Unfortunately, our aged and informed dogs rarely simply pass away peacefully and comfortably in their sleep. In most cases we, their human family, must face difficult end-of-life decisions on their behalf. We are forced to become extraordinary medical advocates for our dogs as we grapple with some really tough decisions. This is often the most difficult part of caring for a pet. Our animals typically let us know when they are reaching the end. Once you recognize this, I suggest recruiting your family veterinarian to help decide what kind of end-of-life (EOL) care might be best.
EOL care and your dog
Some truly lovely guidelines pertaining to end-of-life care for pets have recently been published for veterinarians. I use the word lovely because everything within this document feels exceptionally loving and humane, not only for the animals, but also for their human companions. The guidelines were a collaborative effort, created by the International Association for Animal Hospice and Palliative Care and the American Animal Hospital Association. As difficult as I know this process to be, it’s important to be aware of EOL guidelines, to maximize your dog’s life quality, even at the end. “End-of-life care and decision making embody the critical final stage in a pet’s life and are as important and meaningful as the sum of the clinical care provided for all prior life stages1.”
EOL decisions and your dog
Your veterinarian will use not only the guidelines I mentioned above, but also personal experience to help you with the difficult decisions you must make during this time. These are just a few of the tips that I keep in mind for my clients from the EOL guidelines1:
End-of-life care should focus on maximizing patient comfort and minimizing suffering while providing a collaborative and supportive partnership with the caregiver client.
Timely, empathetic, and nonjudgmental communication is the hallmark of effective client support.
Veterinarians should not allow an end-of-life patient to succumb to a natural death without considering the option of euthanasia and ensuring that other measures to alleviate discomfort and distress are in place.
The end-of-life care guidelines define animal hospice as follows1: A philosophy or program of care that addresses the physical, emotional, and social needs of animals in the advanced stages of a progressive, life-limiting illness or disability… Animal hospice addresses the emotional, social, and spiritual needs of the human caregivers in preparation for the death of the animal and the grief experience.
Euthanasia for dogs
Of course, all decisions about euthanasia for your pet, are yours to make. It’s never an easy choice, and again I encourage you to rely on your veterinarian for guidance. The guidelines I have mentioned accept that the pet parent has the ethical and legal right to choose for or against this process. However, animal hospice does not accept the decision to allow a pet to die without euthanasia unless effective measures provided by a veterinarian are in place to alleviate discomfort and distress.
Hospice care pyramid for dogs
The end-of-life care guidelines feature a three-tiered “Animal Hospice Care Pyramid” that illustrates the many ways in which the hospice patient’s care is to be managed. The base of the pyramid addresses the components of maintaining the patient’s physical comfort, including: • Pain management • Management of symptoms • Hygiene • Nutrition • Mobility • Safety • Environmental needs The middle tier addresses the animal’s social engagement with family members, both people and other pets in the household. The goals are to provide mental stimulation and avoid social isolation. The very top of the pyramid addresses the emotional needs of pets, specifically at the end of their life. The objectives here are preservation of dignity (maintaining grooming, managing self-soiling with urine and feces), stress reduction, and, to the greatest degree possible, preserving the pet’s role in the household such as providing human companionship and barking at the UPS truck.
I encourage you to take a look at these end-of-life care guidelines. While no one wants to think about the loss of a beloved pet, reading this piece is ironically restorative in the sense that it’s filled to the brim with suggestions for creating a loving and gentle final passage.
If you have any questions or concerns, you should always visit or call your veterinarian — they are your best resource to ensure the health and well-being of your pets.