What is Pet Hospice?
Pet hospice, also know as “comfort care,” is a very specialized type of veterinary care for pets in the end-of-life stage once the owners have decided not to pursue curative treatment. Comfort care focuses on quality of life and comfort, not a cure.
Doesn’t That Mean Giving Up?
Not at all. It simply means you have a different goal. With comfort care, we focus on educating owners as to what to expect, and helping you plan for your pet’s end of life transition, be it pet euthanasia or natural death. We focus on your family’s needs, as well as your pet’s.
Interestingly, studies have shown pets in hospice tend to live longer than those who continue to pursue curative therapy! We believe this is because providing good quality of life extends the time a pet can remain with us.
The Quality of Life Assessment
All families considering hospice care are given an initial Quality of Life Assessment appointment. You do not need to wait until you think your pet may be close to dying- in fact, we encourage visits as early as possible! The sooner after a terminal diagnosis is made, the more information we can help you with in terms of planning ahead.
Quality of Life Consultation
The goal of the Quality of Life consultation is to help the family decide if it’s time for euthanasia. The appointment time will be spent with the veterinarian, who will review records, perform a physical exam, and discuss quality of life and pain scales.
Euthanasia will not be possible during this appointment, and will only be considered if the pet is in distress or considered an emergency by the veterinarian.
The Quality of Life Consultation does not including euthanasia, ongoing medical support, or prescription medications.
Comfort Care Consultation
A comfort care consultation is required for pet parents thinking of having Paws into Grace provide ongoing comfort care. The appointment time will be spend with the veterinarian, who will review medical records, perform a physical exam, and spend time with your family to create an ongoing plan of care to ensure your pet’s comfort and quality of life.
This 1.5-2 hour consultation covers everything from the Quality of Life Assessment and adds on a specific medical plan for providing palliative care for your pet, including:
- Two weeks of medical management, communication, and plan adjustments with our Comfort Care Team
- Family education and support with home comfort care routines, including diet and environment
- Support from your pet’s dedicated Comfort Care team
- Optional in-person recheck exam ($325 + travel fees)
- Optional comfort care support renewal for continued remote support with our Comfort Care Team (two weeks for $200, four weeks for $375)
- Optional Comfort Kit medications to support your pet’s transition when it is time ($150-200)
Comfort Care Fees
Once enrolled in Comfort Care, the initial consultation fee of $525 (San Diego/Temecula area) $530 (Orange County) * additional travel fees may apply – includes one month of follow-up phone calls, emails, etc. **
At the end of two weeks, should the client wish to continue the hospice relationship, fees are $200 for two weeks or $375 for four weeks of follow up phone calls, emails, etc.
* Additional travel fees may apply
** Refunds not available
What kinds of diagnoses may benefit from Comfort Care?
Liver Disease: Liver Disease may have underlying causes such as infection, inflammation, cancer or even fat invading the liver known as hepatic lipidosis when cats have anorexia for a prolonged period of time. Symptoms may include anorexia, lethargy, yellow skin known as icterus, seizures and even collapse. Your Veterinarian may have diagnosed liver disease after a blood panel and abdomen ultrasound. Palliative treatment options to enhance Quality of Life may include : appetite stimulants, anti-nausea medication such as Cerenia and others depending on symptoms. Read more about liver disease.
Hemangiosarcoma: Hemangiosarcoma is a tumor affecting the spleen, liver or even around the heart. Patients with these tumors often present with a history of collapse, lethargy, weakness from acute anemia or blood loss. The tumors may bleed internally with no other signs. Often patients are in acute distress and may need an emergency blood transfusion. Palliative care may include pain medications and supplements such as Yunan Biao. Unfortunately, euthanasia is recommended for these patients rather than Comfort Care. Read more about Hemangiosarcoma.
Pericardial effusion: Pericardial effusion is a term used to describe fluid around the heart. A heart tumor may cause fluid around the heart or pericardial effusion may be idiopathic meaning there is no known cause. Fluid around the heart puts pressure on the heart making it difficult for it to contract, sending blood throughout the body. Arrhythmias and a reduced contraction force causes collapse, weakness, lethargy and low blood pressure. Often these patients need critical emergency treatment. The Veterinarian must perform a pericardiocentesis removing fluid around the heart so that the heart can beat. Most often, a cardiac or heart ultrasound will also be recommended to determine if there is a heart tumor. Euthanasia rather than comfort care is usually recommended for these patients because fluid may come back very quickly creating a life threatening emergency.
Pleural effusion: Pleural effusion is a term used to describe fluid around the lungs. There are many different reasons. These may include: cancer, low protein levels known as hypoproteinemia, heart failure, infection, coagulopathy (blood doesn’t clot because of rat bait or a clotting disease from low platelets or severe liver disease, FIP in cats or chyle from the lymphatic system. Symptoms may be: difficulty breathing, open mouth breathing, increased effort breathing, pale gums or muddy discolored gums and tongue. In severe cases there may be collapse. X Rays or an ultrasound are used to diagnose pleural effusion. The fluid may be sent to the lab to determine the underlying cause and thoracocentesis (draining the fluid) is usually recommended. Fluid around the lungs makes it difficult for the lungs to exchange oxygen. Patients have breathing until the fluid is removed. Oxygen levels are often checked with a device known as a pulse oximeter and oxygen or sedative medications to calm a patient are often given. Prognosis for a patient with pleural effusion may vary depending on the underlying cause. Patients with an infection called Pyothorax or those with coagulopathy caused by rat bait (Rodenticide ingestion) usually have a good prognosis with proper treatment while other causes such as FIP (Feline Infectious Peritonitis), Cancer, hypoproteinemia or heart failure have a poor prognosis. Euthanasia is usually recommended in these cases. Intervention with Euthanasia rather than ongoing comfort care is recommended for these cases to avoid suffering.
Lung Tumors: Lung Tumors may be caused by aggressive or benign (non malignant) tumors. Senior patients most often have lung tumors caused by metastasis. Metastasis means there is an aggressive tumor somewhere in the body that has spread to the lungs. Lung Tumor or metastasis symptoms include: breathing difficulty, open mouth breathing or increased effort breathing, pale or muddy colored gums and tongue. Intervention with Euthanasia rather than ongoing comfort care is usually recommended for these cases to avoid suffering. Read more about lung tumors.
Nasal Tumors: Nasal Tumors are usually caused by aggressive cancer. Symptoms include: epistaxis (bleeding from the nose) and louder breathing (stridor). X Rays under sedation or anesthesia are used to diagnose a nasal tumor. Further blood tests called Fungal Titers to rule out Aspergillosis or even a biopsy may be needed to be certain a tumor is present. Comfort Care is focused on pain management. Read more about Nasal Tumors.
Oral Tumors: The most common Oral tumor in cats is Squamous Cell Carcinoma. Unfortunately, this tumor is often very aggressive causing bone destruction, swelling and discomfort. Symptoms include: bleeding from the mouth, decreased appetite, anorexia or difficulty eating and facial swelling. Comfort care is focused on pain management, antibiotics and anti-nausea medication. Read about Oral Tumors.
Seizures: Seizures may be caused by many causes inside or outside the brain. These include: brain tumors, liver disease, low blood sugar also known as hypoglycemia, kidney failure, idiopathic epilepsy or toxins. There are many causes of seizures. It is important to treat the primary disease causing seizures when possible. Comfort care focuses on decreasing how often seizures occur and how long a seizure lasts with medications. Read more about Seizures.
Kidney failure: Kidney Failure means the kidneys are no longer functioning to filter toxins and prevent dehydration. The kidneys are needed to reabsorb water back into the body, remove waste and restore electrolytes. If kidneys are failing common signs include: increased drinking and urination. The kidneys are no longer taking water back into the body. The water is sent to the bladder instead producing excessive urine. Your pet becomes dehydrated when the kidneys are no longer reabsorbing the necessary water back into the bloodstream. They feel dehydrated and drink more water to compensate for the increased loss. Unfortunately, they are not able to drink enough water to stay hydrated. Toxins also build up making them feel nauseous and common signs of vomiting, diarrhea, weakness and lethargy may result. Anemia or a low red blood cell count may also develop because the kidneys are responsible for releasing Erythropoietin which tells the bone marrow to release red blood cells into the bloodstream. When the kidneys fail or shut down the Erythropoietin signal is no longer sent to the bone marrow and the red blood cell numbers fall. Anemia symptoms include pale gums, weakness and faster breathing. Kidney failure can be managed in many cases for a long time with Comfort Care. Read more about Kidney Failure and care.
Congestive Heart Failure: Congestive Heart Failure is caused by the heart not pumping blood forward with strong force to the rest of the body. This may develop from leaky valves (mitral or tricuspid valve disease) or other heart conditions such as dilated or hypertrophic cardiomyopathy. Congestive heart failure symptoms include a distended fluid filled abdomen if there is right sided failure or difficulty breathing with fluid in the lungs if there is left sided heart failure. Comfort care focuses on diuretics to remove fluid from the lungs, oxygen and in most cases emergency hospitals to stabilize a patient if there is acute respiratory distress (breathing difficulty). Read more about Congestive Heart Failure.
Osteosarcoma: Osteosarcoma is another name for Bone Cancer. This type of cancer usually affects the knee also known as stifle or front wrist also known as the carpus but other areas may be involved such as the hip, mandible or jaw, ribs or shoulder. Symptoms include lameness or limping with or without swelling. The most common history is a lameness that initially improves with rest and anti-inflammatory medications but progresses or becomes dramatically worse despite medications. X Rays are used to diagnose this type of tumor with classic changes including bone destruction and swelling. Read more about Osteosarcoma in dogs and Pain Management.
Lymphoma: Lymphoma may affect organs or the lymph nodes. Symptoms may be vague such as lethargy, decreased appetite, vomiting, weight loss or swelling at affected lymph nodes. The lymph nodes should not be enlarged or noticeable around the jaw, shoulders or legs. If these are enlarged there may be lymphoma present. Diagnosis is made by aspirating affected lymph nodes and further tests such as a blood panel, X Rays or Ultrasound are often needed. Lymphoma is most effectively treated with chemotherapy by an Oncologist but palliative comfort care may include only Prednisone. Read more about Lymphoma.