Pawspice an option for pets facing the end

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By the time a client's pet has grown old, the human-animal bond has increased proportionately to reflect the years of caring and companionship. Facing the end of a pet's life, many clients want the same care for their pets that would be extended to any loved one.

So it is that "pawspice," the animal equivalent of hospice, has begun to arise as a viable alternative when pet owners are coping with the problems and pain of their terminally ill pets.

One of the most eloquent speakers about pawspice has been Dr. Alice Villalobos, director of the VCA Coast Animal Hospital and Animal Cancer Center in Southern California. The Animal Cancer Center, established in 1982, was the first private radiation therapy facility for pets in Southern California. During the AVMA Annual Convention in Salt Lake City, Dr. Villalobos led a talk about the pawspice movement. Her presentation was augmented by comments from her longtime oncology nurse, Bonnie McKinley.

"In-home pawspice care is a wonderful next step, and it should be introduced as an interval between the thought and the final act of euthanasia, if the owner really feels that their pet still has a quality of life," Dr. Villalobos said.

After her lecture at the 137th AVMA Annual Convention in Salt Lake City, Dr. Alice Villalobos (left) speaks with Dr. Marie Suthers-McCabe and Dr. John Wright. Courtesy of Dr. Caroline B. Schaffer

"It keeps the pet and the caregiver comfortably close to their nest. We want to celebrate the fragile people-pet bond at this time, and veterinarians on our staff can kindly and respectfully sustain this quality of life for terminal pets during the last days of life."

Dr. Villalobos, winner of the 1999 Bustad Companion Animal Veterinarian-of-the-Year Award (see JAVMA, June 15, 1999), said, "Pets in the terminal stages come to us at all times in all stages of life. I know house-call doctors often get panicked euthanasia calls, and the reason why the client is so panicked is because the doctor has instructed them that that was their only option, and that's not always the case."

She said that palliation should be a bigger word in a veterinarian's professional practice, especially with terminal patients.

"Palliation — that's what pawspice really is all about: to make things better. I like the word palliation because it has pal in front of it. We're doing something for our pal to make things better."

She has not discounted the last chapter of a pet's life as any less meaningful than the rest of its life. "I've had many lymphoma patients that are terminal when they are resistant to chemotherapy. But they're going to live for another three or four months. We have lots of those patients in pawspice care."

In-home care for pets takes a special kind of group commitment, according to Dr. Villalobos. Client and veterinary staff must all play a part in the pawspice care team. Willingness, she said is a key component.

Dr. Villalobos assigns instructions and special duties to her clients for in-home care that also give the owner a sense of purpose. "We get them into shopping for their pet," she said. "People love shopping. They'll go out and get the [diapers] and the wheelchairs and the egg crate mattresses and the ramps and the lifting harnesses."

Some families, she said, even acquire portable oxygen tanks for their pets. "We show them brochures, tell them about day care, bandage materials, therapy pools. They love it. We give them something to do, and it's a fantastic way to help people to tackle some of their problems."

She recommends group sessions for pet loss and encourages networking. "Sometimes I start frequent phone lists and have [clients] all connect with each other. If I find certain breeds that don't do that well with chemotherapy, I have the owners network with each other, so they can all figure out who's living the longest, and who's passed on and why."

A large portion of Dr. Villalobos' talk consisted of addressing specific situations, such as renal failure, paralysis, and cancer, and how she applies pawspice methods to them. In addition to medical care, however, she stressed the value of indulging in the simple joys in life. As has been seen in human medicine, "fun tends to suggest a connection to longevity," she said.

"My favorite story concerns a Newfoundland from Mammoth Lakes, California, that we'd treated over a year and a half before, but who we thought would now die within two weeks." Dr. Villalobos suggested the client engage in pawspice and a daily regimen of fun, which included swimming in Horseshoe Lake. "They wound up having this dog live for another seven months," she said.

Dr. Villalobos believes the veterinary profession can, with the cooperation of clients, emulate the philosophy of the hospice care movement in honor of the special relationship between people and their pets. "We're not just treating a dog or cat that belongs to a person, we're treating an entity called the bond."