Often a pet’s death comes not independently, but with assistance.
“At the end, the vet came and put Ivan to sleep in my backyard under the apple tree,” Emily Rhoads recalls, describing the death of her beloved dog, Ivan.
Over the six months leading to his death, Ivan experienced a slow decline, but one in which Rhoads felt like she was in control. She was empowered to make decisions that would best serve her canine companion.
Every time we bring an animal into our lives, we unwittingly also introduce a shadow: death. Death will trail in the footsteps of a beloved pet until, eventually, it catches up.
Many of us try not to think about this. We insist we’ll have many happy years together, that our pets will outlive the average, and when the end comes, it’ll be gentle, quiet, and natural.
“They’ll just go to sleep and not wake up,” we tell ourselves.
The thought of an elderly dog curling up peacefully next to the fire is a powerful one. But unfortunately, that’s usually not how death happens for pets. It may be preceded by a sudden traumatic accident, or the rapid onset of a serious illness, or months of struggling with cancer or another terminal disease.
And it often comes not independently, but with assistance.
Shrinking back from conversations about death isn’t healthy for us or our animals
Sitting down to think about the kind of death you want to have is important. The same holds true for your pets. It’s a conversation Dr. Lynn Hendrix, a mobile hospice and palliative care veterinarian, says we don’t have often enough. In some senses, vets are failing their clients due to gaps in their own training, she says. She came to animal hospice from a veterinary emergency room background, and it informed her practice. “You do see a lot of end-of-life clients in the ER,” she says. What does a “good death” look like for the animals in your life? How do you want to remember their final weeks, days, and hours? Maybe it looks like this: taking the cat who’s lived with you since college to the park to spend a day outside and then returning home, where a veterinarian will administer euthanasia and you can bury him under the lilacs. Or perhaps it’s going to a veterinary clinic at the end of the day, where you can spend as much time as you like before leaving. The veterinarian will handle the remains, calling you to pick up the ashes in a few days or weeks. Or it’s a swift, compassionate decision made for a dog with severe injuries after being struck by a car. But the question of what a “good death” looks like starts well before the last breath.
Medical interventions mean that we can often see death coming well in advance, and we must make decisions not only about what death will look like, but how the last few months of living will be experienced. Historically, these decisions have been treated like a duality: You try everything, or you do nothing.
There is, however, a third way: Veterinary hospice and palliative care allows your animal to receive interventions that help defray pain, treat infections, and manage other aspects of end-of-life care.
The goal of hospice isn’t to “give up.” It’s to allow an animal to transition gently, spending their remaining time as comfortably as possible: no extreme interventions, no radical treatments, no lingering hopes for a cure. And while the natural termination of hospice is often an assisted death when your pet’s quality of life has declined to an untenable point, the nature of that assistance can also take on a spectrum.
Knowing and thinking about your options ahead of time can empower you to make a choice that feels right for your family.
“These are the most challenging conversations for vets,” says Dr. Jane Shaw, a veterinarian who researches communication between veterinarians and clients at Colorado State University.
No one wants to deliver a terrible diagnosis or bring up end-of-life care. But opening the conversation creates space for talking about worries, fears, and what comes next.
“We want people to reach out to us as early as possible so we can help prepare them,” says Dr. Jessica Vogelsang, a mobile hospice and palliative care veterinarian who also provides consulting.
What’s involved in veterinary hospice?
Some general practice veterinarians, especially in areas where there are no specialists, may offer hospice. Others may refer their clients to a colleague. Palliation — a reduction in pain and suffering — can be a part of hospice care or curative treatment.
Hospice care, which focuses on providing support and comfort to dying pets and their families, is available in clinic and home settings, although the costs of at-home care can be higher. Hendrix says she keeps around 100 clients on her roster at any given time, though only three to five may be near death.
If home care isn’t available or is unaffordable, your veterinarian can work with you on reducing the number of office visits to limit pain and stress. Those visits can also be timed to suit your needs. Perhaps you want to be the first or last appointment of the day, when the clinic is relatively quiet.
Medication to manage pain can be one element of palliative care. Your pet might also receive antibiotics for infections, fluids to address dehydration or stressed kidneys, and medications to address specific symptoms.
The goal is to keep your animal comfortable. At times, that can involve aggressive treatment, says Vogelsang.
Your veterinarian may also counsel you on quality of life and developing options for assessing your animal’s health and comfort. Hospice and palliative care can be stressful for humans, not just pets. Some people find it helpful to work with a therapist who specializes in grief counseling.
Your pet’s quality of life is unique, and you’re the person best suited to determine whether your animal is finding joy in life. Some things to think about can include:
whether your pet is eating and drinking
your pet’s activity level
your pet’s interest in sights, smells, and surroundings
whether vocalizations or body language suggest intractable pain
reactions to beloved foods, activities, or people
your pet’s tolerance for medical interventions and vet visits
Rhoads recommends “day rating.” Keep a journal of how your pet is doing day by day so you can get a look at the big picture.
Some pet guardians say they want a “natural death,” rather than euthanasia. But Hendrix notes that “natural death” is a loaded phrase.
Vogelsang also warns that the natural progression of terminal illness can be grueling for animals and people. Animals may experience incontinence, seizures, and other symptoms that require constant monitoring and care. This may include moistening the eyes of pets who aren’t producing enough tears on their own, cleaning and bathing pets with continence issues, and administering a pharmacopeia of medications.
It’s important to think about what you can take on — and how much your pet can take on. Hendrix adds that it’s always possible to reassess in cases where end-of-life care isn’t meeting a pet’s needs.
What to expect from euthanasia
“A good death (in my opinion) is me holding them, telling them how much we love them, petting them, and them not being in pain, afraid, or alone,” says pet guardian Victoria Howard, who’s shared her life with a colorful assortment of animals. Research on feelings about end-of-life care found that many pet guardians regretted euthanasia. Some cited feeling like “murderers.” That response is natural, says veterinary anesthesiologist and pain specialist Alicia Karas, who says tragedy and loss are often accompanied by thoughts that, “If only you had done things differently, things would have turned out differently.” For pet guardians, this can be mediated by regret about being unable to afford care. But, Karas says, there’s another regret she hears from clients: the feeling that they waited too long and should’ve acted sooner. “I did too much” is a sentiment that repeats itself in veterinary offices, with people seeking a balance for a challenging choice. “The patients that trouble me the most are not the ones that choose euthanasia too early. If you choose euthanasia too early, within limits, you start really grieving sooner, but you probably will prevent a lot of suffering. If you choose too late, the pet suffers.”
Don’t be afraid to ask about anything that’s troubling you
Veterinarians welcome comments and questions from their clients and want you to be well-informed before euthanasia. They also welcome and respect any level of desired patient involvement.
For some, that may mean staying in a room with a pet throughout preparation and the procedure. Other pet guardians prefer to step out during preparation, or for the entire euthanasia.
“The types of people who go into this field, no pet will ever die alone,” says Vogelsang.
Early in Vogelsang’s career, a man came alone to drop off a terminally ill kitten for euthanasia, declining to stay for the procedure. She was judgmental — until he told the clinic staff that his child had died of cancer, and the kitten was a gift to his wife.
“Emotionally, they could not handle that again,” she says. This experience informed her attitude. Vets like Karas share this sentiment of not judging clients for the decisions they make.
The exact process of euthanasia can vary depending on a vet’s training, experience, and preferences — and the pet’s species. Some veterinarians may place an intravenous catheter in your pet’s leg first to ensure that they’re able to access the vein. Euthanasia often involves an initial sedative injection, which may render an animal unconscious, before injecting the euthanasia solution, a barbiturate that will cause respiratory arrest.
Vets aim for a fast, quiet, calm experience. “It’s a ceremony,” Karas says. “You don’t get a do-over.” Veterinarians take it seriously, whether they’re emergency vets seeing your pet for the first time or family veterinarians who’ve known your pet for years.
The ideal experience doesn’t always happen.
Karas ruefully relates the story of a colleague’s cat who vomited after receiving the sedative. Sometimes animals respond unexpectedly to the sedative, and it’s not because the vet did anything wrong. Others may have a higher tolerance for the barbiturate than expected, sometimes because of pain medications used in the final days of life, in which case a second injection may be required.
Vogelsang tries to be prepared for whatever comes, acknowledging that as a traveling hospice vet, she sometimes encounters situations she couldn’t possibly have been ready for. But she can stay calm and reassuring.
After the veterinarian has listened to your pet’s heart and lungs to confirm that the procedure was successful, most clinics allow pet guardians to stay as long as they like. Guardians may take the remains with them or leave them at the vet for final arrangements.
In the case of home euthanasia care, the vet can leave after the procedure and may take the remains by prior arrangement. Sara, who lost a beloved cat in 2017, found the experience of at-home euthanasia very valuable. “We each held her and got to see that she was really gone, that this was really happening and it was really over,” she recalls.
Memorialization and remains
Alongside euthanasia or other paths to death comes another pressing decision: disposition, or what to do with the remains. If conversations about euthanasia are challenging, discussions about what to do with the body can be even more fraught. There’s something deeply uncomfortable about discussing how you want to memorialize your pet when she’s sitting on the couch next to you.
Depending on where you live, you may be able to bury your pets at home if you prefer that option. Most veterinarians also offer cremation, typically through a third party. Some vets may be able to connect you with a pet cemetery if you prefer burial.
For those who aren’t interested in taking the remains home, receiving ashes, or having a formal burial, clinics can also handle disposition independently. There’s a plethora of firms offering urns, grave markers, and other memorial products.
You can also work with artisans and artists on memorials that are more personal, like jewelry or sculptures. Jeweler Angela Kirkpatrick of Wisp Adornments, for example, makes Victorian-style memorial jewelry that can include fur, ashes, and other mementos.
Howard requests cremation for her animals and keeps the ashes at home. “There’s also a soft sculpture artist in Canada, who does memorial sculptures/stuffed toys of your ‘ghost kitty.’ You tell her about the cat, send photos, hair, cremains if you want, and she puts those behind photos of the cat. They are really wonderful! And comforting. The ghost kitty arrives in black tulle netting, tied with black ribbons. This gal is so kind about the loss,” Howard says.
If you have concerns about what happens to the body even if you don’t want to take charge of the process, you should ask. Some clinics work with pet cemeteries that perform mass cremations and scatterings or have mass graves. Staff at these facilities try to be respectful and thoughtful. Other clinics may have contracts with companies that are less respectful, delivering remains to landfills, rendering facilities, and other sites.
In any case, if you want a clipping of hair, a paw print, or another memorial item, be sure to request it. The clinic staff can help you or give you supplies and let you collect your own memento. Some clinics may make paw-print markers for all their clients. If that’s a service you don’t want, it’s OK to say no!
Disposition is only one part of memorializing a beloved pet
Some people find it helpful to perform memorials or funerals, maintain altars at home, or commemorate losses in other ways. If you’re not interested in a memorial in the immediate aftermath of a death, you can always hold one later for those interested in celebrating your pet’s life. This may include children who want an opportunity to process the death with members of the family.
Grief, sometimes very intense grief, is also a natural part of the end-of-life process. It may be compounded by other recent losses, too. There’s no “normal” or “typical” course of grief, but you may find it helpful to work with a counselor.
Similarly, for children, having someone to talk to can help them sort out their feelings about the end-of-life process, regardless of their level of involvement.
“It’s hard to plan for end of life for him, but I know some hard limits for me,” says author Katherine Locke of her beloved senior cat. She didn’t arrive at those limits easily, but experience with previous cats has made her acutely aware of the necessity to have difficult conversations in advance.
“When I had to switch vets after moving, I talked to the new vet about my lines for all my cats (no cancer treatment, probably no obstruction surgery, no PU [perineal urethrostomy] surgery),” Locke says. “And when she said she thought they were reasonable, I knew that we’d be a good fit.”
s.e. smith is a Northern California-based journalist with a focus on social justice whose work has appeared in Esquire, Teen Vogue, Rolling Stone, The Nation, and many other publications.
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