End-of-Life Plans for Pets • Old Dog Haven

By Peabody Johanson

This week we welcome guest blogger Peabody Johanson. Peabody and her husband Jason are Old Dog Haven foster parents for Banjo as well as mom and dad for several other resident Cavalier King Charles Spaniels. Thanks for sharing your thoughts, Peabody.

I’m going to talk about end-of-life plans because creating an end-of-life plan for your pets not only benefits you at decision time but also helps minimize the suffering of your beloved fur family member. You don’t want to have to think about your fur companion’s demise, but to me it’s vital.

Each one of my dogs (and rabbit) has an end-of-life plan and each plan is completely different because each animal is different. No one knows your pet like you.

Example: The day before New Year’s Eve this last year our dog Daisy got what they thought was pancreatitis, which is very common in the breed but usually Daisy has an iron stomach. Often when a dog has pancreatitis the vet wants to hospitalize the dog for days to give them fluids and stop vomiting, etc. We were at our regular vet office (though we weren’t seeing our regular vet due to the holiday) and they would be closing that day (a Saturday) and not opening up until Tuesday morning.

So from Saturday until Tuesday I would not have been able to see Daisy and she would not have been able to see me. For Daisy, not being with her family would do more harm than good because she is also a VERY, VERY needy dog. She NEEDS her people and her fur-buddies.

I informed the vet that I would be back before closing and that if she was still stable I was taking her home. I live about five minutes from a 24 hour veterinary hospital and I knew if things went south I could get her somewhere quick—somewhere I could go and see her during the three days.

Daisy came home and snuggled with her buddies and her mama. She drank and ate right away. She had one more bout of soft stool (she was on something to firm it up) and that was that. Going home was what Daisy needed.

When we start with an end-of-life plan for our dogs, my husband and I discuss what that particular dog loves to do. What brings that dog joy? Again, each pet will be different: Some of our dogs love walks and spending time outdoors with people while others would prefer just to sit on the couch and snuggle.

It’s how we make their bucket lists as well.

It’s important to do the plan ahead of time when you are not in the middle of a crisis, which might cause you to make a decision not based on what is best for the pet but what your emotions are dictating. Your emotions still may take over, but you still are better off planning ahead.

And then there’s Mickey: Mickey’s neurologist seemed a little shocked that we already knew what route we wanted to take with him when it was suggested that he might have lymphoma.

We knew because we had decided well ahead of time that because Mickey is in a more advanced stage of mitral valve disease that going through chemo would not be ideal. Mickey is 12 and has a slew of other ailments. Chemo is for otherwise healthy dogs, which he is not. With some of our other dogs we would have rolled the dice and tried the chemo. It just depends. So we knew with Mickey that alternative care and/or hospice would be the best thing for him. Not for us as his humans of course; we want him around forever, but we know that is not possible. We want what is best for him. Amazingly, Mickey’s results came back not as cancer but as a reaction to an infection in his ear and he is doing just fine five months later.

And then there’s Crissy who passed over the Rainbow Bridge on May 14th. Crissy had been to the cardiologist on May 3^rdand it was discovered that she had a suspected small tear of her left atrium, a ruptured chordae tendinae of her mitral valve, and moderate-to-severe pulmonary hypertension. Her heart had also grown significantly. All in a two month period. Even though she had been doing well, because she had gone through congestive heart failure previously, we know things can change suddenly, which was the case with Crissy as well.

When we took her into the ER they were very optimistic because the fluid build-up was mild and they expected her to be home the next day. But other forces were in play as well and 12 hours later I was calling my husband to come back from work because we were not going to let her continue to suffer since they were no longer optimistic that it was just fluid that was the issue.

Because we had already talked about it ahead of time we knew what we would do and not do. I mean you still cry because it is hard to think about your loved one passing. Was I emotional? Ugly cry galore. Crissy was my baby. But the reality was that it might have taken days to stabilize her while she was struggling to breathe. And the likelihood of us being back in a matter of days or weeks was inevitable.

So, even though I wanted just a few more days with her, that wish was in my best interest, and not in hers.

Here are some things to consider when making an end-of-life plan:

Don’t think because you have a young dog that you don’t need one. Accidents happen. Cancer happens. Bizarre things happen to younger dogs too. But if they are healthy otherwise chances are they have it in them to fight.
Cost: No one likes to think about this but trips to the ER and surgeries are not cheap.
If you have older dogs with pre-existing conditions you probably do not have pet insurance for them.
We have Care Credit for this reason, though it does not always cover long ER visits.
Ask your veterinarian: Besides you, the person who should know your pet the best is your veterinarian and he or she will know how to make an accurate diagnosis. Of course, your vet will always do what you want them to do but input is always good.
Think about your dog, and then you: My friend A loved her senior dog Aspen with all her might. Aspen got cancer in her leg, but was still active and loved, loved, loved to hike and go for walks.
The treatment for the cancer was removal of the leg and then chemo with not a very good outcome.
That route meant that Aspen would have to get used to three legs and would not be able to hike or take long walks—her favorite things to do. So my friend chose to not to remove the leg and go the hospice route with pain management and let Aspen have her walks and hikes up until the very end.

Often when a treatment is invasive and expensive you will need to ask yourself if the extra three to six months you get with them is worth putting your dog through so much, especially if it means they don’t get to do the things they love the most.
(Please note that some cancers are very treatable and your dog’s life can be extended greatly, but each type of cancer is different.)

Quality of Life. This one is a big one. I often refer people to this Quality of Life Scale for your pets.

*Quality of Life Scale*₁ The HHHHHMM Scale
Pet caregivers can use this Quality of Life Scale to determine the success of pawspice care. Score patients using a scale of 1 to 10.
Score	Criterion
H: 0 – 10	HURT – Adequate pain control, including breathing ability, is first and foremost on the scale. Is the pet’s pain successfully managed? Is oxygen necessary?
H: 0 – 10	HUNGER – Is the pet eating enough? Does hand feeding help? Does the patient require a feeding tube?
H: 0 – 10	HYDRATION– Is the patient dehydrated? For patients not drinking enough, use subcutaneous fluids once or twice daily to supplement fluid intake.
H: 0 – 10	HYGIENE – The patient should be brushed and cleaned, particularly after elimination. Avoid pressure sores and keep all wounds clean.
H: 0 – 10	HAPPINESS – Does the pet express joy and interest? Is the pet responsive to things around him or her (family, toys, etc.)? Is the pet depressed, lonely, anxious, bored or afraid? Can the pet’s bed be close to the family activities and not be isolated?
M: 0 – 10	MOBILITY – Can the patient get up without assistance? Does the pet need human or mechanical help (e.g. a cart)? Does the pet feel like going for a walk? Is the pet having seizures or stumbling? (Some caregivers feel euthanasia is preferable to amputation, yet an animal who has limited mobility but is still alert and responsive can have a good quality of life as long as caregivers are committed to helping the pet.)
M: 0 – 10	MORE GOOD DAYS THAN BAD – When bad days outnumber good days, quality of life might be compromised. When a healthy human-animal bond is no longer possible, the caregiver must be made aware the end is near. The decision needs to be made if the pet is suffering. If death comes peacefully and painlessly, that is okay.
*TOTAL=	*A total >35 points is acceptable for a good pawspice

Hopefully some of this was helpful to you.
Again, I know it’s not something any of us want to think about but being prepared can be a powerful tool to help you and your fur babies.