Hospice care has been around for a long time in human medicine. It really is in its infancy for veterinary medicine. But hospice care is a crucial part of the aging process of our pets, when they get old. Hospice is indicated when a pet has a terminal illness and extra, compassionate care is needed at home. The goal is improving the pet’s quality of life and helping to strengthen the family bond in a very difficult time. It is not to add “quantity” at the sacrifice of “quality” of life. It is to extend the quality of life for as long as possible so that family members and pets can spend as much quality time together as possible. It’s important to note, that there is a huge difference in hospice between pets and humans (at least in California). That difference is euthanasia. With our pets, we have the option to determine that if the pet is doing so poorly and with diminished quality of life, humane euthanasia can be performed.
One of the most difficult decisions that we get asked is “when will it be his time?” for our sick friends. It is an exceedingly difficult question for us to answer, for several reasons. Most importantly, is that we don’t get to see them at home in most cases. The stress of coming to the office gives many pets a rally, and they seem to do better. so frequently we have to rely on what pet parents tell us.
While there are several criteria that I like to use when addressing the patient’s well-being, there are other factors that need to be addressed as well. I will try to address them all, but maybe some of you can add some more.
1) Is the pet in pain? Can the pain be controlled with medication? Identification of pain is crucial.
2) Can the pet perform the activities of daily living? This is taking care of urination/bowel movements, drinking, and eating. Pets that are house trained know that going in the house is against the rules.
3) How do your pet’s good days stack against the bad days?
4) Is your pet able to eat without vomiting. Vomiting is not fun. Not eating is a sign to watch for.
5) Can you adequately care for your pet’s needs? This generally means time commitment, financially, and especially with larger dogs, physically. If the answer is no, please do not feel guilty. Many people cannot manage hospice care for their human family members. Fortunately, insurance covers the cost of hiring professionals to provide daily in home support. Pet insurance does not cover in home hospice care for the daily needs, purely the medical ones. In human hospice care, family members who must perform all of the daily hospice care themselves get physically and emotionally fatigued. There are studies that have found that these people die younger than those who have care provided.
6) Do you have philosophical reservations against euthanasia? For some people, euthanasia is morally repugnant, and it is very difficult to advocate this for their pets. And there is nothing wrong with this, provided that the pet isn’t in pain. While many pet owners have a hard time determining pain, we are trained to recognize and treat pain.
Hospice care requires a lot of communication between family members and the medical team. Home visits are frequently required, for examinations, lab testing (if indicated), medication adjustments, and pain scoring. Remembering that the goal of hospice is the quality of life of the pet and the family both.
Part of hospice care is also preparing the family for the end, especially children. We have some very good recommendations on our memorial page of our website. When it is time for euthanasia, having it performed at home can be less traumatic for the pet, family members, and other pets at home.
Dr. Horn is a member of the International Association of Animal Hospice and Palliative Care. He is also a certified canine rehabilitation practitioner. He has a thorough knowledge in hospice care and pain management.