By Alicia Harris, DVM

There’s no doubt that sharing our lives with companion animals provides enrichment, growth and love beyond our wildest imaginations. They take up permanent residence within our hearts, but eventually we are all forced to face the release of their physical presence. It can be a confusing, painful, stressful experience full of heartache with many difficult decisions to navigate: How do I know when it’s time? Is natural death or euthanasia better? What are my options for body care?

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Although nothing can take away our grief for the loss of a loved one, being proactive and informed about these decisions can allow families to face them with courage while creating an end-of-life experience without regret.

Hospice
End-of-life care is an emerging field in veterinarian medicine. We are beginning to move away from the idea that hospice care only entails the administration of subcutaneous fluids and pain medication. Now, we understand the goal of hospice as a means to prevent suffering, maintain the human-animal bond for as long as possible and help families confidently prepare for their pet’s transition.

Hospice requires a lot of listening, time and patience during a sensitive time. It provides support for the family and their pet during the journey through the last few months, weeks and days of their time together. Some elements of hospice may include:
•    Education: integrative therapeutic options, hygiene, massage techniques, non-ambulatory care
•    Creating plans: nutritional, euthanasia vs. natural death, mobility
•    Support: therapist and social worker referrals, memorialization and body care resources
•    Discussing variables: spiritual, financial and scheduling needs
•    Medical therapy: fluid support, pain control, infection control, non-curative surgery

Caring for an aged or terminally-ill pet requires a tremendous amount of dedication from both the family and their medical partner; however, frequent visits to the veterinary clinic, while necessary for care management, can become difficult for pets and their families. In some situations, moving or transporting their companion may not even be physically possible. Hospice care at home is a wonderful option for these families.

Dr. Lucy Hanus with Compassionate Heart provides hospice and palliative care for families in their homes. Significant information she discovers during her initial family consult include their goals, the absolute most favorite thing their pet loves to do, their “deal breakers,” the type of death they wish for (natural or euthanasia) and resources they would like more info on (therapists, integrative medicine, books, etc.).

Hospice and palliative care not only provides basic hospice medical care for pets, but also helps families organize their wishes, goals and thoughts on how their pet will transition. It gives families the tools to be proactive and participatory, rather than anxious and afraid. The education and support empowers them to create an experience with which they feel comfortable.

Euthanasia or Natural Death
In our society, euthanasia is well accepted and the most common path for families. Not everyone is comfortable with it, though, and that’s okay. In Japan, euthanasia is virtually nonexistent. The folks in England fall on the other end of the spectrum and choose euthanasia for virtually all companion animals. As an alternative, natural deaths can vary between being very beautiful and peaceful experiences to ones that are scary, rocky and drawn out transitions.

When considering which is best for your pet, it is important to consider a number of acute conditions that are certain to involve major suffering without successful medical intervention. These include: bone pain (from fracture or cancer), inability to breath (from lung disease or the development of fluid, tissue or air surrounding the lungs) and inability to urinate. After receiving the diagnosis of one of these acute conditions, families understand how uncomfortable their pet is. The decision to quickly release pets from their suffering is relatively clear cut and the goal with euthanasia is to create a peaceful experience that mimics a calm natural death.

There are many ways to euthanize an animal. Important questions to ask to ensure a comfortable transition are: Will my pet be sedated to minimize their ability to feel any pain?
If the euthanasia solution is being given through a vein, is it being protected during the procedure through the use of an IV catheter? If venous access is not possible, will the solution be given through an alternative route painlessly? Will my location and ceremony requests be honored? Making the decision whether to euthanize or allow an animal to transition naturally is never an easy one, but planning ahead can give your loved one peace and dignity.

Body Care
The most common options for body care are cremation and burial. In contrast to human cremations, companion animals can not only be cremated 100 percent alone, but also with other animals, either partitioned by space, bricks or small divider, or in a communal group. Cremation that is 100 percent private is just that — one animal in the cremation unit at a time. Partitioned is a hybrid between group and private, with multiple animals placed in the same unit and separated by a small barrier or space.

The cremains (or ashes) are returned to the family after both 100 percent private and partitioned services. Ashes are not returned after group cremation. Those cremains are usually taken to landfill, spread at sea (if geographically available) or scattered. One thing to note is that with partitioned cremation, there is active co-mingling of the cremains that occurs within the cremation unit. For this reason, some crematories believe this practice to be unacceptable and don’t offer it.

Because partitioned is much more economical than 100 percent private, however, it can often be the only option besides group offered to a family. In some parts of the country, in fact, partitioned accounts for greater than 90 percent of non-group cremations.

To make it even more confusing, the terminology labeling the different cremation options can be varied and inconsistent. The words “private” and “individual,” for example, can both be used to refer to either 100 percent private or partitioned services. As such, it is understandable that fear and apprehension can accompany the selection of a cremation service for your pet. Sadly, there are many crematories where the line is blurred between dignified pet memorial services and those of a waste disposal company.

If 100 percent private cremation is your choice, it is very important to express those wishes. There are also some important core questions you can ask to ensure your pet will be treated with dignity and care:

1.  Can 100% private cremations be witnessed? Is there a public open door policy?
2.  What happens to the cremains of pets cremated communally?
3.  If the remains of those cremated communally are scattered, can they be visited?
4.  Can cremains be returned within a time frame to accommodate my wishes?
5.  What tracking system is used to guarantee animals are identifiable throughout the
process of private (or partitioned) cremation?

Remember that you have a right to ask these questions and your inquiries should be met with compassion, patience and thorough explanations. Anything short of that is a red flag. For an eye opening exposé on pet crematories, check out “The Troubled Cremation of Stevie the Cat” podcast at www.freakonomics.com .

Here in Chicagoland, we are blessed to have several crematories that only offer 100 percent private cremation and group. Examples of such crematories are Hinsdale Animal Cemetery, Chicagoland Pet Cremation, Moss Family Paws and Kozy Acres Pet Cemetery and Crematory.

Burial is another beautiful way to memorialize our pets and can be done either at a pet cemetery or on private property. Check with local county laws governing private burial and, if considering private burial, state law does require calling JULIE (1-800-892-0123) prior to any digging project. To prevent the attraction of wild animals, placement should be at least three-to-four feet below the ground’s surface, wrapped in plastic and placed in a pet casket or wood or metal box. Placing large stones or a heavy object over the top of the grave is another deterrent for curious wild animals.

The delicate subject of the latter days of our pets’ lives is never easy to tackle. Usually filled with questions, heartbreak and stress, families can find comfort knowing there are respectful and dignified options available to help create the kind of experience our companions deserve. They do so much for us. It’s the least we can do for them in their most tender years.

About the Expert

Alicia Harris, DVM is an experienced emergency veterinarian with a vast array of training at acclaimed referral hospitals and animal shelters across the United States. Working as an emergency veterinarian throughout the years has allowed her to gain a tremendous amount of experience helping families make end-of-life decisions about their beloved pets. She founded Compassionate Heart to provide hospice and euthanasia services at home for companion animals. In an effort to raise awareness about end-of-life care at home for pets in other communities, Compassionate Heart partners with veterinarians in Chicago, San Diego, Philadelphia and Sacramento.