Veterinary Hospice Care
by Elisa Black-Taylor
I told you when I was ready to die
Good day friends. This is going to be another LONG discussion on a subject that will eventually be faced by most pet owners. So grab a pot of coffee, some tissue, pen and paper, and a life preserver. We're going to play "sink or swim" because I'm diving into this new concept the same as most of you. It also wouldn't hurt to bookmark this page because it's a lot to take in at once.
Picture this in your mind. You get up and go to your refrigerator. There is a list of medications under a magnet on the door. There are a few bottles of pills in the refrigerator and you compare the list to the bottle to see which to administer to Kramer, who is a terminal aggressive immune cell cancer patient. You've been taught by professionals to administer these medications. Did I mention Kramer is the love of your life? He's already undergone chemotherapy and may not live another year. Your family chose to care for him at home and give him the best quality of life possible. He's been with you for years. Kramer is a poodle/terrier mix and what you are doing is veterinary hospice care. http://www.bestfriends.org/
Let's start at the beginning of this new concept. The date: March 2008; the place:California. The event is the The First International Symposium on Veterinary Hospice Care. Although veterinary hospice care has been around for over two decades, this was the first formal gathering of minds to discuss the subject.
The approach is the same as offered with human hospice care. To provide compassionate comfort to the dying pet and assisting the family with the bereavement process. As with human hospice care, nursing for the patient and psychological care for the family are the number one priority. This is NOT an attempt to prolong life thru suffering or hoping for a last minute cure for a terminal condition. Keep in mind pets aren't aware they are terminally ill. Not until the end and sometimes not at all. They don't have the emotional roller coaster thoughts faced by humans.
Katheryn D. Marocchino, Phd is the president and founder of Nikki Hospice Foundation is leading the way on education on this new end of life concept for pets. Please do more research on this remarkable woman as there is so much information on her online it would fill a book. She emphasizes people shouldn't just decide to start a pet hospice without a veterinarian to assist as that would be a disaster. She does believe euthanasia should be a last resort and is used more often than it should be.
One fact that really jumped out at me concerning Marocchino and the symposium was only a couple of vets questions had ever seen a "natural" pet death. Most animals who come into their practice are needing euthanasia to end suffering either by natural causes or critical injuries. I'm going to throw in my personal opinion a little early and tell readers I HAVE seen several natural, non-suffering deaths. It is the responsibility of the pet owner to always monitor a terminally ill pet and know when euthanasia is needed. I've only had to euthanize three pets in my adult life. The others died peaceful deaths with me by their side. Which is how I believe they wanted to die.
Currently there are more than 100 veterinarians who offer a veterinary hospice service out of their offices. I applaud them for many reasons. Reason #1 is they are entering uncharted territory with no instruction manuals and few case studies because this concept is very new. They are also having to deal with end of life issues many pet owners must eventually face. Therefore, they must be more psychologically prepared to deal with pet grief. The veterinary hospice care veterinarian has an ongoing relationship with the pet owner and is usually more involved in the "when is euthanasia needed" decision.
Many vets who don't offer a complete hospice program for the home now offer the option to come out and administer the drugs needed to end the suffering. This, in itself, is another option. For the pet to be assisted at the end of life in the comfort of home surrounded by family.
I'd like to add that this article is not about prolonging a pets life out of selfishness on the owners part. There are many painful diseases where it is in the best interest of the pet to humanely euthanize to prevent suffering. But many terminal diseases aren't painful until the end stages and veterinary hospice care offers the opportunity for families to keep their pet at home and provide as high a quality of life for the pet as possible. Many diseases we feel are reasons for euthanasia are bravely tolerated by a pet with a strong will to live. I'm talking about the pet whose suffering is alleviated by medication and doesn't want to die. These pets can experience a higher quality of life with control of pain by medications or a holistic approach. The veterinary hospice vet must have a high level of compassion to discuss what is best for the pet.
One problem in this approach is how new it is. Many pet owner's don't know it exists. They don't ask their personal vet and the vet doesn't discuss it because the pet owner doesn't ask. Cost is also a consideration. This subject needs to be discussed by all families with pets before their furry friends get old or terminally ill. It is a major life decision and not one to make without a lot of research. Hopefully I'm giving everyone a crash course and enough resources to continue research past this article.
I want to back up to cost for this service. This is not the round the clock nursing care program involved in hospice care for people. Therefore the price doesn't have to be outrageous. I believe the program is successful because the philosophy is similar to hospice care for humans. Treat the pain and anxiety, offer emotional support to the family and allow the patient dignity and comfort in death. As long as a family caregiver is available and the family works hand in hand with the vet, I would choose this over any other option.
Since veterinarians are receiving better training on the option of veterinary hospice care, they can in turn assist pet owners on when the time is right. A trained vet and a trained owner ensure the pet isn't allowed to suffer. Many pets suffer horrible side effects from chemotherapy and would benefit better with pain management. Again, it's the quality of life rather than the prolonging of death. Everyone involved is educated in how to watch the day to day health of a terminal pet. I was fortunate my pets informed me they were ready to die.
Let me stress I was devastated on the few occasions I had to euthanize a pet. There was no doubt in my mind it had to be done. I imagined myself in their place. Going to the "dreaded" vet's office, being placed on a strange cold table in a strange room, feeling horrible and wondering why "mama" couldn't stop crying. I don't know about my readers, but to me that would be a horrible way to leave this world.
I'd like to introduce you to a few vets who have made pet hospice care their life's mission.
Dr. Liz Palmer of Charlottesville, Virginia. She opened a mobile veterinary end of life practice where she lives. Dr. Palmer has a long client list, but doesn't advertise her services. When a newspaper article ran about her new business (she'd been a general practitioner vet for over 25 years) she received more calls than she could handle. Her approach is to go into a terminally ill pet's home and access the whole situation. She wants to see how the animal lives from the pet's viewpoint. She examines the animal for pain and questions the family as to how caring for a terminally ill pet will affect the family. Care giving shouldn't be an overwhelming burden.
Gail Pope, founder of BrightHaven, a residential pet hospice in California, became involved in pet hospice care 1996. I'd like to share a beautiful experience she had with one of the resident cats there. Gail had been involved with regular veterinary care and wasn't prepared for the death of Mariah. One day s he saw Mariah getting worse. Gail was alone at BrightHaven and couldn't leave the other cats and no vet was available to come out at that moment. She called a friend who advised her to take Mariah outside under a large tree and just hold her. Mariah died peacefully in her lap as they sat under the tree.
Gail now believes in a holistic approach to terminally ill and aging pets. The natural approach has worked well for her and many animals experienced a higher quality of life under her care. She believes many euthanize their pets too soon. She cautions people not to rush into euthanasia on a pet who isn't suffering when a natural death is only a few hours away. I agree with her. The animals I've helped pass peacefully didn't suffer added stress during the last hours of life. I've been blessed with the gift of patience. I've held, talked softly to and caressed each animal when I felt the end was near. No living creature should have to die alone and scared if it can be avoided.
Hopefully we'll all learn a lesson thru the work of these caring vets. They educate, console the family and love their work because it's important and necessary. My hope for this article isn't just to inform my readers that veterinary hospice care exists. I would love for at least one vet in every city in the world to start a mobile pet hospice service. The need and opportunity are there.
And the love and desire to care for our pets until their last breath is definitely there.
The picture above is my baby Bama. We looked at each other and I KNEW in December 2004 and I knew it was time due to massive internal bleeding