Almost every time the door opens, I am greeted with a crying client. As a veterinarian that limits my practice to in-home hospice and euthanasia, it is something I encounter daily with my families. In those moments, I give a warm smile, a gentle handshake and, in many cases, a big hug.
Although the majority of our appointments are for euthanasia, we also offer veterinary hospice care to our concerned pet parents. For years, veterinary hospice was very misunderstood, even within our profession. I would often be asked by veterinarians and technicians, “What is veterinary hospice?” or “Isn’t hospice prolonging the inevitable and making the animal suffer?” But it is quite the opposite.
What Is Veterinary Hospice?
Hospice is simply a medically supervised service dedicated to providing comfort and quality of life for the pet (and the owners) until euthanasia is elected or natural death occurs. We manage their symptoms with palliative care, support the family with caregiving and ensure the pet is not suffering. I am happy to say this type of care is on the rise!
We are finding an increase in families who wish to keep their pet alive for as long as possible while also maintaining a good quality of life. As a veterinary hospice practitioner, I am able and willing to help extend life as long as pain and anxiety are controlled, but this is always preceded by a lengthy discussion on the progression of the disease process present and a clear “stop point” which we agree is the ending of a good quality of life. Communication, preparation and more communication is the hallmark of a successful hospice case.
Many of our clients are referred to us from veterinary specialists—mostly oncologists, cardiologists and internists. While much of veterinary hospice is ideally done in the home, where the pet is most comfortable, many discussions and treatments should be started at the clinic with the veterinarian that the client has had a long relationship with. We are seeing more families ask their primary care veterinarian for this type of service, and while some veterinarians are hesitant, many are now embracing this type of care. By using the word “hospice” with clients, it redirects their thoughts from curing their pet to caring for them and preparing for death, grieving and healing.
The Five Ingredients of My Hospice Appointments
First, it is most important to help the family understand the disease process their pet is facing. Although we cannot predict exactly what will happen in the future, we can use our medical training and experience to give each family facing an end-of-life experience with their pet a possible and probable progression of their pet’s disease process. As doctors, this is the most important piece of information we have to give them and the most valuable tool families have in the decision-making process. This step also includes prescribing palliative care medications. I want to ensure the pet is as comfortable and anxiety free as possible.
Second is helping the family set up their environment so the pet is safe, comfortable and clean. A clinic can ask the family to bring videos of the living space, where the pet eats, sleeps, etc. and then make recommendations to ensure proper care. Some owners are not familiar with products like support harnesses or sticky mats for the ground. You would be surprised how appreciative they are with the simplest recommendation.
Third is discussing caregiver burden. Managing a terminally ill or aged pet is challenging. It will pull on the emotional and physical budgets of a family, and we all must recognize that. I often send families to petcaregiverburden.com for more information.
Fourth is my favorite part, and that is discussing quality of life and where to draw a line in the sand. This is about a 30-minute conversation and one that is so beneficial to the family. This part can often be done via telemedicine.
Fifth is to discuss natural passing and euthanasia. We must, to the best of our ability, explain the most likely “natural” method of death, if left unattended, and then also discuss the process of euthanasia. This educated approach to the physicality of death is essential to veterinary hospice care. By providing the family with knowledge and expectations, we give them the ability to make an informed decision based on their personal wishes for their pet with the gentle guidance of their veterinarian.
The Benefits of Veterinary Hospice
Sadly, 50% of pets that are euthanized in a clinic have not seen their veterinarian a year before that appointment. Hospice can help bridge that gap and provide great comfort to the pet and family. Typically, hospice is done in one appointment lasting about an hour, and a clinic can charge appropriately. There may be a few follow-up appointments which, in many cases, can be done via tele advice (and often by a technician). The families who bring their pet to their veterinarian at least once in the last year of the pet’s life have a 10% higher chance of returning to the clinic after the euthanasia.
While offering veterinary hospice may not provide the largest avenue of revenue, the benefits are immeasurable. Clients tend to experience a high level of satisfaction and gratitude for the knowledge and insight offered during these visits. In addition, this experience will lead to positive word-of-mouth referrals, repeat business with other pets from that client and, most importantly, it is what is best for the pet.
Veterinary hospice is here to stay. When families have a better end-of-life experience with their pets, they heal more quickly from the debilitating emotional loss. They are also able to cope better with their decisions, feel confident in their ability to care for their pets, and more quickly open their homes and hearts to pet ownership again. +