By Monica Turenne
From the moment we adopt our pets to the end of their lives, they are, without question, an integral part of our family. Our relationship with them plays an important role in our lives as their love for us is like no other love. They bring us joy, make us laugh, and they bring comfort and healing when times are tough. While we have always understood this, the isolation of Covid-19 quarantine periods have highlighted the vital role pets play in our mental health.
Because our pets mean so much to us, it is very difficult to think about them growing old or developing a terminal or life-limiting illness. It’s even harder to think about living our life without them.
So, what happens when our pets grow old and need special care? What happens
if they become chronically ill with conditions that cannot be cured or necessitate therapies that would be significantly stressful to them or are too costly?
These are the questions I asked myself for many years when I worked in a brick-and-mortar practice. I was frustrated by the limitation of only being able to offer two choices when a pet was diagnosed with a severe life-threatening disease—either choose a path that cost thousands of dollars or euthanize. I felt like there was no middle ground. Why wasn’t there an option in the middle which would provide comfort and a good quality of life for the pet? When I learned about hospice and palliative care for pets, I realized I had found the middle ground. Hospice bridges the gap between surgeries or treatments that either might not be financially feasible or in the best interest of the pet and a decision to euthanize.
What is palliative and hospice care? These two words are often used interchangeably. While there is some distinction, for simplicity I will refer only to Animal Hospice here.
What is animal hospice?
Animal hospice is care for animals that focuses on the patient and family’s needs and
helps pet parents when their pet has a terminal or life-limiting illness for which there is no cure. The focus of hospice is helping families provide the best possible quality of life for their pet for as long as possible. Animal hospice also provides the family a degree of preparation for death by providing emotional support to the pet parent as they navigate through this difficult time. Hospice is very intimate and very personal, and while it is also very difficult, it can be one of the most beautiful and rewarding times a pet parent has with their pet.
When does animal hospice start?
There is much variation for this but generally, hospice starts when a pet parent understands that their pet has a terminal or life-limiting illness and is entering the last stages of his/her life. It is when pets need their families to provide care in a different way by shifting the focus from “fixing and curing” to to comfort care and helping their pet live their best life for as long as possible. At this stage, pet parents want to discuss how to assess their pet’s quality of life and if any medications, supplements, or diet can help their pets be comfortable and pain-free. It is also at this time that preparations for their pet’s death are discussed, including options such as euthanasia or hospice-supported natural death as well as what options are available for aftercare. These are very difficult and emotional topics. It is with
the loving care and communication of a hospice veterinarian that can help the pet parent discuss these issues and feel supported and understood.
Read related article: Heart to Heart — Valuable Lessons Animals Have to Teach Us
What types of conditions are appropriate for hospice?
The most obvious answer here is a terminal disease like cancer. But there are many other situations when hospice is very appropriate such as chronic arthritis and disc disease, chronic kidney disease, chronic liver disease, chronic GI conditions, endocrine diseases, and cognitive decline, to name a few.It is very important for the pet parent to understand the physiology of their pet’s condition in order to understand what symptoms to look for and understand when to reach out for help.
Veterinarians certified in Animal Hospice and Palliative Care (CHPV) have obtained advanced training to be able to guide the pet parent through this stage of their pet’s life. During a Hospice Consultation, the certified veterinarian provides information regarding the pet’s illness such as the trajectory of the disease. They also discuss how to assess quality of life as well as providing pain management, palliative care, nutritional counseling, and how to manage mobility and hygiene concerns. While this is all important, hospice veterinarians also support the family during this time. They take the time to provide guidance for the whole family as this can be one of the most difficult aspects of pet parentship.
Realizing that your pet has entered the final stages of their life can be very difficult and scary.
As a Certified Hospice veterinarian, it has been my honor to have helped hundreds of families and pets through the hospice process. I am also a holistic veterinarian which has allowed me to provide very specialized care for my patients and offer not only traditional medications but also acupuncture, herbal therapy, ozone therapy, essential oils, Reiki, and more. Complementary medicine has given countless patients not only relief from physical symptoms, such as pain and nausea, but also spiritual assistance as the spirit and body separates at the end of life.
The additional training I gained from the Certification process has helped me to understand how to recognize pain earlier, what herbs and medications to use, and when and how to use them. It has given me a deeper understanding of the physiology and trajectory of disease as well as the process of dying itself. Many people are afraid when their pet receives a terminal diagnosis because they do not know what to expect. Being able to explain what is likely to happen helps mitigate this fear and allows pet parents to be able to care for their pet in a much more present manner. By focusing on this, the bond you share with your pet is strengthened and the love you share together truly deepened.
I can think of no better way to demonstrate both the sadness and love that can be experienced with animal hospice than to provide a quote from a wonderful pet parent and family which expresses their experience with hospice for their boy Kody, a nine-year-old Labrador Retriever with cancer:
Words cannot convey how the hospice process helped me and my family to start the grieving process and to stay present with him as his physical body deteriorated. The love we had for Kody is immense and we still miss him, but not with the overwhelming grief we had at losing a dog suddenly, or with little preparation.
This article is dedicated to Darwin (aka Dar Dar), Dr. Turenne’s nine-year-old Cavalier who passed away from heart failure on June 27, 2021, after two and a half months of hospice care.
Dr. Monica Turenne DVM, CVA, CT, CHPV is the owner of Four Paws Veterinary Wellness. She is certified in veterinary acupuncture, animal hospice, and palliative care. You can learn more about her practice at fourpawsvetwellness.com.
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3:00 p.m.: I just arrived at my sister Deb’s for my pet sitting gig. The cats are wary and stand-offish but I’m sure I can remedy that. I begin by reading the little sticky notes left by my sister. Everything is efficiently tagged and labeled, then I see it—the notebook. As I scan the many pages of instructions, I can only marvel over how these animals have her trained. I will not be dictated to by a pack of felines!