Pet hospice: Bridging the last stages of terminal illness and euthanasia
Pet hospice is an emerging concept in veterinary medicine. It is being adapted for pets by pioneering veterinarians who are called to fill the void between an animal's terminal illness and eventual euthanasia.
By 2009, fueled by Medicare-funding, there were approximately 5,000 hospice programs in the United States and an estimated one-third of dying people were enrolled in hospice care.Pet hospice, on the other hand, is currently a little known and little understood option, even within the veterinary profession. This month, four veterinarians tell their stories. All are determined to find ways to deliver this last option to pet owners who are looking for ways to extend the quality and length of their pets' lives before the final good-bye.
Cody, a yellow Labrador Retriever treated by Dr. Alice Villalobos, offers a good example of when and how a pet can benefit from hospice. Cody's crippling arthritis had finally progressed to the point that there was little more that could be done. Too often in situations like Cody's, pet owners are urged to consider euthanasia to spare their pets pain and suffering. Villalobos' oncology training and cancer-care background helped her see another option. Instead of euthanasia, she felt confident offering Cody's owners "pawspice care" (a name she uses to describe hospice care for pets).
"Cody had this wonderful spirit," she explains. "He loved his walks and the red wagon. Excellent pain management provided a way for him to enjoy them with his family, despite his crippled condition. He was a perfect candidate for pawspice."
In addition to working closely with Cody's family to adjust his medications as his condition changed, Villalobos asked them to assess Cody's quality of life through a scale she developed for the Veterinary Clinics of North America (Table 10.1 in the chapter titled "Palliative Care: End of Life 'Pawspice' Care"). The scale, she says, was created to help a pet owner monitor his or her pet and decide the right time to make the difficult decision of euthanasia. She hopes it will give veterinarians a tool to talk about end-of-life options with their clients.
Villalobos, a 1972 DVM graduate of the University of California-Davis, is considered a pioneer in the field of animal oncology and hospice care for pets. She currently conducts two-day clinics, one in Hermosa Beach and one in Woodland Hills for pets in Southern California. She also provides consultations out of her home office to offer cancer and hospice services to veterinarians and clients around the United States. Caring for her pet cancer patients through their last days helped her see the need for end-of-life care, especially when all medical options were exhausted. From her perspective, the issue is very simple: Veterinarians have an ethical obligation to communicate honestly with clients who have pets with terminal illnesses, and they should offer palliative, hospice care when they run out of other treatment options.
Veterinarians can do this work themselves, or they can refer cases, like Cody, if they cannot make the time commitment that pawspice requires. Keep in mind that pet owners and their pets require time and attention to help make the necessary psychological and physical accommodations necessary. This can require a lot of hand holding and medical adjustments as a pet's condition changes, she says.
However, Villalobos is one of a growing number of veterinarians across the country who offer pawspice as a referral service to veterinary practices and directly to clients who want pet hospice care. Villalobos says she was blessed early on to find a highly trained, registered veterinary technician (RVT), Carreen Lynch to work with in her practice. Lynch was just as passionate as she was about wanting to help patients and clients battle pet cancer. And she wanted to find ways to help clients during the highly emotional journey that follows the end of life. Together Villalobos, Lynch and veterinary team members built and refined the pawspice service she offers today. The members of her pawspice staff are compassionate with the patients and family members, and they provide home-care visits as needed and they honor the human-animal bond at the end of life.