Hospice Care for Pets

Photo Credit: © Tonya Perme

Over the years I’ve counseled many thousands of clients as they’ve struggled with end-of-life decision making for their pets. For many of those years, clients who expressed opposition to humane euthanasia for moral, philosophical, emotional, or religious reasons created quite a conundrum for me: my professional obligation to ease patient suffering seemed incompatible with their convictions. Fortunately, over time, I’ve become wiser, and have embraced the means to reconcile what is best for the patient when euthanasia doesn’t feel like the best or the right choice. The resolution for this moral/ethical dilemma is hospice care, also referred to as palliative care. In fact, nowadays, I discuss both hospice care and euthanasia as reasonable options whenever helping a client figure out what makes the most sense when their beloved pet’s life draws to an end.

Just as in human medicine, veterinary hospice care is selected for patients with terminal illness. And just as in human medicine, veterinary hospice care emphasizes physical and psychological comfort for the patient along with emotional support for the family caring for their loved one.

The venue for veterinary hospice is within the home with family members and friends providing the bulk of care. Typical tasks include turning from side to side, assistance with urination and bowel movements, carrying, frequent bathing, preparation of special diets, and administration of medications and supplemental fluids. Hospice can be a monumental task as round-the clock care is usually necessary. And for larger immobile dogs, a team effort is necessary for lifting and moving, and to keep them clean and free of bed sores. Terminally ill pets are quite capable of “lingering” so it is not uncommon for hospice care to last for weeks or even months.

Health care professionals- veterinarians and veterinary technicians- pay visits as frequently as needed to ensure that that the patient is relaxed and pain free, provide moral support for family members, and coach care providers on various tasks including how best to recognize symptoms of pain and anxiety.

While providing hospice care can be emotionally and physically draining, it can be a richly rewarding endeavor, especially when pain and suffering are well managed. This period of “closure” can create precious memories that feed and nurture the soul, giving everyone involved the strength to withstand that final goodbye.

If you are interested in hospice care for your pet, be sure to spend some time selecting the veterinarian to guide you on your journey. He or she should be a super compassionate person with a large arsenal of pain management options and a willingness to come to your home as often as needed. Be aware that some hospice vets firmly believe in “until natural death do us part” whereas others support their client’s choice for euthanasia should it arise during the course of hospice care. When hiring a veterinarian to assist you with hospice care for your pet, be sure to sort this issue out in advance.

To learn more about hospice care for pets I encourage you to check out The Nikki Hospice Foundation. Their Third International Symposium on Veterinary Hospice Care will be held later this month (July 20-22) at the University of California, Davis. This is a conference geared for veterinarians and nonveterinarians alike. If you are interested in increasing your knowledge about hospice care for pets, this is the place to be!

Another awesome resource is the International Association of Animal Hospice and Palliative Care . Their annual conference will take place in Denver in early November. Can’t make it to Denver? Take advantage of the webinars offered by this terrific organization.

Have you ever been involved in hospice care for a pet? If so, I would love to hear your impressions.

Best wishes,

Nancy Kay, DVM

Diplomate, American College of Veterinary Internal Medicine
Author of Speaking for Spot: Be the Advocate Your Dog Needs to Live a Happy, Healthy, Longer Life
Author of Your Dog’s Best Health: A Dozen Reasonable Things to Expect From Your Vet
Recipient, Leo K. Bustad Companion Animal Veterinarian of the Year Award
Recipient, American Animal Hospital Association Animal Welfare and Humane Ethics Award
Recipient, Dog Writers Association of America Award for Best Blog
Recipient, Eukanuba Canine Health Award
Recipient, AKC Club Publication Excellence Award
Become a Fan of Speaking for Spot on Facebook

Please visit http://www.speakingforspot.com to read excerpts from Speaking for Spot and Your Dog’s Best Health.   There you will also find “Advocacy Aids”- helpful health forms you can download and use for your own dog, and a collection of published articles on advocating for your pet’s health. Speaking for Spot and Your Dog’s Best Health are available at www.speakingforspot.com, Amazon.com, local bookstores, and your favorite online book seller.

 

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10 Comments on “Hospice Care for Pets

  1. Thank you for a very informative article. I am a home hospice veterinarian in the Minneapolis area and I have to agree with Val, creating understanding and addressing misconception has been a huge task! I think this is exemplified in a few of the comments your article has received. Hospice care is never about prolonging suffering, it’s about addressing pain and providing comfort. In my practice, our goal is to maintain a good quality of life for as long as possible. When that can no longer be accomplished, it is time to consider euthanasia. When a devastating diagnosis has been received, hospice care can prevent “premature” euthanasia (euthanasia that is offered just because other treatment options are not available). None of my clients want their pets to linger or suffer, these are treasured family members. Many people simply don’t feel qualified to evaluate suffering in their pets and appreciate the professional support and assessments that hospice care brings. This is not a choice for all families. Different lifestyles, pet temperaments and personal philosophies may require different options. Families who do choose hospice often express tremendous gratitude for the extra days and weeks with their animal and the support that hospice can bring at a very difficult time.

  2. Hospice care isa humane and loving way to deal with our companions toward the end of their lives with us. Last July I lost my beloved Whippet “Niniane” and now I have a 14-year old cat “Serendipity” who we discovered, has a heart murmur. I would dearly love to have a veterinarian or vet-tech who would make sporadic visits to monitor our pets’ condition, but I have yet to find one. Mobil vets are not the answer, they are not involved with them as their regular veterinarian who has known them and cared for them for years. So I watch and keep an eye on them and with a heavy heart wait for their message “I am tired, please let me go”. Let them suffer because of the way I feel? NEVER1

  3. What a timely post, Dr. Kay. I have a 10.5 year old Rottweiler with health issues and while I don’t believe she’s to the point of needing hospice care, it’s good to know there are resources. I’ll have to ask my veterinarian if she or any other vets in the local area offer hospice options.

    Thanks for the resources and your book – it’s on my desk!

    Jeanette Gardiner (and Lexi)

  4. Last year, we provided hospice care for our Golden Retriever/St. Bernard for four months. Our approach was to keep him with us while we all could maintain some quality of life. It was grueling and often heartbreaking, but you are right: it was richly rewarding too, and for all the heartache, we would do it the same way again.
    We “knew” when he had had enough and made the agonizing but humane decision to let him go. He died in my arms at nearly fifteen years of age. When we adopted him at age five, a battered and abused rescue dog, we committed our love to him until the end. We were devastated to lose him but know that we honored our commitment. The grief was severe but nothing compared to all he gave us in our ten years together.

  5. I can’t support people keeping an animal alive because it is “not the right time” for the person to lose the animal.

    This is the height of selfishness and cruelty.

    When we listen closely, our animals will tell us when it is time. Sometimes they will pass on their own, but often they will not. What we must do at that point is have the courage of their convictions and help them into the next world.

    To do less is to let them down.

  6. Thanks for another informative, thought-provoking blog!

    Having recently made the difficult decision to euthanize our beloved, cancer-stricken dog, I felt compelled to comment, especially after reading the sentence on how long a pet in hospice care can “linger.” I’m sorry, but because animals cannot give voice to their pain as humans do, allowing a sick and dying pet to linger when painless euthanasia is an option seems just too cruel to me. Yes, we can watch for signs of suffering, but our pets–much like their wild ancestors–are often adept at hiding their pain. True, euthanasia is not natural, but neither is pumping a pet full of pain medications. Frankly, I’m appalled that any vet would refuse to perform a humane euthanasia.

  7. Great question Pat and thanks for asking! Believe it or not, even with human hospice patients, pain levels can be difficult to interpret. With our pets, we encourage folks to monitor several parameters such as respiratory rate, heart rate, and blood pressure, all of which can be elevated with pain. Restlessness (an inability to seemingly get comfortable), vocalization, trembling, and diminished appetite can also be indicators. Of course, many of these symptoms can be a result of the primary disease process rather than pain, so can be difficult to interpret. Sometimes, the response to pain medication (does appetite improve, does the patient seem more comfortable) is necessary to feel confident that the patient is experiencing pain or discomfort. There is truly an “art” to this process which is why guidance from an experienced hospice veterinarian is so important.

  8. Hi Pat,

    You raise a really important question. It sometimes can be difficult to ascertain whether or not an animal is in pain. There are many parameters to monitor such as heart rate, respiratory rate, restlessness, blood pressure- sometimes it is the response to pain medication that allows the caretaker to know. This can sometimes be the case with human hospice care as well for patients that are no longer fully lucid.

    Thanks for taking the time to post your question and comments in response to my blog post.

  9. Good morning. I read your note-I have 2 dogs currently. I am wondering about the “pain” part. How can you be 100% sure that your dog is not in any pain as they can’t talk and tell us where/when it hurts? I would hate to be responsible for their suffering any more pain. The dogs are getting older now, the “day” will come-but not yet!
    Thank you very much,
    Pat

  10. Thank you, Dr. Kay, for shining a light on this fast growing specialty of veterinary medicine. A group of us formed a non profit, Healing Heart Foundation, Inc. to sponsor programs honoring the spirit of the Human Animal Bond. Our first program is Healing Heart Pet Hospice. We are privileged to assist our pets and their families at this most sacred time. One of the largest obstacles we have is the myths and misconceptions by the public as well as primary care veterinarians. We encourage both to educate themselves about this most compassionate type of care.
    For more information about our hospice program and our other programs visit our website and/or contact me. http://www.hhfipethospice.org