Euthanasia Services and Resources

Allowing Our Pets to Have Dignity: Our Euthanasia Services and Resources

We know the decision to euthanize a beloved pet can be one of the hardest decisions to make in life.

When death cannot be avoided, euthanasia gives our animal companions the kindest and most pain-free pathway towards death. We view euthanasia as a service of compassion and respect for animals who are suffering, and we understand saying good-bye is never easy. It might feel like it is a decision that must be made alone. Our care team of animal-loving staff is here to answer your questions or concerns, and to discuss the options available to ensure your pet will have dignity and comfort in their final moments.

We use the word “pet” interchangeably to acknowledge and give respect to the many diverse types of furry, feathered, and scaley companions.

“The final punctuation mark at the end of the story isn’t the book itself–it’s just the way it ends. You have all those different chapters full of events, adventures, and maybe illustrations. They are the real book, not that last punctuation mark. And when we think of a book, we take it as a whole, not just its final bit.”

Mark Tyrrell

Determining Quality of Life: How will I know, “it’s time?”

Animals do not always show obvious signs they are sick or suffering.

Unfortunately, we cannot ask our beloved companions to tell us how they feel. This makes it difficult to know “when the right time is” and even harder to be objective when considering their well-being.

There are so many difficult emotions and memories involved in making a tough decision such as euthanasia. Utilizing a quality-of-life scale can help you see your companion’s health in several areas of well-being.

When Should You Use a Scale?

  • Have you noticed a decline in your companion’s health?
  • Do they have a terminal illness?
  • Are they no longer able to do or enjoy the things they love?
  • Have you and your vet discussed euthanasia or implementing a quality-of-life scale?

Tips to Guide You Through the Scale

  • Complete the scale at different times such as every two weeks, once a month, or even every 3-6 months. You and your Veterinarian can discuss when the best times are.
  • If you go out of town without your pet, complete the survey right before you leave and again when you come back. Sometimes when we are constantly with our pets, we miss gradual changes in their appearance and behavior.
  • Keep track of their good and bad days on a calendar by drawing a symbol, smiley/frowning face, or simply writing a few words to describe how their day went.
  • Save copies of completed scales to keep track of any changes and always reach out to your Veterinarian when concerns arise.

Quality of Life Scale (HHHHHMM Scale)

If you are concerned about your beloved companion’s quality of life, completing a quality-of-life survey can help you see the full picture of your loved one’s health.

Using a scale of 0 to 10 (0 = Unacceptable, 10 = Excellent), pets can be evaluated for their quality of life.



0–10 Hurt—Is the pet in pain, including distress from difficulty breathing? Can the pet’s pain be successfully managed? Is oxygen necessary?
0–10 Hunger—Is the pet eating enough? Does hand-feeding help? Does the pet require a feeding tube?
0–10 Hydration—Is the pet dehydrated? Are subcutaneous fluids once or twice daily enough to resolve the problem? Are they well tolerated?
0–10 Hygiene—The pet should be kept brushed and clean, particularly after elimination. Does the pet have pressure sores?
0–10 Happiness—Does the pet express joy and interest? Is he/she responsive to things around him (family, toys, etc.)? Is the pet depressed, lonely, anxious, bored, or afraid? Can the pet’s bed be near the kitchen and moved near family activities to minimize isolation?

Mobility—Can the pet get up without assistance? Does the pet need human or mechanical help (e.g. a cart)? Does he/she feel like going for a walk? Is he/she having seizures or stumbling?

Note: Some caregivers feel euthanasia is preferable to amputation, yet an animal with limited mobility may still be alert and responsive and can have good quality of life if the family is committed to quality care.
0–10 More Good Days than Bad—When bad days outnumber good days, the pet’s suffering is substantial, and quality of life might be too compromised. When a healthy human-animal bond is no longer possible, the caregiver must be made aware that the end is near.
Total: A total of more than 35 points is acceptable quality of life for our animal companions.
Adapted from Canine and Felina Geriatric Oncology: Honoring the Human-Animal Bond, Villalobos A, Kaplan L-Hoboken, NJ: Wiley-Blackwell, 2007, with permission.

Euthanasia Services: What to Expect Before, During, and After

Before Your Appointment

Before you schedule an appointment with us, we recommend having a conversation about euthanasia and quality of life with your family.

If you are unsure if euthanasia is the right choice, having that conversation with your family and your Veterinarian is the best way to see if it is time. We also offer a quality-of-life consultation and exam to assure you are making the most informed choice. It can be helpful in the grieving process to know you did everything, within reason, to treat your pet.

During Your Appointment

When you arrive at our hospital, one of our caring staff will help you and your pet get checked in.

We will review your after-care wishes and have you select from our options for after-care of his or her body. We will bring you and your beloved companion into one of our comfort rooms where you can spend as much time with them as you wish. We never want our clients to feel rushed at any point in this process and urge you to let us know if you need more time.

After-Care Options

When you come in for your appointment, we will help you explore our options for after-care and confirm your wishes.

Taking your pet home for burial is an option, however, some counties have certain restrictions in place. If you wish to take home your pet for burial, we will provide a casket for your pet and a complimentary clay pawprint impression, as well as a vial of fur.

If you select private cremation, Southeastern Pet Cremation will cremate your pet and return the ashes in a lovely wooden urn. They will also provide you with a clay pawprint impression.

Another option provided by Southeastern Pet Cremation is communal cremation. This economical alternative cremates several pets together at one time. If this option is selected, you do not receive the ashes back. Instead, the ashes are scattered into the ocean or on one of the farms of friends of Southeastern. We will also provide a complimentary clay pawprint, as well as a locket of fur if this is something you would like.


“Unable are the loved to die. For love is immortality.”

Emily Dickenson

Memorializing: Remembering and Honoring Your Companion

If we think of our beloved pet’s life like a story we have helped write with them during the time spent together, it can help us remember we have control of how the ending is written.

How will we choose to remember them after they are physically gone? Memorializing our animals, however that looks for you and your family, can also help with the grieving process and provide closure for the family.

Here are some suggestions and ideas for celebrating the life of your loved one:

  • Create a place in the garden or yard for them by planting flowers or a tree. You can put a marker or bench there to sit outside and spend time with your memories of them.
  • Take a bowl or a pot and clasp their leash around its middle. Plant something special inside to honor your pet.
  • Funerals are not just for people! Hold a funeral or remembrance ceremony and invite your loved ones and people who knew your special companion.
    We can honor our pets as well as give ourselves time and space to grieve for their loss.
  • Create art out of their paw print, ashes, and fur/hair/feathers. At College Road and Carolina Beach Animal Hospitals, we offer a clay imprint of your beloved pet’s paw if you choose communal cremation or take home for burial. If you elect private, Southeastern Pet Cremation will provide a paw print. *We also offer a small locket of their fur.
    *Please don’t hesitate to ask us any questions and let us know if you have any specific requests. We try our best to accommodate your needs during this difficult time.
  • Spreading their ashes can be cathartic and peaceful and many families choose to spread the ashes of a loved one in a place where they have fond memories or a beautiful location such as the ocean. Do this in a place where you find beauty, peace, and happiness.
  • Create a photo album of all your wonderful memories together.
  • Some people find donating their pet’s items and food to a non-profit rescue or people/animals in need as a way of giving back. You might consider volunteering at a shelter or fostering a rescue animal in honor of your pet’s memories.
    We can honor our pets as well as give ourselves time and space to grieve for their loss.
  • Create a shadow box full of their favorite things, pictures of them, their leash or collar. Place objects that hold meaning for you and if or when you feel ready, display this shadow box in a place of your choosing.

There are so many ways to memorialize your beloved companion. Always do what feels best for you and your family, and for what holds true to your beliefs.

Grief and Bereavement

After experiencing a difficult loss, people will feel grief in significant and impactful ways.

They might feel disbelief their companion is gone. They might experience intense moments and outbursts of anger; directed towards others, or anger at the situation, and most harmfully, anger directed inwardly. Many people commonly feel guilt about the loss. They might feel there was more they could have done, or they might feel guilty about having waited “too long” to make the decision (animals hide pain very well, and saying goodbye is so difficult). A person might not be able to look at their pet’s toys, items, food, anything that reminds them of their companion, without feeling sadness and a sense of loss. They might not be able to talk about their pet without crying.

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All these feelings and more are normal experiences of grief and bereavement. We can experience grief over the loss of our animal companions in the same way we would mourn the loss of a human. Often this sadness might even feel more intense than when we grieve for a human loss because our relationship with animals is unique and less complicated than our relationships with people. The human-animal bond is an incredibly powerful thing, and we form very special bonds with our pets.

“Grief is not a disorder, a disease, or a sign of weakness. It is an emotional, physical, and spiritual necessity, the price you pay for love. The only cure for grief is to grieve.”

Earl Grollman

Disenfranchised Grief

Unfortunately, it can be difficult for some to understand the bonds we have with our animal companions.

We might hear phrases such as “it was just a dog” or “why are you still sad about your cat”. We call grief over the loss of an animal disenfranchised grief because our society does not always acknowledge and validate the very real and acute sorrow we feel after this loss. People do not always understand and might minimize the experience, often unintentionally. This can make it incredibly difficult to talk about our feelings and the impact their death is having on us with other people.

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It can be very beneficial to share everything there is about your relationship with your pet with someone. Your favorite memories, how their loss is affecting you, and the complicated feelings you might be experiencing. Having positive support during this time is essential. If you have a friend, family member, or significant other you can talk to, it can be healing to process this grief with their support. There are also support groups specifically for pet loss where you can learn about what to expect with grief, healthy coping skills, and receive support from others who are going through a similar experience. Helping professionals such as grief support counselors, therapists, and social workers are another great way to receive support, education, guidance, help in setting goals and have a person who will listen to what you are saying.

National Suicide Prevention Hotline


ASPCA Pet Loss Hotline


UTK’s Pet Loss Support Group



If you’re interested or have questions.

Helpful Resources: Pet Loss and Related Topics

Resources for Adults on Pet Loss

A thorough series of common questions about pet loss answered in a validating and thoughtful way.

A resource aimed at helping readers understand their guilt and questions they can ask themselves to assess the validity of the “shoulda, woulda, coulda’s”.

Helpful tips to support you through the grieving process from a well-known animal society.

An online space for comfort and healing- read letters others have written to their deceased pets or compose a loving letter to your pet and post it with your favorite photo of them.

Understanding and coping with the loss of routine after a pet dies.

A gentle guide for transitioning into bringing a new animal home after the death of a pet with relatable case examples from a puppy.

Resources for Parents/Caregivers with Children Experiencing Pet Loss

Tips for talking about death and pet loss with children as well as helping them develop healthy coping skills.

Guidance about talking to your children on topics surrounding death and sickness of pets from a well-known and trusted organization.

Published as a guide for pediatricians facilitating children’s grief and providing education, but extremely helpful for parents/caregivers supporting grieving children at different ages/developmental stages.

Resources for Older Adults Experiencing Pet Loss

A look into the unique aspects of grief and loss for the aging population and tips for supporting older adults through their loss.

Resources with suggestions and examples of how you can help a grieving older adult experiencing pet loss.

Resources with suggestions and examples of how you can help a grieving older adult experiencing pet loss.

Books: On Grief and Bereavement

Books for Children

The Invisible Leash

by Patrice Karst

A story about a child experiencing a range of difficult emotions when his dog dies of old age.

Until We Meet Again: From Grief to Hope After Losing a Pet

by Melissa Lyons

A simple but meaningful message written from the perspective of a pet to their child.

Charlotte’s Web

by E.B. White

A marvelous story about Wilber the pig and his dear friends as they explore the miracles of life and death.

Books for Adults

Preparing for the Loss of Your Pet: Saying Goodbye with Love, Dignity, and Peace of Mind

by Myrna Milani, D.V.M.

Veterinarian Myrna Milani guides the reader through the various stages of pet loss as well as coping strategies and the healing process.

Coping With Sorrow on the Loss of Your Pet (2nd Edition)

by Moira K. Anderson

A thoughtful book on the reality of pet death written with compassionate honesty about the more difficult topics of pet ownership.

Conversations with My Old Dog: For Anyone Who Has Ever Loved and Lost a Pet

by Robert Pasick

A refreshingly honest and relatable collection of poems on the “everyday life stuff” any animal lover will enjoy.

P.S. I Love Your More Than Tuna

by Sarah Chauncey

An illustrated book for adults that helps readers cope after pet loss through laughter and tears without minimizing their pain or needing to “fix” it.

Gently Into The Night

by Barbara Rosenfield Douglas

This guide aids readers in honoring the life of their special companion and support in creating a loving memorial service.

Book Appointment

Flexible Appointments

We understand that our clients have busy lives, so we do our best to be as accommodating as possible by offering flexible hours, weekend availability, and online appointment scheduling. To schedule an appointment for your furry friend, head over to our appointments page or contact our office directly.

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Online Shop & Pharmacy

Our online shop has everything that you need to keep your pet healthy after a visit to the vet. From prescriptions and preventatives to diets and compound medications, you’ll find it all here! We also offer free expedited shipping with no minimum purchase, so you don’t need to worry about waiting around for your pets’ medications to arrive.

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