Hospice Care for Pets – Overview – Part 2

Hospice care for pets is an emerging niche of veterinary medicine that creates and relies on a unique caring collaboration between the pet owner and members of the veterinary healthcare team. Pet hospice is patterned after the delivery of the end-of-life care provided for human patients, with the additional provision from the veterinarian for humane euthanasia when the pet’s day-to-day quality of life becomes unacceptable.

How will I know if my pet needs to enter hospice care?

Open, honest, and direct communication with your pet’s veterinarian and members of the veterinary healthcare team throughout the pet’s life lays the necessary foundation for effective communication as the end of life approaches. As soon as a life-limiting disease is diagnosed, it is time to open a dialogue about treatment options and how the approaching end of life will be handled.

Many life-limiting diseases, or illnesses that cannot be cured, can be treated aggressively and managed well in some pets—sometimes for many years. Examples of these diseases include diabetes mellitus (also called “sugar” diabetes), the degenerative joint disease associated with osteoarthritis, and various cancers. Treatment strategies are as varied as the diseases themselves and the pets involved. Your veterinarian can create a “big picture” perspective to clarify specific appropriate treatments, the schedule for medication delivery, a recommended schedule for reassessment at the veterinary practice, and the costs associated with all aspects of the recommended therapies and rechecks.

Communication with your veterinarian truly is the key to success in transitioning from chronic disease management to hospice.

As veterinary medicine has matured and advanced, treatment options for chronic incurable diseases have advanced as well. It is commonplace to see pets living with successful management of chronic diseases that until recently would have precipitated euthanasia soon after diagnosis. Although this has been a boon for older pets—those at greatest risk for developing these conditions—it complicates our decision making as our pets age. Communication with your veterinarian truly is the key to success in transitioning from chronic disease management to hospice.

I am worried that I will not be able to provide what my pet needs in a hospice setting. How can I be sure that I do?

Delivery of hospice care is as individual as the pet and the family. There is no one “right” way to provide pet hospice. Instead, there are many different aspects of care that may be appropriate for your pet in a hospice setting. Ask your veterinarian and veterinary healthcare team to be as specific and detailed as possible in creating a hospice care plan. That way, you can ask all the necessary questions to feel confident in the care you will provide.

It is important not to be intimidated by the idea of providing hospice care in your home for your pet.

If a particular procedure or treatment is uncomfortable to perform, seems to make the pet uncomfortable, or is simply impossible to perform, be sure to communicate openly so that an alternative can be explored. A particular pet’s hospice care “plan A” may need to evolve into a “plan B” or “plan C,” depending on the pet’s response to the actual treatments/procedures as well as the progression of the life-limiting condition. It is important not to be intimidated by the idea of providing hospice care in your home for your pet. Your veterinarian and veterinary healthcare team will help in any way they can. And euthanasia remains the final compassionate gift we can provide our dying pets when that time comes.

How will I know when hospice care for my pet should end?

When a pet enters hospice, palliative, and end-of-life care, we need to identify the benchmarks by which we will measure the quality of day-to-day life for that animal. Dr. Alice Villalobos’ quality-of-life scale is an easy-to-use document that helps us make a somewhat objective measurement of a very subjective experience (see the handouts “Quality of Life at the End of Life for Your Cat”).

As death approaches for a pet and we struggle with the timing and details that surround euthanasia, it is often easier to “begin with the end in mind”—that is, to begin with a detailed discussion and plan around euthanasia, specifically when during the course of the disease euthanasia would be considered most appropriate, how and where euthanasia will be performed, and your desires for taking care of your pet’s body. As difficult as these discussions are, it is easier for all involved when the important decisions are made before the crisis of impending death is before us. Establishing a plan for the very end of a pet’s life merely creates guidelines. The final details of such a plan will be determined by the pet itself as its life comes to a close, so it is appropriate to maintain some flexibility.

Living and caring in the day-to-day way that is associated with hospice care supports a unique emotional connection and intimacy with the pet.

Applying hospice and palliative care principles to our pets as they approach the end of their lives can be an emotionally rich and satisfying experience. This honors the precious, loving relationship we have with our pets, and it honors the pet’s own life force and desire to live. It may be frightening to think about the death that is inevitable and coming soon. That said, living and caring in the day-to-day way that is associated with hospice care supports a unique emotional connection and intimacy with the pet that is difficult to replicate. The hurt and the happiness go hand in hand in this scenario.

With a bit of help and guidance, we really can help our pets “live until they die.”