\u201cAt the end, the vet came and put Ivan to sleep in my backyard under the apple tree,\u201d Emily Rhoads recalls, describing the death of her beloved dog, Ivan.<\/p>\n
Over the six months leading to his death, Ivan experienced a slow decline, but one in which Rhoads felt like she was in control. She was empowered to make decisions that would best serve her canine companion.<\/p>\n
Every time we bring an animal into our lives, we unwittingly also introduce a shadow: death. Death will trail in the footsteps of a beloved pet until, eventually, it catches up.<\/p>\n
Many of us try not to think about this. We insist we\u2019ll have many happy years together, that our pets will outlive the average, and when the end comes, it\u2019ll be gentle, quiet, and natural.<\/p>\n
\u201cThey\u2019ll just go to sleep and not wake up,\u201d we tell ourselves.<\/p>\n
What does a \u201cgood death\u201d look like for the animals in your life? How do you want to remember their final weeks, days, and hours?<\/p>\n
The thought of an elderly dog curling up peacefully next to the fire is a powerful one. But unfortunately, that\u2019s usually not how death happens for pets. It may be preceded by a sudden traumatic accident, or the rapid onset of a serious illness, or months of struggling with cancer or another terminal disease.<\/p>\n
And it often comes not independently, but with assistance.<\/p>\n
Sitting down to think about the kind of death you want to have is important. The same holds true for your pets. It\u2019s a conversation Dr. Lynn Hendrix, a mobile hospice and palliative care veterinarian, says we don\u2019t have often enough.<\/p>\n
In some senses, vets are failing their clients due to gaps in their own training, she says. She came to animal hospice from a veterinary emergency room background, and it informed her practice. \u201cYou do see a lot of end-of-life clients in the ER,\u201d she says.<\/p>\n
What does a \u201cgood death\u201d look like for the animals in your life? How do you want to remember their final weeks, days, and hours?<\/p>\n
Maybe it looks like this: taking the cat who\u2019s lived with you since college to the park to spend a day outside and then returning home, where a veterinarian will administer euthanasia and you can bury him under the lilacs.<\/p>\n
Or perhaps it\u2019s going to a veterinary clinic at the end of the day, where you can spend as much time as you like before leaving. The veterinarian will handle the remains, calling you to pick up the ashes in a few days or weeks.<\/p>\n
Or it\u2019s a swift, compassionate decision made for a dog with severe injuries after being struck by a car.<\/p>\n
But the question of what a \u201cgood death\u201d looks like starts well before the last breath.<\/p>\n
Medical interventions mean that we can often see death coming well in advance, and we must make decisions not only about what death will look like, but how the last few months of living will be experienced. Historically, these decisions have been treated like a duality: You try everything, or you do nothing.<\/p>\n
There is, however, a third way: Veterinary hospice and palliative care allows your animal to receive interventions that help defray pain, treat infections, and manage other aspects of end-of-life care.<\/p>\n
The goal of hospice isn\u2019t to \u201cgive up.\u201d It\u2019s to allow an animal to transition gently, spending their remaining time as comfortably as possible: no extreme interventions, no radical treatments, no lingering hopes for a cure. And while the natural termination of hospice is often an assisted death when your pet\u2019s quality of life has declined to an untenable point, the nature of that assistance can also take on a spectrum.<\/p>\n
<\/p>\n
Knowing and thinking about your options ahead of time can empower you to make a choice that feels right for your family.<\/p>\n
\u201cThese are the most challenging conversations for vets,\u201d says Dr. Jane Shaw, a veterinarian who researches communication between veterinarians and clients at Colorado State University.<\/p>\n
No one wants to deliver a terrible diagnosis or bring up end-of-life care. But opening the conversation creates space for talking about worries, fears, and what comes next.<\/p>\n
\u201cWe want people to reach out to us as early as possible so we can help prepare them,\u201d says Dr. Jessica Vogelsang, a mobile hospice and palliative care veterinarian who also provides consulting.<\/p>\n
Some general practice veterinarians, especially in areas where there are no specialists, may offer hospice. Others may refer their clients to a colleague. Palliation \u2014 a reduction in pain and suffering \u2014 can be a part of hospice care or curative treatment.<\/p>\n
Hospice care, which focuses on providing support and comfort to dying pets and their families, is available in clinic and home settings, although the costs of at-home care can be higher. Hendrix says she keeps around 100 clients on her roster at any given time, though only three to five may be near death.<\/p>\n
It\u2019s important to think about what you can take on \u2014 and how much your pet can take on.<\/p>\n
If home care isn\u2019t available or is unaffordable, your veterinarian can work with you on reducing the number of office visits to limit pain and stress. Those visits can also be timed to suit your needs. Perhaps you want to be the first or last appointment of the day, when the clinic is relatively quiet.<\/p>\n
Medication to manage pain can be one element of palliative care. Your pet might also receive antibiotics for infections, fluids to address dehydration or stressed kidneys, and medications to address specific symptoms.<\/p>\n
The goal is to keep your animal comfortable. At times, that can involve aggressive treatment, says Vogelsang.<\/p>\n
Your veterinarian may also counsel you on quality of life and developing options for assessing your animal\u2019s health and comfort. Hospice and palliative care can be stressful for humans, not just pets. Some people find it helpful to work with a therapist who specializes in grief counseling.<\/p>\n
Your pet\u2019s quality of life is unique, and you\u2019re the person best suited to determine whether your animal is finding joy in life. Some things to think about can include:<\/p>\n
Rhoads recommends \u201cday rating.\u201d Keep a journal of how your pet is doing day by day so you can get a look at the big picture.<\/p>\n
Some pet guardians say they want a \u201cnatural death,\u201d rather than euthanasia. But Hendrix notes that \u201cnatural death\u201d is a loaded phrase.<\/p>\n
Vogelsang also warns that the natural progression of terminal illness can be grueling for animals and people. Animals may experience incontinence, seizures, and other symptoms that require constant monitoring and care. This may include moistening the eyes of pets who aren\u2019t producing enough tears on their own, cleaning and bathing pets with continence issues, and administering a pharmacopeia of medications.<\/p>\n
\u201cThe types of people who go into this field, no pet will ever die alone,\u201d says Vogelsang.<\/p>\n
It\u2019s important to think about what you can take on \u2014 and how much your pet can take on. Hendrix adds that it\u2019s always possible to reassess in cases where end-of-life care isn\u2019t meeting a pet\u2019s needs.<\/p>\n
\u201cA good death (in my opinion) is me holding them, telling them how much we love them, petting them, and them not being in pain, afraid, or alone,\u201d says pet guardian Victoria Howard, who\u2019s shared her life with a colorful assortment of animals.<\/p>\n
Research on feelings about end-of-life care found that many pet guardians regretted euthanasia. Some cited feeling like \u201cmurderers.\u201d<\/p>\n
That response is natural, says veterinary anesthesiologist and pain specialist Alicia Karas, who says tragedy and loss are often accompanied by thoughts that, \u201cIf only you had done things differently, things would have turned out differently.\u201d For pet guardians, this can be mediated by regret about being unable to afford care.<\/p>\n
But, Karas says, there\u2019s another regret she hears from clients: the feeling that they waited too long and should\u2019ve acted sooner.<\/p>\n
\u201cI did too much\u201d is a sentiment that repeats itself in veterinary offices, with people seeking a balance for a challenging choice. \u201cThe patients that trouble me the most are not the ones that choose euthanasia too early. If you choose euthanasia too early, within limits, you start really grieving sooner, but you probably will prevent a lot of suffering. If you choose too late, the pet suffers.\u201d<\/p>\n
Sometimes animals respond unexpectedly to the sedative during euthanasia. It\u2019s not because the vet did anything wrong.<\/p>\n
Veterinarians welcome comments and questions from their clients and want you to be well-informed before euthanasia. They also welcome and respect any level of desired patient involvement.<\/p>\n
For some, that may mean staying in a room with a pet throughout preparation and the procedure. Other pet guardians prefer to step out during preparation, or for the entire euthanasia.<\/p>\n
\u201cThe types of people who go into this field, no pet will ever die alone,\u201d says Vogelsang.<\/p>\n
<\/p>\n
Early in Vogelsang\u2019s career, a man came alone to drop off a terminally ill kitten for euthanasia, declining to stay for the procedure. She was judgmental \u2014 until he told the clinic staff that his child had died of cancer, and the kitten was a gift to his wife.<\/p>\n
\u201cEmotionally, they could not handle that again,\u201d she says. This experience informed her attitude. Vets like Karas share this sentiment of not judging clients for the decisions they make.<\/p>\n
The exact process of euthanasia can vary depending on a vet\u2019s training, experience, and preferences \u2014 and the pet\u2019s species. Some veterinarians may place an intravenous catheter in your pet\u2019s leg first to ensure that they\u2019re able to access the vein. Euthanasia often involves an initial sedative injection, which may render an animal unconscious, before injecting the euthanasia solution, a barbiturate that will cause respiratory arrest.<\/p>\n
Vets aim for a fast, quiet, calm experience. \u201cIt\u2019s a ceremony,\u201d Karas says. \u201cYou don\u2019t get a do-over.\u201d Veterinarians take it seriously, whether they\u2019re emergency vets seeing your pet for the first time or family veterinarians who\u2019ve known your pet for years.<\/p>\n
The ideal experience doesn\u2019t always happen.<\/p>\n
Karas ruefully relates the story of a colleague\u2019s cat who vomited after receiving the sedative. Sometimes animals respond unexpectedly to the sedative, and it\u2019s not because the vet did anything wrong. Others may have a higher tolerance for the barbiturate than expected, sometimes because of pain medications used in the final days of life, in which case a second injection may be required.<\/p>\n
Vogelsang tries to be prepared for whatever comes, acknowledging that as a traveling hospice vet, she sometimes encounters situations she couldn\u2019t possibly have been ready for. But she can stay calm and reassuring.<\/p>\n
After the veterinarian has listened to your pet\u2019s heart and lungs to confirm that the procedure was successful, most clinics allow pet guardians to stay as long as they like. Guardians may take the remains with them or leave them at the vet for final arrangements.<\/p>\n
In the case of home euthanasia care, the vet can leave after the procedure and may take the remains by prior arrangement. Sara, who lost a beloved cat in 2017, found the experience of at-home euthanasia very valuable. \u201cWe each held her and got to see that she was really gone, that this was really happening and it was really over,\u201d she recalls.<\/p>\n
<\/p>\n
Alongside euthanasia or other paths to death comes another pressing decision: disposition, or what to do with the remains. If conversations about euthanasia are challenging, discussions about what to do with the body can be even more fraught. There\u2019s something deeply uncomfortable about discussing how you want to memorialize your pet when she\u2019s sitting on the couch next to you.<\/p>\n
Depending on where you live, you may be able to bury your pets at home if you prefer that option. Most veterinarians also offer cremation, typically through a third party. Some vets may be able to connect you with a pet cemetery if you prefer burial.<\/p>\n
For those who aren\u2019t interested in taking the remains home, receiving ashes, or having a formal burial, clinics can also handle disposition independently. There\u2019s a plethora of firms offering urns, grave markers, and other memorial products.<\/p>\n
You can also work with artisans and artists on memorials that are more personal, like jewelry or sculptures. Jeweler Angela Kirkpatrick of Wisp Adornments, for example, makes Victorian-style memorial jewelry that can include fur, ashes, and other mementos.<\/p>\n
Howard requests cremation for her animals and keeps the ashes at home. \u201cThere\u2019s also a soft sculpture artist in Canada, who does memorial sculptures\/stuffed toys of your \u2018ghost kitty.\u2019 You tell her about the cat, send photos, hair, cremains if you want, and she puts those behind photos of the cat. They are really wonderful! And comforting. The ghost kitty arrives in black tulle netting, tied with black ribbons. This gal is so kind about the loss,\u201d Howard says.<\/p>\n
In any case, if you want a clipping of hair, a paw print, or another memorial item, be sure to request it.<\/p>\n
If you have concerns about what happens to the body even if you don\u2019t want to take charge of the process, you should ask. Some clinics work with pet cemeteries that perform mass cremations and scatterings or have mass graves. Staff at these facilities try to be respectful and thoughtful. Other clinics may have contracts with companies that are less respectful, delivering remains to landfills, rendering facilities, and other sites.<\/p>\n
In any case, if you want a clipping of hair, a paw print, or another memorial item, be sure to request it. The clinic staff can help you or give you supplies and let you collect your own memento. Some clinics may make paw-print markers for all their clients. If that\u2019s a service you don\u2019t want, it\u2019s OK to say no!<\/p>\n
Some people find it helpful to perform memorials or funerals, maintain altars at home, or commemorate losses in other ways. If you\u2019re not interested in a memorial in the immediate aftermath of a death, you can always hold one later for those interested in celebrating your pet\u2019s life. This may include children who want an opportunity to process the death with members of the family.<\/p>\n
Grief, sometimes very intense grief, is also a natural part of the end-of-life process. It may be compounded by other recent losses, too. There\u2019s no \u201cnormal\u201d or \u201ctypical\u201d course of grief, but you may find it helpful to work with a counselor.<\/p>\n
Similarly, for children, having someone to talk to can help them sort out their feelings about the end-of-life process, regardless of their level of involvement.<\/p>\n
\u201cIt\u2019s hard to plan for end of life for him, but I know some hard limits for me,\u201d says author Katherine Locke of her beloved senior cat. She didn\u2019t arrive at those limits easily, but experience with previous cats has made her acutely aware of the necessity to have difficult conversations in advance.<\/p>\n
\u201cWhen I had to switch vets after moving, I talked to the new vet about my lines for all my cats (no cancer treatment, probably no obstruction surgery, no PU [perineal urethrostomy] surgery),\u201d Locke says. \u201cAnd when she said she thought they were reasonable, I knew that we\u2019d be a good fit.\u201d<\/p>\n
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