As I prepare for my third year at IAAHPC, the veterinary hospice conference, I’ve taken pause to reflect on this journey and how it affects the way I view veterinary medicine. Personally, I have only euthanized a personal pet in a clinic (versus at home) one time.
It was Nuke, my vet school coonhound, and he was diagnosed with hemangiosarcoma just a month after I graduated and came back home. The veterinarian was lovely and did as great a job as one can do in that situation, but so many memories still stick in my head:
-They asked me to come in at the end of the day, ostensibly to make it easier for me. It meant I had to wait all day and then sit, sobbing, in rush hour traffic. It wasn’t what I preferred, but I was too tired and sad to realize I should have asked for what I needed.
-They took him in the back to place a catheter. I get it, I did the same thing throughout my entire clinic career. It’s definitely easier for the staff. I would have preferred to be with him the whole time. After doing it by myself in people’s homes with no backup- yes, it is perfectly possible.
-After I left, they took his body and placed it in a black garbage bag in the freezer until the aftercare place arrives on their weekly rounds. I know, because we all do this. Every clinic I have worked at does it this way. It is just the way it is done.
But does it have to be?
I know that the answer is no. I know that there are options out there that so many people want, so many ways we can better respect the dignity of our patients and clients before and after death, and we owe it to you all to let you know they are possible. Veterinarians have many reasons for not offering them, and they are not invalid concerns:
- They are more expensive
- They take more time to organize
- Most people do not want them
While many if not most clients are fine with the process the way it is, it hurts me to no end to know that so many people are still unaware of the myriad additional options out there to help your pet at end of life and to ease your pain as a family through the process. You may have to advocate for yourself, prepare, and find these options on your own- trust me, after having to advocate for my mother to get into hospice when it wasn’t offered as an option, this is kind of a universal problem.
To that end, I’d like to share with you my End of Life Bill of Rights- the things that you as an owner have a right to ask for and, after having worked with so many like minded colleagues now for several years- I can tell you that someone out there is equipped to provide you with:
The Right to Refuse Treatment. If your pet is suffering from a terminal disease, you have the right to say no to chemo, or surgery, or radiation. I believe in my heart that most veterinarians out there support clients in that, but there seems to be a lost-in-translation moment where so many owners feel pressured into heroic measures they were not prepared to take, emotionally or financially. This does not mean I am advocating to neglect an ill pet in suffering- quite the contrary, I am advocating for aggressive and patient focused comfort care.
The Right to Pursue Treatment. On the flip side, if you want to take your pet to the best of the best and do everything in the book possible to change things, it’s your call, not ours. We can offer you guidance and advice, but our job is to help you make an informed decision about realistic outcomes.
The Right to Have Your Family Involved. Unfortunately, some veterinarians still actively discourage families from having children present during euthanasia in the clinic. The emotion makes them uncomfortable and is disruptive. It is a clinic-focused way of thinking that is not focused on family needs. This is a once in a lifetime transition, and you need to do what you need to do. Many clients do not want their children present, which is fine- especially for kids under 5 who don’t understand what is happening- but it should be your choice. What your children see and hear- or don’t see- will live with them forever. If you don’t know how to approach the conversation- there are many, many professionals who do, and they have excellent resources to help.
The Right to Impeccably Respectful Aftercare. Most people don’t want to know what we do with a pet’s body afterwards. If they ask, I would tell them, and assure them we are as respectful as we can be. I believe in transparency. Nonetheless it is a disturbing image to many, myself included. If we can’t be honest without feeling like there’s a need to cushion the blow, why not change it? Especially when it’s such an easy thing to do?
More recently I have worked with a local business that doesn’t use bags or hold pets onsite; pets are wrapped in a clean white sheet and transported directly to the crematory facility, with the family knowing that the position their pet was last placed in is how they will remain. Yes, it costs more. And yes, many people are happy to pay it for that peace of mind. Some clients of mine transport their pet directly to an aftercare facility themselves, or have a trusted friend do it, because that chain of custody is important to them. These are all valid options.
The Right to Die at Home. The first time I went to a hospice conference, it changed everything for me. We can do so much better by our clients. In-home hospice and euthanasia veterinarians are changing the landscape of the profession, and providers exist all over the world. We are trained to offer not only medical support, but we are able to direct your family to the compassionate emotional support you may need, through chaplains, grief counselors, and support groups. We can offer palliative care options when medical treatment is discontinued- as in humans, we have a wide array of comfort care support that goes far beyond a pain pill here and there that can ease the discomfort of end of life.
And when the time comes, you will be at home, in a safe place, with those around you that you need. I bring blankets, candles, music- things that might not be practical in a busy clinic but, in a time of grief, provide small but vital bits of calm through all the senses. For those who experience euthanasia in a clinic, you also have the right to take the time you need, to make the environment what you need it to be for you. It matters. Your bond matters, too.
With love, Dr. V
This is most awesome. It even upsets me when I’m in the vet’s office and I see the guys carrying out the trash bags, but I own that. It does, however, break my heart to think of Bailey in a garbage bag in a freezer over the 4th of July weekend.
I also had decided against radiation for her, given that she had a mast cell tumor at base of her tail, just above her anus. Her surgeon was completely supportive.
I think it’s a function of the way we get used to things that I’ve been doing this for years and years and it still bugs me, yet it took this long for me to say, I’m going to not do that now. Sometimes it’s the smallest things that make the biggest differences.
This is so important. We had two dogs and when our boy Teddy was terminally ill our vet who happens to be a big animal vet accustom to house calls told me to call her when I felt it was time. She explained it would really help our other dog in the grieving process if she was there when he died and could smell him after. That dogs understand death and the grief period would be shorter than if he just disappeared. When it was more than clear we were at the end I made the call and our vet and a vet tech were here within the hour. They were loving and kind and it was very peaceful. After a while when they didn’t leave i realized they were watching me, making sure I was OK. I just can’t tell you how much that meant to me.
I really do think our country vets have a more inclusive approach because the animal owners on a farm do so much of the follow up care and hands on help during exams.
The death of a pet involves the whole family (people and all pets) and being thoughtful of everyone is key.
Lisa G in TN
It’s odd, I never thought it mattered one way or the other until I started doing in-home euthanasias. It does matter. The other pets absolutely understand, and handle it with such grace.
I made the extraordinarily difficult decision to euthanize my cat about two months ago. It wasn’t a black and white illness, there were some shades of grey, and in the end I made the heartbreaking decision to refuse treatment. There were buckets upon buckets of uncertain, guilty, sad tears. That said, I am so grateful to you and your site for making me aware of the option for home euthanasia. LouLou HATED the vet, and she hated the car. I did not want her last hours to be lived in fear. Your advocacy enabled a feisty, sweet little soul to leave this world peacefully from the comfort of her favorite place, my lap, instead of from a cold table, scared, in a place that she hated. My credit card is still reeling, but all that cat ever wanted was to be near me, or preferably, on me. I owed her peace in the end, a thousand times over. Thank you for what you do, and thank you for making your readers aware of options.
I’m so sorry about LouLou Laura. I feel so blessed that in some small way I helped make a horrible time a tiny bit easier by sharing what is possible. Thank you for sharing, it’s comments like these that keep me going <3!
Becoming involved in pug rescue and doing a lot of hospice work for the organization I help I can tell you that I have helped more than one of my friends over the bridge. The one that hurt the most was Gizmo. He was my soulmutt. The poor thing was murdered by Waggin Train chicken jerkey tenders. I thought I was giving him a treat. I loved this bill of rights article because it points out how many more rights our companion animals have than our nation’s elderly. I also work in a nursing home. I truly wish I could come work in your office Dr. V. If nothing more than for the assist with vet care. LOL. Seven pugs gets spendy.