When you lose a beloved pet, the memory of that loss stays with you like a scar.
Ask Harrisburg resident Allison Adams Martinez. She had her cat Athena for nearly 17 years.
“She was the world’s best cat, and she was a constant presence in my life through many moves and changes,” she said.
When Athena became ill with kidney disease, Allison and her husband knew the end was near, but they still weren’t prepared. The decision to compassionately euthanize her was the right one, Allison said, but also fraught with sorrow and grief.
This year, Americans will spend more than $60 billion on their pets, according to the American Pet Products Association. So, it should be no surprise that pet palliative care and hospice programs have surged in the past few years. In many ways, these programs replicate human programs, but they also have aspects that are unique to pet care.
“The veterinary hospice movement extends from human hospice,” said Beth Marchitelli, a veterinarian at 4 Paws Farewell Mobile Pet Hospice and Home Euthanasia in Asheville, N.C. “People were benefiting from hospice, and people wanted this for their pets, as well.”
Pet hospice can take a variety of forms and can start days or weeks before an animal’s demise. Generally, care involves consultation with a veterinarian. Then the hospice team works with the family to identify and access services that are most likely to benefit the pet. This commonly involves pain management, as well as opportunities for owners to share final memories with their pet and say goodbye.
Making decisions about a pet at the end of life is a terrible burden, so hospice and palliative care can help bring comfort to owners, as well as to their pets. This happens even when owners know it’s time and that they are doing the right thing.
“They’re still not prepared,” says Anne Johnson, a bereavement support specialist at Cumberland Valley Veterinary Clinic in Hagerstown, Md. “It’s the owner’s worst day.”
Harrisburg resident Jackie Goodwin knows this from experience.
“I had my first airedale for 13 years, and I kept her alive too long,” she said. “I wasn’t ready for her to leave, and she suffered as a result. I was very selfish.”
She learned a lesson from her loss, and when her pet, Chelsea, was terminally ill with kidney failure, she focused on keeping the dog comfortable.
“My vet always said ‘we,’ and I really appreciated that,” she said. “I asked her how I would know when it was ‘time,’ and she said, ‘You’ll know.’”
And her vet was right, Jackie said.
“I noticed that Chelsea wasn’t happy,” she said. “She didn’t want to go outside, and she was sleeping all the time.”
Goodwin was with her dog at the end.
“It was very private and very peaceful,” she said.
No Perfect Answer
When a pet is ill or injured, owners don’t want their animal to suffer. In addition to pain control, they want symptoms such as diarrhea and lethargy managed. As with people, this may mean medications, but it also involves environmental modifications such as the installation of ramps and lifts, massage, aromatherapy and acupuncture.
“We’ve starting using toe grips to help prevent slipping and falling, and these have been a game changer,” said Marchitelli.
Heating and cooling pads, as well as chicken broth ice cubes and other products to improve hydration and caloric intake, also are popular.
“There are even some TV programs and videos for pets to stimulate cognition,” she said.
Johnson said that some animals, such as those with advanced kidney disease, may benefit from subcutaneous fluid injections. Family members have the option to do it themselves or have the vet administer them.
As the pet’s condition deteriorates, Johnson tries to help them understand that, when an animal is losing weight rapidly, unable to eat and unable to walk or stand, the pet is likely suffering.
“We have a quality-of-life discussion as a gentle way to move the owners in the end-of-life direction,” she said.
The burden of decision-making can be significant for pet parents. They want to do the right thing, but the pet can’t tell them.
“There is no perfect answer,” Marchitelli said. “Their previous experiences with death, their own spiritual orientation, and their feelings about mortality all have an influence.”
However, one shared belief is that the animal shouldn’t suffer.
“This is an overarching theme, and this is often what guides decision-making,” she said. “People want to know when their pet’s quality of life is compromised.”
Peaceful Spaces
Many veterinary clinics focus on services to help owners through the process.
“We remodeled two years ago and decided to create a special room—a comfortable, quiet place where the whole family could come to say goodbye,” Johnson said. “It’s away from the flow and has a private entrance.”
Often, she noted, people are expecting to take their pet home, and she doesn’t want them to leave empty-handed. Her practice gives these pet owners some literature on grieving, seeds they can plant in their yard or garden, and a pin or ribbon to wear.
Johnson, along with her colleague, Faufat Odebe, became certified as bereavement support counselors through the Association for Pet Loss and Bereavement. Now, they host a twice-monthly bereavement group.
“It’s free, and you don’t have be a client here to participate,” Odebe said. “We pass around pictures, eat cookies and cry. That is sort of the rhythm.”
The group also holds special events, such as a luminary lighting last year that attracted 70 participants.
Whatever the grieving process, many families still experience guilt when a beloved pet dies.
“With pet owners, it’s difficult because they often have made the decision to end their pet’s life,” Marchitelli said. “We have to help them understand that their feelings are normal.”
Where To Go?
There are a few specialized pet hospice programs in Pennsylvania. You can find a list of these, as well as other resources, at the International Association for Animal Hospiceand Palliative Care website.
Otherwise, your own vet is the best source for learning more about palliative care and hospice.
“Family members and friends who have gone through a similar experience, or who have suffered the loss of a pet, can also be a referral source for palliative and hospice care,” said Jennifer Mahoney, a clinical assistant professor of medical oncology at the University of Pennsylvania School of Veterinary Medicine.
