Home Hospice and Euthanasia for Pets: Saying Goodbye with Love and Dignity

Join Amy Castro and Dr. Mary Gardner from Lap of Love in-home pet hospice and euthanasia as they have a poignant yet frank discussion about the benefits of in-home pet hospice and euthanasia and offer insights into navigating the emotional journey of a pet's end-of-life. Discover the nuances of end-of-life care, managing chronic conditions, and coping with anticipatory grief. They share tips on preparing for and coping with pet loss, including:

- Creating meaningful end-of-life experiences
- Communicating about the decision
- Understanding and navigating the journey
- Managing the guilt about decisions made and not made
- Letting go of the guilt pet parents may feel over the relief of a pet's death
- And more.

Celebrate the uniqueness of each pet's journey and explore compassionate care options to ensure their final chapter is filled with dignity and love. Tune in for heartfelt conversations and support during this challenging part of the pet parenting journey.

Shoutouts in this episode:
Parkwood Animal Hospital, Friendswood Texas
End-of-Life Pet Photography from One Last Network
Nancy Gordon - Pet Loss and Grief Expert

• Check out Nancy's new book "I Miss You Already: Bearing the Unbearable Loss of Your Pet."

Pet Vet Animal Hospital - Deerfield Beach, Florida

Additional Resources Provided By Dr. Mary Gardner:

Mary's personal website: https://www.drmarygardner.com/
Lap of Love website: lapoflove.com
Dog Quality of Life Scale: https://www.drmarygardner.com/resources/forms/dog/dog_QOL.pdf
Cat Quality of Life Scale:

Transcript

Amy Castro, MA, CSP: 0:00

When we're facing the end of a beloved pet's life, the journey we create for ourselves and our pet is as important as the decisions we make along the way. For many, this journey culminates in a final car ride to the vet, and while most veterinary practices strive to make this process intimate and comforting, there's an alternative that many pet parents aren't aware of. Today, we're shedding light on this overlooked option and exploring how we can provide even more peace and dignity to our pets in their final days and moments. Stay tuned. You're listening to Starlight Pet Talk, a podcast for pet parents who want the best pet care advice from cat experts, dog trainers, veterinarians and other top pet professionals who will help you live your very best life with your pets. Who will help you live your very best life with your pets. We also share inspiring rescue and adoption stories from people who've taken their love of pets to the next level by getting involved in animal welfare. My name is Amy Castro and I'm the founder and president of Starlight Outreach and Rescue and a columnist for Pet Age magazine. I've rescued thousands of animals and helped people just like you find the right pet for their family. My mission is to help pet parents learn all the ways that they can care for, live with and even have fun with their pets, so they can live their very best lives and their pets can too.

Amy Castro, MA, CSP: 1:15

Welcome to Starlight Pet Talk. I'm your host, amy Castro, and my guest today is Dr Mary Gardner. And for Dr Gardner, there is nothing better than a dog with a gray muzzle or a skinny old cat A woman after my own heart. Her professional goal is to increase awareness of, and medical care for, geriatric veterinary patients and to help make their final stage of life as peaceful as possible, surrounded with dignity and support for everybody involved. A University of Florida graduate, she discovered her niche in end-of-life care, which inspired her to found Lap of Love, which has more than 350 veterinarians around the country who are dedicated to veterinary hospice and euthanasia in the home. Dr Gardner has also published two books on caring for geriatric pets, which I think everybody needs to check out, but the first one is called it's Never Long Enough, which is about dogs. And then, for us cat lovers, nine lives are not enough for cats. So, dr Gardner, thank you so much for being here with me today. I really appreciate it.

Mary Garnder, DVM: 2:14

I'm excited. I love me some cat lovers.

Amy Castro, MA, CSP: 2:18

Well, you know it's funny. So the podcast for those who are listening who may not know, is that our podcast is called Starlight Pet Talk because our animal rescue is called Starlight Outreach and Rescue and we didn't start off intending to be a cat rescue and we're not. I mean we've got donkeys, horses, dogs. But because of just the sheer nature of trying to run a rescue out of a five bedroom suburban house, it's like where can I stash animals in bedrooms? And it's kind of hard to stash puppies in bedrooms or donkeys, or donkeys. Yeah, exactly, but you know cats and kittens you know, I think.

Amy Castro, MA, CSP: 2:51

I had somebody living in every bathtub along the way. So yeah, but we're expanding. We're expanding out here at our rescue ranch. So this subject, I think, is one and I was talking to Dr Gardner before we get started about one of my last experiences with euthanasia with my personal pets. But this is a very tricky time for pet owners and I think people really struggle with what to do. And you know how is it that you decided to start the business Lap of Love and what got you so interested in this final stage of a pet's life?

Mary Garnder, DVM: 3:27

interested in this final stage of a pet's life. So great question, and I think it's best actually if I start with my pre-veterinary life. Sure, so I actually did not grow up thinking I wanted to become a veterinarian like many do. I loved animals, but I was not the academic nerdy person. Not the academic nerdy person, but I uh.

Mary Garnder, DVM: 3:47

I actually was in um, the, uh, the software industry. So I was a business analyst and a software designer, uh, in many ways. So I worked for a very large software company for about a decade and it was, yeah, so it was during one of my trips where I cause I had to travel a lot for that job and I had to. Uh, I had an older dog. She was about 12 at the time, her name was Snow White and she was a Samoyed and so I had to travel for work. So I I left her in the care of my brother and so he had two Rottweilers.

Mary Garnder, DVM: 4:19

He was putting his house up for sale, so he had to leave cause they were doing a showing or whatever, and so he put his all three dogs in this very large pen area that he had out back like 20 by 20, like huge thing.

Mary Garnder, DVM: 4:29

And when he came back he didn't really notice. But while he was gone they all got in a fight and Snow White sustained a lot of injuries. So she had 72 bite wounds and a broken jaw and, um, I'm not against Rottweilers, but when you have an old Samoan against two Rottweilers and you know it can it's not totally fair. So she was in the hospital for about three weeks, in and out with with wound care, you know, infection, the broken jaw and everything. And one day they called me. She was in the hospital and they just said you should probably come and visit her Cause we had to do a blood transfusion and I didn't know what that meant, you know. So I I go, you know, to the, to the clinic and they bring me to the treatment area and she's on the ground and she's like yellow and she wasn't doing well. She wasn't as happy to see me and I sat with her for a few hours and at 6 0, 1 PM she just died in my arms.

Mary Garnder, DVM: 5:18

And that just that just rocked, rocked my world. That was my first, my first dog, you know, my first heart dog, shall we say. You know, I I always say I'm a little polygamist because I got a lot of heart dogs and cats, you know, but she was my first one, and so I went through a lot of grief for quite some time, and I I just literally actually woke up one day and thought, I wonder, you know, I had such an amazing experience with that clinic and they were so lovely there, and I said I wonder what it what it takes to become a vet. So I looked into it and I said, well, I need to get some classes. So, while I was still working, I took some night classes and weekend classes, and I took something I needed to get for my first degree and then applied, and when I was 31, I got into vet school. So the death of Snow White is what was the genesis of me going to vet school? Like just the grief that I encountered. I did not think, though, that I was going to do end of life. That was just the reason why I went to vet school. So I got out in 2008, when I was 35, and I went to private practice, which I loved.

Mary Garnder, DVM: 6:21

Pet vet animal hospital in Deerfield Beach, florida Great little clinic. I loved everybody. Pet Vet Animal Hospital in Deerfield Beach, florida Great little clinic. I loved everybody, loved the clients. I was not burnt out but I wasn't making the impact that I wanted to make. So I was actually considering going into the industry. So, whether it's working for a technology company that services the vet space, whether it's for a pharmaceutical company, whatever, so I was just looking like maybe my business background I'm better suited for that company, whatever. So I was just looking like maybe my business background I'm better suited for that. So at the time my girlfriend and classmate, dr Danny McVitie, was an emergency vet up in Tampa, so that's about four hours North of me, and she was doing in-home euthanasia on the side and it's it's something that's been around for decades, amy, like it's. It's not common, but there's. We had one in South Florida that I would refer to every now and then, but I never considered doing it as a job.

Mary Garnder, DVM: 7:08

I always thought that sounds really depressing, right? So so she called me up and she's like hey, I'm doing this on the side, I'm doing maybe 20 appointments a month and everything's very manual for me. And she's like you know, it might be something you're interested in doing, but I need software. So she says I know.

Amy Castro, MA, CSP: 7:24

You know how to design and build.

Mary Garnder, DVM: 7:25

And, and you know, a lot of vets reach out to me to how to get started and do this and so she was actually the one that first was doing it, and so I drove over to Tampa and we just sat and she started talking about the experience that we can provide in the home.

Mary Garnder, DVM: 7:39

And I thought back to Snow White and I thought there I went. You know, she died in my arms at a clinic. I didn't know what to do with her body afterwards. I did. You know, it's just. It was just horrible. And not that the clinic was bad, but just you know it was so.

Mary Garnder, DVM: 7:59

Experience is not what you is not ideal, it's not ideal, right, it's not ideal. So I thought it. It, literally the death of Snow White, is what could change my world, where I go to vet school, you know, like after leaving a good career, then if I could make it better for a family, I've come full circle.

Mary Garnder, DVM: 8:13

So I said, and Danny, you know, the goal was always to grow the company larger than us, and so we always wanted to to be the background and the and the system, the support system for veterinarians who want to provide this but they don't know how to do the marketing, they don't know the software, they don't know. You know they just want to do a beautiful appointment, not answer their phone. You know, try to. You know do credit card payments, all the things that come involved. So early on I started building the software and that was 2010. So Danny was doing the work for about 10 months before I started, and so in 2010 was really when we jumpstarted it to grow nationwide, and now we have probably close to 400 vets it's over 350. It's a lot, and so we have a wonderful support center that answers our phones. We have great veterinarians out there. We're mostly in a little bit more populated areas, so like Houston South.

Mary Garnder, DVM: 9:06

Florida, la, seattle, there's a ton and it's been awesome so I never looked back. It's been whatever 14 years now and I absolutely love end of life care. People ask me all the time if I'm depressed, because one would assume that, right, amy, you're helping two or three families a day say goodbye, and I think depression is very different than sadness. Right, amy, you're you're, you're helping two or three families a day say goodbye, and, and I think depression is very different than sadness, right?

Mary Garnder, DVM: 9:31

And I say I feel sadness for every family that I see, just like if you were to help one of your fosters or something that needed to say goodbye. You're going to be sad and I'm very sad for those families. But we go to homes where the pet's not good, the pet's sick, whether it's a physical or a behavioral issue, because they're separation, anxiety or whatever it may be, and when we can provide that end-of-life care in the home where they're comfortable, the owners are comfortable, it's actually such a fulfilling feeling so it counterbalances the sadness. But I cry all the things and so it's been awesome and all of our veterinarians really enjoy this work as well. We get the best hugs.

Amy Castro, MA, CSP: 10:10

I bet, I bet Well, and I want to time you out there for just one second. Like this is the whole aspect that I hadn't even thought about from the standpoint of everybody who's listening should realize that it's never too late to not that 30 is all that old. But there've been many times like I'm trying to convince my daughter to, who just turned 31. It's like you know, it'd really be helpful if we had a vet in the family with running this rescue. It's never too late to change, to change gears, because if you've got the will you can make it happen.

Amy Castro, MA, CSP: 10:37

You had mentioned the uh, the aspect of, you know, sad versus depressed, because people will say all the time like I don't know how you do it. You know, with the animals that we see, the condition that we see animals that come in, I mean, I've had fosters that have literally quit after losing, you know, a litter of baby kittens and it's like I get it, but at the same time it's such a privilege or, you know, it's actually comforting to me to know that at least I was there and I was able to provide a certain experience for that animal. You know, when I think about, like I said, infant kittens, we get a lot of infant kittens and a lot of them don't make it.

Amy Castro, MA, CSP: 11:14

But better to be warm and have had a last meal than to be out there being torn apart by animals or under a bush, freezing and getting rained on, and it's an honor to be part of the process, I think.

Mary Garnder, DVM: 11:28

I couldn't agree more. And we make it so good. What upsets me the most, believe it or not, as a veterinarian, is we want this appointment to go perfectly.

Mary Garnder, DVM: 11:40

I want it to go perfectly. But this is deck and this is medicine and it's not always perfect. So we have processes and the medicines we use are as perfect as they can be, but you're still dealing with life and and whatever's going on in the body. And so if I give the sedation cause, we always sedate our pets first and you know, if a kitty cat is in their arms and they like jumped because I gave the sedation and it, you know they might've it was cold or whatever it is. And they like so many too, amy are, are in so much pain and owners don't realize it and pets don't complain.

Mary Garnder, DVM: 12:16

So then when you do anything, it's called allodynia, where you're. You're in so much pain so even the lightest touch is is extreme painful to you.

Mary Garnder, DVM: 12:23

It's it's a it's an actual thing. Like I have, I get migraines, and when I have a migraine don't touch me, cause that is like. So if a pet squeaks, or you know, or squeals or whatever, when we give the sedation, I I that bothers me because I I know the pet's gonna be fine in a hot second, but the owners think that the pet was suffering, the owners think that was pain and I don't want that. Or, you know, if there's some rapid breathing, that happens or it may take a little bit longer, or it was too fast, like you know some people are like oh, that was so fast and, you know, because your pet was really bad and it just was on the way, yeah, or it?

Mary Garnder, DVM: 13:00

took a really long time. Well, because whatever you know, blood flow and stuff like that, so, um, so that's. What makes me sad is when I can't deliver absolute perfection, and sometimes I liken it to being a pilot, an airline pilot. They want the flight to go perfect, but every now and then you hit turbulence, right, and so the best thing a pilot can do is get on that phone and talk you know the speaker tell everybody, you know expectations, we'll be, you know rumbling for 10 more minutes and then we'll get some smooth air and communicate.

Mary Garnder, DVM: 13:30

But they never want that because they know there's, you know, 400 souls freaking out in the back Right, and so I always feel like I'm a pilot in some ways, where I'm just like, oh, here's some turbulence coming, like, just like, let's get through it and everything will be fine. So that's what makes me sad is not being perfect.

Amy Castro, MA, CSP: 13:49

Yeah, yeah, because there's so much riding, it's the memory that that person's going to be left with. You know, I've experienced a lot of you know, but again, both with personal pets and with other animals, and some experiences have been have been better than others, for sure. Yeah, right, right. So so, from the perspective of a of a client, cause I one of the things that I thought was interesting. I hadn't even thought about the hospice care aspect of it and I know probably every experience is different, but you know, you get a call from a client and they're looking for X, y, z and what and what's the journey like with, with, just, maybe take us through a case, okay.

Mary Garnder, DVM: 14:27

So there's really two, actually three kinds, but there's majorly two kinds of appointments. First is the euthanasia, where families call us, and 75% of the families that call us need us within 24 hours.

Mary Garnder, DVM: 14:41

So they need us today or tomorrow, because this is an appointment you don't really like want to book. You don't book it in advance. The pet declined, really you know, badly overnight and they no longer get up. Whatever the story is right, because every story is different how they go through the process. But families don't like to make an advance appointment for this. So the majority of our appointments are those.

Mary Garnder, DVM: 15:04

But for those that have a pet that's dealing with either terminal illness or a lot of geriatric conditions that their pet is dealing with because there's never just one, you know, I mean, it's never just mobility issues yeah, there's, oh, there's incontinence. There's kitty cats, 2 am. They're howling because they have cognitive issues, right, like there's it's. I always say they're like little jalopies. So they're little jalopies and it's time to bring them into the shop. But, as you know, we were talking privately towards the end many people don't bring them in to their veterinarian because they're you know, they're anxious to get in the car. It's difficult to get them into the car. It's stressful, all the things, and some, you know what, don't want to hear it. They almost don't want to hear how bad their pet is, because denial Island is a place I've been to myself and the moment, like they know that their pet's not good and they kind of just don't want or they'll just say he's getting old.

Mary Garnder, DVM: 16:00

So uh, sadly, 58% of cats, um, and about 48% of dogs are not seen by their veterinarian the year before they die.

Amy Castro, MA, CSP: 16:10

So that's massive.

Mary Garnder, DVM: 16:11

So 58% of kitty cats have not been to their regular veterinarian the year before they're euthanized, and that is so like that's such an important year. We could do so much to help them, um, as veterinarians. So, whether it is appetite stimulants, some hydration, uh, helping a family set their home up for safety. So hospice appointments are really when the pet is so poor that we'll probably be seeking euthanasia within three months. But, dare I say, people still don't know what that means, right, they don't know what hospice means for pets right.

Amy Castro, MA, CSP: 16:45

So they're like oh, I don't think they understand what it means, what it is for humans. It's like you know cause you're so right.

Mary Garnder, DVM: 16:52

Yeah, you're so right. I lost my sister a year and a half ago to liver failure. She was in and out of a coma and the doctor came over, and so I happened to be there when he came in and he was telling me that, you know, her liver values are so high Like I.

Mary Garnder, DVM: 17:05

I knew instantly and so I said should we be talking about hospice? And so he's like, well, that's really up to her. And I'm like, well, she's like in and out of it. And so for two or three days I was there, you know, I was caring for her, and then finally, towards the end, it was decided, yes, now let's put her in hospice. And all they did at that time was put her on morphine. And I'm like that's not actually hospice. There's so much more to hospice. Even what I was doing for the days before is more hospice than morphine.

Amy Castro, MA, CSP: 17:34

She needed the morphine.

Mary Garnder, DVM: 17:35

Correct, but it's caring for them Also. We could have had better conversations with her, so while she was awake we could have said hey, alice, you know your three dogs. What do we want? Who want? Do you want to have care for them?

Amy Castro, MA, CSP: 17:47

And you know, and she was younger, she didn't have a will or anything.

Mary Garnder, DVM: 17:49

So there's so many things we could prepare for for the, for the parents to say goodbye, all those things Anyway. So human hospice still got a long way to go. But what the sad thing is that people associate hospice whether pet hospice or human hospice, with giving up or it's the end. The end is near, yes, but it's not about prolonging suffering at all. It's about making sure that up into the end they live really good.

Mary Garnder, DVM: 18:16

So, I want that pet on pain management. I want that pet on appetite stimulus. I want that pet to get some you know supportive care, whether it's in the home. Like you know, you and I, we can't take aspirin for 10 years in a row without hurting our liver, you know, or kidneys, or whatever. Right, but you know what, three months before our passing, load me up on all the drugs Cause I don't.

Mary Garnder, DVM: 18:34

There's not enough time to hurt my liver, right? So some people are like, ooh, but what about her liver failure? You know her liver and I'm like I don't like, let's make her feel good, her liver's going to be fine. You know, we don't run blood work, we don't look at x-rays. I don't care what the BUN was yesterday or today. Is your cat vomiting? Let's get them on anti-vomiting medication, like why let them struggle and suffer without getting the support they need and then, when it comes time to say goodbye, they're actually not like horrible and um, the number two thing is sometimes I do have hospice failures, meaning I kick them out of hospice because, they start to do better Like.

Mary Garnder, DVM: 19:11

I had one cat, romeo. I remember Romeo had lymphoma so we started him on some steroids, which is, you know, we call it the silver bullet, and I'm like, listen, it's not good long-term, it can give pancreatitis. Romeo was kicking it Six months later. I'm like you need you now need to go to your veterinarian and make sure that we're not doing worse things to Romeo, because I think he's actually doing really well In human hospice. They found that the sooner we get a person into hospice, actually not only will they live better until the end, they do live longer. So it's not prolonging suffering. We're actually. We're actually removing suffering as best as we can and in many cases, you know, prolonging the end of life and making it better. And so same thing with pets. Sadly, on average, when we see a pet for hospice, 50% will call us for euthanasia just two weeks later. So I want that. The reason why I get on podcasts or write a book because I want them to see their veterinarian sooner, because we can do so much stuff.

Mary Garnder, DVM: 20:07

Two things make me sad. One is when the turbulence happens right, so I don't like that. Number two is and no judgment by this and this is why I wrote my books, but, like when I go to the homes, I realized that so many pets are not seen by their veterinarian that year before they died and we could have done so much.

Mary Garnder, DVM: 20:30

And it doesn't have to be loads of money on on blood work and x-rays and stuff like that Although I do some, you know it would be great if we did, you know, but it's they. They have tile floor and they're 30, they're 70 pound. Labradors got arthritis, can't get up off the bed and they're like, and they're, and he's walking around like on ice skates. I'm like why didn't we think about yoga mats and bath mats? Oh, that's a brilliant idea. Adjusting where they eat, how they eat, where they sleep, hygiene you know, when you've got an incontinent dog or cat and they're peeing on themselves and it smells Well, we could do a sanitary shave. Let's get some beard trimmers and clean them up a little bit so it's easier to wipe them down. Let's put some baby wipes in a baby wipe warmer so it's warm to the little old girl, the potato chip cat, you know, that's got no body fat Like there's. I have a list of things that we could do.

Mary Garnder, DVM: 21:14

So that's what we said is that we could help, and so because families aren't going to their doctor is why I wrote my books, because I'm like all right, I gotta, I gotta write a book that talks about the ailments. So vision issues mobility issues, cognitive dysfunction. So I don't care if the mobility issues is because of osteosarcoma, neurological issue or arthritis. They still can't move around the house. So how do we set up the house to make it easier to move around?

Amy Castro, MA, CSP: 21:41

So I mean, one of the things that I was thinking about before we started recording is is it too obvious to ask the question how is doing this at home better than doing this in a veterinarian's office? And that you know. To me, obviously, there's this, the stress factor for the animal, for sure, and one of the things that I said in the teaser of this episode is that I feel like, as somebody that you know, I had my own pets way before I ever had a rescue, so I have a lot of veterinarians, let's just put it that way.

Mary Garnder, DVM: 22:08

Yeah, I'm sure you do.

Amy Castro, MA, CSP: 22:09

Because I'm loyal to the ones that I started with.

Amy Castro, MA, CSP: 22:13

But at the same time there's other ones that I work with directly with the rescue, and I want to put business their way and I'm loyal to them. And then I've got the horse vet that comes to the house. But I've seen the veterinary practices do and it's a range based on their resources A really good job at trying to make the experience, if it occurs in the office, better. One of my vets, parkwood Animal Hospital, has a special room which I think is brilliant, having the exit to the room, exit out to the parking lot, so you don't have to come with your red, blubbering face through the lobby with everybody else with their new puppies and kittens, and it's got a sofa in there and it's less clinical, and then the whole candle on the counter. You know to be respectful, but um and but. So that goes a long way. It makes things better. But how is the home experience? I just imagine it's got to be better than that. But what specifically?

Mary Garnder, DVM: 23:03

okay, so kudos to that veterinary clinic and I lecture. I travel the country and lecture two clinics on how to make that experience better. And what you're doing that clinic, what are they doing? They're trying to make that room not look like a clinical room like you said. They're trying to make it look like a living room. That's why they have a couch there. So they're trying to make it look like home. So clearly, home is where everyone wants to be. So the obvious is the drive. Okay, so there's that, and getting them in the car, it's privacy, things like that.

Mary Garnder, DVM: 23:36

So, I will say I do want to at least advocate for your veterinarians right. Like when I was in general practice, I loved my, I loved my families. I loved the pets that I saw. I was only in general practice for maybe two years. I didn't have 10, 12, 15 years with some that. I saw them as kittens all the way till they were adults.

Mary Garnder, DVM: 23:53

We veterinarians get very attached also, so there are a lot of veterinarians that want you to come to the clinic because they want to be the ones that help you from cradle to grave.

Amy Castro, MA, CSP: 24:05

You know, and they almost, and they're the ones that start crying first. First, because I don't cry anymore, but boy rave you know and they they, almost they're the ones that start crying first. The staff, cause I don't cry anymore. But a boy, you start bawling and your tech starts bawling. Okay, fine, now I'm going to start crying.

Mary Garnder, DVM: 24:19

No, right, I mean they cry so so I do appreciate how some of them get upset at us because we're going to the homes doing it, and so we always let them know, like all the things, Other things that may not be so obvious is that there's other pets involved in the house and they may actually find some comfort with being present.

Mary Garnder, DVM: 24:38

I've had many dogs that are, you know, will lay right next to the dog or cat that has passed and like almost mourn for a little bit. I've had some that just walk right over them, like no big deal, I think they've known for a while.

Mary Garnder, DVM: 24:49

in some ways they'll come and follow me to the car. They'll sniff the basket Like they can be. So not only for them but also for the, for the families, it's nice to have their pet, their other pet, there as support, to love up on and things like that, and to be there for each other. Some people want to bury their pet. That's another, not obvious one. So 20% of families would like to bury their pets. They have the yard that they hope to stay there for some time, right?

Amy Castro, MA, CSP: 25:16

My Snow White.

Mary Garnder, DVM: 25:17

I brought her home to bury her and that was difficult. I had to bring her home in the car.

Mary Garnder, DVM: 25:21

That's a tough drive. It's a tough drive, right. And then so I'm like there's my dead dog in the back of my car. That's what I was thinking in my head. I hate to be so blunt, but that's what I'm thinking. And then I have to bring her out, and I you know so, and dig the hole, like so, I wasn't ready for it, but families can prepare that and prepare a nice area and stuff like that, and then it's, it's so much easier to bury their pet at home. So there's also I've been where there's probably 40 people at a party for a dog. There is.

Mary Garnder, DVM: 25:50

I live in California. I lived and worked in Southern California for about eight years and I remember that a bull massive he's in my book, his name was Jupiter and I was looking for the house. I'm driving down the street and I'm looking for the house and I see this like tent, you know, 10 by 10, like a craft fair tent, right. I'm like what's going on down there? There's a whole buzz of people and that was Jupiter's house and they had this giant sign out front, next to the mailbox where everybody in the neighborhood was signing goodbyes to Jupiter. They had Hawaiian lays, everybody had Hawaiian lays, we all had tropical drinks and it was the most amazing.

Mary Garnder, DVM: 26:22

Goodbye, and on the complete opposite end is where I've been to a home where family only wants to be present for me to walk in. They say the dogs are over there and they want to step out and they can't imagine watching that process. And, respectfully, that's OK too. Or it's just me and one person, you know, and it's somber and I have to be quiet. So sometimes it's such a nice gentle experience at home on so many levels, nice gentle experience at home on so many levels. And for me as a veterinarian it helps me with doing this because I do believe all of the pets. It's time for them and that's another question when it's time. But I don't feel as bad because I know I'm doing it so good. So there's a lot of reasons. With that being said.

Amy Castro, MA, CSP: 27:03

Also, some people are like I don't want to do it in my house. I don't want to remember them here.

Mary Garnder, DVM: 27:07

I've also been in backyards, I've been on beaches, I've been to parks. I've done it in cars. I had one woman who her dog had cognitive dysfunction, so like Alzheimer's for dogs, and every night she had to hold the dog and walk around her house.

Mary Garnder, DVM: 27:32

And when I went to go to euthanize, she's like I don't know where we should do this. I don't want to always remember the couch, I don't want to remember the bed, I don't want to, I don't know what to do. And so I said, well, would you like to hold, hold him and walk around the house while he passed? She's like yeah, so I actually injected the final medication, which is an overdose of anesthesia. Instead of directly into a vein, I injected it into his abdomen, which just takes a little longer. No, no problem, he's sedated, he's sleepy, takes about 15 minutes. And she held him and just walked around the house.

Mary Garnder, DVM: 27:51

So she doesn't know exactly when he passed, and neither do I but it was his final sleep, so there's many things that we could do to make it even better at home or at the clinic, and so whatever is best for a family, I support that decision.

Amy Castro, MA, CSP: 28:04

Yeah, yeah, you know, and I I think that it's about the. Yeah, yeah, you know, and I I think that it's about the. The experience is so important. The, the second episode I did of this podcast. I interviewed a woman by the name of Nancy Gordon who does a lot of work in counseling and coaching people with loss and grief, specifically for pets, and to me it was the most profound. Like I got goosebumps, you know, hair raising goosebumps when we were having this conversation and for the longest time it was the least listened to episode of my podcast and I was like, oh my God, people need to listen to this episode. It is so important because what? And it's taken off since then, but I think people don't want to think about it.

Amy Castro, MA, CSP: 28:43

But the message from that episode, or one of the many fine messages from that episode, was if you, you create the journey as the human I mean, we don't always have that choice if something you know, a dog suddenly dies or something, but when you know there's going to be a finite time span, you can create that journey as something that is a positive or at least something that you want to remember for your pet, whether it was the party or whether it's the carrot being carried around the house, and I think that I think they think so much about the pet. But I think we need to think about ourselves in this experience, because the pet in many instances and maybe I'm wrong about this, you can tell me if I'm wrong but they probably know they're already going, or they feel it and in the reality it's not like they have this cognizant thought of. Oh my gosh, today is my last day. I'm going to go to the hospital and I'm going to die. It's like they're here, they're in the car, they're in the vet, they get a cookie and then they're gone.

Amy Castro, MA, CSP: 29:47

But it's us that has to live with oh, how that went. Oh, I have to live with how that went. Or, oh, I regret, I waited too long, I regret I did it too soon, I regret I let him suffer. Whatever it is, we live with all these regrets and I think we can take control of that a little bit better, especially with a service like Lap of Love.

Mary Garnder, DVM: 30:04

A hundred percent. It's a good point about like, do they know? I think they know, sort of like a 98-year-old grandmother knows. You know, like, like you know, I'm not well, I'm not getting around and stuff like that. Do they understand the concept of dying and death? Who knows, like we? We don't know that, right, but they know they're not well, they know. They also know if they're sick, they know if they're nauseous, they know if they're not feeling good, but with the most thing that they know is they still love their owner, right, and so you can see the sickest dog. So you can see the sickest dog. You walk in and they're going to wag their tail as best they can. You know it's like, oh my gosh, I'm so happy to be there with you. So, but making the experience so. So there's something called anticipatory grief, and she might've talked about this right.

Amy Castro, MA, CSP: 30:43

She did when it's a big piece of it.

Mary Garnder, DVM: 30:45

It's a big piece. So everybody listened to episode two. But the most important things I suggest my family to do every hospice family or anybody who talks to me because their pet is, you know, not doing well is do a bucket list and I'm like it doesn't have to be grandiose, it could just be I had for my Doberman.

Mary Garnder, DVM: 31:07

I had peeing on the neighbor's plants, barking at nothing at all you know, it's just like things that made Duncan Duncan, you know, and um, saying goodbye to all his girlfriends, and those were all like these you know, my human, my girlfriends that love Duncan, you know, like I had a list of 15 things. Um, you know, french fry parties sleep, so it doesn't have to be like, oh, take it to the beach, but if they can go to the beach and whatnot, and just checking them off, it took away so much regret that, oh, I didn't do this.

Mary Garnder, DVM: 31:36

I didn't do one more thing Like I did a freaking awesome bucket list and I've got this one. Oh, it could make you and cats people say cat bucket lists are hard to make. I've got tons of examples in my book Like they're amazing. But one of my favorite was this dog, edie, and they had this whole big thing and it was like a steak dinner, a new park, uh, you know, weekend with grandma and riding a bonus ride in a fire truck and they took pictures for every bucket list item that they were doing and they sent them to me and I I have them in my book and like it makes you cry to see edie in the in the fire truck.

Mary Garnder, DVM: 32:11

Right, this old girl sitting in the fire truck and then breakfast in bed with dad Like so it's just. It's just you can make that experience a little bit better, right? We can't make it good because we're saying goodbye.

Mary Garnder, DVM: 32:25

There's. There's nothing good about saying goodbye, but you actually can make it good. You can do so much and I think it does take away a lot of those. I regrets people. Typically the first time saying goodbye they don't know what to do. They don't know what they're going through Like, so typically people wait longer the first time and after that they say goodbye sooner because they feel like they waited too long.

Mary Garnder, DVM: 32:46

And I always say it is way better a week too soon than a day too late. You know like it will. It will always feel too soon until it's too late. It's just, it's a it's. It will always feel too soon until it's too late. It's just it's a it's. It flops right over. I think anticipatory grief is actually a good thing, so that way we can. We can not not to focus on it, but it helps trigger us to like okay, what can we do? Let's get a professional photographer out to take some pictures, like all the things.

Amy Castro, MA, CSP: 33:09

We just did an episode on that too, oh.

Mary Garnder, DVM: 33:11

I love it. I too. Oh, I love it. I love it. I had, I had, uh, my Samoyed, my second Samoyed I got after Snow White died. She would rue, because they do this ruing and like, and I said to the photographer, I said I need to get a picture of her ruing and she got the best picture of her ruing. So it's like I will always remember that and I recorded that. You know, I always take pictures, take videos. You can't have enough of them. Yeah, I could keep talking forever on that.

Amy Castro, MA, CSP: 33:37

Amy, I love that, yeah, that's such a good. That was a good episode too, because it is, even if it's. I mean, I definitely believe in the power of professional photographs. No-transcript two photos of him, but I'm but I'm bad about taking pictures like those kinds of pictures. You know.

Mary Garnder, DVM: 34:17

I mean, I take a lot of photos and I've got you know, if I scroll through my phone, I've got a million cat photos, but most of them are not my own. Let me tell you it is so true. I'll listen to that episode too, because it is the power of professional photography is unbelievable what they see, the compositions, when you know all the different nuances and also just having somebody else, through literally their lens, looking at somebody else through literally their lens looking at.

Amy Castro, MA, CSP: 34:38

Yeah, yeah, so you actually kind of covered a little bit of what one of my last questions was related to advice for pet owners. But is there anything beyond what you talked about as far as the anticipatory grief and creating the experience?

Mary Garnder, DVM: 34:49

Yeah. So the number one question we get is how all I know is time. To be honest, I did actually a whole video on it, because it's not an easy answer. It is so complex and it drives me nuts when somebody says, don't worry, amy, you'll know, like you don't know. This is why, like, hold on, you will know when your cat is so bad that it's obvious. Like, do we want to wait until it's so obvious that it's like that's active suffering? No, we want to say goodbye before then. So therefore, we don't always know and there's a lot of different. There's a lot of different things that I put into to play into this. The ailment that the pet has is going to change their quality of life. So if they've, you know, have mobility issues, it's different than cognitive dysfunction. That's different than cancer making them feel sick. So you've got mobility. That's painful, but they're still eating, they're still wagging their tail. How does an owner deal with that Right, like.

Mary Garnder, DVM: 35:46

That's a whole different conversation than a pet with lymphoma that's now vomiting and can't eat well, and like all those things, versus a cat with cognitive dysfunction that's just going to, you know, and stare at a corner all day long. Now, is that suffering that like? But they're, they could live like that for years. Yeah, and and it and. So then we talk about the caregiver fatigue.

Mary Garnder, DVM: 36:09

It's tough caring for these pets and I, like, I give grace to my families and what I could do doesn't matter. I, I'm a big girl, you can't tell him six one, I can lift a dog, like, but you can have a five, two person that can't lift a 30 pound beagle. You know my mother, she couldn't pick up her dog, was in cottage, she couldn't pick, she couldn't bend over to pick that up, right. So there's the physical limitation, there's time limitation. Yeah, these guys can't, you can't leave them alone eight hours to 10 hours a day, and when you don't work from home, that's where you're gone for. Uh. So there's the physical component. There's the monetary component.

Mary Garnder, DVM: 36:48

Sometimes the drugs are not cheap that we have to give. And you know my Doberman, he was 110 pounds and he had heart disease. His drugs were $300 a month. Not everybody can do $300 a month, and so you know, okay, then we need to say goodbye. And the last budget I always talk about budgets is the emotional budget of that family. What does this pet? Is this pet the last living link to their child that died last year? Right, like this was their child's dog or sub cat, right, and they they're holding on.

Mary Garnder, DVM: 37:18

Well, okay, that's okay, we're going to make sure that your pet's not suffering, but I understand that it's going to take you more time, or was it? Was that your last golden retriever? You waited so long that they died on their own and it was horrible that you came home and found them dead when you walked in. That you don't want that, so you want to do it sooner. So quality of life is also probably life of the family that's managing this pet, and what?

Mary Garnder, DVM: 37:39

experience they want for that pet? Do they want every last moment of moment possible? That's okay, as long as they're not suffering? But let me tell you where your emergency clinic is Cause. If you want to wait until for for the very last moment, until you know the sign from heaven is telling you it's time, that means you got to take your pet to the emergency room and it's usually respiratory distress and that's at 2 am and that's not fun.

Mary Garnder, DVM: 38:04

So this is a big conversation to have. It is not just you'll know when it's time. It's not when they stop eating, it's very disease. You know specific um, and there's a lot of scales out there and I actually like quality of life scales. I have one specific for cats. So a lot of quality of life scales are just are both species and they're two different they're two different beasts. Right so and I also have owner quality of life assessments for the owner to not feel bad about, you know being stressed.

Amy Castro, MA, CSP: 38:34

Well, I think people feel guilt, and that's, I think that's such an such an important point to to hone in on is that I mean, I feel a tremendous amount of responsibility towards my pets and when you start thinking, well, that's becoming super inconvenient, like when my dog Coco died. When she did die, I was somewhat relieved because A because I didn't have to make the decision, but it was. You know, it was no more listening to her howling at night, it was no more watching her walk across the carpet that I just cleaned and just dribbling urine and you know. But it's, but it's hard. It's hard to make that decision when she still I mean she could run and she ate like a pig. I mean she had no, no problem with appetite, but she was really negatively impacting the quality of my life, with all of my responsibilities, and so it was sad, but it was also sort of a relief when she was gone.

Mary Garnder, DVM: 39:25

I'm so glad we're talking about this, because I think it's a sort of a taboo thing to say right. I think none of us would say I can't wait for my pet to die. None of us like I want them around forever, right? That's why I say nine lives are not enough for for my most recent girl, sam she was a lot of work. She was the Q-tips, the cleaning the rug cleaner was out all day long.

Amy Castro, MA, CSP: 39:46

I was.

Mary Garnder, DVM: 39:47

I don't think I slept more than two hours a night, like you know, in a row, like I was always. I was always tired, I mean it was, it was. It was horrible. I thank God it was COVID time Cause I wasn't traveling, but it was a lot of freaking work. I would do it for 10 years If I would do it, but let me tell you the day, the night I had the best night's sleep was that night and I woke up, and then I felt guilty, cause I'm like, oh, that was so nice not having to wake up.

Mary Garnder, DVM: 40:11

And then I'm like well, Mary, aren't you just horrible thinking like that? You? Know, like, and then I felt guilty, that I felt relief and I'm like no, I would do it, but it's okay to find relief in the fact that you don't have to clean up the dribble spots anymore. You know, and I tell them, I shared that with with owners when appropriate you got to know how to read a room and what people are ready to hear.

Mary Garnder, DVM: 40:31

But but it's nice being in homes because I see. I see what they're going through, I smell, I smell what they're going through. So like I'm, I kneel on the rug and I get my knees soaked in urine and I'm like I know what they don't want to live like this. You know, sometimes I think of. Euthanasia is like when you're feeling nauseous and you need to vomit. So you feel nauseous all the way up and you don't want to vomit.

Amy Castro, MA, CSP: 40:53

So you don't want to say goodbye.

Mary Garnder, DVM: 40:55

It's horrible. You're feeling bad. The euthanasia is like the vomit, and then you feel better after You're still not great, but you feel a little better after. They're okay, they're not in the state of struggle anymore.

Amy Castro, MA, CSP: 41:09

Right, I did want to make a point about as much as people like to use the word pet parent. I have this philosophy and I've said it many times on the show and it's pissed people off sometimes. But there's pet parents, there's pet guardians and there's pet owners. This is just in Amy Castro's book. And so a pet parent is the person who feels the way that they feel about their pet, the same way that they would feel about a human child, and treats them in the same way. To me, a pet guardian treats that animal with all the dignity and respect and love and care, but it's still an animal, it's still my pet and I don't attribute a lot of human factors to it. And then there's the pet owners who kind of it's more of a property thing.

Amy Castro, MA, CSP: 41:51

But even for those people, or maybe especially for those people I think the pet parents are probably the ones that struggle the most with this, because it's just such a gut-wrenching thing is that you love your animal and you feel like your animal really loves you and cares about you and you've attributed all this emotion to that animal. If your animal could speak and tell you, what would they say? Not only about their own suffering like it's time, mom. I mean, our animals do love us unconditionally and they care for us, and so, therefore, they don't want us to suffer and to be kind of dreading their existence or, you know, regretting their existence or whatever words you want to use, and so better to make that, like you said, better to make that decision a little bit early, because what were they? You know, what was that week really going to bring for them other than a week more of suffering or discomfort, or I'd have to say that, right.

Mary Garnder, DVM: 42:41

What would you think they would say? I'll often say or if what you see today is not good, it's only going to get worse, and do not take a good moment as a good day.

Mary Garnder, DVM: 42:51

So you had a spark of joy. They ate some Turkey, like that does not mean that whole day is good. So, and what's a good day to you versus me, my, my ex, he would like with Sam, with with her pooping on herself, right, he would say. If that was me, I would hate having like being pooped on myself and I'm like yeah, yeah. But so we're going to clear up and and you know, and there are some dogs that kind of get upset, like they, they they know and some dogs are just like.

Mary Garnder, DVM: 43:23

Well, I got a pile of poop hanging off of me. Who cares?

Amy Castro, MA, CSP: 43:25

Right Like yeah, I had a little. I had a little dog named Buddy and he was such a good little dog and he was just one of those dogs, as opposed to my doberman, who cost me thousands and thousands of dollars of dietary indiscretion. We used to joke about buddy, that buddy could eat glass and rat poison and still be like I'm fine. But when he was towards the end, when he would urinate, it was, there was a lot of blood in it and he and he started urinating on the floor. And the look, I swear to goodness, the look on his face when he had an accident, he was mortified, the indignity for him, whereas here's Coco prancing across the living room, pissing as she goes, and she didn't care, you know it's so important.

Mary Garnder, DVM: 44:05

I say about the pet's personality like a part of my quality of life discussion. I'm like is your pet mortified? Like, do they know? And I know that is a little humanistic, it's still like I know when sam could care less that there's poop all over her, but duncan, he would have been like, oh god, no right, and I did a bad thing and whatever exactly their personality, like can you get the pills down and can you give them fluid therapy?

Mary Garnder, DVM: 44:27

so quality of life, too, is how well we can manage some of the things that they're that they are dealing with, and this is what hospice can do. All these things that we're talking about is what we talk about at hospice. We also, amy, offer tele-hospice and we go over this conversation. Well, okay, your cat's got kidney failure. Let's talk about what's going on. How's your house set up? Are you struggling with your partner? Is your teenager mad at you? Because you're thinking about it Like? There's so many things that go into this and every conversation is individualized. Every pet story and every family story is so individual and everybody's situation is different. What they're going through is different. What they can financially, emotionally, physically, time-wise afford, everything is individual, and so I think having a home visit allows us to see what's going on in the home and assess it properly. It's sort of like part counselor.

Mary Garnder, DVM: 45:19

I remember this one. It was Domino. Was the cat, your cat? Behind him, the black and white picture reminds me of Domino.

Mary Garnder, DVM: 45:24

So I went to the help of this guy and his cat, and the cat had diabetes. It's a very common, you know. So I went to his house and Domino is not in the living room at the time. So we sat and had a whole conversation. He was saying that the last time he had his insulin check was six months ago. Domino's not eating, vomiting, you know the whole thing. So I'm ready to like find Domino and see this. You know pickled cat, you know like all sick and whatever.

Mary Garnder, DVM: 45:47

So we walked through his house to go to his bedroom, where Domino was on the bed, and we passed the laundry room and I look inside the laundry room and this was like Shangri-La for cats, you know. It was just. Everything was like cat, like it was gorgeous. It was so clean and tidy, like this guy loved his two cats. So we go see Domino and I see him on the bed. I'm like he's not actually like as bad. So I said to him I've had my own diabetic cat and they're not easy to always manage and I support your decision to say goodbye today. But I can tell you love Domino and I can tell how much you love your cats. And I said but what you're telling me, though, sounds like we may be giving either too much or too little insulin and if we could just check his blood sugars again.

Mary Garnder, DVM: 46:30

I actually didn't charge him. I said I'd rather you take that money and go find out and if and if you decide it's time for domino, then I'll come back and like no problem. But just would you? But I'll, but if you're done and you're done with this like I'm okay today and and so I didn't see domino again, because it was just a little change in his insulin levels. You know, and this is a guy- that I'm like why?

Amy Castro, MA, CSP: 46:53

and in my mind I'm why, didn't?

Mary Garnder, DVM: 46:54

you take him back to the vet. I think he was hopeless by that time. His emotional budget was done. He just needed a little extra encouragement and support, and sometimes that happens. The two pets that I have a hard time that I've lost are the two that have died without me.

Mary Garnder, DVM: 47:13

I didn't get to say goodbye, I didn't get to say I love you. And Dr Kubler-Ross, who wrote a book on death and dying, she says when you're able to sayI love you, you can grieve a little bit less. You know, because you've gotten to say it one more time. So I think the message should be no matter how we say goodbye, whether it's in the clinic or in the home, just make sure you say I love you.

Amy Castro, MA, CSP: 47:37

Yeah, that's a. I definitely think that that would be a good point to to end on for sure. First of all, I want to say thank you, dr Gardner, for for being such an awesome guest here today. You know, I did not anticipate laughing as much as I laughed on an episode about euthanasia and hospice. You know, it's part of life and we have to think about everybody's quality of life in this whole process. So thank you so much for sharing your experiences and your expertise and, for those who are listening, please make sure you you know not only listen to this, but listen to this again, especially as that time might be coming closer. Maybe it's not on your horizon right now, but it might be at some point. So, definitely listen to this and if you have a friend or a family member as we all probably know somebody that's struggling with some of these questions and decisions, go ahead and share this episode with them as well. I think it will give them a lot of comfort and also a lot of guidance in making the right decision for themselves and for their pets.

Amy Castro, MA, CSP: 48:35

Thanks for listening to Starlight Pet Talk. Be sure to visit our website at wwwstarlightpettalkcom for more resources and be sure to follow this podcast on your favorite podcast app, so you'll never miss a show. If you enjoyed and found value in today's episode, we'd appreciate a rating on Apple. Or if you'd simply tell a friend about the show, that would be great too. Don't forget to tune in next week and every week for a brand new episode of Starlight Pet Talk. And if you don't do anything else this week, give your pets a big hug from us.