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.

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 (http://www.spiritsintransition.org/) 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.  

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.
xxxjme

Saying Goodbye To Sparky

Tonight I think my 23 year old kitty Sparky may be beginning the active dying process.    I am much more aware now of the stages of dying that we and our animal companions move through as we near death. It is a kind of backwards dance with life; a graceful exit.  I have learned much through practical experience with dying patients.   But even more valuable was attending the first two International Veterinary Hospice Symposiums sponsored by the Nikki Hospice Foundation (www.pethospice.org) and taking Dr. Ella Bittel's Spirits In Transition course (www.spiritsintransition.org).


I am very peaceful and comfortable being present at a beautiful goodbye for my beloved pet.  I am making sure he is comfortable and trying to allow his wishes and not intefere as long as I believe he  himself is ok with it.  For the first time I am wholly committed to this experience. I am not attempting to control or change or  "fix" it.  I am trying to completely accept the best most holistic definition of Hospice as allowing the dying process. I hope I can accept it, not fear or avoid it,  not postpone or hasten this precious death.  I think I can do this because he is not suffering and I am not as ignorant as I was!  


Sparky is teaching me about my own life as I accept his death.  I feel so much at this moment like celebrating this miracle much as if it was a birth!  These are very personal statements, and I am not saying I would never euthanize him as I did many many animals in my past history.  I just pray that I do not need to.  I am hopeful that I can let him take his own time to die.  


This is absolutely the first time I have greeted the end of a dear life with joy and peace and not fear,avoidance or tragedy.  I will write more on these specifics of what I have learned later. 


I have no idea when he will decide to pass into the next realm. I am humbled and grateful to have arrived at this place to be just with him now in this sacred space.

The First Post/What is iaahpc?

We are here to help with the difficult questions, answers, feelings, decisions, and current lack of information on hospice care for animals.  This means we are here to help anyone concerned with the end of life compassionate care for animals or relieving pain in animals near the time of death or trying to understand and relieve pain in animals.  Whether you are a professional, (Veterinarian looking for information about providing Veterinary Hospice care,a Human Palliative Medicine provider, a Veterinary Nurse, or any Animal Care Professional) or just trying to get answers for your own animal, we are here.  Currently there is not a lot of information out there.  There ARE Veterinarians who have been practicing Animal Hospice (or Palliative or comfortable pain relieving care) for decades.  Unfortunately they are not yet in every city in the world, in every State in the USA, nor do most Veterinarians even know Animal Hospice exists.  There is a great deal of information available from both professional, commercial, owners and breeder sources to easily answer questions you may have about your new kitten or puppy.  We want to make information about Elder pet care just as easy to find when you need it.  Because we are all taking such good care of our animals, they are living longer and longer just like we are.  They are old enough to have more geriatric diseases and we must each ask what we want to do given our personal beliefs, what we can do given our resources and how to make these decisions in the best way we can.  We want to provide a place where those conversations, decisions and consideration can occur.  We also want to educate both Veterinarians and owners as well as other health professionals can get information or find a practitioner near you who can help.  There are both Allopathic, and Naturopathic  and inbetween Veterinarians practicing Palliative Care for animals.  There are those of us who believe in euthanasia and those that don't.  We hope we can provide a place for these debates to occur.  Our forums are open for discussions now, and we hope that you will help us grow this field so that when Jacquie-O needs it, there will be a place nearby that she can go.  Please comment here or contact us through www.iaahpc.org.  We grew out of a need that one dedicated Veterinarian (Dr. Amir Shanan) with a core group of people active in Veterinary Hospice Care and Veterinary Medicine.  This was done after the First International Symposium for Veterinary Hospice Care was held at the University of California at Davis College of Veterinary Medicine March 28-30,2008.  This conference was sponsored by the Nikki Hospice Foundation For Pets and the Assisi International Animal Institute, Inc.  I will talk about this legacy in another post, but in the meantime you can learn more here: www.PetHospice.org (Nikki Hospice Found.)  or www.iaahpc.org, the International Association for Animal Hospice and Palliative Care website for information about what this organization is trying to accomplish.  I say "we" because I am committed to helping this organization get off the ground.  It is very new just having been granted 501c status that allows members to join.  This is not an "official" website, I have just been inspired to add this to the effort.  I have been so humbled and overwhelmed at the amazing conversations that have taken place through Twitter.  I also have been reinvigorated because I see just how important this is for the gentle creatures that we love.  I practiced Veterinary Medicine for a long time before I knew about Animal Hospice.  I struggled years with trying to find the most gentle ways of touching and treating older animals that were in pain.  I spent many years trying to read and communicate with others about euthanasia and it is a sacred and heavy responsibility to decide on and to assist.  I spent many of my working hours counseling pet parents  about their choices and options.  I had a "comfort room" like a living room where I could talk quietly and let parents and kids spend the night with the ill animal members of their family.  I began to understand that some folks just did not feel it was their right to euthanize their pet, and I helped those animals be as comfortable as possible until their time came to leave our world.  I had practiced Animal Hospice for many years without knowing it existed.  No matter what your beliefs are it is wrong for each Vet, each pet owner and each animal to go through this re-inventing the wheel.   It is wrong we are left feeling alone with these wonderful/terrible questions.   Animal Hospice needs to be as much a part of your pets lifeplan as good preventative care and good nutrition.  Hospice needs to be a part of every veterinary practice or Veterinary Hospice Practitioners be available everywhere.  I want this to be easier for Jacquie-O when she grows old BECAUSE I took such good care of her at the beginning of her life so I CAN take better care of her near the end of her life.  Please, comment, here or follow me on Twitter and let me know what you think!  xxxjmedvm

Under Construction!Coming Soon!

Hi!  We are busy figuring this out,and we will get this up and running real soon!  This will be a place to remember your pets,ask questions,discuss end of life and palliative care....in short:WELCOME TO hospice4animals!!!