucous membranes, and rigor mortis

How must the body be disposed after a euthanasia?

• Must be handled in accordance with state and local laws

• Use of pentobarbital – legal responsibility to properly dispose of body (can get into soil)

• US Fish and Wildlife Service recommendations to prevent secondary poisoning:

1. Incineration

2. Bury deeply (if law permits). Can store body if ground is currently frozen

3. Prevent scavenger access to local landfills

4. Educate clients – include warning about disposal on euthanasia consent

form

5. Tag animal and outer bags with prominent poison tags

What are physical modalities?

the use of multiple non-invasive techniques to physically benefit the patient’s overall health such as exercises, massage, aquatic therapy, acupuncture etc

What are the goals of physical modality?

• Restore, maintain, and promote optimal function

• Improve the outcome of patient following major surgery

• Enhance the quality of life

What are active functional rehab assessments?

• Posture

• Gait/mobility

• Transfers

• Muscle strength test

What are passive functional rehab assessments?

• Passive range of motion

• End-feel

• Goniometry

• Joint play

• Flexibility

• Muscle girth

• Myofascial exam

What is a myofascial trigger point?

taut band of skeletal muscle

What sort of environmental modifications for the patient would you be sure to explain to the owner of a dog diagnosed with OA?

• Flooring

• Bedding

• Stairs

• Nail/foot care

• Feeding station

What is cryotherapy used for?

acute inflammatory phase (post op pain or after exercise) to reduce inflammation, edema, and pain → improves mobility, minimizes hematoma formation and reduces muscle spasms

Who is thermotherapy indicated for?

indicated for patients with chronic pain and muscle spasm

How does thermotherapy help chronic pain?

• Increased tissue temperature leads to vasodilation and increased blood flow ➔ removes accumulated metabolites

• Helps with connective tissue extensibility and muscle relaxation ➔ reduces overall stiffness

When is thermotherapy contraindicated?

during acute inflammation, over an area of hemorrhage or thrombophlebitis, or over malignant tissue

What is the benefit of therapeutic massage?

pain relief, relaxation, and promotes circulation

What are the therapeutic effects of photobiomodulation (laser)?

• Direct pain control

• Increases release of endogenous opioids

• Reduction in inflammation

• Treats muscle trigger points and acupuncture points

• Cellular stimulation helps wounds heal faster and tissue to heal

What therapy is useful for managing chronic and minor pain, especially OA and muscle spasms?

photobiomodulation (laser)

What safety precaution must be taken for low-level laser therapy?

protective eye gear must be worn to prevent retina damage

How does targeted pulsed electromagnetic field (PEMF) therapy work?

• Works by delivering microcurrents that ➔ increase blood and lymph flow ➔ reduce edema and pain

  • No heat is produced by device and does not interfere with nerve or muscle function

  • Theoretically works to restore normal cell functions

What is PEMF therapy FDA approved/cleared for?

• FDA approved for treatment of non-union fractures

• FDA cleared to treat post op pain and edema, OA, plantar fasciitis, and chronic wounds

How does extracorporeal shock wave therapy work?

• Application of high-energy, high-amplitude acoustic pressure waves to tissue

• The waves travel through soft tissue and fluid and release their energy into tissue when a change in density is encountered (ex. between bone and ligament)

• This energy release is thought to stimulate healing

How does therapeutic ultrasound?

• Uses high intensity (>20,000 Hz) to affect biological tissue

• Creates a mechanical energy wave that moves through tissue and the absorbed energy is converted to kinetic energy.

• Therapeutic effects due to thermal (i.e. heat) and nonthermal properties

What are the non-thermal effects of TUS?

• modify cellular function and membrane permeability

• stimulates fibroblast activity

• increases blood flow

• increased protein synthesis

• promotes tissue repair and healing