How do pets typically respond to the injections?
     Most dogs don't mind the first injection, especially if they are distracted by petting or a small, special food treat (peanut butter works very well). Cats, however, can be unpredictable. While many cats don't mind the injection or react to it at all, others may react in a fairly negative way, lessening the desired peacefulness of the process. Negative reactions may vary from the usual slight discomfort to the occasional very dramatic reaction, with hissing, attempts to run away, or even lashing out at anyone nearby. However, even in the most dramatic reactions, once the initial injection is complete, animals usually begin to calm down within a minute or so, and are completely relaxed within 3-5 minutes. 
     Once the initial injection has taken complete effect, the second (final) injection can be given. Before this injection is given, I will test the pet's reflexes to ensure that he/she doesn't feel anything at all. So, this final injection will be completely painless.


Why do you use two injections rather than one single injection?
     While some veterinarians give only the final injection (which must be given directly into a vein), we prefer to use the two injection method. Because the final injection must be placed very precisely into a vein (or body cavity), if your pet is not sedated, it must be restrained very carefully to avoid a mis-injection that can be extremely painful. In our experience with thousands of these procedures, we generally find that it is much easier on the pet and people involved to take a little more time and provide sedation prior to the final injection. The sedative injection can be given easily and quickly into a large muscle or under the skin. Once the pet is completely sedated, the final injection can easily be given, with no physical restraint and no chance for a painful mistake.


Is there anything that can be done to minimize any negative reactions to the initial injection?
     We use only the very smallest needles and smallest volume of drug possible to give this first injection. As a result, most of the time, this injection is tolerated very well (or at least it is done within a few seconds). However, if you are very concerned about your pet's potential reaction to an injection, there are several possible things that can be done to minimize any reaction:

• Pain medications: if your pet is already receiving pain medication, it may be helpful to give an additional dose 1-2 hours prior to our scheduled appointment. In cats, the drug Buprenorphine (Buprenex), works very well for this. Your regular veterinarian may be able to provide this for your cat, depending on the circumstances.
• If your pet is very fearful of strangers, it may help if we arrange to have someone in your family give the first injection (this is fairly easy and we can walk you through the procedure).
• It often helps to distract the pet with petting, scratching, or feeding a favorite treat while the injection is being given.
• In cats, sometimes it may be preferable to give an additional  "pre-sedative" injection of a drug that is less likely to sting, but doesn't always provide enough sedation to complete the procedure. The drawback of this method is that a total of three injections may then be required, rather than the usual two.
• It does NOT usually help to try to give the injection when your pet is sleeping. Invariably, your pet will be surprised and awaken unhappy with receiving the injection.
• If your cat does react badly to the injection, it is ok to let him/her get off your lap and hide somewhere until the drugs take effect. It is important that the pet doesn't go somewhere that it might be injured when falling asleep (e.g. on something high) or hide someplace where he/she cannot be reached (e.g. under a bed or outside).