Facing the end of our pets’ lives brings complicated feelings. Grief, yes. Sorrow, yes. But also regret, uncertainty, and sometimes, even relief.
If we saw end of life care for our animals as a way to keep our bond strong, would we both benefit emotionally from the experience?
Specialized help – pet hospice
Last week I attended a presentation by Katherine Goldberg, DVM on pet hospice.
No, Honey is just fine and I don’t expect to be thinking about such issues for many years to come.
But I had very profound and unsettling experiences with the end of life for my last three dogs and I wanted to explore a better way.
Amazing advances in medical interventions for animals raise new questions:
- If I can provide a medical intervention for my pet, should I?
- Is cost a good reason to reject a treatment?
- How do I balance quality of life with length of life?
- What kind of care can I personally provide to my pet?
- When is it time to say goodbye?
- Is it even my right to chose the time of my pet’s death?
In her talk, Dr. Goldberg raised these issues but framed them in a new way.
It’s all about the bond with your animal
Our local hospice organization has the tag line, “It’s about how you LIVE.”
Dr. Goldberg took a similar approach to hospice care for animals by expressing it in terms of what kind of end of life care will keep the bond strong.
If your cat’s last memories are of being stuffed into a carrier and a nauseating car ride to a vet that has only ever brought discomfort, what does that do to your bond? And to your memories of that relationship?
Hospice care emphasizes caring when curing isn’t possible or desirable and gives a higher priority to quality of life instead of quantity. Among its interventions may be:
- controlling pain
- assessing appetite and deciding whether or not to stimulate it
- improving mobility
- adjusting medications
- addressing the emotional suffering of the animals and providing mental stimulation
- providing meaningful euthanasia, if chosen.
Dr. Goldberg’s practice provides this help in the comfort of a pet’s home through her mobile vet services.
Hospice and personal philosophy
As a movement, hospice makes sense to me. It’s respectful of human dignity and it doesn’t exalt technology and medical interventions undeservedly.
And I have my own freaky ideas about life. I’m extraordinarily healthy and have the immune system of Wonder Woman.
My first thought of medical interventions turns to the people who had spinal surgery that left them in more pain then when they started. Or rounds and rounds of invasive tests that reveal lots of information medical knowledge is not yet advanced enough to deal with.
My husband trusts the medical establishment much more than I do. As well he should–he’s a survivor of childhood cancer. And he would not be my husband today if not for bold and invasive medical treatment.
His family is prone to severe chronic health conditions. And medical treatment has prolonged and improved their lives.
All this background information means that when my husband and I have had to make decisions about the end of our pets’ lives, we haven’t been in total agreement.
I suspect Mike thinks I gave up on our dogs too easily.
And for my part, if I have to hear one more story about how an animal in the wild will chew off his own foot to avoid bleeding to death in a trap, I’m going to scream.
Not having a common background or philosophy has made for some hard discussions.
I hope that reframing the hard talks in terms of what benefits our relationship with our dogs the most will make future decisions easier.
I was very emotional listening to Dr. Goldberg’s talk. I was taken back to the deaths of my last three dogs and the regrets that remain.
Christie – Christie was fourteen years old and suffering from Cushing’s disease.
On her last night with us, Christie had multiple seizures throughout the night. I was upset to find her regular vet was closed for Columbus Day when 9 a.m. came.
We took her to Cornell Vet Hospital with hopes of stabilizing her condition enough so we could consult with Christie’s regular vet the next day. I had no idea what I was doing.
When I got home and read the stack of literature given to me by the hospital, I saw that they allowed people to visit their pets. No one mentioned that when we left Christie behind.
I immediately got on the phone with the attending doctor to arrange a visit. In the middle of our conversation, she was called away for an emergency. I later found out that Christie had gone into cardiac arrest and was resuscitated by the doctors on duty.
I’ve never gotten over the thought that Christie’s body was ready to give up. And that some of her last memories were of being dragged back to “life” when she was obviously ready to die.
I wish I had thought to sign or been given the option to issue a Do Not Resuscitate order. Allowing her to die in peace would have been worth not getting to say goodbye.
Agatha – Sixteen years old, nearly blind and entirely deaf, Agatha had lived a full life. And upon Christie’s death, she seemed to flourish as an only dog.
Agatha’s primary care vet suspected Agatha had liver cancer. Her last treatment was to remove some of the fluid from her abdomen to give her relief and a few more comfortable days for us to say goodbye.
It became obvious on a Sunday that Agatha was wearing out. Once again, the 7 day a week, 24 hour a day services of Cornell Vet Hospital were necessary.
The young intern who did the intake with us was a chipper, smiling young woman. When I told her we were there so we could end Agatha’s suffering, the intern enthusiastically started telling us about the work up they could do and all the tests the hospital could run to develop a treatment plan.
I was put in the unenviable position of arguing with someone to kill my dog.
Shadow – After two unhappy experiences with Cornell Vet Hospital (I still can’t drive by there without welling up in tears), I determined to do everything possible to prevent my next dog from ending her life there.
A few short months after adopting her, our vet diagnosed bone cancer in Shadow’s jaw during a routine teeth cleaning.
The consulting oncologist at Cornell said that if we had surgery to remove Shadow’s jaw and weekly radiation treatments, she might live a few months longer than the two or three the doctor predicted.
I had just come from a crowded waiting room filled with people sitting knee to knee with their dogs and cats. Reactive Shadow found it so stressful that I took her outside and asked the staff to come get us when the doctor was ready.
It didn’t take long to decide that subjecting Shadow to that waiting room every week for radiation just to give her a few more months to live would not enhance her remaining days.
So I started making nutritious, homemade meals for Shadow knowing that she wouldn’t be able to eat conventional food once the tumor in her jaw started growing.
Shadow surprised everyone. She was with us for nearly two years. And at the end, she looked healthy and happy–except for the horribly bleeding mass in her mouth.
The only reason we opted for euthanasia was because Shadow was bleeding so heavily she began to choke. I was terribly afraid she would suffocate at home alone.
I wonder if a hospice consultation would given us a better option for dealing with the horrible tumor even as Shadow was still happy and full of life?
Exploring hospice, before you need it
Discovering that hospice services could be available the next time we need them was very comforting to me. I hope that having new resources to draw on will lessen the regrets even if it can’t remove the sorrow.
Here are some links you might want to check out:
- Whole Animal Vet – Practice website for Dr. Katherine Goldberg
- Pet Hospice Movement Gaining Momentum – JAVMA News
- The Nikki Foundation for Pets
Have you used formal hospice or palliative care services for your pet? Have you practiced principles of hospice care on your own? Please share.
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