Postmortems: A Delicate Subject

In this paper I will discuss an important but delicate subject that we would all rather not think about, and that is the postmortem, or examination of a pet's body after death. A post mortem is an important diagnostic tool without which our knowledge of pet medicine would be sorely lacking.

Death is an inevitable part of our experience here on this earth. I will not attempt to discuss the various philosophies associated with this phenomenon, but its existence is part of the normal cycle of nature. Whether you believe there is a rebirth after death or whether you believe it is an end, we cannot prevent it for ourselves or for our pets. Unfortunately Western society spends a great deal of time avoiding the subject, pretending it won't happen and taking desperate measures to try and stave it off, rather than accepting death as natural. Death brings with it an end, of course, sadness and certainly the grieving process, but it can also bring relief from suffering and great knowledge. The knowledge can come from what we learned from that being's spiritual and physical existence here, lessons such as love, forgiveness, laughter and letting go. We also can learn valuable lessons from that being's physical body, such as cause of disease, effectiveness of therapy, effects of diet, environment and genetics to name a few. Some of you will have spiritual beliefs that do not allow the physical body to be altered after death, which we sincerely respect. But for those of you that do not hold these beliefs then you may consider allowing that dear pet to reveal to us that last bit of knowledge that only examination of the physical body can reveal.

The correct name for the examination of the physical body is a postmortem, post meaning after and mortem meaning death. The term autopsy is used only for humans because auto means self and only refers to humans doing postmortems on the same species (self) which are other humans. Postmortems have been performed for thousands of years, primarily to determine the cause of death of the person or animal. Much of our medical knowledge comes from these examinations. Without postmortems, we would probably be hundreds of years behind in our ability to detect and manage disease. Therefore, the postmortem is vitally important to the future health and welfare of any species in question.

How long after death should a postmortem be performed? In order to gain the most useful information, a postmortem should be performed within 48 hours of death. It is particularly important to keep the deceased pet cool during this time. If the pet is kept at 70°F or higher, then decomposition will be rapid and 48 hours may be too long. In general, it is best to get the pet to the veterinarian as soon as possible after death and to keep the body cool (below 60 if possible), but NOT frozen. If the tissues freeze, the sharp ice crystals can damage them. This may affect the ability of a pathologist to access microscopic tissue samples accurately.

What actually happens during the postmortem examination? There are different ways that a postmortem can be approached. In some cases, only one feature of the pet will be examined, say an eye or the heart because that is where the problem was most prominent. However, most often the entire animal will be examined because we have found over the years that sometimes what is obvious during life is masking other disease that is only discovered after death. To get the whole or “holistic” picture, it is best to look at all the organ systems. To do this, it is necessary to make an incision on the underside of the pet from the neck to the anus in order to be able to open up the body cavities and take a look. Other incisions may have to be made in the extremities or head depending on what tissues need to be examined. Initially organs are examined in place to look for gross abnormalities. Eventually the organs will be removed for closer examination. The cause of disease may be obvious to the naked eye, but often it is necessary to take small samples of tissue and perform further testing such as microscopic examination, bacterial culture, and viral isolation or toxin assessment. The samples are usually small and can involve any organ in the body including blood, intestinal contents and bone. In addition, impression smears, where a glass slide is placed on the surface of the tissue lightly and the cells that cling to the slide are then looked at under the microscope, can provide a quick evaluation of the health of a variety of organs. Since the incision is surgical in nature, it is possible for the veterinarian to sew up the wound after the post mortem is completed. This is referred to as a “cosmetic postmortem” which returns the animals' physical body to as normal appearing state as possible.

Why should a postmortem be performed? After all it won't bring the pet back to life, so what is the point? The following are some of the important reasons to consider a postmortem examination for your pet:

• MULTIPET HOUSEHOLDS - If you have a multi-pet household, particularly if you have several animals of the same species, a postmortem may reveal disease that could potentially spread to others in the household. If disease is diagnosed through a postmortem then preventative measures can be taken. I can tell you that postmortems have saved literally hundreds of animals' lives in our practice over the years because of the knowledge obtained when one of their cage mates died and revealed a serious group problem.
• ZOONOTIC DISEASE - A postmortem can reveal potential zoonotic disease which is disease transmissible from animals to man. This is particularly important for human members of the household with immunosuppresant diseases such as HIV or hepatitis. Common examples of exotic animal zoonotic diseases include salmonellosis, psittacosis (parrot fever) and certain intestinal parasites.
• CAUSE OF UNEXPECTED DEATH - A postmortem can reveal the cause of death when it comes unexpectedly. When a pet dies suddenly or without obvious cause, owners often blame themselves for negligence or oversight. Usually this guilt is unwarranted but without a postmortem, the cause of death will remain unknown. Not only do owners and veterinarians continue to torture themselves with second guesses, but also without the postmortem there is no information available to prevent the same problem with future pets if the problem is preventable. We cannot completely control when an animal will pass from existence; it is going to happen eventually. We can however, try to understand when and if we had any effect on the event. It is often a relief for clients to know that the death was not something that they could alter or prevent in any way.
• EFFECTIVENESS OF TREATMENT REGIMINS - A postmortem can reveal the success or failure of certain treatment regimens. Without this feedback, veterinarians cannot know for certain if treatments that are used, including medications, diets and surgeries are effective. With information from a postmortem veterinarians can make improved therapeutic choices in the future.
• GENETIC/DIETARY/ENVIRONMENTAL PROBLEMS - A postmortem can reveal genetic, environmental and dietary problems. With knowledge of genetic problems we can hopefully stop breeding for certain defects. With knowledge of environmental and dietary disease we can improve those areas. We have learned a great deal, for instance, about appropriate diets in rabbits, birds and reptiles from postmortem examinations of pets that succumbed due to the poor diets we fed in the past. We can thank those early pets that passed on and the veterinarians that examined them for the improved health and longevity of these animals today related to improved diets.

So what is this going to cost me? Postmortems can have a wide range of costs depending on the practice and what is the goal of the postmortem examination. Some veterinarians offer postmortems free of charge only if it involves a patient that was under treatment at that hospital at the time of death. Others have specific costs involved depending on the size or species of patient or the extent of the postmortem. All veterinarians will charge for the pathologist's fees if samples are sent in for microscopic examination because the pathologist is charging the veterinarian for that service in addition to packaging the tissues, mailing them and the time involved in interpreting the results.

In conclusion, a postmortem examination can be an extremely useful tool in continuing our quest for knowledge on the improvement of health in our pets. Often veterinarians are hesitant to bring up the subject because it is so difficult to think about at the time of death and grief. Try to think about this subject and come to a decision about how you will proceed before the time comes. If you are not comfortable with a postmortem at any time, or with certain pets, your veterinarian will respect your decision and it should not be necessary to explain your position. This was your friend in life and it is ultimately your decision as what happens after death.