Thursday, July 19, 2012

The Third International Symposium on Veterinary Hospice Care

Talia and Orli with Wally on his last walk
The Third International Symposium on Veterinary Hospice Care is at UC Davis July 20-22, 2013 !  It is open to all who are interested in learning more about Veterinary Hospice.  There are many amazing speakers scheduled and much food for thought.

The Symposium is sponsored by the Nikki Hospice Foundation ( and the California Holistic Veterinary Medical Asssociation.

More information and a link to registration can be found at

Veterinary Hospice seeks to take the principles from Human Hospice and provide quality end-of-life care for our dear animal companions.

I will be live tweeting from the conference, so join me on Twitter @hospice4animals to get updates on the proceedings at the Third International Symposium on Veterinary Hospice Care as they happen!

Monday, May 16, 2011

Saying Goodbye To Tanti

Two weeks ago, I again said goodbye to a dear animal companion.  This time, almost exactly a year after Sparky, it was my cat Tanti.  This time it was not the peaceful, idyllic experience that I had with Sparky’s death.  It was difficult.  I was second-guessing myself and on the verge of seeking euthanasia for Tanti daily.  She did die a natural death, but it was not comfortable for me, though I do not believe that she suffered.  Unlike Sparky, she just did not seem to be ready to go.

I think one thing that I have learned this time is that each death is an individual experience as unique and individual as those involved.  I do not think that any two people or animals live this life in exactly the same way, nor do they exit it in the exact same fashion.  Each death is, itself, a direct expression of the unique life that was lived.

Tanti was an annoying, ferociously loving cat that was always in my face  Whatever she made her mind up to do, she would not give up, no matter how many times I tried to deter her or distract her.  It did not matter if it was getting on the counter to drink water from the sink or kneading her claws on my back.  If she wanted it, she was going to do it with an unequal zeal and joy, and she persisted until she got what she wanted, every time.

It was no different in her dying.  Unlike her sister Mesa, she had not settled gracefully into old age.  She was as spunky as she had always been.  One day, seemingly overnight, she began to lose weight and became disinterested in eating and playing.  She started coughing and soon after went into a serious decline. After a week, I thought she was dying and decided that I should shift my philosophy of care from a cure to comfort care for her.  I tried to do everything I could do to make her comfortable and pain free, but it was very hard to watch her have a progressively difficult time breathing.  She never complained, she took it in stride, but she was clearly increasingly exhausted by her laborious efforts to get air into her lungs. 

It took, though, about ten days of this before she seemed to give up the idea, herself, that she was going to live on through this and persevere.  Eventually, instead of fighting it, I sensed her resignation as well, and it was a relief for me.  Death suddenly became the objective, the reward for both of us as a team and we could accomplish that in her time and with as much comfort and closure as possible.  As a veterinarian, I thought that she could not continue to live given the damage to her lungs, but as her owner that was difficult for me to accept.  One of the biggest difficulties was my panic that she did not understand how sick she was and that she was trying to continue to live despite how unrealistic I thought this had become.

It took Tanti about two days before she actually passed from this life.  She had been lying on the floor for a day, near the edge of my bed without moving around very much.   I spent much of the day lying beside her on the floor.  Suddenly, she struggled to get up and seemed to be trying to get in my lap.  It almost broke my heart because if I tried to pick her up her breathing would become much worse and she seemed to be entering the active immediate process of dying.  I would lay her back down, and only when I did let her struggle to breathe her last in my lap did she actually die.  I felt so conflicted, and did not know if the act of picking her up killed her, or if she was waiting to die to get in my lap!  I will never know except that I know that against my own comfort, I did what she was asking me to do ultimately.

In retrospect, her actual death was not nearly as difficult for me as the days leading up to it.  I felt I was suffering and at cross-purposes to her wishes to continue living, and I was giving her terminal, palliative care.  This was completely the opposite of the experience with Sparky, whose slow, gentle progression to death was easy and without conflict.  I have learned that my inability to remain peaceful through Tanti's death was a reflection of her tenacity and deep bond we shared.  There was not much peaceful about Tanti in life, and I guess I know now that her death reflected her life.  It was very difficult for both of us to let go and accept that our long integral journey together was ending.  It also was difficult because she was suddenly ill.  She seemed vibrant and healthy one day and weak and sick the next.  Once she died, I was able to examine her mouth and throat and saw a large tumor way back in the back of her throat with small nodules all over the very farthest part of her tongue that I could see.  This tumor must have quickly strapped her strength and weakened her immune system.  The virus and bacterial infections she had were only secondary. 

I buried Tanti next to Sparky in my backyard.  My house seems very empty, and yet, despite the difficulty of this experience, for me I am still glad that I was able to maintain hospice care for Tanti.  I am glad she died at home.  I can, though, never judge for anyone else when euthanasia is a gift they choose to give their pet.  Not all of us can spend the time at home, as long as it takes.  We have to be able to afford the luxury of both time and resources to offer the appropriate hospice experience.  We have to have support from our friends and family, and have understanding professionals to aid us in this journey.  I hope that with time, hospice care for pets will become a reality that is available to those who can offer it.  The availability does not always make this an ideal and peaceful process, though the result is usually gratitude and a much greater understanding and appreciation of life from our experiences with death.

Thursday, March 31, 2011

Saying Goodbye To Sparky: One Year Later

One year ago I said my final goodbyes to my dear twenty-three year old cat Sparky; or so I thought. I sat next to him and offered him comfort care as he approached the end of his life. I was fortunate enough to take care of him at home and give him Hospice care until he chose when to make his transition from this world we shared for so many years.  I was able to keep him comfortable and he seemed happy and peaceful right up to the very demonstrative way he made his exit.  (He demanded to go outside for the first time in ten years and died peacefully a few moments later on his blanket in the sunshine.)

Contrary to what you may think, Sparky's and my hospice experience was one of the most joyful times in my life. That was a very positive surprise. I was blessed to be able to set aside a few weeks of my life to be with him and tell him how much I loved him, tend to his every need and help him as his focus shifted away from this life. Experiencing hospice with Sparky taught me more than I could have imagined about my life, not just death. Instead of wrestling now with my grief and guilt, as I have for all the other pets I have loved that have died, I am instead, at peace. I am more comfortable with my life and the certainty of my own death. I even enjoy each day more.

How are all these positive benefits possible from an experience I dreaded and expected to be gut-wrenching and traumatic? My dear friend Dr. Ella Bittel teaches a course entitled Spirits In Transition ( that I took a mere six months before Sparky died. She taught me about the dying process itself: breaking it into stages just as we know from human hospice. We are most afraid of what we do not understand. By learning more about death I was freed from my overwhelming fear of the unknown. As a Veterinarian, I have seen death as the ultimate failure. I have advocated for Hospice, practiced it, as well as helped my animal clients make life and death decisions about their beloved pets, and I have euthanized thousands of animals.  Hospice does preclude euthanasia, but does not assume it is always the best option.  I have learned that Animal Hospice can teach us to accept death as part of life, not dread this process, and say goodbye to our dearest animal companions a different way.  We can allow them a comfortable, natural death.

I have come to cherish this time I had with Sparky, and it has truly rewritten my life.  Instead of saying a final goodbye to Sparky, his death has become a part of my life.  His lesson has left me daily with a new gratitude for each moment and every small experience of the deepest love that we can share; especially with the animal companions of our lives.  My personal hospice experience with Sparky left me most of all with an overwhelming experience not of mourning, but of abiding joy. He remains with me now each day, and he taught me that our dearest pets really are, always,eternally, and right now, here with us.  

Sunday, November 28, 2010

Writing Saying Goodbye To Sparky

Infinite Blessings                
 It has been so difficult to take Sparky's story to fruition.  I have been writing and writing and yet at times going around in circles.  I am trying to publish Sparky's story to help spread the word about Animal Hospice.  I feel driven to share my intense agonizing over the decision not to euthanize him.  I need to recount the experience and help others in the same situation arrive at their best solution given the wonderful/terrible responsibility we have for the animal members of our families.  I most want to share the incredible blessing that being present to his death became.  I finally am taking some steps to find a publisher and put it out there.  I hope it will explain how death progresses, why a natural death without suffering is possible, and help for those going through the grieving process.  I hope, also , that I can do justice to this calling that has captivated me and will not let me go!  Thank you for all the support and comments here and elsewhere, I will keep you posted!  In the meantime, have a Blessed Holiday Season, and love your pets, family, friends and your world the best you can while they are here.

Monday, August 30, 2010

Saying Goodbye To Sparky: Final Chapter 3/04/2010

Mesa keeps watch over Sparky
I thanked Sparky for moving to the new house with me.
Mesa loved him
Sweet Mesa kept vigil, watching over Sparky until one day before he died.  She sat for weeks, literally touching him all hours of the day until March 3, when I saw something very odd.  She stood up, and very carefully and deliberately stepped over his body one leg at a time.  She then walked away and never showed any interest in him again.  I knew she had said her goodbyes.  The next day he grew weaker and weaker, hardly lifting his head and his body became more and more stretched out.  I had to go to the title company one more time to deliver new loan documents in a very stressful, long drawn out refinance that was forced on me due to complications with the purchase on my new home.  I had to turn these papers in by five o'clock, and I was leaving town the next morning.  I knew Sparky was finally getting ready to leave this life, and I did not know what to do.  I left him on my bed for a few minutes and went to make some tea.  I heard a terrible THUMP and thought he had rolled off the bed onto the floor.  I was panicked and did not know what I would find as I ran from the kitchen to the bedroom.  Sparky had hardly moved for an entire day, yet there he was next to my bed on the floor dragging himself across the floor.  My heart broke as he started to howl.  I picked him up yet he struggled with all he had left and climbed frantically up my shoulder.  I took a deep breath and tried to feel what it was he wanted.  I put him back on the bed, only to have to watch him launch himself right off the edge and again, he fell, and hit the floor with a terrible thud.  I opened my bedroom door, and watched in panic and horror as he dragged himself through two rooms and pressed his nose against the french doors leading outside to the back yard.  He looked like a turtle trying to push open those doors with his nose alone.  He looked up right into my eyes and meowed. It was not any longer a howl, but a demand.  For a moment he again was my demanding bossy cat, though physically he was just skin and bones, his voice had all the strength and timbre of his younger self.  Suddenly I relaxed.  I knew he wanted to die outside NOW.  I asked him to wait as I ran and got his favorite blanket, grabbed him and rushed out into the beautiful Spring Arizona air and the sun warming the backyard.  I put the blanket and Sparky on the ground and lay down by him, now he was almost completely motionless.  Almost.  He stuck out his paw, and to my shock grabbed my hand with his nails and pulled it to him.  I stared in wonderment, all fear and anxiety had evaporated as I tried only to BE THERE with him.  He was running the show!  In another instant he completely relaxed and he seemed to sigh very deeply.  It came into my mind to tell him his life story and the words just began to pour out of me.  I thanked Sparky for moving to the new house with me, and waiting to die until I knew I could keep this home.  I told him what an amazing cat he was and how much he meant to me, and also how much Mesa loved him.  I told him how grateful I was that he had shared so much of my life with me.  I reminded him that he had gotten me through Vet School, the beginning and end of a marriage, and the birth of my daughter.  He had been there so long; longer than any man, through both wonderful and terrible times.  He was there so long I could not remember my life without him.  I told him I loved him, but I would be OK, and he could go.  
I will always love you Sparky
He breathed out deeply and he was gone.  I promised him I would bury him right there, in the spot he had chosen to die.  

I planted two small red sunflower seedlings next to his grave, and they flourished.  They grew tall and beautiful and made many seeds that fell there.  I know there will be many more red sunflowers next year to remind me of my special Sparky.

I will always love you Sparky.  You taught me that death was truly a beautiful journey, you taught me to let go of my fears.  I know I will see you again.