More and more, cats and dogs get the human treatment. There are pet spas, pet therapists, pet clothes. And as it goes in life, so it now goes in the twilight. The latest phenomenon: pet hospice.
Around the country, a growing number of veterinarians are offering hospice care, and marketing it as a way to give cats and dogs - and their owners - a less anxious, more comfortable passing.
The approach, in the spirit of the human variety, entails ceasing aggressive medical treatment and giving pain and even anti-anxiety drugs. Unlike in hospice care for humans, euthanasia is an option - and in fact, is a big part of this end-of-life turn. When it's time, the vet performs it in the living room, bedroom or wherever the family feels comfortable.
That's a big part of the job, the vets say, relieving pet owner guilt, giving them an emotional bridge to a pet's death, and letting them grieve at home - rather than in a clinic or animal shelter. The intimacy carries a premium, sometimes costing 25 percent or more than euthanasia in a clinic. Vets, and their customers, say it can be worth it.
"They're in their own environment, not only the pet but the owners," said Dr. Mary Gardner, co-founder of Lap of Love, a Florida-based company that is one of the leaders in a small but growing market.
"They're allowed to have other animals present, other cats or dogs present, other children," added Gardner, who refers to a pet's owner as its "mom" or "dad," and has since relocated her own practice to Los Angeles. "I've been to some homes where they had barbecues for that dog, and invited me and the neighbors, and the dog was the man of the hour."
Lap of Love's business has blossomed since 2010 from two providers to more than 68 vet partners in 18 states. The International Association for Animal Hospice and Palliative Care, a group started in 2009, now has 200 members, mostly vets, but also several family therapists, lawyers and an animal sanctuary in Northern California that takes in and provides holistic healing and hospice for terminally ill and elderly pets.
"There is a formal end-of-life movement, a formal hospice movement," said Dr. Eden Myers, a veterinarian in Kentucky who runs JustVetData.com, which tracks industry trends. Of the providers who do this, she said: "They're everywhere."
Dr. Amir Shanan, a vet in Chicago who started the International Association of Animal Hospice and Palliative Care, described the movement as growing, but still not mainstream; veterinary schools are only now embracing the idea.
"There are skeptics out there," he said. "But 20 years ago, there was almost no one other than skeptics, and that's changing rapidly."
There are no formal standards for this hospice care, and Shanan said there was a debate about what those standards should look like.
"The core of the debate is who is to decide when is the right time to euthanize, if at all," he said, noting that some hospice supporters advocate giving pets palliative care until they die naturally, as in human hospice.
Hospice and in-home euthanasia are different things. Their growth is owing to similar factors, said Myers, including a growing acceptance of hospice for humans, as well as cellphones, laptops and online marketing that make mobile vet services easier to operate. Plus, she said, more vets offer the services as a business alternative to the high cost of starting and maintaining a traditional clinic.
"And," she added, "you've got people willing to spend scads of money on their pets."
For pet owners, the financial implications of this end-of-life movement cut two ways. In one light, hospice can be seen as reducing the cost of aggressive medical care, or it can be seen as its own version of aggressive comfort care, at least when compared to euthanizing a pet sooner.
A hospice or euthanasia visit from Lap of Love generally costs $200 or $250, including drugs. Euthanasia at a clinic typically runs less, though prices vary widely, and is even less at a nonprofit shelter, like a local animal shelter. Some pet owners say costs are irrelevant given the peace of mind - their own.
"It was more for me than him," said Jan Dorr, a bookkeeper in Boca Raton, Fla., who was an early Lap of Love customer in 2010.
She'd spent $5,000 on chemotherapy for her chocolate lab, Darby, but the dog's health continued to fail. When she heard about the idea of pet hospice, her reaction was positive; a year earlier, her own father died after a positive hospice experience. She called Gardner, who helped make Darby comfortable by increasing his pain medications, and giving Dorr a checklist of ways to recognize when it was time to let go, such as when Darby stopped eating, walking or interacting.
When Darby's condition worsened just days later, the vet returned to perform euthanasia. Dorr lay down on her bed with Darby, hugging him.
"She let me say when," Dorr said, referring to the vet's final injection. It was far preferable, she said, to the alternative: "I just couldn't get it into my head to put him on a steel table in a cold room and let him go."
Kathryn D. Marocchino, a professor of death and dying at California State University in Vallejo, who in 1996 founded the Nikki Hospice Foundation for Pets, said the end-of-life movement for pets addressed what she described as a "sense of coercion" faced by owners of sick pets forced to decide between aggressive treatment or euthanasia. She said that her group got calls from people thanking them, and saying things like: "Where were you 30 years ago? They made me kill my dog."
Dr. Michele Price, a veterinarian in northern Virginia whose in-home end-of-care business has doubled since 2009 to 20 percent of her practice, got a call recently about an ailing Labrador named Champ. She'd first seen the dog in August when his owners thought it was time to euthanize. But when Price got to the house, Champ was doing OK, and she and the family decided on hospice treatment and pain meds. Later, Champ took a sharp downward turn and couldn't walk. Price returned and they set up for the euthanasia.
Champ was on a quilt next to the fireplace when Price administered the initial sedation.
"They hugged him, and told him what a good dog he was. They said, 'We love you' and 'We'll miss you,'" Price said of the dog's owners. As for Champ, "He fell asleep. That's the last thing he remembered."
By MATT RICHTEL
The New York Times