HOSPICE CARE - ENDING LIFE WITH COMPASSION
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A family with companion animals might see several life cycles within
their lifetime as our pets age seven times faster than us. There may
come a time when you experience the hardship of a companion pet
with a terminal disease. In many cases the cost of treatment can
become more than the benefit to the pets and family’s overall health. During advanced stages of neurological disorders, body organ failure,
or cancer treatments a patient can become ill and uncomfortable. Sometimes a curative outcome is no longer a possibility and the family
is faced with the question of quality of life or quantity of life. Veterinary medicine allows the family to have the option of stopping aggressive treatment and allowing the pets life to end in a comfortable manner. Measures such as allowing the companion animal be at home with the family in a familiar environment will reduce the stress and anxiety that
can be experienced by traveling to or being in an unfamiliar environment.

The practice of veterinary hospice care is a relatively new concept to veterinary medicine. Our hospice service offers an approach that is personal and comfortable for the family. This allows the pet to experience their life, illness, and death with dignity while the family is allowed
closure while in their home environment.

Hospice is focused on giving pets a safe, caring, intimate end-of-life experience in their familiar environment. As such, it is not geared toward curing a pet's disease, but rather toward keeping the disease from causing the pet any discomfort. Hospice care focuses primarily on providing pain control and physical and emotional comfort to the pet.
To prevent the anxiety of hospital visits and to allow pets and owners the maximum amount of time together. Owners are trained to attune themselves to their pet's physical and emotional needs, and often find that the increased attention and physical contact allows them to feel close to their pet at the end of its life. Owners are given one-on-one time to come to grips with their pet's progressive disease and can say good-bye in their own way. Hospice helps to make a pet's death a kinder, more intimate experience for both pets and owners.

Though it can be extremely rewarding, hospice care requires preparation and work from the family. The family will learn how to administer medication, feed their pet, keep it clean and comfortable, and monitor
and document the pet's pain and general health. Working as a team,
the family and the veterinary staff can make a plan for the pet's treatment, to be adapted as the owner and pets needs change.

After instruction and training from the veterinarian, the family will have responsibility of the day-to-day care. One of their most important responsibilities is medication. It is much easier to prevent pain than to relieve pain that it is already present. In hospice care, medication is
given preemptively, before pain actually starts. Medication is generally given on a regular schedule, rather than in response to symptoms of pain, in order to keep the pet comfortable. It therefore becomes the caretaker's responsibility to monitor their pet closely for signs of pain, such as agitation or vocalization. These are signs that pain management is not working and that a new plan needs to be discussed with the veterinarian. Caretakers also need to observe and monitor their pet's behavior and physical state. They become the eyes and ears of the veterinary team, recording any changes in their pet's weight, temperature, eating habits, mobility, and other characteristics. The family needs to remember, most importantly, the need to stay flexible. Hospice is a trial and error process. Sometimes medications, feedings, and other treatments are not effective, and they need to be changed by the veterinarian and the family until the pet is comfortable.

Our goal is to limit hospital visits as much as possible which means caretakers may also have to take over medical tasks that make them uncomfortable. Sometimes pet owners are nervous about handling medications, blood, or feces. We will work with the family to develop a treatment plan within their comfort level. Often, as pet owners adjust to their role as caretaker, they find that they can handle more than they thought and may even come to appreciate the physical intimacy of caring for their pet. If the pet's illness ever becomes more than a caretaker can handle, our veterinary staff is available to help.

Euthanasia: when hospice comes to an end

Though it provides a valuable alternative to end-of-life hospital care, hospice is not a substitute for euthanasia. Though pets are sometimes able to die comfortably at home, often hospice works as a transitional stage between treatment and death. It can be a hard decision for caretakers to make. After months or more of caring for a progressively worsening pet, it becomes difficult for owners to choose a final ending point. Dr. Robin Downing recommends in Pets Living With Cancer:
A Pet Owner's Resource (AAHA Press, 2000) that pet owners establish
a bottom line for their pet's quality of life before the time comes to make the decision about euthanasia. At what point is their pet's quality of life
no longer acceptable: when the pet can't control its elimination, when it can no longer stand or walk, when it becomes disoriented and no longer knows where it is, or when its pain is out of control? With this bottom
line established ahead of time, owners can know they will make the right decision when it comes to the sad and stressful final days of the their pet's life. The act of euthanasia can become a final gift of comfort to an animal in a great deal of pain. To continue the hospice experience, we will do out best to make arrangements to have the euthanasia process occur at home, allowing pets and family to experience death in safe, familiar surroundings.

Hospice can be a wonderful, caring option for terminally ill pets.
However, pet owners should keep in mind that pet hospice care may
not be for everyone. Some owners may not be ready or able to take on the often painful, emotional, and time-consuming work of the day-to-day care for a sick pet. Hospice may not be the right decision for owners who live alone, have a heavy work schedule, or are not in good health. Owners should carefully consider whether they have the resources necessary to care for their pet at home and talk to the veterinarian about what is right for them.

Whatever decision pet owners make, it is good to know that hospice exists as an option. Hospice allows pets to pass away feeling safe and loved and gives pet owners a chance to say good-bye at their own pace.
It can transform the frightening circumstances of terminal illness and the loss of a beloved friend into a life-affirming opportunity. In the words of
Dr. Clough, -Death isn't losing the game. Death is unavoidable; it's a
part of life. If you make death a safe, loving, comfortable experience,
then you've won the game.