Wondering if dog hospice is the right choice for your sweet pup? Integrative veterinarian, Dr. Julie Buzby, invites her friend and pet end-of-life care expert, Dr. Dawnetta Woodruff, to the blog to discuss this difficult but important topic. Over the years, Dr. Woodruff has had the honor of providing hospice care to countless dogs and their families, making her the perfect person to talk about hospice care for dogs.
You may have heard of hospice care for dogs. But how well do you understand it? In simple terms, hospice is a way of caring for our dogs that focuses on palliative care or “comfort care.” A dog’s family may choose hospice care when the vet has diagnosed their dog with a terminal illness. Or perhaps when their pup is in a lot of pain, and the cause of the pain can’t be fixed.
When our young and otherwise healthy dogs get sick, we focus on curing their diseases and extending their lives. But at some point in every dog’s life, our focus shifts from the “diagnose, treat, and cure” mindset, to a “quality-of-life” mindset.
Now the family and the veterinary team are making a conscious choice to prioritize comfort above longevity. For some dogs, this may happen after an aggressive bone cancer diagnosis at the age of four. For other dogs, this may happen at the age of 17 when his or her whole body has grown weak, frail, and painful.
No matter when your dog’s quality of life starts to decline, choosing palliative care may be scary and emotional. It is natural to want our beloved furry family members to be with us as long as possible. However, advanced disease can take away their good moments, and it is difficult to see our loved ones struggling with pain.
Which dogs might need hospice care?
Hospice care can be a good consideration when dogs are dealing with ongoing pain and struggles from disease or conditions such as:
- Advanced canine arthritis or other joint diseases that cause loss of mobility (torn ACL in dogs, hip dysplasia in dogs, etc.)
- Nerve pain secondary to spinal disease such as IVDD in dogs
- Osteosarcoma (bone cancer)
- Transitional cell carcinoma (bladder cancer)
- Hemangiosarcoma in dogs (blood vessel cancer that may cause splenic masses in dogs, liver tumors, or heart tumors)
- Degenerative myelopathy in dogs
- Liver failure
- Kidney failure
- Seizures in dogs
- Brain tumors
- Lymphoma in dogs
- Squamous cell carcinoma (tumors in the mouth or other locations)
- Dementia in dogs (otherwise known as canine cognitive dysfunction, which is similar to Alzheimer’s in people)
Processing your dog’s diagnosis
So what happens when your dog is diagnosed with a terminal condition? You may feel alone, scared, and angry. These feelings are normal, and there are many other dog parents who understand what you are going through. It might be helpful to reach out to an online community for support. You could also consider seeking out local resources (such as counselors and pet loss support groups) to help you during this difficult time.
Also, you can research what to expect as your dog’s disease progresses. The veterinarian who made the diagnosis probably went over this with you, but you may still have questions. It is a good idea to schedule a follow-up exam (or a telehealth visit) with your vet to go over your concerns. Ask your dog’s doctor for a handout about the new diagnosis, or for links to a trusted website. As a word of caution, there is a lot of information on the internet, but it isn’t all reliable. When in doubt, always refer back to your vet.
When might a dog enter hospice care?
Your vet may also recommend a consultation with a specialist such as an oncologist or a cardiologist. Together, your dog’s veterinary team can help you make a decision. Do you want to pursue advanced surgical and medical treatments? Or is it time to consider hospice care?
When a dog’s future includes a lot of pain, struggles, and even suffering, we want to do everything possible to make it better. Sometimes, that means scheduling surgery or pursuing chemotherapy. And sometimes that means allowing him or her to enjoy a few good weeks instead of enduring a few very difficult months.
There is no shame or guilt in choosing hospice. You are not giving up on your dog or choosing for him or her to move closer to death. As much as we would like to, we cannot stop death from happening. We do not have control over when our dog gets a terminal diagnosis. However, we can have a measure of control over the quality of life he or she has in the final days and weeks.
How do I find a hospice veterinarian?
Your regular vet may be able to act as the hospice veterinarian for your dog. Alternatively, you may wish to begin a relationship with a new vet who focuses on hospice and palliative care. The International Association for Animal Hospice and Palliative Care maintains a searchable database of veterinary hospice providers. This can be a great way to find a hospice veterinarian. Also, some hospice vets make house calls, so your dog can stay comfortable and relaxed at home for a veterinary examination.
What does hospice care for dogs look like?
During your dog’s hospice consultation, your vet will do an exam and ask you some questions. This will help him or her figure out if your dog may be dealing with pain or anxiety. Your vet will then make recommendations based on the exam and prescribe medications to control pain, anxiety, nausea, and other symptoms of your dog’s disease.
A hospice veterinarian is able to use a variety of medications (and different doses of common medications) to keep your dog as happy and comfortable as possible. Sometimes, by prioritizing comfort, hospice care can actually help your dog to live not only better but longer!
If the visit happens within your home, your vet will also evaluate your dog’s environment. Then he or she can provide suggestions to make daily life easier. The hospice vet will also discuss your concerns and fears. This can help you prepare the rest of your family (human and animal) for the end of your dog’s life.
Managing a dog’s symptoms at the end of life often means he or she is likely receiving many medications. Pain control often needs to be “multimodal.” This means that you will give several medications that work together in different ways to achieve maximum pain relief. At times, this can be confusing and overwhelming. Each medication has a specific goal for your dog—so if you’re not sure why your dog is taking a certain medication, ask your vet! They will be glad to explain.
It can be helpful to keep a list of what each medication does, as well as a chart documenting when your dog receives each medication. Mark each dose off after it has been given. This keeps everyone in your household on the same page. It also ensures your dog doesn’t miss a dose of medication or receive the same dose twice!
Some dogs take pills well, and giving comfort medications is relatively easy. But other dogs won’t take pills! You can try wrapping the medication in cheese. Cream cheese and Velveeta cheese work well since they are soft. (As an aside, avoid routinely giving healthy pets these foods due to the risk of pancreatitis in dogs.) Some pills can be crushed and mixed with a bit of yogurt, applesauce, or meat-puree baby foods that do not contain onion or garlic. (But be sure to ask your vet if it is ok to crush your dog’s pills. For some medications, it is important that they stay whole.)
Whether your dog is a good pill taker or a challenge, at some point, many dogs get tired of taking a lot of medications. When this happens, you may wish to have your dog’s medications compounded into a flavored liquid.
Sometimes you get to the point where nothing works and medication time has become stressful. If this is breaking the bond that you have with your beloved canine, it may be time to consider end-of-life care. Sometimes refusing food or medications is your dog’s way of telling you that he or she is tired, and done fighting.
How can you prepare for your dog’s passing?
Quality-of-life is very important but so is quality-of-death. Hospice care allows you to prepare for the “worst case scenario” while making a plan to prevent that scenario from happening. Your goal is to provide your dog with the very best and most peaceful passing he or she can have.
For many families, hospice care will end with euthanasia. They will choose to end their dog’s struggles with the help of medication that allows their dog to pass away in a deep, medicated sleep. However, other families may wish to consider a “natural (unassisted) death.” Your hospice veterinarian will talk through what to expect in each scenario. Then, he or she can help you decide what is best for you and your beloved dog.
Euthanasia is a word that actually means “good death.” When a veterinarian talks with you about euthanasia, his or her goal is to provide your dog with the least painful, most peaceful way to die. Making the decision to euthanize never feels “good” to our hearts. However, there is comfort and calmness in choosing to help your dog pass away peacefully. You know your dog is no longer struggling, and you were able to be with him or her during the final moments.
If your heart is aching over this decision, you may find solace by reading my additional articles on euthanasia and preparing for your dog’s passing:
- Preparing for Your Dog’s Euthanasia: 10 Thoughts for Peace
- In-Home Dog Euthanasia: Heartfelt Answers to 12 FAQs
- Grieving the Loss of a Dog After Euthanasia (& Finding Peace)
- Dog Euthanasia: Knowing When to Say Goodbye
- How Will You Know When It’s Time to Euthanize Your Dog? 5 Caring, Heartfelt Messages
Choosing to let your dog pass away on his or her own is something many people refer to as a “natural death.” But it would be more accurate to call it an “unassisted death.” When you think of a natural death, you may think of a dog peacefully closing his or her eyes and dying a few moments later. However, it often isn’t that fast and smooth.
Yes, there are times that an unassisted death can happen quickly. Unfortunately though, death is more often a long, drawn-out process. When a dog stops eating and drinking, it can take many days before he or she passes away on his or her own. During that time, you may or may not be able to give comfort medications. Many dying dogs are not alert enough to swallow near the end. If giving medication is not possible, your dog may experience varying levels of pain, confusion, and anxiety.
If you have chosen an unassisted death for your dog, it is best to talk with your hospice veterinarian about options to control pain during your dog’s final days of life. It may also benefit you to read Dr. Buzby’s blog that lists some signs your dog is dying so you will know what to expect.
Dog hospice care brings support and peace
Hospice care may sound intimidating, but it shouldn’t be. The goal is to make the end of your dog’s life as full of love and joy as the early years. Hospice care allows you to maintain the precious bond that you have with your dog through the final days. Choosing palliative care for your dog can give you peace of mind. It also means you don’t have to walk through that difficult journey alone. The hospice vet will be there with you, and your dog, every step of the way.
Did you decide to pursue hospice care for your dog?
Please comment below to share your experience.