The relationships people share with their pets are incredibly meaningful. These bonds bring joy, companionship, laughter, unconditional love, and enrichment to their lives and families. 

The flip side is that with those close relationships comes the unique responsibility of caregiving and making end-of-life plans for animal companions when they're ill and when they're aging. It’s a process that can be difficult and disheartening and puts pet owners in a unique position, according to Tanja Philhower, veterinary social worker for the University of Minnesota Veterinary Medical Center. 

“There are very few situations other than this one where we are so intimately involved in making those decisions without the input of our loved one,” she says. “When we are making healthcare decisions for our children, spouses, parents, or other family members, they're often able to give us input. The challenge with pets is that we're having to do a lot of guesswork in making those decisions and trying to do what's best for these members of our family.” 

In her role, Philhower helps hospital clients navigate end-of-life planning and the grief they experience both before and after their pets pass. 

Assessing quality of life

When a pet is reaching the end of its life, knowing when to say goodbye is one of the biggest struggles for owners. 

“Our pets are instinctively going to hide pain and discomfort,” Philhower says. “It's actually counterintuitive to think about them telling us when it's time—that's not their job. Instead, they try to mask that discomfort.”

Quality of life—the degree to which a pet is healthy, comfortable, and able to enjoy daily living—is a key aspect of end-of-life planning. Assessing this is unique to each pet, but there are areas that pet owners can monitor:

• Mobility: Your pet’s movement can reveal a lot about their quality of life. How is your pet getting around? How much do you have to assist them? Are they able to do basic things like take walks or go to the bathroom outside or in a litter box without many challenges?
• Signs of pain: Animals can’t tell us verbally that they’re in pain, but there are signs. For dogs, these may be whining, panting, or sensitivity to being touched. For cats, the signs can be more difficult to observe or differentiate from typical behavior, but these fact sheets can help you identify pain.
  -Colorado State University Veterinary Medical Center Feline Acute Pain Scale
  -University of Montreal Feline Grimace Scale Fact Sheet
• Appetite: Paying attention to eating habits also can help determine a pet’s quality of life. Is your pet eating their typical diet? Do they still get excited for meals and treats?
• Breathing: Is your pet wheezing, coughing, or open-mouth breathing? These are not normal and can indicate more critical problems.
• Hygiene: Is your pet struggling to reach and groom parts of their body? Are they no longer interested in grooming? Are they missing the litter box or no longer covering bowel movements in the box? Deterioration of grooming habits, especially in cats, can be a sign of quality-of-life decline. Social activities: Finally, is your pet still engaged with you? Are they still engaged with the other animal companions that you may have in your home or with other family members in their homes? Do they still enjoy their favorite activities?

Noting changes in these areas can help inform decisions about end-of-life planning for your pet. 

Making plans

As humans, we’re aware of our past, present, and future and often apply that perspective to our pets' lives and impending deaths as well. However, that’s not how pets see their existence.  

“Our pets don't experience the world in that same way,” Philhower says. “They live in the moment, so when we start seeing their detached, uncomfortable, or painful moments outnumbering the engaged and content moments, that's when it really might be time to start thinking about end-of-life plans.”

There are multiple end-of-life options that we can consider for pets, including unaided death, palliative care, and euthanasia.

Unaided death: 

When a pet dies without medical assistance, such as euthanasia, it’s known as unaided death. In some cases, this type of death can be peaceful, but in others it can be traumatic for both the pet and the caregiver. Philhower recommends being realistic about what that option could look like and its impact on all involved. Unaided death can be the best option for some people who have cultural or religious beliefs that conflict with euthanasia. If that's the case, then death can often be aided with palliative care options. 

Palliative care: 

This form of care doesn’t seek to treat illness but rather focuses on alleviating pain and discomfort and preserving or improving the quality of life for pets. It can include medication, acupuncture, and mobility assistance. 

“While palliative care may not necessarily extend the amount of time that you have left with your pet, it may extend the quality of time or the quality that you experience in the amount of time that you have left,” Philhower says. 

You can work with your pets’ veterinarian or a specialized service provider on a palliative care plan. 

Euthanasia: 

Euthanasia, the act of administering a lethal dose of drugs to induce death quickly, is likely the most recognized end-of-life option, but it’s one that often invokes feelings of discomfort among pet owners. In many cases, particularly in those where a pet’s quality of life has significantly deteriorated, it can be the best option. 

“Veterinary professionals consider euthanasia to be an act of kindness and compassion that they can offer to their patients to alleviate suffering and allow for peaceful and dignified death for our beloved animal companions,” Philhower says. 

Euthanasia is offered at veterinary clinics, but more clinics and specialized providers are offering in-home euthanasia services. Home-based euthanasia might be preferable if you have pets that are fearful of car rides, become anxious in the veterinary clinic, or are struggling with mobility issues. Some also pursue this option to allow other animals in the home to be part of the goodbye process. 

It may be preferable for you to pursue in-clinic euthanasia if you feel a strong connection to your pet’s veterinary care team, if the act of your pet passing at home is too painful, or if you have limited space for the procedure. 

You matter, too

While serving as a caregiver for a pet nearing the end of its life, it’s easy to get wrapped up in your companion's needs and neglect your own. It’s important to acknowledge that caregiving can have a profound impact on your physical health, emotional well-being, finances, and the bond you share with your pet.
 

It can feel like that bond is fraying when you start to struggle with caregiving duties, their impact on your life, and how your pet reacts to you while performing them. 

“If you're administering daily insulin shots to your cat, and suddenly your cat starts running away from you because they don't want to get those shots anymore, that's going to be hurtful,” Philhower says. “It's going to be hurtful to know that now this kitty who just loves sleeping by your head runs away when they start seeing you coming because they don't want to receive the treatment you're providing.”

Recognizing this impact and others can help you mitigate their effects on you and your pet. Other areas affected by caregiving include:

• Physical health: Caregiving can come with physical challenges. For example, if you have an 80-pound dog who is starting to struggle with mobility issues, you may find yourself having to lift them and developing back fatigue. You may also find yourself sacrificing sleep and nutrition to provide care.
• Finances: Caring for an ailing or aging pet can come with expenses such as medical procedures, medications, and special dietary needs. To afford these, you may struggle to pay bills, buy food for yourself, and meet other needs due to the financial strain of medical care.
• Emotional well-being: When the death of a pet seems imminent, you may start to experience what feels like an emotional rollercoaster that includes crying, sleep disturbances, and appetite changes. This is called anticipatory grief, or starting to grieve in advance of your pet’s death.
  “With anticipatory grief, it's important to practice self-compassion,” Philhower says. “I think that being patient and kind with yourself and recognizing that losing a loved one, whether it's a human loved one or a non-human family member, is deeply painful, and it's even more painful when you're the one who is responsible for making the decisions regarding end-of-life care.”

Even when anticipated, the death of a pet can still be an overwhelming and devastating experience, but planning and resources can help with navigating the loss, honoring the pet’s memory, and finding peace.   

For more resources on this topic, visit the Veterinary Medical Center’s Social Work Services webpage or watch Philhower's Animal Health Education Series webinar.