Monday, December 2, 2013

Pet hospice: Not so crazy after all

Eamon the cat snuggled up in his bed

In yesterday's New York Times, the authors covered the pet hospice industry under the somewhat silly headline: "All Dogs May Go to Heaven. These Days, Some Go to Hospice." Predictably, the author compared hospice to other pet expenditures the petless might consider frivolous, including clothing and therapy. I was prepared for that.

But what I wasn't prepared for was the implication that pet hospice was somehow a new idea that is just now catching on. You see, I think most dedicated pet owners are quite familiar with the idea of hospice, and most of us have been dealing with the difficulties of caring for aging pets for years.

The basic idea behind hospice is that the patient isn't expected to improve and live a long and healthy life. Instead, everyone involved knows where this journey will end, and all work hard to ensure that the path is smooth. Medications play a role, but gentle understanding and reasonable expectations are also part of the hospice package.

Eamon, my old guy, has been in what I might consider hospice for well over 3 years. I've chosen not to perform advanced diagnostics on his back problem, as I'm not sure a cat in double digits should go through an orthopedic surgery. Instead, I manage his pain with prednisone and heat, and I'm quick to bump up the application of either if he's painful. (See more about that here and here and here.)

When Eamon goes to the vet, he gets no vaccinations. We don't discuss the years of life he might have left. Instead, we discuss his pain and his comfort. We discuss his appetite and his mood. We keep him comfortable.

I'd bet that pet owners all across the country have these conversations with their medical professionals on a yearly basis. They may not call these visits "hospice visits," but they're discussing pain control and comfort. They're easing the path from life to death, and I'd call that hospice.

Some of the pet owners interviewed in the NYT piece, however, seemed to need just a bit of an extra push. They didn't know if they were making the right decisions for their pets, and they were worried about what would happen in a pet's final moments. These owners seemed to want to cede control, and the companies that were willing to offer supervision called themselves hospice providers.

This is a little new to me, but I must say that I find the concept refreshing. It's difficult to know when you're doing the right thing for aging or ill pets, and I know many pet owners torture themselves when death is near about they could be doing or what they should have done. If hiring a hospice provider allows them to prevent guilty feelings from forming, I'm all for it.

I would say, however, that owners might need to consider this option a little sooner. Calling in hospice 24 hours before a death might not help as much as working with a provider in the last year or two of a pet's life. That's the kind of care that really eases the path, and whether it's called hospice or routine care, it's not frivolous. It's a necessity.

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