What is Animal Hospice?

March 12, 2013 3 comments

Definition

Merriam-Webster(.com) defines hospice as, “a facility or program designed to provide a caring environment for meeting the physical and emotional needs of the terminally ill.”  The definition of animal hospice will often depend on who you ask and what they have to offer you.  To compare to animal hospice, break down the (human) definition into ints components:

16yo dog, Oscar

  • a facility or program
  • to provide a caring environment
  • meeting the physical and emotional needs
  • terminally ill

All of the above can be met when supporting our pets with animal hospice.

Facility or Program

Hospice is a philosophy and care plan more than a place.  While human hospice facilities exist for patients in hospice that are medically too fragile to stay home, may families utilize skilled nursing facilities with the added support of a hospice support team that come to the facility.  As of this writing, there are no known animal hospice facilities to board and provide 24/7 care.  There are veterinary clinics, including 24 hour clinics that support hospice services compliment the hospitalization.  Animal sanctuaries may also support animal hospice.  As these require the pet parent to give up their pet, it is not considered a hospice facility as a resource for care.

A caring environment

For humans, hospice often happens at home.  For an elder man, not recovering well after a heart attack, hospice is in the hospital.  For a woman in a care facility for her dementia, hospice is in the facility.  It is important to note that hospice can happen anywhere.  In this regard, the animals are no different.  In most cases, hospice for our pets will happen at home.  If a dog is hospitalized when his cancer creeps into his lungs, hospice can happen at the vet clinic.  When a cat is hit by a car and a veterinarian can get her comfortable until the kids get out of school to come say goodbye via in-home euthanasia, this is also animal hospice.

Meeting the physical and emotional needs

The physical and emotional needs of the animal being met is the activity that one might consider hospice on a logistical level.  This is also the part of the definition that defines a team.  At Animal RN, we believe that animal hospice starts first with pain management and identification.   Once pain is addressed, then we can get into details on the hospice plan and creating a team to help support the individual.  By utilizing a team, families are able to provide quality, loving care while saving money and assuring comfort.  The emotional needs component is a wonderful variable that changes from one family to the next.  What we know from work with humans and our experience is that joy is an important part of life.  As we age, what brings us joy shifts.  That joy is what makes the effort of hospice so worth it.  Its not about extending life, its about living.  As one woman described her experience with her dog in hospice, its not about adding time, its about the time being precious.

Terminally ill

The diagnosis or suspicion of a terminal illness is the difference between animal hospice and palliation.  Hospice means we have the diagnosis or a high likely-hood determined by a veterinarian.  To simplify, palliation is the application of the hospice philosophy without a confirmed terminal diagnosis or limited (6 month) prognosis.

For most people, the terminology doesn’t matter.  Call it what you want, so long as your taking outstanding care of the animal.  The terminology may play a bigger role in the future as pet insurance and more veterinarians get involved in animal hospice and palliation.

At Animal RN, our definition of animal hospice and how we support it everyday is so much deeper and more involved than the dissection of this one definition.  To find out more, subscribe to this blog or check out our website http://www.animalrn.com.

Hit the Slopes with the Dog

January 20, 2013 1 comment

Is your dog fit to join you on your weekend snow get away?

Beyond your dog’s personality and how much you know he’ll enjoy the snow, its important to consider their bodies.  Here are a few of the considerations to see if your pooch is ready for the trip.

dog, snowman on his head

  • Size: Small dogs have a more difficult time both maintaining body temperature and navigating even shallow snow depths.  If you have an emergency, can you carry home your large dog?  It may seem ridiculous now, its important to remember we wear our seat belts for the accidents, not the uneventful drive.
  • Coat: Thinner coats may need supplementing with a sweater and jacket.  Not all dogs are built to brave the extreme temperatures on this planet.  Even large breeds with undercoats may be cold in certain situations.  Its important to consider the situation for each outing.
  • Age: Just like us, the very old and the very young have a harder time in colder weather.   Keep the old and young home with the sitter this trip, they’ll thank you for it.  Their bodies are more fragile than their stronger adult dog friends, increasing the risk of trouble on your trip.
  • Pad condition: Some dogs have soft, supple paws while others are more tough and thick.  Using shoes (boots) can help a dog with soft pads endure the cold, wet and extra abrasive surfaces, if your dog will tolerate them.
  • Gear: Do you have the right gear?  Some basics are: water, leash, harness (not a collar,) and coats and boots as needed.  Additional items to explore are: a GPS collar attachment, Ruffwear’s Beacon light, and pocket first aid kit.

If you find yourself really getting out there and off the beaten path, consider taking avalanche training course and inquiring about additional tips for handling emergencies with dogs.  If the dogs are joining you for the trip, but not the trek, find a reputable local pet sitter or doggy day care.

Do you have a great tip for dogs in the snow?  Share them in the comments.

It’s a dirty job, but someones’s got to do it…sometimes

November 16, 2012 1 comment

Small dog owners everywhere, after enough years with their petite companions, learn about the dirty duty.  Occasionally big dog owners cross into this territory, although often not with the same frequency and familiarity of their smaller buddies. Its even more rare for a feline to need for the stinky relief.  Of course we’re talking anal glands!

Why does this happen all of a sudden?  In Dr. Nancy Kay’s blog on Anal Sac Disease  she mentions many potential contributors in the section referring to possible treatment and predisposing factors.  I believe there may be another connection.

Over and over, I have seen dogs that began their life seeing the groomer regularly.   After the grooming visits are discontinued or reduced, they develop a scooting and/or anal gland impaction issue.  This was especially apparent as the economy shifted and families were adjusting where they spent their income.  In the first few waves of our last recession, I noticed I was getting quite a few calls to see why Fido was scooting all of a sudden.

Now the question… Which came first the issue or the expression?

These dogs may have had anal gland issues their whole life, and the family would have never known.  The groomer was expressing the glands as a part of their basic service.  After the service was discontinued, the dog’s body, scooting and excessive grooming in that area were insufficient to express the glands.

Is it possible by manually expressing the glands, the anal sacs came to rely on the manual expression?  Or would these pets have had issues earlier in life, if the groomer hadn’t been expressing them?

What do you think, can grooming history affect anal sac health in dogs?

Halloween Horrors: how to stay out of the veterinary clinic

October 16, 2012 2 comments

As the second biggest decorating holiday of the year approaches its important to not forget about our furry family and keep them safe.  Dangers lurk behind every hay bale and corn stalk  for our four legged friends.  The trick to keeping fur kids safe includes keeping them away from the treats.

Don’t let these dangers raise any hairs at your house this Halloween:Cat jack-o-lantern

  1. Xylitol
  2. packaging
  3. and chocolate

Xylitol is an artificial sweetener often used in “sugar free” products.  While no candy is good for pets, candies containing xylitol can be deadly.  If your pet ingests Xylitol, grab the wrapper, bring it and your pet to your local veterinary clinic.  The sooner you get to the clinic, the better.  Do not assume you should induce vomiting.  If you are unable to get to a veterinarian immediately, call an animal poison hotline (there is usually a fee for this call.)

Maybe the underdog and therefore most dangerous on our list is the packaging.  Foil wrappers seem small and easily passed thru the system.  In the super sensitive turns and twist of the GI tract, foil can be razor sharp causing life-threatening damage.  Don’t let other wrapper types fool you; these foreign bodies can build up together causing blockages and serious medical consequences.

One of the biggest and most debated dangers is chocolate.  In the past, the dangers of chocolate were widely broadcast from the veterinary community.  In more recent years, the vets have been assuring us that while we never want to feed our dogs and cats chocolate, perhaps we don’t have to rush into the emergency clinic for getting into the kid’s backpack.  So how much is too much?

According to Kevin Fitzgerald, PhD, DVM, DACVP, 20 ounces of milk chocolate, 10 ounces of semi-sweet chocolate, and just 2.25 ounces of baking chocolate could potentially kill a 22-pound dog

Below is an excerpt from the Merck Veterinary Manual containing the approximate levels of Theobromine in chocolate products.  Theobromine is the most toxic component in chocolate for our pets.

Theobromine levels in different types of chocolate:
From The Merck Veterinary Manual

  • Dry cocoa powder = 800 mg/oz
  • Unsweetened (Baker’s) chocolate = 450 mg/oz
  • Cocoa bean mulch = 255 mg/oz
  • semisweet chocolate and sweet dark chocolate is = 150-160 mg/oz
  • Milk chocolate = 44-64 mg Theobromine per oz chocolate
  • White chocolate contains an insignificant source of methylxanthines.

Reference: ASPCA Poison hotline, (888) 426-4435.

Buyer beware: Animal Hospice or Hoax

July 30, 2012 1 comment

I recall that first family that brought me to the understanding that what we were doing was animal hospice.  I remember the hours spent scouring the internet, calling strange veterinarians on the phone. I was looking for a sympathetic ear, a peer to encourage, mentor or otherwise be a resource for me as I tried so desperately to support this family.

Photo of Bella in hospice

Thankfully, this dog, Bella was not in pain.  She still needed creative care as we supported her to live 5 years past the veterinarians suggested euthanasia.  She didn’t just live, she really loved in those days.  That girl and her person had their best times in that phase of her life.  Her veterinarian was willing to support them on this journey – as she wasn’t in pain, he just didn’t know how.

Bless them for knowing that I didn’t know how either.  Some true, basic nursing and common sense modifications for her home area and routine were all this girl really needed.  I spent hours with her.  When she was sleeping, I would read.  I read about pain management and how to identify pain.  I read about dying naturally and what that could look like.  I read about the spiritual side of transitioning, the stories of human hospice workers and oncology nurses.    Every waking thought was about how to support this family, what might come next and how to make sure Bella stayed comfortable and what to do if she didn’t.

As I look around today and see veterinarians, technicians, pet sitters, dog walkers, groomers and many others entering the animal hospice arena, I am cautiously optimistic.  On one hand, I am thrilled.  Together we can really love and support families when hospice is indicated.  What a brave and beautiful army.  The caution comes from the dark side of any monetized industry.  Pet parents beware.  Yes, please seek help with your animal hospice support.  This can’t, shouldn’t, and doesn’t have to be done alone.

Due diligence  is especially important as some try to jump on the buzz words and bandwagons to make a quick buck.  Ask questions.  Ask for references.  Get specific stories.  Years of experience is a great help, but how can we check those that have the right heart and intention that are new?

Help us create a great list of questions for people to screen their hospice support team.  What would you ask to determine if someone is qualified to help you with your cat or dog?

A family’s review: In-home Euthanasia for their Dog

July 15, 2012 2 comments

A real review of a euthanasia at home.  The focus is on the experience and interaction with the veterinary clinic and staff.

Legend: (=) neutral experience, (-) negative experience, (+) positive experience

  • (=) Dr. and staff were late to leave hospital.  Could have been a positive if communicated.  Since the family was treasuring every second, they started to worry when they were not there or communicating there adjusted arrival – this intereupted their time with the dog.  The  family appreciated the extra time.
  • (=) The Dr got lost on the way.  Again,  no problem as the family appreciated extra time.  Directions were clarified when they called for them.  The lack of communication and the blaming for the directions on the phone were the only reason this was not seen as a blessing.
  • (-) Overall, the family made comments after the fact to other areas and past experiences with the clinic.  The team not communicating regularly enough regarding status, leaving family on pins and needles anticipating their arrival.  As a result the family questioned past experiences with the clinic and their future use of the clinic.
  • (-) The Dr and staff member pulled up in a mercedes sedan – no possibility of transporting the 80# dog back to the clinic for the requested private cremation, no communication or arrangements made with the family for them to handle dead body transportation.
  • (-) On their eventual arrival, the Dr got out of the car loudly complaining about how whoever gave the directions was wrong and telling us what they should have been.  This was communicated to a liasion that met the team at the driveway and after subdueing them, led them to the family expresssing their desire to be calm and quiet and peaceful around the dog.
  • (-) On the short walk to the family and dog, the Dr again complained to 2 others regarding the directions, again loudly as nearing the dying dog and his grieving family.
  • (-) When the Dr and staff member joined the dog and family they proceeded with small chat and self focused conversation, disrupting the tone and dishonoring the moment the family had carefully created for themselves.
  • (=) The Dr explained the process of the euthanasia and approximately what to expect.  Explanation was sufficient at best.  Having had a better explanation previously from a third party they did not feel unaware.
  • (-) During the short process, the staff member had to go back to the car for additional supplies.  The family considered something might be going wrong or unexpected in the process, raising concern for the comfort of the dog.
  • (-) The Dr and staff member left.  They left before discussing or helping with the logistics of moving the dog from the yard where he was euthanized to a vehicle for transportation for cremation as arranged with the clinic.
  • (-) The Dr left before verifying their clinic would be open after hours for cremation drop off.  The family had to make an additional call to the clinic in this raw moment to make sure they could take the dog after being left with him.  Since the clinic did not answer the first call, they called another clinic to see if they would be open and available to help with their dog.  This disrupted the beauty and peace of the moment after the euthanasia.
  • (-) When arriving at the clinic with thee dog, no one was ready or available to help. The family had called in advance and were expected.  The car had to moved 3 times to accomodate the clinics request for getting the dog inside and the family members had to  carry his limp body.
  • (-) The assistant asked the family member if they could put the dog in a garbage bag before removing from the car.  This process surprised the family member and while he acted strong said “sure,”  it was clear he would rather not have known this logistical piece.
  • (-)When confirming we’d like a paw print, the staff member sounded surprised.  The receptionist had confirmed that paw prints were standard when making the initial inquiry for the euthanasia house call and cremation arrangements.  The family member almost took back the request to be accomodating, but couldn’t part with the memorial.

Overall score: 2 neutral,  12 negative and 0 positive

Have you had an experience that should have or could have been almost a nice way to say goodbye that was tainted?  Share in the comments your story – how can we improve the experience?

2-Speed Dogs, a lesson in comfortable mobility

June 14, 2012 2 comments

The name started with my first dog.  He would walk so much faster in the sun, then slow to a snails pace in the shade.  It was such a dramatic shift in his speed and his desire to walk, he earned the nickname “2-speed.”  image dog resting in shade

As I worked more and more with seniors animals, I noticed my “2-speed” was not alone.  Some dogs would walk slower going away from the house and double time-it on the way back.

One of my loudest messages as a senior pet care provider is to honor your animal.  I’m not talking about letting a young dog rule the roost.  This is about when you sleep wrong and you kink your neck, you don’t turn it to the left that day.  Listen to your body.  In this case, we’re passing that respect on to our senior pets.  If they seem to be having a slower day, let them.  Its OK to have a less than 100% day.  By honoring what our pets bodies are telling them, we can help them have comfort and quality in their life.

2-speeds are the exception to this rule, sometimes.  Maybe.  My dog wasn’t tired of the walk, he wasn’t even super hot.  He was a wise, older animal who had figured out his joy was not found exercising, especially in the sun.

I honored him by changing the times of day we walked.  I made sure it was cool.  He would still act tortured to be out on a walk.  I didn’t see any gait changes or subtle signs of pain in him, but wanted to respect him in this phase of life.  I then shortened our walks, they were almost to nothing.  We added in swimming to help him move with relief on his joints.

Maintaining comfortable mobility is a major quality of life component in comfort care for hospice animals.  Mobility is a longevity and comfort staple.  All the 2-speeds to date have taught me that animals, like people, don’t always want to do what’s best for them.  Caring for them well sometimes means taking that walk, even if its shorter.

Imagine an old man whose doctor asked him to walk once a day for his health and his wife may sometimes have to…encourage him to take that walk.  Serve your pets well.  Keep them comfortably mobile and honor them, as opposed to being swindled by these wonderful souls.

Have you had a 2-speed in your life?  I’d love to hear about them!  Use the comments below to share your story.

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