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Miss. Belle your memory will live forever in our home. You were far more than a pet, you were a valued family member. You took taking care of me on as your “job” and I will be forever grateful. We welcomed you into our lives shortly after the passing of my father, you were my savior. You even shared the same birthday as the wonderful man you never met. I miss you more than words can express. Please run pain free and happily over the Rainbow Bridge.
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Kringle was an amazing little fellow with a big spirit and a mind of his own. When he lost his best buddy, Lullabies, in the summer of 2014, he chose to live on with spirited engagement. He was truly blessed with good health, good mobility, a good appetite and strong curiosity right up to the last week of his near 21 years of age.
He had independence of spirit which both made me smile and reassured me that his spirit was fine. If I asked something of him that he did not want to do—like take vitamins or spray his teeth & gums–, he would “snort” at me. It was his favorite way of expressing his independence, and it always made me smile…..
About two weeks ago, life suddenly became difficult for him. He announced that he did not want medical intervention and further shared that he felt his life was “complete”. He was ready to join his five Pack buddies who were waiting for him in the Meadow. He announced that he wanted to go naturally as long as it was not too painful. He faced all bravely, and only at the very end did he ask for help over the last hill standing between him and release. As he had lived with spirited engagement, so he passed on to his new life peacefully and without hesitation.
I will hold Kringle’s 21 years of companionship in my heart forever, and it will always bring a smile to my face………
Kringle Watching Over Teddies

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I recently wrote this article for the Daily Progress “For Pets’ Sake” column.  See why I am passionate about spreading the word about hospice and palliative care for Charlottesville’s pets!SeniorCat_behavioral Palliative Care and Hospice for Pets Palliative care and hospice are important parts of end-of-life care in human medicine, and are a growing area of interest in veterinary medicine. These types of care can be described as treatment meant to give support and improves quality of life so that an individual may live as fully and comfortably as possible despite incurable disease. These philosophies provide guidance as we define hospice in veterinary medicine and extend this type of care to our aged and terminally ill pets.

 When is palliative care appropriate for a pet? Truly, much of what we do in veterinary medicine is already ‘palliative’. When our pets are ill, we often prioritize comfort and quality of life over exact diagnoses and long-term cure. Specifically, palliative care often begins when a diagnosis of a life-limiting disease is made, when a pet is very elderly or when more aggressive treatments have been tried, but are no longer effective or tolerated. Examples of conditions that may be suitably treated with palliative care include some types of cancer, kidney disease (especially in cats), arthritis and cognitive disorders. Although most patients are never cured, careful pain management, hydration and nutritional support and environmental modifications can vastly improve their comfort and extend their lives. Many palliative care patients also benefit from physical modalities such as acupuncture, laser therapy, massage and therapeutic exercises. There is no one “typical” palliative care plan. Each is designed to address the individual needs of the pet and their family, with the goal of having the pet feel and function as well as they can, despite ongoing and often progressive disease processes. Treatment plans always include extensive owner education about their pet’s condition, quality of life assessments and nursing care at home.

When does palliative care become hospice care?  In human medicine, hospice begins when a person‘s death is imminent, and focuses on supporting the patient and their family through the dying process. In veterinary medicine the line is not as clear, as we most often offer the gift of compassionate euthanasia to our pets before they reach the stage of active dying.  

Euthanasia  Euthanasia means “good death”, and most owners choose this when their pet’s quality of life is poor, providing a peaceful and pain free passage from this life. Typically, pets are first sedated and then given a painless overdose of anesthetic medication by injection. The entire process usually takes less than 30 minutes and most veterinarians allow owners to be with their pets the entire time.

What about “natural” death for my pet?  Death without euthanasia has often been called “natural” death.   In reality, there is nothing natural about pets dying of chronic diseases in our homes. In the wild, sick animals succumb to the elements or become prey, both of which offer a fairly swift demise. The preferred term is “palliated death” and it can be an option for some pets. It is, however, an intense and emotionally difficult option, requiring frequent and ongoing veterinary support to be sure our beloved pets are not “suffering to death”

This is really sad; why do we have to talk about death? Though we hate to think about it, our beloved pets’ lives are relatively short. Death is an inevitable part of life; necessary decisions and care deserve careful thought and attention. With palliative and hospice care plans, the focus turns away from cure and toward managing symptoms, hoping to maximize happiness and comfort and preserve the bond between the pet and their owner until the end of life.

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