Dog Hospice Care Guide

No matter how gently a vet breaks it to you, nothing is more heartwrenching than learning your dog’s condition is untreatable. In this situation, many pet parents opt for euthanasia as a humane way to ease their pet’s suffering. However, it’s not the only option. Many pet parents are considering dog hospice care to provide comfort and dignity for a pet’s final days.

Though pet hospice care is relatively new, this specialized field is evolving rapidly [1]. Pet hospice care has become so well-received, in fact, that demand for these services now outpaces supply [2].

There’s a lot to consider when choosing the right hospice care provider for your beloved dog’s end-of-life care. It can feel overwhelming, especially when you’re already dealing with so many emotions. However, you don’t have to make this tough decision all on your own.

Your veterinarian can be a valuable source of support and guidance. And if you’re not sure how to approach the conversation, here’s a simple, helpful guide. It’s full of expert insights from veterinarians who specialize in hospice care to help you navigate this difficult process.

What is Dog Hospice Care?

Dog hospice care is a compassionate option for pets nearing the end of life. While it takes inspiration from human hospice care, it doesn’t necessarily mean the same thing.

We talked to Dr. Robin Downing, DVM, hospital director at The Downing Center for Animal Pain Management in Windsor, Colorado, to learn more.

One key distinction is the role of euthanasia. “While it is true that veterinary medicine has adopted the term hospice, euthanasia is a critical part of that care,” says Dr. Downing. By contrast, in most cases, human patients must legally die without any assistance, she says.

Pet hospice care is an option for dogs nearing the end-of-life stage. But that doesn’t always mean euthanasia is imminent. “No specific time frame is established,” says Dr. Elke Rudloff, DVM, a veterinary emergency & critical care specialist with BluePearl Pet Hospice in Milwaukee, Wisconsin. “It may be many months or a day,” she adds.

Unlike traditional veterinary care, the goal of dog hospice is not to treat a disease or condition. “The emphasis is on management,” says Dr. Downing, who is board-certified in pain management. There’s a focus on comfort and quality of life for the patient and ongoing support and partnership with the family,” she adds.

Palliative care for dogs is another term often used interchangeably with dog hospice. While palliative care also emphasizes comfort and disease management, it makes treatment options available.

As Dr. Rudloff explains it, palliative care can involve “targeted treatment and tests of the illness or injury.” In some cases, you may have several providers managing problems within their expertise. Palliative care and hospice care are both focused on improving comfort and quality of life. While palliative care can occur at any time in the course of disease, hospice care specifically refers to end-of-life comfort care.

What Services Does Dog Hospice Care Include?

The following are general categories of services pet hospice providers typically offer, though they can vary. 

• Pain management. Dogs may receive medications to relieve pain, anxiety, and other symptoms. Hospice providers may also provide alternative therapies like acupuncture, heat therapy, and hydrotherapy.
• Assistance with mobility and hygiene. Dogs with difficulty walking may have access to ramps or special harnesses to help facilitate movement, or the provider may use tools like exercise balls to help with range of motion.
• Nutritional support and hydration. Staff work to ensure dog hospice patients eat an appropriate diet and drink ample water. Veterinarians may also prescribe a custom diet and nutritional supplements.
• Emotional and grief support for pet parents. Although the primary focus is on canine well-being, dog hospices may also provide guidance for grieving pet parents. Pet hospice providers may have partnerships with grief counselors, therapists, and pet loss support groups. 

The Difference Between In-clinic Hospice Care and At-home Hospice Care

Dog hospice care can happen in various locations. Here’s how it typically breaks down.

In-clinic hospice for dogs

In-hospital pet hospice is reserved for patients who are not responding to veterinary medical treatment, says Dr. Rudloff. These are 24-hour care facilities equipped to handle end-of-life care for dogs.

Such facilities typically have certified veterinarians and/or technicians with experience in hospice and palliative care for animals. “They may also provide the support of a veterinary social worker or grief counselor,” Dr. Rudloff explains. “In addition, they may offer the alternative to euthanasia with hospice-assisted death.”

At-home hospice for dogs

Providing hospice care for dogs at home may be an option for some pet parents. However, it’s essential to have the support and guidance of a trusted veterinary professional.

Dr. Downing recommends working with a veterinarian who makes house calls to ensure your dog’s at-home hospice stay goes smoothly. Such vets often work independently with the patient and family or in partnership/cooperation with the primary care practice. 

“As an alternative, a trusted and well-trained veterinary technician who has a relationship with the client and patient can serve as an intermediary,” she adds.

There may be some tasks, like wound care, that pet parents can perform on their own at home. However, it’s important to know how to do so safely. Dr. Downing suggests asking your vet care team to make a video demonstrating proper care techniques. “Or ask if there is a way for you to do the task yourself in front of the team for coaching,” she says.

Although costs for at-home pet hospice services vary, they typically run between $300 and $650 dollars. This price might include a home evaluation, a wellness plan, and one month of care. After your pet has passed away, there is an additional cost for body aftercare.

How to Tell if Dog Hospice Care is Right for Your Pet

Whether to use end-of-life care for dogs is a decision every family must decide for themselves. And there’s no one right answer that fits every situation.

“Each person arrives to that point in their pet’s life with a different point of view,” says Dr. Jerry Klein, DVM, chief veterinary officer at the American Kennel Club. Various factors may shape their perspective. These may include moral, religious, emotional, or economic considerations, Dr. Klein adds.

The key is to work with a trusted veterinarian who can guide you through the process. In general, some signs that it may be time to consider pet hospice include:

• Chronic illness or terminal diagnosis that can’t be treated
• Severe pain or discomfort that traditional treatment cannot relieve
• Difficulty eating, drinking, or moving comfortably
• Inability to breathe easily or independently
• Inability to urinate or go to the bathroom

“Hospice care can be appropriate when a pet has a terminal illness, an injury or disease that is not manageable, or age-related changes that negatively impact a pet’s quality of life,” says Dr. Rudloff.

However, according to Dr. Rudloff, there’s another key element to consider. “The burden placed on the caregiver must be factored into the decision to pursue hospice care,” she says.

Veterinarians often recommend using quality-of-life (QoL) scales to help guide this process. Dr. Downing suggests two helpful tools: the Alice Villalobos Quality-of-Life Scale and the Lap of Love Quality-of-Life Scale.

“These scales provide a way to create at least some objectivity within a very subjective situation,” Dr. Downing says. “As the score declines or gets close to zero, it may be time to engage a palliative/comfort care focus,” she adds.

Many animal hospice providers offer in-home and virtual quality-of-life assessments, says Dr. Rudloff. These can “bring clarity to their pet’s situation and bring the family together in their beliefs.”

How to Choose the Right Hospice Care for Your Dog

Finding the right pet hospice provider can be overwhelming, especially when you’re already under stress. Here are a few things to consider to help you make the best decision.

Resources for Finding a Reputable Dog Hospice Provider 

• Start with your primary care veterinarian, says Dr. Rudloff. “They may have a team in their group who welcomes hospice patients. If they do not, or if they may not be as accessible as you want them to be, ask for a referral.”

Other places to look for canine hospice providers:

• Blue Pearl Pet Hospice provides a wide range of in-home services, including senior care and end-of-life services. If you’re uncertain which service to opt for, they offer convenient virtual quality-of-life consultations. 
• Lap of Love has veterinary hospice practices across the country.
• Search pet hospice directories like Vetangel.com and Inhomepeteuthanasia.com.  

Get Personal Recommendations and Check Online Reviews

Ask people you trust if they’ve had experience with end-of-life care for dogs. “In some cases, it can be one’s own veterinarian or a reputable veterinary technician. Ask your vet if they have had other clients use their services,” says Dr. Klein.

Be diligent about checking online reviews from a variety of sources. Keep in mind that one negative review doesn’t necessarily mean a provider is unfit, especially if the person wrote it while experiencing grief. 

How to Evaluate a Dog Hospice Provider

The veterinary hospice provider should have staff that are compassionate, confident, and respectful of your beliefs. They should also be available at your convenience.

“The ideal hospice care provider has trained medical staff (veterinarians and/or credentialed technicians) who are available seven days a week,” says Dr. Rudloff. Staff should also be able to answer any questions, arrange for medication refills, and provide resources for grief support.

Consider asking for an initial consultation. Dr. Rudloff says this should include a quality-of-life and pain assessment, review of the pet’s medical history, and a patient examination.

In addition, she suggests discussing these key topics with the provider:

• your pet’s disease trajectory
• what is essential in the provision of comfort care
• ways to memorialize their pet
• what euthanasia and natural death may look like
• aftercare options
• grief support resources

Questions to Ask a Potential Dog Hospice Provider

Questions Dr. Downing recommends asking include:

• How does the practice handle end-of-life patients?  
• Do they offer in-home assessments when the patient can no longer travel comfortably?  
• Do they partner with any house call veterinarians to provide in-home care?
• Do they offer in-home euthanasia? 
• What is their availability for in-home care?

She also recommends checking if the facility has received certification in end-of-life care. This is a continuing education course offered by the American Animal Hospital Association (AAHA), a nonprofit organization that sets standards of excellence for veterinary hospitals.

Caring for Your Dog During Hospice

If you’ve opted for in-home dog hospice, with the guidance of your veterinarian, here are some general tips to help you navigate the process.

Set up a comfortable and safe environment

“The foundation for hospice care at home is setting up a comfortable and safe environment,” says Dr. Rudloff. She says the following can be beneficial:

• Easy access to food and water.
• Padded and washable bedding and slip-resistant flooring.
• Elevated food and water bowls to relieve neck strain. 
• Tasty foods that don’t upset the stomach. 
• Boots, toe grips, and paw pad adhesives to help navigate slippery surfaces.
• A well-fitting harness with a handle for support.  
• Ramps or steps positioned in front of the sofa or bed. 
• A resting place in the sun or a heating pad if the dog seeks heat. 
• Obstacle-free spaces if the dog tends to wander.
• Washable pads or absorbable bands and pants, provided the moisture doesn’t create an environment ripe for infections and ulcers.  
• Webcams to monitor the dog when you’re not at home.   
• Gated-off areas that are unsafe for your dog when unsupervised.

Monitor your dog’s condition 

As the dog’s health declines, it’s essential to perform regular quality-of-life assessments, says Dr. Downing. “When the score is below a certain level, or when one category seriously dips, it is appropriate to reach out to the healthcare team,” she says. “This is one time when a house call option becomes very important.”

Establish a grief support network

Although pet hospice care providers are trained at recognizing grief, they may not be equipped to help with complicated grief, says Dr. Rudloff. “They should, however, provide resources on where to find help.”

She suggests pet-loving friends, family members, prayer groups, clergy, or a trusted professional can also be effective sources of comfort. 

Pet parents providing end-of-life care to their pet may experience anticipatory grief, which is grief that is felt ahead of an expected painful loss or experience. Dr. Downing recommends checking social media groups that cater to pet parents with aging pets. “They provide opportunities to connect with and interact with folks facing similar situations. It can be very isolating to be wrapped up in the complex care for a pet approaching death. Knowing and connecting with folks having like experiences can be both comforting and empowering.” Mental health professionals may also provide help to you as you navigate this time in your pet’s life. 

One social media group veterinarians recommend is Pet Hospice Community, currently on Facebook.

Make a plan for post-hospice self-care

It’s normal to feel overwhelming feelings of sadness, guilt, indecision, and other profound emotions, says Dr. Rudloff. You’re not alone, however. Aside from leaning on family, friends, your faith, or a trusted professional, you might consider joining a pet loss group. Ask the pet hospice for recommendations or check with your own veterinarian or humane society. 

A few other support groups to consider:

• BluePearl Pet Hospice has a private Facebook support group. 
• Association for Pet Loss & Bereavement publishes a directory of support groups.
• Lap of Love offers free pet loss support groups.

You can also take solace in knowing that you selflessly prioritized the well-being of your dog. Dr. Rudloff expresses it this way: “Seeking hospice or palliative care does not mean you have sentenced your pet to death. Seeking hospice or palliative care means that you want to honor them with the best care possible for the rest of their life, whether it will only be for a few days, many months or a year.”

And remember that dogs view life differently than we do, reminds Dr. Klein. “Animals are blessed in that they appreciate life in the here and now. They are not as bogged down by the possibilities or disappointments that the future may bring.”

REFERENCES

1. Shanan, A. and Shearer, T. (2023). What Is Animal Hospice and Palliative Care?. In Hospice and Palliative Care for Companion Animals (eds A. Shanan, J. Pierce and T. Shearer). https://doi.org/10.1002/9781119808817.ch2
2. Kanda, S. (2024, May). Pet Hospice in the US – Market Research Report (2014-2029). IBIS World. Retrieved from https://www.ibisworld.com/united-states/industry/pet-hospice/6410/