By Monica Turenne, D.V.M.

Death is not an easy topic. No one likes to talk about it, even when it's regarding pets. As a veterinarian, I believe the reason pet parents do not like to talk about death is fear of the unknown. Perhaps they had a bad experience in the past or heard terrible stories from friends, but whatever the case, they are left with a lot of tough questions. What will it be like? Will my pet suffer? When will it happen? Will it be awful? So when our pets become terminally ill, it can become overwhelming. This is when in-home hospice can play such an important role in helping your pet and your family.

““When our pets become terminally ill, it can become overwhelming. This is when in-home hospice can play such an important role in helping your pet and your family.””

Let me introduce you to Max:

Max was a 10-year-old dachshund. He was diagnosed with lymphoma in July 2013. His pet parents elected not to pursue chemotherapy, but they also did not want to euthanize him yet. They asked me to come to their home for a hospice consultation and to create a hospice plan for them. Max was so sweet and so happy when I met him! He was even sticking his head into my doctor’s bag to get treats. I collaborated with his parents to create a plan, and over the following four weeks, Max was kept comfortable on various oral medications.

During the last 10 days of his life, we followed his hospice plan, made several home repeat examinations, and gave subcutaneous fluids and injectable anti-nausea medications to keep Max comfortable until he was truly ready to die. Then, one day, his pet mom called me and said that he was ready, and they were ready. I went to their home and indeed saw a little dog lying on the laps of his four women (mother and three daughters). Max was peaceful and resting comfortably. He was where he was meant to be, when he was meant to be there.

When I graduated from veterinary school 15 years ago, it was my vision to care for dogs and cats through every stage of life — from puppy and kitten-hood to the end of their lives. Part of that process included helping pet parents with their terminally ill animals. But I found that I had a limited ability to help during that stage of life. In many cases, I had very little to offer when I delivered grim diagnoses in an examination room. I could recommend expensive diagnostics or refer them to specialists. If neither was feasible, the only other option I could offer was euthanasia, either right then or in the very near future.

““When I graduated from veterinary school 15 years ago, it was my vision to care for dogs and cats through every stage of life — from puppy and kitten-hood to the end of their lives.””

I always felt there had to be something better I could offer. Why wasn’t there something that might allow their pet to experience a pain-free, comfortable, and good quality of life until either the time was right for euthanasia or the pet died naturally at home? Why weren’t there other options that would allow pet parents to spend quality time with their pet? When I learned about hospice for pets, I realized that it was exactly what was missing!

What exactly is pet hospice? Generally speaking, the goal of pet hospice is to offer the best possible quality of life for animals who have terminal illnesses or who are at their natural end of life. Pet hospice provides pets with palliative relief from pain, nausea, discomfort, and other symptoms that may occur. These measures may take the form of oral medications, injections, herbs, acupuncture, massage, or other treatments.

Hospice care strives to help not only the pet, but also the pet parents, by helping them prepare for the death of their pet. We help owners make difficult decisions regarding medical intervention and aftercare. We want them to understand the process so that when the time is at hand, they do not need to make decisions based on fear or quick judgment. While there is tremendous sadness and grief during this time, hospice has the potential to help pet parents manage this process and care for their pets. Many people have found deep meaning by fully experiencing this time with their pet.

““Generally speaking, the goal of pet hospice is to offer the best possible quality of life for animals who have terminal illnesses or who are at their natural end of life.””

A hospice plan is the next step to alleviate some of the stress and fear. The pet parent and their hospice veterinarian create a hospice plan. It is very comprehensive and serves as a guide for the pet parent, so that when times of crises occur, the pet parent is prepared because the situation has already been anticipated and discussed. The types of situations that are covered in a hospice plan might include:

What are the pet parents’ primary concerns? This could be anything from lack of appetite, to pain or discomfort, or to the question: What will I do when my pet can no longer go outside to urinate?
What is the living arrangement of the pet? This might include where the pet sleeps or eats. Is the current setup feasible, or should it be modified given the current or future health status of the pet? A house-call veterinarian can be very helpful with this because he or she can directly observe the environment and recommend any changes.
What are the pet parents’ wishes regarding medical intervention? For example, what would the pet parent prefer to do if their pet stops eating? Do they want to intervene with medications, or do they prefer to let their pet guide the process?
Do the pet parents prefer euthanasia or natural death for their pet? If they prefer euthanasia, would they prefer an in-home euthanasia, or would they prefer to go to their primary veterinarian?
What are the plans for aftercare? Does the pet parent prefer a general cremation (when ashes are not returned) or private cremation (when their pet’s ashes are returned)? Or perhaps they prefer a burial at a pet cemetery?
What are the wishes for a memorial service? Some pet parents would like to have a service but are not sure what to do. The hospice veterinarian can assist in generating ideas to help the pet parent prepare. It is amazing what beautiful and creative ideas can be created when pet parents just simply talk about their love for, and devotion to, their pets.

As you can imagine, these discussions are not easy. However, they can be very important in making the end-of-life process as smooth and as comfortable as possible for the parents and their pet.

In-home hospice is a gift that we can give to our pets, and it is becoming better known among pet parents. While the grief and the sadness are so real, hospice can help to give our pets and their families comfort, love, support and quality time.

Monica Turenne, D.V.M., C.V.A., owns Four Paws Veterinary Wellness, an integrative veterinary house-call practice in Ann Arbor. She has been a veterinarian for 15 years and is a Certified Veterinary Acupuncturist. She is also a member of the International Association for Animal Hospice and Palliative Care. For more information, visit fourpawsvetwellness.com, call (734) 385-7161, or email mt@fourpawsvetwellness.com.