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Veterinary Services: Hospice Care and End of Life Decision Making

Geriatric Care for Pets

As your pet approaches the end of life stage there are several things to consider:

  • Pain - Controlling pain is primary to the goals of hospice for your pet. An individual plan of medical and alternative therapies can be developed by our doctors for your pet. Talk with our veterinarians and staff about signs of pain that are particular to the disease process(es) your pet may be suffering from.

  • Appetite - During hospice care many pets may become uninterested in food altogether. Our goal at this point is not worry about a balanced diet but rather about getting enough food in your pet to maintain energy. Trying novel foods may help. Feed your pet different things in different areas of your home at different times of the day. Baby food, ground beef, puréed meat, Vienna sausage, and cottage cheese can help stimulate appetites in some patients. Syringe feeding may be recommended by our doctors but we would encourage you to never force your pet to eat, however, as this may cause unnecessary anxiety. Please know that at some point your pet may stop eating as the end is near and organs aren’t functioning well.

  • Hydration - Just as with food, many pets may become uninterested in drinking. You may try adding low/no sodium chicken broth, warm water to the food, or use a syringe to gently wet the tongue. Adding a small amount of glycerin to the water may thicken it up and make it easier for a weak pet to lap up. You may continue to wet the mouth even in the later stages of the end of life process, but never force water down. Hydration of the eye is something easily over-looked; eye lubricants, if needed, are available at the clinic, just ask the staff.

  • Mobility - At some point, medical and external modalities will cease to work and your pet will not be able to stand. This is usually a very difficult thing for pets to experience and you may also see signs of anxiety (such as whining, heavy panting). Without intervention, animals can develop bed sores, urine scalding, infections, and eventually may have difficulty breathing. Our doctors and staff can guide you on how to keep them the most comfortable and to help to prevent these issues.

    Several harnesses are available to help with mobility and allowing your pet to stand to urinate and defecate and, where possible exercise. Sources for harnesses with handles include Help ‘Em Up, Solvit and Handicapped Pets. Orthotics and braces however should not be used without a consultation with a veterinary orthopedic surgeon or a veterinarian certified in physical rehabilitation. Open sores and fractures can occur with these devices if not used properly.

  • Hygiene - Uncontrolled urination and defecation can be normal as our pets age or diseases worsen. Maintaining hygiene is important to prevent sores, urine scalding, and infections. Shaving the hair from these problem areas will keep the skin dry and aid in cleaning. Baby powder and small amounts of diaper rash cream can also prevent problems from arising.

    It is best to choose bedding that is easily cleaned and changed such as mattress covers and other water-proof bedding. A waterproof shower curtain liner can also be placed over the bedding and under a blanket or sheet to protect the bedding. You can buy “chux pads” at any drug store or through an internet source. You can also use puppy pads, however, they may be more expensive and less absorbent.

  • Happiness - You know your pet the best and know what he or she loves to do, so you will be the best judge of your pet’s happiness. You will know when they no longer enjoy food, toys, or the environment around them. Most of all, when they no longer enjoy or seek out contact with you and the rest of the family and other pets.

    Think about the things that make him or her special to you. Look at the amount of time that he or she seems to be doing well and the amount of time that he is not. When in doubt, sometimes sitting quietly with your pet and asking them if they are ready can help to give you clarity when the time comes to make final decisions. As veterinarians, our job is to assist the family in the decision-making. There is not one perfect moment in time in which to make that ultimate choice (unless the pet is truly suffering, something we are trying to prevent in the first place).

    Some owners need time to come to terms with the decline of their pet while others want to prevent any unnecessary suffering at all. Everyone is different and entitled to their own thoughts. After all, pet owners know their pet better than anyone. When discussing the decision to euthanize, we should be just as concerned about anxiety in our pet as we are about pain. Anxiety may present as panting, pacing, whining, and/or crying. Anti-anxiety medications can sometimes work but for pets that are at this stage, the end is usually near.

    Many people want their pets to die peacefully in their sleep at home. There are those pets that peacefully fall asleep and pass naturally on their own, but just as in humans, this type of peaceful death is rare. Because of this we encourage you to make arrangements ahead of time so that when the time comes it is not made stressful by your pet in advanced suffering and care is not available except late at night at the emergency clinic.

Below are two resources that you can use to help to determine your pet’s quality of life and aid in end of life decisions that you might have to make, these are from the LapofLove.com website:

  • A. Quality of Life Scoring Chart
    Dr. Gardner's Pet Quality of Life Scale: Pet Quality of Life Scale and Daily Diary ~ Dr. Gardner"


  • B. The Grey Muzzle application developed by two veterinarians, Drs. Gardner and McVety, and produced by their Lap of Love Veterinary Hospice has a calendar so you can visualize the month at a glance as well as a summary page to see a pie chart of your pet's progress. It is simple to use and free!
    CLICK HERE TO DOWNLOAD GREY MUZZLE APPLICATION FOR IPHONE/IPAD
    CLICK HERE TO DOWNLOAD GREY MUZZLE APPLICATION FOR ANDROID

    Download the Grey Muzzle application from the app store and create your pet's profile. Then everyday mark if your pet had a good day, bad day or neutral day. This will help you to keep track of those bad days so you and your family have a more objective way of evaluating quality of life for your pet.

    You may want to mentally prepare yourself for when your pet has more bad days than good. As a family you may for instance, decide that if your pet has 30% or more bad days, that it is appropriate to say goodbye. The quality of life can be different based on the disease the pet is struggling with, the pet's personality and the family’s beliefs and abilities to care for their pet during this time. We are here to support you with whatever decision you make.

 

How Will I Know When It's Time and Anticipatory Grief

We understand that caring for a terminally ill or geriatric pet is very challenging no matter how ready you think you are. It often involves special care routines that can be time consuming, frequent veterinary visits and intense worry. Even worse is the knowledge that the time you have left with your beloved pet is limited.

Many pet owners experience anticipatory grief at this stage in their pet’s life. Anticipatory grief occurs prior to the actual loss of the pet and consists of a range of emotions including fear, guilt, and frustration due to lack of information as well as anxiety. Anxiety surrounding the anticipation of death is normal, but allowing the anxiety to overwhelm you can be detrimental to enjoying the remaining time you have to spend with your pet.

The best way to deal with anticipatory grief and help your pet is to be prepared for this stage of life. Please ask yourself the following questions:

How do I envision the last few moments of my pet’s life?
Where do I want it to take place?
At what time of day?
Who should be present?
Is there anything I don’t want to happen?

How do I feel about Euthanasia?
Do I understand that most pets do not die at home of a “natural” or peaceful death?

Do I understand the process?
Do I have questions I need to ask my vet?

What can I do now so that six months from now I can look back at this time and think “I have no regrets?”
Are there any “bucket list” items I want to experience with my pet?
What can I do to make my pet feel extra special?

While it’s extremely difficult to face the prospect of life without your pet, answering these questions will help you when your pet’s time is near. Thoughtful advanced planning will help alleviate some of your anxiety so you can focus on providing your pet with compassionate physical care. Making your pet’s last days extra special with lots of love, favorite toys, activities, and favorite foods may ease your grieving heart as well.

 

The Euthanasia Process

At Belton Animal Clinic and Exotic Care Center we strive to make the euthanasia process as stress and anxiety free as possible for both you, your family and your pet. The doctor may do a brief exam to confirm that euthanasia is appropriate and to prepare for the proper sedative based on your pet’s condition and needs. A sedative is given, usually by intramuscular injection. This injection may sting a bit but it is just a very brief discomfort. Your loved one is then placed on a comfortable blanket and the lights are dimmed in the room.

After about 10-15 minutes the doctor will come back into the room with a technician. You may choose to leave your pet with us at this time or you can stay for the actual procedure. Either way your pet will be treated with compassionate care and told that you love them by our staff. At this time an IV catheter will be placed and the euthanasia solution will be administered. The medicine acts quickly to stop the breathing and heart and your loved one will be put to peace as they are petted and loved one last time.

 

After-Care Options

It is better to think about options for aftercare before the emotional day arrives so that you don’t have to think about these things and try to make a decision while you are grieving.

  • Home burial – your pet will be placed in an Angel bag (blue biodegradable canvas bag) that you can bury your pet in or you can choose to not accept this bag.
  • Simple Cremation – your pet’s ashes are not returned and will be cremated in a group with other animals and the ashes will be buried in a common grave.
  • Individual Cremation – your pet is cremated privately, all by him/herself, and their cremated ashes are returned in a basic plastic box about 1 week later. A special urn may also be purchased at this time or in the future to transfer your pet’s ashes to something more personal. If you need help with this process just let our staff know.

 

Grief Counseling Resources

Colorado State University Veterinary Teaching Hospital – Argus Institute

Louisiana State University School of Veterinary Medicine- Best Friend Gone Project - You may reach the Best Friend Gone counselors by calling (225) 578-9547

University of Tennessee Knoxville - HELPLINE: 865-755-8839

Overland Park Counseling

Loss of Pet Counseling

 

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