Pet hospice, a new aspect of veterinary medicine, helps loved ones on final journey

Karen Coradi is celebrating her first Christmas season in 20 years without her beloved cat Dakota.

The elderly feline was euthanized in her arms at home in October, when his suffering from a variety of medical problems — including renal failure and severe arthritis — no longer could be relieved.

“I'm sad, and I miss him, but I had a much longer time with him than I ever expected,” says Coradi of Wilkinsburg. She credits “the long goodbye” to Dr. Nancy Ruffing of Gentle Journey Veterinary Hospice, a North Hills-based mobile veterinary service.

“She was a godsend,” Coradi says. She sought Ruffing's services when it appeared Dakota's time was drawing near. “At one point, he got very, very sick, and I felt things were going to progress rapidly. I thought if his time had come, I wanted him to be put down at home.”

As it turned out, Ruffing determined that, among other things, Dakota was badly constipated, in part because arthritis made using the litter box painful. She developed an overall treatment plan that included a daily laxative and an anti-inflammatory for his joints and extended his life by a year.

She taught Coradi how to medicate Dakota, and guided her through the end-of-life process. “I asked her often if I was taking his care too far, if I was hanging on for me more than him,” Coradi recalls. “And she reassured me that I was doing the right thing at the right time.”

Joe Kent and his wife, Kay Drummond, of Highland Park were referred by their veterinarian to Ruffing when their 17-year-old cat Yogi's kidney problems became acute, and he required near-daily injections of fluid.

“Those constant trips to the vet were stressful for him, so we decided to have him treated at home,” says Kent, a patent attorney. “We knew his disease was terminal, so we focused on making him comfortable.”

Besides fluids, Ruffing prescribed anti-nausea medication and weekly blood-boosting shots. “She predicted Yogi wasn't going to survive for very long, so she prepared us for it,” Kent says. “That he lived another four months is a testament to the good care she gave him.”

Kent says he and his wife were grateful Yogi could be euthanized at home.

Hospice is a relatively new, but growing, field of veterinary medicine that focuses on palliative rather than curative care through technology, medication and nutritional support. Although most vets can provide supportive end-of-life care, few make house calls, and, of those, fewer still call themselves hospice specialists, which, according to the American Veterinary Medical Association, typically includes 24/7 on-call availability, extended visits and helping owners deal emotionally with impending loss.

Ruffing says she founded Gentle Journey after a decade of treating pets in an emergency clinic and seeing voids in conventional veterinary care.

“You meet people who are doing their best to provide hospice on their own, and when they no longer can, end up in the ER,” says Ruffing, who now works from a medically equipped van. “I have just about everything you'd find in a veterinary office, and I'm seeing pets where they live, when their adrenaline isn't pumping.”

Coming into the home also lets Ruffing assess the pet's environment and suggest changes that can enhance quality of life. “I open a family's eyes to what they may not have thought of, like putting extra water bowls around the house. Some pets get too thirsty because getting up to get a drink is so painful,” she says.

Because they are seeing their pet every day, many owners fail to notice subtle changes in condition, or recognize when their pet is hurting, Ruffing says. “Animals are good at hiding pain because of their instinct to not look vulnerable to predators in the wild. Not every limp is painful, and suffering can take many forms. A pet may not be eating because his stomach is queasy, something we can easily treat with medication.”

Jen and Bob Mankowski of Kilbuck turned to Ruffing when their beagle Bojangles was 9 and began to experience a series of health problems, including a herniated disc, and, eventually, liver disease and a parathyroid tumor.

The Mankowskis, who both work as rehabilitation engineers, decided against aggressive treatments, opting instead to address Bojangles' symptoms with pain medication, fluids when necessary, antibiotics and adjustments to the home, such as a night light and a ramp that helps him get onto the couch.

He is now 15½.

“We didn't expect him to be here last New Year's,” Jen says, “but he's still in it. He still wants to be here. As long as that's the case, we're going to give him the best life possible.”

Besides regular in-home check-ups, Jen and her husband know that Ruffing can be called in case of emergency. Jen says they once contacted her in the middle of the night when Bojangles suddenly developed alarming symptoms that turned out to be vestibular vertigo.

“With Nancy, there's this sense that we're in it together, which is very comforting, very reassuring,” Jen says. “We know that when his time comes, it will be peaceful and painless. We'll grieve a lot because he has been so much a part of our lives, but his has been a life well-lived, and he has been well-loved.”

Marsha Koschik, a veterinary technician who leads the Pet Loss Support Group at Animal Friends in Ohio Township, praises hospice and any veterinary practice sensitive to the challenges owners face in caring for a terminally ill pet.

“A lot of it is they don't know whether their pet will die on its own or they will have to choose euthanasia,” says Koschik, who formerly worked as a psychotherapist. “They're looking for reassurance that the decision they may have to make is appropriate and not guilt-laden, that they didn't wait too long or act too soon.”

The Good Grief Center for Bereavement Support in Squirrel Hill provides peer support for pet loss, which includes anticipatory grief.

“Pet owners experience what we call a ‘disenfranchised grief.' It's not recognized or socially sanctioned, so support goes away,” says Diana Hardy, a licensed professional counselor by training and director of the Center, which is a part of Ursuline Support Services. “They are surprised and grateful to learn that this is a place where they can talk and feel understood.”

Deborah Weisberg is a contributing writer for Trib Total Media.