07.17.15-Sable1-by-Jamie-Augello.jpg
Sable, a 16-year-old Akita-chocolate Lab mix, is no longer mobile but she still loves eating, spending time with her family and being outdoors. Her owners, Suzi Mattox and Don Miller, are offering her hospice care to ensure she enjoys the time she has left.
(Jamie Augello)
Southeast Portland resident Suzi Mattox and her husband, Don Miller, believe that their beloved dog, Sable, will let them know when she's ready to let go.
The spirited 16-year-old Akita-chocolate Lab mix is no longer mobile, but she relishes spending time with her family, eating and being outdoors.
"I know her, and she wasn't ready to go," says Mattox, a registered nurse and human hospice volunteer who picked Sable from a litter when the dog was 12 weeks old.
"She still is so present with us when she can be, she still is part of the family; she doesn't want to leave. When she's ready to leave, we'll help her with the same compassion we have right now."
Sable is a spirited 16-year-old Akita-chocolate Lab mix.
To help care for Sable during this precious time, Mattox and Miller enlisted the help of At Home Veterinary Services, which provides veterinary house calls in the Portland metro area.
While At Home Veterinary Services treats pets in all stages of life, its veterinary staff has a special passion for helping those that are geriatric or terminally ill.
What is hospice?
Animal hospice is a philosophy of care that involves coordinating physical and emotional support for a pet patient and its owners, explains Sable's veterinarian, Dr. Heather Dillon.
"Particularly, it is care in which the focus has shifted from curing disease or extending life, to providing comfort and quality for the life remaining," she says.
"This philosophy continues up to and through the time of death, whether through euthanasia, or hospice-assisted natural death. Usually, our patients 'in hospice' are assumed to have less than about 4 months to live."
Many veterinarians have been practicing hospice and palliative care, which alleviates pain, suffering and discomfort, for years.
As more pet owners become aware that there are other options besides simply curing or euthanizing a beloved pet, the services are becoming more common nationwide.
"I think making it known, calling it by the name of hospice, all this gives people permission to make more decisions about their animals' end-of-life care," Dillon says.
There are no set requirements about how to practice veterinary hospice, but the International Association of Animal Hospice and Palliative Care has published guidelines to offer veterinarians a framework to follow.
Bridging the gap
When Dr. Louise Mesher first launched At Home Veterinary Services in 2008, she was responding mostly to requests for in-home euthanasia.
"A lot of the time, what would happen is, I'd get there and realize these animals are not ready - and the owners are not ready - for euthanasia, but they don't have any options for getting through whatever time they might have left."
To alleviate the pain (for pet and owner), Mesher began carrying medication to provide some comfort to ailing animals and hired a technician to conduct blood work to get a better evaluation of the pet's condition.
"It's about creative problem-solving," Mesher says. "How do we bridge that gap between a terminal diagnosis and when they are actually ready to pass away?"
Assesses a pet's quality of life is an important component to determining a next step. Owners are asked to fill out a questionnaire individually to get each person's perspective on how their pet is doing.
For instance, a once-athletic border collie with a tumor that makes it too painful to move is unlikely to enjoy a lazy life on the living room floor, Dillon points out.
On the other hand, a golden retriever who loves being brushed or a cat that can still sit in the sunshine and groom may be relatively content for awhile longer.
It's less about extending life just for the sake of life, Dillon says, and more about enhancing whatever time is left.
Small changes, big improvements
Simple and inexpensive changes sometimes can make big differences in improving a pet's quality of life.
Providing in-home care offers veterinary staff an advantage because it enables them to spot environmental or logistical challenges that may be easily fixed.
"It's really nice to be in the home, because you can sort of see the potential issues that might be causing the problem," points out Rachel Long, a certified veterinary technician with At Home Veterinary Services. "It's a lot easier to help and advise them when you can see what's happening."
For instance, older dogs with mobility issues might struggle on slippery surfaces such as hardwood or tile.
Simple suggestions, such as carpet runners or a special harness to make handling the dog more easily can make an ailing animal and its owner more comfortable.
Long and her co-workers also teach pet owners how to inject subcutaneous fluids, administer oral medication or provide other care that would otherwise be provided at a clinic.
For Mattox and her husband, that includes learning to express Sable's bladder and relieve her bowels.
She emphasizes that she and Miller have ongoing discussions about Sable's care, and the level of care they provide may not be for everyone.
"It's a very personal decision, and it ranges from companion to companion," Mattox says. "Sable has the will to live. We want to honor that for as long as we can."
***
Advice for owners of pets with terminal illnesses:
"Always seek more opinions," says Dr. Louise Mesher, owner of At Home Veterinary Services. "Get a second opinion, get a third opinion, get opinions from your family and trust your heart. Know there are lots of options out there and lots of resources."
Just because an animal is diagnosed with a terminal illness does not mean you have to euthanize it then and there.
Know that deciding whether you're going to euthanize your pet, stop treatment and/or provide hospice care is a very personal decision.
Take into account your life experience, budget and schedule. People who work from home or have flexible schedules may have more time to provide in-home care.
Don't feel guilty if you decide on euthanizing an ailing pet. "It is a gift to relieve suffering," says Suzi Mattox, whose dog, Sable, is currently receiving hospice care.
--Monique Balas; msbalaspets@gmail.com