• Palliative Care - Palliation is defined as relieving or soothing the symptoms of a disease or disorder at any stage of an illness. Animal palliative care guides animals’ caregivers (their human family members or owners) in making plans for living well based on the animals’ needs and concerns and on the caregivers’ goals for care. It also provides caregivers emotional and spiritual support and guidance. Palliative care is of special significance in the context of terminal illness and end-­of-­life care. 

• Hospice Care - This special service is a mindset shift from curative treatment to symptom management and emotional support. Hospice care is about giving patients and caregivers control, dignity, and comfort during the time they have remaining to live. Importantly, hospice care offers spiritual support to patients and accommodates their beliefs about death and about afterlife as much as possible. It also provides spiritual and grief support for caregivers. 

Many people consider their pets as family members. It is always difficult and painful to say goodbye when the pets get old or have terminal illness. Similar to human hospice, veterinary hospice addresses treatment of pain and other symptoms to achieve the best quality of life regardless of disease outcome, while at the same time, provide the emotional support to the pet owners during this difficult time. Our goal is to provide the best quality of life and not necessarily the quantity of days. 

It can be devastating to find out that your pet has only a few weeks to live, that there is nothing that can be done about it. However, there is always something we can do about it. We can evaluate the pain level and treat the pain. We can adjust some home setting to help the pet maintain the daily routine. We can also utilize an integrative medicine as part of the multimodal approach to improve the quality of life.

Additionally, end-of-life care is a team effort involving the hospice veterinarian, the regular veterinarian (if there is one) and the pet owner. Together, a point-of-contact can be offered to families in need for consultation, hospice care, euthanasia, cremation services and most importantly, support during this difficult time.

One of the main focus of veterinary hospice care is to continously evaluate the quality of life of the patients. Since our pets cannot use language to communicate to us their discomfort and the pain points, it is important to have a veterinarian who is specialized in end-of-life care to educate pet owners on how to assess whether the pets are having good days or bad days. The goal is to avoid convenience or premature euthanasia. This will ensure that the pet is comfortable until the time has come, whether it is to die naturally, or until the need for euthanasia is determined by the family in consultation with a hospice care professional.

What to expect

During a hospice consultation, Dr. Kleefisch will review your pet's medical records and perform a thorough physical exam of your pet. He would listen in order to learn your expectations, goals and commitment in performing hospice care at home. He will evaluate your home setting and make suggestions to ensure your pet can still carry on the routines without difficulty. In a home situation, Dr. Kleefisch can evaluate whether the animal is in pain with more confidence. In the clinical settings, it is more difficult to do so as stress-induced cortisol (stress hormone) can mask the animal's pain. Depending on each pet's situation, medications may be prescribed for pain control, appetite stimulation, and wound care. Dr. Kleefisch will also provide you tools to monitor your pet's quality of life, discuss the end-of-life care plan, and provide emotional support.

If your pet can potentially be aggressive towards strangers, please let Dr. Kleefisch know in advance and he will discuss with you on how to prepare for the home visit appointment.

When Should You Consider Animal Hospice?

Hospice care for pets is still a new concept for a lot of people and even for some veterinarians. The bulk of the veterinary training is devoted to the goal of saving an animal's life. When all treatment options are exhausted, often the only humane option left is euthanasia to minimize prolonged suffering. However, this needs not be the case. Hospice care provides an alternative to the traditional approach of aggressively treating terminally ill patients.

Hospice care does not try to cure the incurable. Instead it focuses on caring and meeting the holistic needs of pets and their families during the final stages of life. It emphasizes managing pain and preserving the dignity of life using different palliative modalities. For many who revere modern medicine, it requires a paradigm shift to acknowledge that within reasonable human efforts to cure the disease, death is still a part of life and can be anticipated in comfort and with dignity.

Goal of animal hospice:
1) Focus on giving pets a safe, caring, intimate end-of-life experience in their familiar home environment
2) Focus on providing pain control and physical comfort to the pets, as well as educational support and emotional comfort for their families until natural death occurs or euthanasia is chosen
3) Educate and guide families to care for their pets' medical and emotional needs at home
4) Families are given time to adjust to their pets' progressive disease and say goodbye in their own ways in the comfort of being at home

Animal hospice should be considered if your pet faces the following situations:
1) Cancer with metastasis (spread to lungs or lymph nodes or other organs)
2) Treatment has been attempted but failed
3) Geriatric patient with multiple degenerative diseases
4) Trauma/disease that severely impairs pet's mobility or excretion control
5) Chronic illness that affects pet's routine
6) Owner decided not to pursue further diagnostic/treatment

You may want to consider these questions before committing to hospice care:
1) Do you have time and energy to care for your pet that may need multiple medications, wound care, and treatment that keep your pet comfortable?
2) Do you feel comfortable of administrating medication via injection or learning how to perform it? Most of the pets at their end stages would not want to eat or drink, and we will need to supplement them with fluid therapy by giving fluid under their skin.
3) Do you have time and resource to monitor your pet closely and report any changes to Dr. Kleefisch as soon as possible?
4) Is your family on the same page about hospice care by knowing that this is not for prolonging suffering or out of guilt of avoiding euthanasia?