Hospice For Dogs: Let Them Have Whatever They Want and Love

When deciding how to give an ailing dog the best life possible, consult them.

Posted May 21, 2018

We must do the very best we can for the nonhuman animals (animals) who depend on us for our goodwill and for having their best interests in mind

"And, painful as it is, I have looked Maya’s mortality in the eye and reckoned with its reality. I will be walking these last miles with Maya with a greater sense of peace." 

 "I too went against my vet's advice and gave my 14 year-old dog everything in the world she wanted to eat -- and she lived 10 months beyond my vet's dire predictions!" (Lisa Murray, via email) 

Dr. Jessica Pierce's latest essay called "A Hospice Visit for My Dog Maya" hit me hard and made me teary. I've known Maya for many years and had the pleasure of spending time with her over the course of many years when Jessica and I were writing Wild Justice: The Moral Lives of AnimalsThe Animals' Agenda: Freedom, Compassion, and Coexistence in the Human Age, and a number of essays. People often ask me questions about hospice for dogs, and while I can offer up some advice that I think is useful, I always send them to Jessica because of her vast knowledge about the topic and also because of her incredible sensitivity to what these people are going through. I truly believe that her latest essay on hospice for dogs should be required reading for everyone who brings a dog or other animal into their homes and hearts. I know few if anyone likes to think about the end of life, but it's a reality and we need to do the very best we can for the nonhuman animals (animals) who depend on us for our goodwill and for having their best interests in mind. 

Just about everyone who's chosen to live dogs or other companion animals is, at some time, faced with questions about life and death -- when's the best time to say a final and permanent good-bye because it's the best decision for the animal themselves

One type of hospice doesn't fit all: The animal comes first

 "I was not looking for longevity for him, but a decent quality of life for the time he has left. The vet agreed."

In end-of-life decisions, let's not be selfish: the dog (or other animal) comes first. Jessica's essay made me think about a piece I wrote a few years ago called "What's a Good Life for an Old Dog?" in which I wrote about how I dealt with the final days of my dog, a large malamute aptly named Inukpak, or Inuk, which means "person" in North Baffin Inuktitut. Indeed, he was quite a guy and I often thought of him as being as "human" as my human friends. I also wrote about another amazing dog named Jethro whom I rescued from the Humane Society of Boulder Valley. Perhaps it's more correct to say that he rescued me, but that's another story. 

Inuk was a very fit dog, getting regular long runs as he was a mountain dog, and very healthy for 13+ years. But, he declined fairly rapidly due to a gastrointestinal problem, so the veterinarian to whom he went and really liked prescribed a large orange pill, as I remember it, that had to be shoved down his throat. There was no guarantee that the pill would work but it was worth a try. To say the least, Inuk hated the pills, and after having three a day for four days, he ran away when he knew the pills were coming no matter how softly I spoke to him. He'd cringe in the corner of his large outdoor run or scoot up the dirt road as best he could. No one seeing him would draw any conclusion other than he didn't want to take the pills. If Inuk were a human, and in many ways he was, there wouldn't have been a shred of doubt that the pills were not at all welcomed. Inuk also did not appear to get any better and clearly was telling me no more pills please.

 We considered different alternatives and then decided (without asking the veterinarian, but letting her know what we had decided to do) that because the pills weren't working and were causing him a good deal of unneeded and obvious emotional distress, Inuk should spend the last weeks of his life enjoying every single moment as much as possible. He loved ice cream, so that's what he got. Every day he got a frozen pint of ice cream and he worked on it for hours on end, tail wagging, ears up, and clearly enjoying every second of this special treat. And, most remarkably, after a few days, he had more energy, took longer walks up the road, played with some with his dog friends who lived up the road, and loved to snuggle once again.

I decided that the other dogs with whom I've shared my life or to whom I became closely attached, would be treated similarly if it were clear that standard drugs didn't work or they caused far too much stress. Indeed, that's what I chose with my wonderful dog mate, Jethro. His favorite fare included bagels and tortillas filled with black beans (and they didn't make him gassy)!

Dr. Pierce told me that many dog caregivers seriously struggle with balancing the benefits of treatment against the burdens of care, and hospice veterinarians are especially cognizant of the burdens, like Inuk's displeasure, and weigh that into whether a treatment is "working."

In response to my essay I received a number of comments, all of which can be read online, and a good number of emails. Here are some examples.

I couldn't agree more, prolonging a dog's life when they no longer enjoy it is time to be selfless and let them go with love.

Mine is 16 years old and was diagnosed with cancer 6 months ago. Deciding to let nature take its course was incredibly difficult but the only compassionate choice. I've been trying tramadol for pain but she hates that stuff. So instead of refilling that prescription, I've decided to use my own prescription: peanut butter and bananas and hanging out in the grass when the weather is nice. Thanks Marc for validating that choice.

From a veterinarian:

I guess as I vet I do try to take all of these things into account. I usually say to owners, particularly where animals are terminal, "feed them what they enjoy most".  I am very much focused on doing what I can to ensure that patients I see enjoy the best possible quality of life within their circumstances, and if that involves eating ice cream I really don't mind!

One email I received read, "Thanks for your realistic view of what dogs at the end of life need. I've always given them what they previously loved, and in this case it was whatever I was eating and giving them tons of hugs." Another read, "This is common sense. Give them whatever the want and more of it. Look at what they gave to us and gave up to live with us. This is a no-brainer."

Give dogs who need hospice what they want and love: Maya gets cat food and Finn gets to run to her heart's content

When deciding how to give an ailing dog the best life possible, consult them. 

When I mentioned to Jessica that I wanted to write more on the topic of animal hospice, along the lines of what I wrote above, she wrote back to me: "Yes, I like that. Maybe the core idea is that there are many different kinds of hospice care, for many different kinds of dogs -- not a one size fits all. And when a dog is near death, it doesn't matter whether a food is 'good' for them -- it might be bad for their body, if they were to eat it every day for their whole life. Like ice cream. But towards the end, who cares? What matters is whether it is good for their spirit. If people food makes a dog excited and happy, he should have it. And then there is Maya, who loves cat food above all else. The vet used to warn me not to let her have cat food--too rich. But now, she gets as much as she wants (as long as it doesn't upset her tummy)."

Along these lines, in The Last Walk, Dr. Pierce writes about her friend, Pansy, who was warned by a veterinarian that she shouldn't let her elderly dog, Finn, run around because Finn had a heart problem. When the woman resisted invasive surgery, the veterinarian became testy and scolded her saying, "You don't want Finn to die chasing a rabbit, do you?" Pansy replied without hesitation, "That's exactly what I want" and grabbed Finn's leash and they walked out the door. (p. 119)

One type of hospice doesn't fit all. It's essential to know your dog as the individual who they are and what she or he loves. There's a lot of variation among dogs in terms of whom they are, what they want and need, and what (and who) they love (for more discussion on this point please see "How Well Do You Know What Dogs Do, Think, and Feel?"). So, give them everything they want and love in abundance. This isn't asking too much and they will be so appreciative as their lives come to a close.

My view, and one with which many others agree, is that a tasty treat, running freely and perhaps engaging in frenetic zoomies, and a lot of love are far better than a nasty pill with major emotional side effects including extreme fear and anxiety (and there also may also be significant physical side effects as many drugs have pages of negative side effects associated with them). I hope someone will make a similar decision for me if a comparable situation arises. 

I feel the correct decision had been made for Inuk and Jethro. I've replayed it many times over the years. While I can't remember Inuk's last meal, I do remember that Jethro munched on one of his favorites, a rice and bean burrito, as his dog and human friends came to say their last good-byes. Both of these canine beings had incredibly good lives and the very best they could have as their time on earth grew short. I know others who have followed a similar course of action. I also know that Jessica and her family and friends are doing all they can for Maya. It's quality, not quantity, that counts. 

References

Bekoff, Marc. Canine Confidential: Why Dogs Do What They Do. Chicago: University of Chicago Press, 2018.

Pierce, Jessica. The Last Walk: Reflections on Our Pets at the End of Their Lives. Chicago: University of Chicago Press, 2012. 

Bekoff, Marc. Older Dogs: Giving Elder Canines Lots of Love and Good Lives. Psychology Today, December 1, 2016.

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