Hospice Care
Intro
When you decide with your family and veterinarian not to pursue any further testing or treatments to fix your pet’s health problems, you have entered hospice care. This is a very emotional decision, but it is one that is made out of love. It is very normal to struggle with this decision or to feel some guilt, but it’s okay to say that you don’t want to put your pet through anymore tests or procedures.
During this care, we focus our attention on making your pet as comfortable and happy as possible for as long as we can. We no longer try to “fix” whatever problems are causing your pet’s illness, but instead try to manage symptoms like pain, inflammation, and nausea so that they can comfortably live out the time they have left. Try to focus on making this time you have with your pet as special as possible. Make as many happy memories as you can. Treat every day as an extra day with them.
Will my pet still be on medications?
Often pets will still be on medication during hospice care. These medications are given with the intention of making your pet feel better. We will often use things like antinausea medication or pain medication to make your pet more comfortable. We may also use things like prednisone or seizure medication to make your pet’s symptoms less severe.
If a medication is causing any discomfort to your pet- for instance if they really hate taking pills, or if there are side effects that are unpleasant- be sure to discuss this with your medical team. The goal of hospice care is to help our pet’s feel better. It can be a tricky balance sometimes, but if the medication is causing more problems than it is helping, it’s probably not the right choice for your pet. Make sure to discuss things with your veterinary team before making changes to any medication.
How do I know it’s time?
At some point you may be faced with the decision to euthanize your pet. It is never an easy thing to decide to help your pet die peacefully.
People often ask their veterinarians, “How will I know when it’s time?” The truth is, making the decision to put your pet down is a deeply personal one. There is rarely a truly right or wrong answer. However, there are some things you can do to guide your decision. Make a list of five things that are important to your pet’s quality of life. They can be good things like “Enjoys going on walks” or “Eats meals twice a day,” or they can be bad signs like “Can’t go up the stairs anymore” or “Has another seizure.” The list will be different for every pet, so sit down with your family and really consider what is important to you and your pet. What makes your pet special? What makes them happy? Are there things that you don’t want them to experience? If you are having trouble coming up with a list, try using this list from the Ohio State Vet School.
Once a week check the list. If your pet is still good on all five things great, put the list away for another week and enjoy your time together. If your pet has bad marks on one or two things check in with your veterinarian to see if there are adjustments to be made to make your pet more comfortable. If your pet has more than three bad marks on the list, your pet has more poor quality of life markers than good and it’s time to consider letting them go.
You might also consider discussing your pet’s well being with a trusted friend who shares your values of pet ownership. Remember, this is a personal decision, but sometimes the outside perspective of someone who knows us well can help shape our decisions when we are unsure.
Watch for important warning signs that your pet is very unwell and may be suffering. If your pet is displaying any of these symptoms you need to speak with a veterinarian urgently. If these symptoms cannot be treated, it’s likely time to let your pet go:
Difficulty breathing
Not eating anything for more than a day
Not drinking water for more than a day
Moderate to severe pain despite medications.
What is euthanasia and what does it look like?
Euthanasia is an overdose of anesthesia medication. Your pet will first fall into a deep sleep, then they will stop breathing, and then finally their heart will stop.
There are options to consider for your pet’s euthanasia. Some people prefer an inhouse visit, while others prefer that euthanasia be performed in the animal clinic. Some people wish to be present for the euthanasia, some do not. Some people wish to have children or other pets present, some do not. These decisions are deeply personal and different members of your family may have different desires. Your veterinarian may also have some limits on what they can provide for instance, some veterinarians do not make housecalls and some do not allow children of certain ages or other pets to be present. It’s important to respect everyone’s wishes as much as possible during this difficult time. Discussing everything beforehand can make a very emotional process go smoothly. If you choose to be present for the euthanasia, there are some things that can happen that you need to be ready for. They are 100% normal and do not indicate that your pet is in pain or otherwise suffering.
If you choose to be present for the euthanasia, there are some things that can happen that you need to be ready for. They are 100% normal and do not indicate that your pet is in pain or otherwise suffering.
1) Pets will sometimes take a deep breath, make sounds or even struggle slightly as the medication is injected. This is sometimes because the medication makes them feel dizzy or woozy before they go to sleep. They may also experience something called the “excitement phase of anesthesia.” Similar to people who do strange things as they go under anesthesia, this is just your pet’s brain falling asleep due to the medication. People who do similar things under anesthesia do not remember these reactions.
2) Pets will not always close their eyes as they die, and their tongue may fall out of their mouth.
3) As the body lets go, there may be fluid/foam from the nose or mouth, or they may urinate or defecate.
4) The procedure takes a couple of minutes, but it is usually over much faster than you are ready for.
5) It is normal for the body to twitch for several minutes after death.
Grieving
It is normal for both people and pets to grieve the loss of a loved one. Some will experience grief before the loss has occurred. There are many resources available to help you and your family through this difficult time. The San Francisco SPCA has a monthly support group. A list of other support resources in the greater California area can be found here.