You’re familiar with hospice care as it applies to humans, but what is hospice care for dogs?
“Simply put, hospice care focuses on providing the best quality of life possible for a pet with a terminal disease or condition until the pet dies or is euthanized.” This is a snippet of a longer definition provided by The American Veterinary Medical Association.
It is an approach to “end of life care” that focuses exclusively on making a dog’s final days or weeks as comfortable and pain free as possible using medications, therapies, diet, and of course the companionship of their humans.
A quick note
I will be referring to dogs simply because of the focus of my website, but the information in this post will help no matter what type of pet you have.
A painful topic indeed
No matter how much time has passed, I vividly remember how I felt the moment my vet would tell me there was nothing more he could do. It’s devastating because not only do I have to say goodbye, I had to find the strength to say the words that would end the life of a beloved companion.
For all except my one cat TT, the right decision was to put them down immediately. TT had cancer and when the tumour no longer responded to chemo, rather than put him through trying a third, fourth and fifth drug, we decided the kindest thing would be to leave him in peace. He was not in any pain, and had a very good quality of life until one day a couple of months later he had what appeared to be a stroke. We rushed him to the vet and put him to sleep.
When is hospice considered?
Before you make plans for hospice care you must first determine if, ethically, it is the right course of action. I realise how hopeful it sounds but it is not an option in every case, and cannot automatically be justified simply because you are not ready to say goodbye.
Here are a few scenarios where hospice may be an option:
- When your dog is reaching the end stages of a terminal illness, there’s nothing more that can be done medically but he can still enjoy quality of life.
- The cost of continuing treatment is so steep, the parents cannot justify it when no cure is expected.
- The parents wish to stop painful treatments and focus instead on having their dog live out his life in the comfort of his home, surrounded by loved ones.
- Some time is needed to say a proper goodbye.
- The chance to avoid making an irreversible decision while standing in the vet’s office still in shock.
- Perhaps you have a bucket list of things you’d like to do with your dog that you never got around to doing.
- Would like the chance to take him to the beach one last time, for example.
- Maybe you need more time together for closure.
- Other family members may like to spend some time with the dog.
- The only option for anyone opposed to euthanasia.
What are the goals of hospice care?
In a nutshell, it is about keeping your dog pain free and comfortable until the time comes when he no longer has a good quality of life, and it’s time to say goodbye.
How long does hospice care last?
If you just needed a few extra days to prepare yourself, there’s your answer. Otherwise, depending on your dog’s condition it can be weeks or even months.
What are some of the benefits?
The benefits can go hand in hand with some of the scenarios I listed above in the section “when is hospice considered.”
- Caring for a dog at home removes the stress of transporting a sick dog back and forth.
- An even deeper bond than already exists may develop as a result of such a hands on approach to care. It may even be therapeutic.
- Your dog can die comfortably at home in familiar surroundings.
This is very important
Hospice is not a substitute for euthanasia, but rather the chance for your dog to remain with you when there is no longer anything that can be done, keeping him comfortable until it is time to say goodbye.
Where does hospice care take place?
In your home.
Is it ethical?
I don’t ask this question in the greater philosophical sense, but rather specifically as it relates to your dog. Just because hospice care is available, it does not mean it is right in every situation.
When faced with the heart wrenching task of having to say goodbye, it can be difficult to separate our not wanting to experience that pain from doing what’s best for our pet.
It is wrong and yes, unethical, to prolong another living being’s suffering in order to delay our own.
Believe me I don’t mean this in any harsh way. I have said goodbye too many times, and as sick as I felt because I couldn’t do anything to save them, the only thing that mattered was they did not suffer. That belief is the only way I was ever able to let them go.
Is hospice care the right choice for you and your family?
The first step would be to have a talk with your vet about your dog’s condition, how far advanced his illness is, is he in pain and of course quality of life.
If your vet does not offer hospice care, you may want to have this same discussion with a veterinarian that does. Not every vet may see it as an option, so best to speak with someone experienced and more qualified to answer. Be sure to have all your dog’s medical records transferred over before a meeting.
How to find hospice care
If your vet doesn’t offer it, ask if he knows who does. Otherwise an internet search in your area and The International Association For Animal Hospice and Palliative Care (IAAHPC) should help.
I recommend you do some reading about the various services on offer so you’re better informed before you meet the caregivers. Of course they’ll explain everything, I suggest this research because it’s something I would do.
Questions to ask and information to gather
I have compiled a list of questions you may want to ask during your appointment.
- How long have you/your practice been offering hospice care?
- What is the severity of my dog’s illness?
- Is it/will it be painful as it progresses?
- Can it be managed well with medication?
- What kind of pain management is offered?
- Do you provide alternative therapies such as supplements, remedies, acupuncture…
- How can I be sure he won’t suffer?
- Will my dog be doped up and out of it or still “himself?”
- What kind of care and support can you offer my dog?
- How flexible are you in terms of what you’re willing to do and what I should be doing?
- How often will a vet or other team member visit to assess the dog?
- What happens if I need help out of hours?
- If you (the vet) is away, is there someone else experienced enough in hospice care to help?
- How will I know when it’s time to let him go?
- What kind of commitment is required of me/my family?
- How long will my dog have before he can no longer be kept comfortable?
- How much time do you think we have with him?
- How long is each visit?
- Will care be available 24/7?
- Is euthanasia at home an option?
- Do you offer grief support?
And of course the question most of us ask our trusted vets – what would you do?
It always comes down to money doesn’t it?
Fees will vary by practice and the services you require. Having a vet or other professional come to your home will always cost more than going to their office.
During your meeting be very clear about costs. They need to spell it out for you, and don’t assume anything. The last thing you want is to be hit with a shocking great bill. What are the costs for the various team members who come? Must it always be the most senior person or can a more junior, equally competent person perform the same task at a lower rate?
Do the charges vary depending on the time of day? Day of the week?
You may be able to do some of the things on your own, saving money to pay for what you can’t. For example, if your dog needs injections you could be taught how to do it, then use that money for something like acupuncture or another type of therapy that only a professional could perform.
Be honest with yourself about budget and how much you are willing/able to spend.
Who is on a hospice care team?
A veterinarian and trained staff who are experts in palliative care and pain control/management. Depending on the support you’re interested in receiving they could include professionals in massage therapy, acupuncture, homeopathic remedies, Reiki…
What does hospice provide?
Everyone’s needs are different but help can include:
- An in-depth explanation of your pet’s medical condition, including what to expect in the last weeks, days and hours
- A detailed care plan
- Training on how to provide home medical care – i.e. administer medications, injections, iv fluids
- Training on recognising changes in behaviour (sleeping patterns and willingness/ability to eat), help in identifying pain levels and when to call for help
- On call vets for emergencies
- Personalised diet/supplements
- In home care
- Pain relief
- Changing bandages
- Taking temperature
- Keeping your pet clean
- Euthanasia (in home or at the practice) with an explanation of the process
- Physical therapy
- Massage therapy
- Alternative therapies such as acupuncture, Reiki…
Discuss with your vet how much you are able to do on your own, and what you prefer a team member to do.
What other services does hospice provide for pet parents?
In addition to the help and training I’ve listed above, hospice also offers:
Help in adjusting to the idea of losing a loved one
Extra time to make decisions without feeling rushed, standing in your vet’s office with a waiting room full of people
An opportunity to discuss, in advance, how and where you would like to say goodbye to your dog – what kind of environment you would like to create, who should be there, cremation or burial
Pet loss grief support and counselling
What will be expected of you?
Know in advance it’s a lot of work, and the participation of family members is a critical part of providing your dog with the best care possible. It requires a 100% commitment.
You will be your pet’s caregiver, but how much you do will depend on what you are comfortable doing.
Even if you’re able to hire others to do most of the caregiving, you will still have to ensure your dog has someone around 24/7. He can take a turn for the worse very quickly so you need to be ready to take action in an emergency.
Other very important things you can offer your dog include:
- Keeping his environment as stress free as possible
- Ensuring he is warm enough
- Surround him with his favourite things whether that’s a blanket, a toy…
- Do some fun things your dog loves to do and will look forward to. That may even cheer him up
- The company of his loved ones
- If a dog has limited mobility there is a chance of bedsores so make sure he’s lying on a soft padded bed
- Provide traction and avoid mishaps by covering slippery floors with carpeting
- If he’s able to go for short walks, don’t keep him trapped in the house – a change of scenery and some fresh air may do him good. If he’s having trouble walking use a sling or a stroller. Speak to your vet first to make sure it’s okay
- You must have an emergency plan in place should your dog take a sudden turn and immediate euthanasia is necessary
Sometimes the answer is clear cut, other times it isn’t – much like the answer I’m giving you now.
You’ll be spending lots of quality time with your dog and you’ll come to see what his new “normal” is and what isn’t. He will have good days and bad days and you’ll need to know the difference to prevent any suffering. Your vet will help you figure that out.
Natural death or euthanasia?
I know it’s tough to read this but it’s part of this whole process. Did you want your dog to pass naturally, or will you be making a decision on when to euthanise him?
It’s best to learn what they each entail in order to make a better informed decision.
Euthanasia is a humane, painless and peaceful way for your pet to pass. Your vet will inject a sedative than a medication that will stop his heart. In all the times I’ve been with my pets they never experienced any pain and passed peacefully in seconds.
It can be performed in the office or your home. Many pet parents choose the home option as it is less stressful for their pet, and he can be surrounded by everything familiar and everyone he loves.
For those who for, whatever reason, disagree with euthanasia or prefer to let nature take its course, a natural death is what they will opt for.
You must have a brutally frank conversation with your vet about what “natural death” means. Don’t expect your dog to gently close his eyes and leave this world. That’s what happens as a result of euthanasia not nature.
Allowing your dog to die naturally usually means a lingering and painful death. Yes it can be managed with drugs, but is this really what you want your dog to endure?
You may be personally against euthanasia, but should your beliefs cause suffering to a living being that cannot speak for himself?
What to do if your dog dies at home
If your dog dies suddenly at home and you can’t get to your vet, you may have to keep your dog in your home until other arrangements can be made.
The best thing to do is wrap him up and put him in a fridge or freezer. If that’s not an option, putting him on a cement floor, unwrapped, will keep him cool. A last resort would be putting him in the coldest part of the house packed with bags of ice. To prevent your dog from getting wet wrap him in plastic.
Sorry I know how gruesome this sounds, but it’s better to be as prepared as possible should the unexpected happen.
Cremation is very common and you have the option of having your dog’s cremains returned to you by opting for a private cremation. Keep his ashes in a beautiful urn or scatter them in a favoured spot. The vet can make the arrangements for you.
I know many people who have buried their pets in the backyards but of course that would depend on local laws. An alternative would be burial in a pet cemetery, with a service as simple or elaborate as you want.
There is a small cemetery on the grounds of the shelter where I used to volunteer, and one day I saw a service that rivalled one for a human. How beautiful to see that human-animal bond.
Pet loss grief support
Time to take care of you. I know how emotionally exhausting this is so it’s important to grieve. Anything seems preferable to having to “go through the process” but it’s the only healthy way to deal with such a loss. Grieve, cry, lay in bed but don’t let the grief consume you. Create a memorial, light a candle, share your stories and know you shared a beautiful and special bond.
What is hospice care for dogs – conclusion
While it can be an option for terminally ill dogs, it is not for everyone. It also does not mean euthanasia won’t be necessary.
Whatever decision you ultimately make, I hope this post on what is hospice care for dogs, will help you make the right choice for the welfare of your dog.
Have you ever provided hospice care for your dog? What did that entail? Would you do it again? Share your experiences in the comment section below or my Facebook page.