Animal hospice care: the power of three

This is a story of loss braided with three strands – Razz, Angus and Deedee. In 2021, three of Sally’s dogs died within six months. All of them were seniors, over ten years old each, but especially the first death was completely unexpected.

To live in this world you must be able to do three things:
to love what is mortal;
to hold it
against your bones
knowing your own life depends on it;
and, when the time comes to let it go,
to let it go.

Mary Oliver
Last stanza of her poem In Blackwater Woods.

Before hearing about my experiences providing hospice care for my dog Louie, Sally had never encountered the idea of allowing an animal you care for to live out their life. Even though she was present at several human deaths in the past, which she experienced as sacred transitions, it took some time to reflect how animal hospice care sat with her given the prevalent belief that euthanasia is the kind thing to do at the end of a pet’s life, often also referred to as the last gift. Thus there is a certain righteousness upholding euthanasia as the best choice and it takes inquisitiveness to even look at another way of meeting the reality of a dying animal. Sally recalled the peace, calmness and grace she sensed while at the bedside of her dying human friends as a feeling of privilege, an honour to be part of. She thought, ‘We should be able to do that for our animals too. It’s not a necessity to always run to the vet for instant release.’

Razz came into Sally’s life in 2013 when his original owners planned to euthanise him because they didn’t want him around their baby even though he had no issues with children, however, he had previously been declared a menacing dog by their council after attacking a couple of dogs. He was a six years old Red Heeler cross English Bullterrier. Not long after being rehomed, Razz bit a person, Heeler-style, in the back of their leg. Sally advocated for him and he dodged being destroyed by the council and instead was classified as dangerous dog which comes with strict obligations such as always being muzzled in public, wearing a special, identifying collar, living in escape proof housing, etc. It also came with several thousand dollars of expenses for the council fee and legal cost.

Razz was fourteen years old, he was healthy and fit like a much younger dog, when one morning he started to behave weirdly. Sally had given him a bone the day before and – because this was just a few days after my dog Enzo choked to death on one – worried that it might have been the cause for Razz’s troubling behaviour. He looked very uncomfortable, Sally wondered if it had gotten stuck. An x-ray showed that yes, there was a bit of bone inside him but it didn’t have any sharp edges and the vet believed it wasn’t an issue. Razz continued to behave strangely and the next day he suddenly collapsed. He had no use of his back legs and his bladder emptied itself onto the floor. Sally helped him up and brought him outside and he regained the ability to stand, however, he was clearly distressed, walking backwards in circles and crying.

Back to the vet they went. Another x-ray revealed that the bit of bone wasn’t there anymore but still didn’t give a clue as to the origin of Razz’s condition. He was kept at the clinic overnight and the next day Sally was informed that he now had completely lost the use of his back legs and that they were unable to identify the cause. They recommended euthanasia. Sally collected her dog from the vet and brought him back home.

Razz’s complex personality and having been declared a dangerous dog made providing him with a good quality life a challenge. After having been best mates for three years with one of Sally’s other dogs – Angus – one day, out of the blue, Razz turned on him and never accepted Angus again. Consequently, caring for him became even more demanding. And he was not the only animal in the household requiring special considerations. Sally and her partner, after long discussions, had agreed that should any of their complex dogs be sick or injured to the degree of needing extensive care, they would put them to sleep.

It would have taken elaborated and expensive tests to work out what was going on with Razz. Back home, having no use of his back legs, he was agitated – whether from physical pain or feeling distressed about his condition wasn’t clear, though the painkillers he was given didn’t change his demeanour. It was a heart-wrenching decision to organise a vet to come to their house and euthanise Razz. With tears running down her face, Sally shares the memory of Razz on the couch with his head on her lap, looking at her knowingly. He died quickly and peacefully, with a look of understanding on his face.

Sally was in shock of how fast things had unfolded, she hadn’t had the time to think about what she wanted for Razz’s dead body other than cremating it. After some moments of privacy, the vet offered to make all the necessary arrangements and to take the corpse with her. Still in a dazed state, Sally just agreed without asking to be given some time to consider these important decisions. Today, more than six months later, Sally still has this sense of something unfinished, incomplete. If she had the chance to do it over again, she would choose to transport the dead body to the crematorium herself, at a time she was ready to do so. It is so valuable for the grieving process to allow time in the presence of the earthly shell of a beloved animal family member. It pays to not rush or be overly practical. It’s like suspending yourself in timelessness for a while, stepping into the mystery of life that is kept at bay all too often in everyday’s hubbub. It’s where coherence is found, where the parts of us that can’t comprehend yet what has happened are tended to.

I have talked about this in some of my previous articles on animal hospice care but it bears repeating: we don’t make the best decisions when we are highly emotional. I remember a friend who when hearing the diagnosis for her two-year old dog decided to have her euthanised on the spot. She witnessed her dog fighting the deadly injection. Yes, it happens. And seeing your animal objecting that way is traumatising. None of the other family members had a chance to say goodbye. When asked what to do with her dog’s dead body she said to please disposed of it for her. The vet nurse who had known my friend for years made a judgement call and instead of sending the corpse off, she kept it in cool storage. When my friend went to the clinic the next day to settle her bill, the vet nurse told her what she had done and her intention to give my friend the opportunity to bury her dog like she had done with her previous one. My friend was grateful as this provided the chance for the rest of her family to have some form of closure.

Life, and therefore death, has a coherence to it. When that is disrupted by not taking the time it takes, trying to avoid or bypass something, we might end up feeling incomplete. It is essential to contemplate our mortality and that of our loved ones, to launch an internal inquiry into our values and fears around dying and death. This prepares us to make better choices when the time comes.

Some dogs are special. Though we have love and affection for all our dogs, some stand out. For Sally that was her Smithfield Terrier, Angus. She calls him her soulmate. When she adopted him from the shelter, he was eighteen months old, weighing only 13 kg and his coat was brittle and coarse. In the first two weeks with her, Angus gained 7 kg! Her profession took Sally to different, sometimes remote, areas of Australia, Angus her steady companion by her side. And when she switched careers, opening up a dog walking business, he was her trusted partner. Angus was also an actor, starring in a commercial as well as a short film.

In 2020, during an altercation with another dog, Angus broke his leg. He needed surgery which included implanting a plate and screws to fix the break. A growth developed at the site of the surgical hardware that quickly grew into a mango sized lump on his leg. After examination, the vet said that Angus needed to be put to sleep before he broke his leg again. Sally consulted another vet who did a CT scan that revealed that the tumour had eaten away at the break so there was no alignment anymore at all, the plate was bent and the screws had been pushed out of the plate. Sally couldn’t believe her eyes when she saw the image and wondered how Angus had been able to still use his leg like this. It was decided to amputate the leg.

After the leg was taken off, Angus stayed at the clinic overnight. When he was back home, Sally noticed straight away, he embraced life with a sense of relief. It had been a year almost exactly to the day from the start of the tumour to the amputation. Removing the leg had been on the table before, when Angus first broke it. And Sally so wishes she had chosen that option then. Unfortunately, the consulting vet didn’t discuss the correlation between injuring a bone and the later development of osteosarcoma (bone cancer) in that area, that Sally learned from the second vet.

Angus embraced being a tripod at fifteen years of age. Within days he was up and about, adapting with ease to the changes in his body. As a nurse, Sally had cared for people post-amputation which usually involved a drawn-out and slow adjustment period. Angus was on no medication but received herbal supplements and homeopathic remedies to boost his system and help him heal. Things went well for a good three months but then Angus started being off his food.

The amputation had removed the main tumour but there was a chance that the cancer had already spread into the body. After all the invasive treatments, Sally decided that from now on her intention was to keep her dog comfortable by providing palliative care for him, no longer seeking to cure or fix. Angus’ appetite was low for about two weeks, he could be coaxed to only eat things like a bowl of spaghetti bolognese or hand-fed morsels of fillet steak. He seemed flat, spending his time resting on the couch, only getting up to go outside for toileting. I remember receiving a message from Sally during this time saying that she wondered if he would make it through the night.

But then, one morning, he perked up again and returned to eating happily and being his cheerful self. For the next six weeks, until his death, his appetite waned and waxed several times. He became quite skinny – a normal symptom of the dying process – and sometimes needed assistance to manage the stairs. Sally says he very much looked like when she first adopted him, super thin, but unlike then, his coat was soft and healthy until the end. Angus lost all enthusiasm to engage with the world but contently watched its going-ons from his favourite spot.

Sally didn’t make it publicly known that she was providing hospice care for her dog. When friends or fans inquired how he was doing, she let them know, truthfully, that he was quiet, relaxed and showed no signs of pain.

Towards the end, Angus was not interested in food at all anymore and also stopped drinking water, once a day, however, he still had a big pee. Sally noticed that whereas before he didn’t mind at all, now, when she lifted him to help him change position or assist him with getting up or carrying him when necessary, he often was a bit uncomfortable with it.

One day, when Angus was lying on the couch, Sally noticed a stench from his direction. She thought, he had maybe leaked some faeces. A moment later, when he tried to get up, there was this popping noise and about a cup of blood-coloured, foul smelling fluid hit the back of the couch and the towel he was lying on. Sally believed it had come out of his bottom. Even though she cleaned him up straight away and placed him onto a fresh bed, only later in the day did she discover the true source. Because Angus favoured that side to lie on, only when she flipped him onto his other side (as a prevention for bedsores) did she realised that part of his amputation wound had opened up and released the unpleasant liquid. Sally carefully examined the opening and found that when she put light pressure just beside it, more pus drained.

Sally says she knew that this was the end of his journey. Suddenly it had become so final. Up to this point she had expected him to bounce back again like he had done several times before. He would not live to see his sixteenth birthday – and Sally so had wanted him to do that. He would be gone, no longer part of her life. It was inconceivable.

I remember receiving a phone call from Sally, upset and crying, saying that she just couldn’t do this anymore. She thought she didn’t have it in her to support Angus through the last stages. I reminded her that it was ok to choose euthanasia if she felt like she had reached her limits. She didn’t want him to suffer. I asked how Angus was. She said he was calm and peaceful. There was no agitation, his breathing was normal. She realised that she had made an assumption, ‘This terrible thing has happened (the wound reopening), he must be suffering.’ She recognised that she was projecting, that her dog was actually doing well, his body was simply approaching its end. And this is what it looked like in his case.

Sally felt conflicted. The whole situation was very confronting. She didn’t want to make the wrong decision. She phoned the vet to arrange a home visit to put Angus to sleep, however, the vet was fully booked that day. It felt like a relief and gave more time to consider.

Angus’ decline had happened during Covid lockdown which had given Sally the opportunity to care for him, however, the restrictions were about to be lessened, Sally was due to go back to work the following week. She couldn’t imagine leaving her dying dog unsupervised for hours a day. Aware that animals, like people, choose whether they want to die alone or with their loved ones around, Sally says she didn’t want Angus to choose the former. She so wanted to be there when he took his last breath. It had been weeks, and she felt emotionally drained. That suspense of not knowing when death is going to happen had exhausted her. It was all quite confusing.

The next morning, Sally decided to take Angus to the vet clinic where he had had his amputation to look at what had happened to his scar and find out what they could do for him. Sally was questioning herself, she needed someone to tell her that what she was feeling was right and that there was nothing else they could do. The vet said that to find out what was going on would require extensive, invasive surgery. Sally was certain that that was not the way to go. Having this clarity made her feel much calmer.

Though she had a sense that Angus would not live much longer, Sally made the choice to organise his euthanasia at home that afternoon. Because his body would be buried, the vet left quietly after she had put Angus to sleep. There was an overwhelming sense of peace.

Digging the grave for Angus was cathartic. The soil was hard and difficult to get into. It took a while to excavate a big enough hole. The next day he was buried. He was lowered into his grave with the help of a sheet. Sally reflects that there is something so final when you cover up the dead body, heart-rending and gut-wrenching. She felt nauseous and an acute pain in her heart.

When I ask Sally if she could go back in time, would she choose euthanising Angus again, she immediately says, ‘No. I would let him go on his own. I would be with him for however long it would take.’ I inquire how she feels about that. She answers, ‘At peace.’

How such a big personality fit into Deedee’s tiny Pug-cross body nobody knows. Self-determined, caring and friends with every animal in the house even though they might not have gotten along with anyone else.

At nearly seventeen years old, her teeth were in very bad shape. It was such a difficult decision to make to have them removed. To weigh the general risk of anaesthesia – particularly in such a senior dog, compounded, in her case, with the possibility of worsening the seizures she infrequently experienced, against the risk it posed for her heart and other organs if the teeth were not removed, was trying to determine which of two bad choices was better. Talk about being between a rock and a hard place!

Deedee seemed to recover well from the anaesthetic. Three days later, however, she had a cluster of seizures that left her confused and exhausted. The vet suggested all kinds of tests but considering Deedee’s age and fragile condition Sally opted for giving anticonvulsant drugs a try. After a few days of getting used to the medication, the little dog responded well. She engaged with life again, walking around in her cheerful way and eating.

A few days later, Deedee suddenly started seizuring again, short little ones (about ten seconds long), but one after another after another with just fifteen or twenty minutes between each. Sally knew that seizures are not painful which helped her better understand what was going on when Deedee started to vocalize. She was in distress, likely disoriented, but not in pain. By the end of it, the little dog was tired and drained. Sally slept next to her that night.

The next morning, Deedee was out of it, not very responsive, drawn inwardly, but let her eyes come back into focus for brief moments as if to reassure Sally that she was ok, just very tired.

Though her gut knew, her head needed confirmation, so Sally took Deedee to the vet who suspected that she had either had a stroke or had a brain tumour. She was grateful that she was not pressured to euthanise her dog. She felt deeply that, at long last, with this dog, she would be able to allow the dying process to unfold in its own time.

When they returned from the vet, Sally and Deedee sat in the garden because it was such a lovely day. In the sun’s warm embrace Sally told her dear little one that everything would be alright, that she didn’t need to hang on, that she was free to leave whenever she was ready. A neighbour who adored Deedee came by to say goodbye. It was clear that it wouldn’t be long now.

Sally went inside to fetch something to drink and a bite to eat for herself. When she came back outside and sat down next to her dog again, Deedee took two huge breaths. Remembering her friends’ deaths, Sally recognised that the end was here. After a couple of minutes, Deedee took one more really big breath and then she was gone. Just like that. Sally was caught a bit by surprise and at the same time incredibly relieved that it all had happened so quickly. She wasn’t sure how she would have coped with another long and drawn-out dying process. It was so easy, so simple. What a blessing.

Sally sat with Deedee’s dead body for a while, feeling sad yet deeply grateful and at peace. Then she carried her inside to let the remaining two dogs and the cats say goodbye. They buried her the next day beside Angus. Into the grave with her was placed the placenta of the newest family member, recently born.

Three deaths in six months. When I ask Sally what was the most challenging part of caring for a dying animal, she responds, ‘The emotional rollercoaster,’ learning to manage her feelings in a balanced way so that neither over-dramatising nor holding back interfered with her ability to care for them properly. What did that look like? Giving herself permission to cry; not fawning over the dogs; allowing them to be, knowing they didn’t have to hang on for her.

Sally also found it hard to change reference points. She remembers how helpful it was for her to be reminded by me that Angus was not ‘refusing his food’ but simply dying. Not eating is perfectly normal at the end of life. He got skinny. Again, not a bad thing in the context of dying. Nothing to do but allowing, nothing to fix, just witnessing.

Sally says that she took great pleasure out of the physical side of caring. When you love someone so much, nothing seems disgusting or off-putting, you just want them to be as comfortable as possible. Acts of service are one way to show our deep affection and care.

I ask Sally what the biggest take-away is from providing animal hospice care that she feels blessed with? ‘To actually see the whole process,’ she replies. You usually don’t get that when you choose euthanasia. Thinking back to her past experiences she says that there were always doubts. When you allow the process to happen on its own, the body just does its thing. At the right time. She understands now that dying does not necessarily mean that there is suffering.

What would Sally like to convey to someone considering hospice care for their dying pet? ‘Be prepared for the gamut of emotions that come with being with an animal that is going through that process,’ she says. There will always be times when you question what you are doing, so it’s so important to have someone to talk to who has been there, who knows where you are coming from. Any experience where you fly by the seat of your pants is scary. To have someone to reassure you that what you are feeling is normal and who can be a sounding board for your thoughts, is essential.

Throughout her life, Sally hasn’t really cried much, keeping her feelings in, displaying the typical brit’s stiff upper lip – her words not mine. But that changed with the deaths of these three dogs. The floodgates opened and this has been a profound healing experience for Sally. Even though it is exhausting, it makes her feel more complete and at peace.

When I ask Sally if she still feels connected to her dead dogs or if they are just gone, she tells me that she often senses their presence and that the other night, when she went to bed and shut her eyes, all three of them were staring at her as if to say, ‘Oh, hi there! It’s us!’ They were just sitting there, as clear as day, looking at her. Sally was wide awake after that unexpected experience. What struck her as so beautiful was that the earthly animosities that had existed between them were gone.

When I finished writing this article I still had no title for it. As I was browsing the internet for inspiration I came across the triquetra, an old symbol found in the ancient Celtic, Viking and Indian cultures, representing the power of three in its many forms such as life, death, rebirth (or perhaps instead of rebirth, afterlife). Perfect!

The circle that connects the three parts symbolises their unity. A circle is also known to mean eternity. It occurs to me that the circle in this particular story could represent a doorway. Braided – or knotted together – her three dogs’ deaths created a sacred threshold beyond which lay a new way of seeing for Sally.

Vale Razz, Angus and Deedee.

Support for providing hospice care for your dying animal

If you’d like me by your side while you are providing hospice care for your dying animal, please get in touch with me. I speak English and German. I encourage you to read my blog articles on animal hospice care, they share my own experiences, provide practical tips and links to valuable resources as well as hold a death positive space (where it’s not morbid or taboo to speak about death).