11/19/2025
Those of us who have been long-time horse owners know the trauma of euthanasia death throes and thrashing as the horse doesn’t exit quietly.
Recently I read a traumatic story about a horse euthanasia where things went terribly wrong. The horse was given pentobarbital but didn’t receive enough sedation, stumbled around disoriented, and ended up falling into his own grave before the vet had to use a gunshot to complete the euthanasia. It was devastating for the owner and completely avoidable.
I recently rescued a horse that came from a kill pen and was adopted by a well-meaning cattle farmer who knew nothing about horses. I kept the horse over the summer. He didn’t gain weight and he was ataxic, indicating he had something neurological going on. When I called out the vet and they recommended euthanasia, she introduced a method I hadn’t heard of before. It was kinder and more controlled than anything I’d experienced in my years of horse ownership.
I want to pose a question and suggestion to horse owners: have you asked your vet about intrathecal lidocaine euthanasia?
Here’s how it works: The vet sedates the horse using xylazine, midazolam, and ketamine so the horse lies down peacefully and is completely unconscious. The vet then accesses the atlanto-occipital space behind the poll, withdraws approximately 60 mL of cerebrospinal fluid to make space in the spinal column, and administers lidocaine hydrochloride directly into this space. This stops brain activity within minutes, followed by cardiac arrest. The horse never wakes up, never stumbles, and never experiences distress.
This protocol was researched and validated by veterinarians at UC Davis School of Veterinary Medicine and published in the Journal of Veterinary Internal Medicine in 2015. The AAEP officially added it to their euthanasia guidelines in 2021. While traditional pentobarbital is faster and simpler, research shows that intrathecal lidocaine results in fewer muscle movements, fasciculations, and agonal breaths that can be traumatic for owners to witness.
The traditional pentobarbital method is the easiest and cheapest option for vets, but it isn’t the most predictable or least invasive. The intrathecal method eliminates the risk of underdosing, stumbling, and falling that can occur with standard euthanasia protocols. Yes, it requires more veterinary training and costs more, but it can significantly reduce trauma and eliminate the risk of euthanasia gone bad.
Ask your vet if they’re familiar with intrathecal lidocaine euthanasia. It’s worth knowing about before you’re facing that difficult decision.
