Hospice care is the compassionate care of the terminally ill or dying. In veterinary medicine, the word “pawspice” was coined but I prefer to stay away from the term. Pawspice is too cute for me. This is a process that requires earnest and dignified discussion. As a house calls veterinary service, we frequently assist in the care of pets in their final days and hours. We take this responsibility very seriously.
The goal of hospice is to provide palliative care…… to alleviate pain, suffering, discomfort and anxiety associated with a terminal condition or advanced age. With people, a fear of dying or the unknown may be a factor. This is not an issue with pets. We have no reason to think animals fear death any more than an animal worries about something that might happen tomorrow.
Animals may not worry but they do experience pain, and they are programmed to hide it. They also experience hunger, nausea, and anxiety. These are all conditions that can be treated, even when a disease or condition cannot be cured. It has been said many times because it is true: death is inevitable but suffering is not.
Our goal is not to prolong life but to alleviate discomfort, pain, nausea, anxiety, and dehydration for as long as it is humane, and to do this in a comfortable (home) environment. One rule in hospice care is “no more diagnostics.” At this time in a life, we treat symptoms, not lab results. I will not recommend diagnostics (x-rays, blood work, ultrasound) unless you decide you want more information. We have medications for pain, nausea, anorexia, appetite stimulation, diarrhea, anxiety, and inflammation, and fluids can be given for dehydration which, even by itself, is uncomfortable. I will discuss the possible side effects of any medicine prescribed but once a pet is in hospice, long term side effects are of little consequence. The goal is simple: Relief. Today.
We will not perform procedures or provide medication when further care is only to extend the life for the benefit of the human when there is no hope for relief for the pet. We will discuss your options and expectations. Sometimes, when a diagnosis is unexpected and the prognosis is very dire, our goal may be to alleviate symptoms for just one day to give a family a few hours to say goodbye. Other times, we can achieve a comfortable life for an extended period with frequent conversations or visits, as needed for the pet’s changing condition.
In the end, we hope to provide comfort to both the animal and their humans during the pet’s last days on this earth. And, when it is time, we can assist with a peaceful euthanasia.
Killian and Fang
Blu with lymphoma at age five
How Does Hospice Work?
Dear Old Fang
Call our clinic and leave a message requesting hospice care. Becky or Crystal will call to arrange an appointment. Typically, appointments are at your home but it can be at the Old North End Clinic, if your pet can travel.
At the first appointment, it is best if you have copies of your pet’s current medical records, if there has been a recent vet visit. This helps me know exactly what conditions we are addressing. I will discuss with you what to expect from the progression of the disease. If it is old age, we’ll address that, including associated ailments and frailties. We will discuss signs of pain, quality of life, and will develop a plan for your pet’s pain control, nutrition, hydration, and when appropriate, hygiene, wound management, and other therapies available (e.g. acupuncture, laser). I may also discuss simple environmental changes, in the home, that might help.
When appropriate, I will put together a home care kit for your pet. Each kit is patient dependent, designed to help one specific patient. A kit might contain something for pain, for nausea, for anxiety, for seizures, or for better sleep. If there are wounds or lesions, we will address wound care. If possible and necessary, I will teach you to give your pet fluids subcutaneously to prevent dehydration. Together, we’ll put together a short or longer term strategy for you and your pet.
We will also go over your plans for end of life care. This is for when medication and home care no longer provide relief. In spite of all our efforts and wishes, death is both inevitable and unpredictable. To achieve a peaceful death, without suffering, requires planning. I strongly believe that hope is not a plan. We cannot just hope that an animal dies in his sleep.
End of Life Care
At Home Euthanasia
It is likely one of the most difficult decisions many of us will ever make…… to let a beloved companion go when age or disease causes more discomfort, pain, or infirmity than is tolerable. When the time comes, some clients find that it is just a bit easier if the euthanasia can be performed at home. Some pets have never liked going to the vet. Some older dogs are large or not mobile or have always feared car rides. Or, it may feel too overwhelming and sad to go out in public. Being safe and quiet and comfortable at home may offer just a bit of solace.
When you call us for an appointment:
Vet to Pet Mobile offers at-home euthanasia on a non-emergency basis through much of Chittenden County. Initially, we will work with you on the phone as you determine that euthanasia is an appropriate and humane conclusion. Or, if you are already sure that it is time, we will arrange an appointment and talk you through the process. You will decide who should be there. Some individuals prefer a very private time and place while others want to include close family or friends. Family, children and other pets may certainly be present. It all depends on what you feel is best. Some children want to be present and others are not comfortable. We will talk you through each step of this difficult procedure.
We will also ask how you would like to handle your pet’s body after euthanasia. You may have a place to bury your pet. Cremation is also an option. We can transport the body and arrange cremation with our provider, Hillside Crematory. You will decide if you want your pet’s remains (ashes) returned. This is called a private cremation. The remains are returned to us and we contact you as soon as we have them. This typically takes 10-14 days. If you do not request this, your pet will be a part of a communal cremation and his/her ashes will be buried at the wooded 5 acre site in New Hampshire where the facility is located. In either case, your pet’s body will be handled with care and respect.
What to expect at the appointment:
Our appointments are usually within a one to two hour window of time so you will know when to expect Dr. McMillan. If your appointment is between 9 and 10 am, she will arrive as early as 9 a.m. and as late as 10 a.m. You will be asked to sign a release form which states 1) that you are the pet’s owner, 2) that your pet has not bitten anyone within 10 days (this is required for public health (rabies) purposes, and 3) that you give Dr. McMillan permission to perform the euthanasia. The sheet will also state your wishes regarding burial or cremation. We do request that at home euthanasias be paid for in advance. We can give you a quote over the phone so that you can have a check prepared. This will get the “business” end out of the way up front.
When you are ready and wherever you decide that you and your pet are most comfortable, Dr. McMillan will sedate your pet. This is an injection in the muscle and will offer your pet the relief of a general anesthetic.
For pets who are not comfortable with strangers, or are in pain, or prefer to not be handled, or are dehydrated from their illness, the sedation will ease their stress or eliminate the pain. The actual euthanasia is given as an intravenous injection. It is an overdose of a barbiturate and causes a severe depression of cardiac and respiratory function. It is without pain and is the most humane way to accomplish euthanasia.
If your pet is to be cremated, Dr. McMillan will ask that you provide a sheet, towel, or favorite blanket to wrap your pet in before she takes the pet from your home. For larger dogs, we do have a stretcher and she will need some assistance carrying your pet out. We will provide transport, arrange the cremation, and will contact you as soon as we have your pet’s remains. You can come to our clinic to pick them up or we can arrange delivery to your home. The remains will be in a decorative tin, labeled with your name and your pet’s name. There are other options for memorial stones and urns and wooden containers available on-line.
One last word:
When that difficult time comes, and it is almost inevitable as long as we own pets, we believe in the humane relief from suffering provided by euthanasia. Yes, it is an awful decision to have to make for another living being but we each must remember a couple of things. We have no reason to think that animals fear death. We absolutely know they fear pain, discomfort and distress. As the stewards of our pet’s lives, we must put their comfort ahead of our own emotions. Our primary goal must be the happiness of the animal. We have the ability to prevent the extended suffering that can come from debilitating disease or the sometimes relentless deterioration of old age. This decision is never made easily but when there is no hope for improvement and before an animal has been drained of all the spark of life, it is a humane and loving choice.