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December 21, 2014

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For those who think of pets as their children, end-of-life care could include hospice

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L.E. Baskow

Dr. Toby Goldman recently started providing hospice care to Las Vegas pets for their owners and enjoys play time with his own dog Brizzie on Wednesday, July 2, 2014.

By the time Judy Moss picked up the phone to call a veterinarian her friend recommended, she didn’t think her golden retriever would last even a few more weeks.

IS IT TIME?

Quality of life is essential when caring for an aging pet. But how do you know when their suffering exceeds their joy, and it’s time to take end-of-life measures?

“Write a note to yourself and put down three to four little things your pet likes to do when it is acting normal and happy — such things like greet you at the door, chase the ball or come for attention,” veterinarian Dr. Toby Goldman said. “Put it away in a drawer and leave it there. When you are considering if it’s time for euthanasia, take it out and see if those things are still there.”

Other signs a pet may be hurting: Loss of appetite; loss of mobility; decreased energy or desire to play; increased sleep; loss of interest in human interaction; and constant licking at themselves.

Buddy, 12, had begun dragging one of his rear legs. Then, he started stumbling. Eventually, he couldn’t run to catch a ball without falling down.

Moss knew it was almost time, because she’d been through this before. Buddy is the fifth golden retriever she and her husband have owned together.

But she wanted to make Buddy comfortable before he passed, and she wanted him to die peacefully, at home.

She wanted him to have hospice care.

Though Moss was loyal to her usual veterinarian, who diagnosed Buddy with a degenerative spinal cord disease, she knew he might not be able to “just come when it happens,” she said. A friend referred her to Dr. Toby Goldman, a Las Vegas hospice vet who began seeing clients through the national organization Lap of Love this year.

“I had no idea if he had any treatment that he’d even think about doing,” Moss said. “I just needed someone to give me some direction.”

Luckily for Moss and her husband, Gary, Goldman did provide treatment, and Buddy’s health improved. In fact, the dog is doing so well that Goldman said he has scratched Buddy off the hospice list for now.

Goldman will continue to check on Buddy’s health until the inevitable is necessary. Then, he’ll likely make one more visit to the Moss home, where he will put down Buddy surrounded by the comfort of his owners.

Plenty of animal hospitals and mobile veterinarians offer hospice and euthanasia services. What makes Goldman unusual is he doesn’t do anything else. His work week is spent playing “psychologist, grief counselor, cheerleader” to owners of aging pets.

“We let them go with a little peace and dignity,” Goldman said. “When they’re suffering in real life, it’s a way that we can help them out.”

Buddy’s case is fairly unusual. Most of the time, when someone calls Goldman, the passing of their pet is imminent.

Still, the Mosses’ decision to seek out Goldman reflects an increasingly popular desire to give pets what The New York Times called “the human treatment.” Rather than ending their animals’ lives the expected way — usually at an animal hospital on a cold, metal table — many Americans are turning to practitioners who focus solely on end-of-life pet care from within the home.

Coleen Ellis, president of the International Association of Animal Hospice and Palliative Care, said there’s been a shift toward treating pets “as if they’re little people.” A variety of factors could be behind this, she said: aging baby boomers with empty nests, millennials who are waiting longer to have children and people working from home, to name a few.

Sometimes, people give their pets hospice care without even knowing it.

“When you talk about animal hospice and you describe that to someone, a lot of times you’ll hear people say ‘Oh my God, I provided that to my aging animal and I didn’t even know it had a name,’ ” Ellis said.

Opting for this type of care, however, isn’t cheap — Goldman’s visits typically cost at least $300.

Maxine Niems, who had Goldman euthanize her eight-year-old Bouvier des Flandres last month, said it was more than twice what she would have paid had she gone to a veterinarian. Her dog, Chunk, was succumbing to bone cancer.

Yet Niems decided the cost was worth it before she called Goldman.

“I spoke with my son, and he said ‘Don’t even think about it, just do it,’ ” she said. “It was better for the dog. It was much better for me.”

Hospice-focused veterinarians can also be useful in guiding pet owners through the grieving process, Ellis said. Though owners do it partly in order to make their animals as comfortable as possible, they can see benefits, as well.

“Sometimes we need education from a professional as to what the act of dying looks like, and why to not fear death and not fear euthanasia,” Ellis said. “Sometimes it’s to give us permission to be OK with both of them.”

Is pet insurance a good investment?

Without insurance, medical bills for an ailing animal can reach thousands of dollars or more, particularly if the pet requires surgery or other expensive care.

But buying pet insurance isn’t cheap. A policy for a 5-year-old boxer costs about $42 a month; a 1-year-old Great Dane about $52 a month; and a 5-year-old tabby cat about $15 a month.

Is it worth it?

Pet care costs are on the rise. Embrace Pet Insurance found that veterinary fees rose 85 percent from 2000 to 2011 and expects fees to double every 13 years.

And insurance, like for humans, can cover a wide range of medical care. Tropicana Animal Hospital in Las Vegas says the insurance it offers covers surgeries, prescriptions and even hospitalization.

The perks

• Insurance can save you big bills from vets. Regular medical care for cats and dogs averages $150 to $200 a year, and surgeries can cost as much as five times that. A tooth extraction for a cat costs an average of $924, while leg surgery to repair a torn ligament on a dog can run as high as $2,667.

• A policy can calm owners’ fears that something catastrophic might happen to their pet and they wouldn’t be able to afford care.

The pitfalls

• Policies typically carry deductibles, co-pays and coverage caps.

• Hereditary conditions are excluded by some carriers.

• Premiums rise as pets age, and some insurers won’t cover senior pets.

The bottom line

Many experts advise against buying pet insurance but suggest that owners stash away a little cash each month to cover the unexpected. They argue that the cost of an insurance policy over the lifetime of a pet can easily exceed the money an owner would spend getting their pet medical care.

Shop around

If you decide to buy pet insurance, make sure to ask the right questions:

• Is a physical exam required?

• Is there a waiting period?

• What percentage of the bill does insurance pay? What is the deductible? How much are co-pays? Are payments capped?

• Does the plan cover pre-existing conditions?

• Can you choose any vet or hospital?

• Are prescription drugs covered?

— Sources: Embrace, PetFinder, Veterinary Pet Insurance

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