How Can Senior Patients and Palliative Care Patients Benefit From being Examined and Managed In Their Homes?

• ​Dogs and cats feel more comfortable and relaxed in the comfort of their home surrounded by the things and people that are most familiar to them.  Veterinary clinics can have a lot of strange noises and smells that can induce fear.  Many patients do not see us as being any different than another visitor you may have to your home.

• Many patients may feel anxious and or nauseous in the car​

• Palliative care patients or seniors may have aches and pains that may make travelling in the vehicle uncomfortable.

• Large breed dogs with mobility concerns or arthritis may be difficult or impossible to transport.

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What is Palliative Care?

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• The International Association of Animal Hospice and Palliative Care defines palliative care as “the total care of patients with a life-limiting illness that is not responsive to curative treatment.

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Examples of palliative medical interventions that can help pets with life- limiting symptoms include:

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• Antibiotics for chronic skin, dental or urinary tract infections.

• Anti-anxiety medications for psychological distress associated with limited mobility, nighttime pacing or signs of cognitive dysfunction.

• Pain medications for relief of discomfort and pain.

• Skilled use of narcotic and non-narcotic medications for adequate pain relief. 

• Physical-medical modalities such as heat, massage, physical therapy to improve mobility, comfort and muscle tone.

• Appetite stimulants to improve food intake and improve overall well-being. 

• Fluid therapy for patient's with renal disease or dehydration

• Medications to relieve nausea, or other symptoms limiting quality of life.

• The use of mobility aids 

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What Is Hospice Care?

Hospice exists to provide support and care for patients in the last phases of incurable disease, or at the natural end of life. Hospice care provides palliative care to allow the pet to live out their lives as fully, and as comfortably as possible until the decision to euthanize is made. 

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 Through appropriate care and the promotion of a caring community sensitive to their needs, patients and their families may be free to attain a degree of mental and spiritual preparation for death that is satisfactory to them.  In most human hospice organizations, services are limited to patients who have decided not to undergo any further curative treatments, and have a limited life prognosis of 6 months or less.

Hospice Care for animals has been described as "management of palliative care patients who have progressed such that death will likely occur within a period of days to weeks"; however, the distinction between hospice and palliative care for animals has not yet been sharply defined.  Hospice care may be an alternative to immediate euthanasia, when you feel you or your pet are not yet ready to say goodbye.  Hospice care does not prolong nor hasten death. Hospice care focuses on the physical and emotional needs of both you and your pet.

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What kind of diseases or conditions would warrant hospice and/or palliative care?

A hospice or palliative care approach is commonly chosen in animals with:

• Cancer

• Organ failure [kidneys, liver and heart are common examples]

• Arthritis or other diseases affecting mobility

• Cognitive dysfunction (dementia)

• General "slowing down" or chronic conditions that are worsening

• Failure to thrive

•  Any life-limiting condition that is contributing to an excessive burden of caregiving for a family, or treatments/interventions that are unacceptable to the pet

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How do I know if hospice care is the right decision for me and my pet?

Many pet parents choose hospice care in order to have the time to say goodbye to their companions, to plan for their death, and to ensure that all the decisions about the pet's needs are guided by their personal view of the pet's needs. If you have the resources to support comfort care, the time and desire to care for your pet during the last days, weeks, sometimes months of their life, and a good support team in place, then hospice care may be the right choice for you and your pet.

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Should my child/children be apart of this process?

Children learn responsibility and love in caring for their family pet. Similarly, aging, illness, and death provide rich lessons about the cycle of life. Just as with their adult caretakers, children can be taught techniques to remain involved with their animal friend’s care so they might feel important and even inspired by this tender and memorable time. Depending upon your child’s temperament and your careful preparation, consider allowing them to be present at the time of euthanasia. If you would like another opinion about how to assist in their coping and grief work, a child therapist could be considered.

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What should I expect at the euthanasia appointment?

It is often helpful for owners’ peace of mind to know what to expect when Dr. Coulter comes to their home to perform a euthanasia.  Prior to the appointment, a medical history will be obtained and questions regarding the euthanasia process will be discussed.  If you have any special requests for the appointment please share during this conversation.  Upon arrival at the home a veterinary technician will review the paperwork and request that the owner sign the consent forms for the procedure .  She will also review aftercare options and accept payment. Payment for services is taken before the euthanasia process begins so those present may focus on saying goodbye to their beloved companion.  You can choose to complete the paperwork and payment in advance of the appointment.

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Depending on the patient we may choose to give a little sedation. The sedative is given with a small needle just under the skin and this will help to put your pet at ease and also provide pain relief.  Once the patient is well sedated, an IV catheter is placed in the front or hind leg for administration of the final injections.  After family have had the opportunity to say goodbye, a second drug called propofol is given to induce deep sedation, followed by the euthanasia drug.   This drug acts rapidly stop brain, heart and respiratory activity.  The pet is unaware of what is happening and   will pass peacefully without any pain, or discomfort.  

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It is very rare, however some pets may exhibit some mild muscle twitching or tremors and may even take a deep breath after they have passed on.  These are reflexes and should not be misinterpreted as a sign that the pet is still alive.  Contrary to what most people believe, a pet’s eyes do not close when they die.  In addition, as their muscles relax, it is not uncommon for the pet to release their bladder and bowels.  In anticipation of this, an absorbent pad will be placed under the animal prior to administering the final injection. 

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After the pet has peacefully passed on, those present may spend as much or as little time as desired with their pet.  Depending on your aftercare request the pet's body will either remain with the owner (i.e. if you have chosen burial) or Heart With Wings--Coulter Mobile Veterinary Services will arrange to have the pet's body transported to 'Pets Above' for either private or communal cremation.  You can visit 'Pets Above' for more information.

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