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.
Ending regrets
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
- 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.
I recommended a vet who does hospice care to a friend with a German shepherd named Ellie — a friend of a friend of mine had recommended her — and she couldn’t have been happier with the experience. The vet came over and discussed options with her and then, a few months later, came over and gave Ellie the shot and took her away. All the cats and the other dog were there and it was very peaceful and pleasant. My friend could not recommend it more highly.
I too am vary wary of the medical establishment — and like you, Pamela, am very healthy and don’t like taking medication of any kind — and certainly will not take Frankie to a vet his time has come since he hates car rides. (Of course, he’s not fond of strangers coming to the house either). I can only hope that I’ll recognize that time in good time.
I’m just so relieved to hear about new options and a new way of thinking about caring for our animals.
And hospice goes beyond just euthanasia. Dr. Goldeberg told a story about a cat whose tests results showed near liver failure. The cat refused to eat because it had terrible dental disease but no one would perform the needed cleaning/extractions under anesthesia because it would probably kill the cat.
The family decided to go ahead and have the surgery and the cat was eating an hour after coming out of anesthesia. For all anyone knows, the liver failure could have been related to the cat’s inability to eat or the dental disease.
Whatever was going on, it appears the cat is much happier with his teeth cared for and he has no idea he’s supposed to be dead.
Thanks for the testimonial from your friend. It sounds like a wonderful way to say good bye to a dear friend. I hope you don’t have to consider such things for Frankie for many years to come. But I suspect he’ll amaze you with his grace and dignity when the time comes.
Wow, what an open and honest discussion about when to say when. This is a topic that has been on my mind a lot lately, as Leah has been on and off sick, and also has fallen a few times. She’s okay for now, but as a 12 year old large breed, I know in my heart her days are numbered. Thank you for sharing all of your experiences with your dogs. First, it is wonderful that they all lived so long, and that you followed your heart as to when was the right time to say goodbye. I love that the vets only gave Shadow a few months, and she showed them by living another two years! It just shows you that you that no one can really predict when their time is up, and gives me hope that maybe Leah will be around a little longer than I expected. 🙂
It’s never a good idea to assume we know everything about our dogs. They continually surprise us–sometimes in very happy ways.
I hope Leah is full of surprises for you.
Thank you for the information. As someone with a lot of aging pets I find it very useful. I have only ever had to euthanize one pet, Bingo, our foster and later adopted dog who had cancer and liver failure. Currently our brussesls griffon Zira, age almost 13, is suffering some medical issues. She has early renal stage disease which is well managed and also a heart murmur that recently appeared. We just had to have a suspicious lump on her leg looked at. If the lump on her leg turns out to do be something I am not sure what we will do. I dont consider Z that old but she has a bunch of issues going on. In general Im the type to pursue treatment but I dont think I feel right about pointless uncomfortable treatments, particularly for a dog who is afraid of the vet. Of course I am hoping Zs problem is nothing, but if it turns out to be something I will have some tough choices to make
It’s an awesome responsibility we have for our pets, isn’t it?
I hope you have a great vet who can help you review all Zira’s needs as a whole. It sounds like she already has a terrific advocate in you.
I cried my way through reading this post. But it was a good cry remembering my dogs and the good lives they had. My one regret was prolonging a life when dignity and quality of life were gone. The young veterinarian was more interested in marketing his services than carrying out the difficult decision I had made. I was so vulnerable then that I gave in and today I remember the needless suffering that I put her through.
I cried my way through writing it, Jan. Forgive the typos. I just wasn’t able to bear the chore of proofreading.
We learn a lot in our years of caring for our animals. Thank you for sharing your heartfelt lesson.
One of the greatest gifts my vet gave me with Sage was permission to let her go. It seems kinda silly to say it, but I needed it. It meant the world to me and helped me be proactive in making the decision. Hospice assistance with a vet or someone who specializes in the area is a wonderful thing.
Having a compassionate vet you can trust is so important. It sounds like you were fortunate to have someone looking out for Sage along with you.
Thanks for your wonderful post. My vet convinced me that my kitty Yogi still had some fight left in him and he died at home in my arms the following morning. I was heartbroken that he suffered and wished I could have made his passing more peaceful (he had a heart attack). I still cry every time I thing about it 🙁
I love the idea of Hospice for pets – I was so grateful for Hospice when my grandmother passed – they helped me understand what was happening. I hope that we continue to have new alternatives for our beloved pets.
The people who work in hospice take on the job of guiding those of us who aren’t dying through the process our loved on is going through. They do amazing work.
And I’m pleased that people are recognizing the need for this help with our animal friends.
I’m sorry to hear about your friend, Yogi. We’re often left wondering if we made the best decisions. But it’s so fortunate you were able to be with him when he passed.
It’s great to know that there are alternatives. It’s something I hope I don’t have to think about for a long time again, and I’ve had good luck with vets. It’s sad to know that some out there are only in it for the money, and good to hear that some are more concerned with the best care for pets and their people.
I’ve also been fortunate in finding excellent vets. They do amazing work. And for a lot less money than you might think.
Another wonderful, thought provoking, heartfelt post, Pamela. It’s an excellent idea. Hopefully it will become well established very quickly.
I’ll be keeping an eye on pet hospice. Do you have in in NZ?
What a wonderful (? Doesn’t feel like the right word.) post. It’s so good to see people embracing some alternatives to the traditional route. Like you, I do not place a whole lot of trust on conventional medicine. I rely heavily on natural health solutions and I’ve been lucky to find a vet with the same philosophy as me. It makes me feel good to know that one of the first things she did after taking us on as clients, was give us her cell number to be used in emergencies, so that we are never facing tough decisions with an unfamiliar vet.
Wow, sounds like you found a very caring vet. That can be such a comfort.
One of my greatest sorrows was that Agatha and Christie weren’t seen by their regular vet when they were ready to go. I hated having to go through that with strangers.
First of all… I’m sending you a giant hug. I cried reading this post, and I can only imagine how hard it was to write it.
Pet hospice does sound like an useful service… anything to make the end a little less scary and sad. I typed about 5 different things after this sentence and none of them sounded right or accurately conveyed what I wanted to say. So I’ll just leave it at that.
Thanks. Yes, that post left me shattered for the rest of the day.
And given your recent worries about your sweet little conehead, I thought you’d understand.
I’m thankful that pet hospice is becoming more widely available and hope that it will help many people avoid the regrets I (and many other pet people) have had about their friends’ passing.
Shadow looks like she was absolutely beautiful. How amazing that she surprised you like that, living past her “expiration” date.
I think it’s rotten luck that the end had to come outside regular vet hours. Let go the guilt about Christie– I’m sure are dogs are no more anxious to leave us than we are to let them go. And good for you for giving thought to a topic most of us would rather avoid thinking about. I love your blog because I can always hear the moral reasoning behind your writing, and true morality is so rare these days. But you have it. In spades.
Thank you for this post – for promoting the idea of thinking about hospice before you need to and for sharing your own painful experiences. I recognize some of my painful experience in your stories about Christie and Agatha and Shadow’s passings. It’s going on two years since I lost my best friend, Daley, and I still can’t talk or write about his last hours. It’s hard to not to have regrets but I do think there’s a chance of lessening them if we think about death before we need to. The process is a mystery to many of us yet it will happen to each and every one of us. I will be sharing your post and the links you provided with friends. Thanks,
-Chandra at Daley’s Dog Years
What a touching and valuable post. I’ve only lost one dog as an adult and I still wish I’d handled things differently. Things could have been worse, but I wish Blitzen had been able to pass on in our home, in his bed, where he was comfortable and felt loved rather than in the veterinary emergency room where I imagine he was scared even though we were there with him. These services these people provide are invaluable. I’d definitely consider this option.
I actually started my blog as a way to deal with the guilt and grief I was feeling regarding the loss of our Australian Shepherd, over a year after we lost him. I’ve never regretted trying the surgery, just that we didn’t go visit him sooner that day, that his last conscious hours were spent in a kennel surrounded by people he didn’t know. I was expecting him to come home, it kills me that Moree didn’t know we were there at the end.
With our Lab/Pit mix, we did choose palliative care, for many of the same reasons you made that choice for Shadow. Smokey had hemangiosarcoma. We could have extended his life by six months or so if we’d chosen surgery followed by chemo- this for a dog was traumatized by getting his nails trimmed. We knew that if we went the agressive route, it would be for us, not him. Sadly, we only had a week before we could hear the fluid in his lungs and knew it was time.
We still took him to the vets’ office for the end, but having made the decision, and having that last week with him meant everything.
We are lucky enough that we are able to choose as our regular vet a vet that is also a 24 hour emergency clinic. This relieves a huge amount of stress for me as I always know where we’re going, we know the staff, and we know the vets.