Considering Hospice Care For Your Pet?
A new book offers practical guidance for caregivers
Posted Mar 20, 2018
Life with an aging or ill companion animal can feel like riding a down-escalator: you know your friend is going to pass through various phases of decline, that things will get more difficult over time, and that eventually you will hit bottom, no matter how much you dread reaching that point. My dog Maya is just shy of fifteen and is clearly on this down-escalator. She is facing an increasing array of physical challenges and we’ve had to make various adaptations to her routine and to our house. She can’t hear much of anything, and can’t see very well, so we no longer let her walk off leash, since she no longer hears “come” and doesn’t always watch where she’s going. She has some arthritis in her front right paw, as well as some stiffness in her back and hips, so we’ve moved our mattress onto the floor so she can still “jump” into bed. We need to lift her in and out of the car. Every inch of our house is covered with throw rugs, runners, and yoga mats because Maya has trouble keeping her balance on our hardwood and tile floors. And Maya has her own medicine cabinet to keep track of her pharmacopeia of pain medications, thyroid pills, estrogen (to help manage urine leakage), joint supplements, and so on. But we’ve had no concerns about her overall quality of life. Although clearly geriatric, she has been a happy, relatively mobile, slowed-down version of her usual self.
A few weeks ago, however, she had a medical crisis. Over the course of a few hours one Saturday, she almost completely lost the use of her back legs and was stumbling around the house like a drunkard, panting from anxiety and pain. We rushed her to the emergency clinic, where she was given some heavy opioids and an uncertain diagnosis (a ruptured disk, a vascular “event” or spinal embolism, or possibly a tumor pressing against her spinal column). When I called Maya’s regular vet the following Monday, she told me I ought to call the mobile euthanasia service just to let them know we would probably be needing their help soon.
I didn’t make that call. It isn’t that I am opposed to euthanasia, when an animal is really suffering. I just know how resilient Maya is. She has been through several difficult surgeries, including an 8-hour oral surgery, and has survived a rattlesnake bite. I thought we needed time to see how things would shake out. (Okay, maybe I was also suffering a bit of denial . . . )
Maya bounced back, as I had hoped, but not completely. She can get in and out of the dog door and enjoys going for short outings and really enjoys her food. But we are now clearly in hospice mode. In other words, we are done trying to cure Maya’s various illnesses—we’re done with big surgeries and fancy diagnostics—and are shifting attention to keeping her quality of life as good as possible for as long as possible.
As I explored in my book The Last Walk, offering care to an animal nearing the end of her life can be emotionally, physically, and financially challenging. We need to constantly adapt to our animal’s changing status; what is working one day to keep them comfortable may no longer work the next day. We need to be observant, creative, patient, and flexible.
Providing care for an animal during her last days, weeks, or months can feel like a lonely endeavor. Veterinary medicine can offer a wide range of treatments and support for ill and dying animals. But in between visits to the vet, an animal has daily needs that must be met and may experience ups and downs that the caregiver must try to manage. In this situation, many caregivers feel like they are flying by the seat of their pants, simply doing their best until the animal declines to a point at which, usually, a decision is made to euthanize. Many caregivers feel like they are creating the wheel or inventing fire for the first time, because they lack a network of support and have little guidance in how to provide day-to-day care, in between veterinary visits. But there is help for caregivers.
A few months ago, I was given a copy of a new book called A Caregiver’s Guide to Pet Hospice Care, by Ruth Gordon. I’ve found the book very helpful in caring for Maya as she faces increasing physical challenges. Gordon is part of an organization called Peaceful Passings for Pets, an innovative group (based in Minnesota) that seeks to make hospice care for animals more accessible, less lonely, and more supported. I’d like to give a shout out to Gordon's book. Despite its small size, it is full of useful information for the caregivers of ill or aged animals. The goal of the book is to provide practical tips and support for caregivers who decide to pursue hospice. One of the overarching messages of the book—and one with which I strongly agree—is that any hospice plan for an aged or ill animal must be supervised by a veterinarian, preferably one with specialized interest and training in pain and symptom management.
Chapters help caregivers think through:
- Deciding whether hospice care is appropriate for your pet and your family (do you have sufficient time, emotional and physical energy, money?)
- Providing physical and psychological support to an animal (sleep, nutrition, peeing and pooping)
- Controlling pain (recognizing pain, pain medications, acupuncture, laser)
- Giving medications (tips on how to give pills, ear drops, eye drops, and injections)
- Assessing quality of life and making decisions about when quality of life is so compromised that euthanasia may be appropriate
- Grieving (what to tell children, what to do when other pets are grieving)
Finally, the book has some useful appendices, including a pain inventory for dogs, a flowsheet to keep track of medications, and a tool for thinking through quality of life.
One of the hardest but most fulfilling aspects of sharing our lives with a companion animal is that we will likely usher them through the final stages of their life. It is exceedingly important that we do this well, because our animals depend on us to keep them comfortable and safe. This book can help us provide the kind of loving care our animals deserve.
Ruth Gordon, A Caregiver's Guide To Pet Hospice Care: For You and Your Terminally Ill Pet. Pogo Press, 2017.