In-home services help pets and owners with end-of-life transitions

Traveling with Patience was one of Stephanie VanDeventer and Leigh Lohwasser’s favorite things to do.

The orange-and-white tabby would ride in her cat bed between the two women in the car, keeping them company as they traveled back and forth between the Asheville area and Florida. Patience even became something of a pet celebrity when a video of her meowing along to “If You’re Happy and You Know It” made it to America’s Funniest Home Videos.

While Patience had suffered from kidney disease most of her life, at 15 her illnesses and age had begun to take a noticeable toll. VanDeventer and Lohwasser were referred to 4 Paws Farewell Mobile Pet Hospice and Home Euthanasia, which offers in-home veterinary care within 45 minutes of downtown Asheville.

Patience initially received palliative care, which emphasizes symptom management and quality of life. “We didn’t have to put her through any more tests,” Lohwasser recalls. “There were no horrible procedures or trips to sterile environments. It was so much more comforting.”

Lohwasser says 4 Paws’ Dr. Beth Marchitelli treated Patience in their home over a two-year period.

“It’s not about waiting to die,” Lohwasser says. “It was about her quality of life, about not being tested for things all the time, about making her comfortable.” And when it was time for the end, Marchitelli helped the whole family through the process.

“Being able to care for the pets at home is not only less stressful for the pet but also the pet owner,” Marchitelli says. “There’s less stress from travel as well, and the animal is able to be in familiar surroundings. It can be so much more intimate with no time limits.”

With Dr. True Ballas and registered vet tech Kelly Carter, Marchitelli offers hospice and palliative care for ailing and aging pets like dogs and cats, as well as in-home euthanasia services.

Carter spent time working in hospice for humans before entering the hospice for animals profession. Hospice differs from palliative care in that it serves pets “in advanced stages of terminal disease, chronic illness or debilitation,” according to 4 Paws’ website.

“My passion is supportive care for the elder cats and dogs. Support is also needed for the families who love and care for their elderly cats and dogs. They, the human family, are so unsure, hurting when they call us for our services. I want to support them in their decision, be it palliative support, hospice care or euthanasia. It’s one of the hardest phone calls to make. For me, there is no greater gift than that of relieving pain and suffering,” Carter says.

At 18, VanDeventer and Lohwasser’s other cat, Sarah, has, like Patience, lived way past the 12 or 13 years that is the estimated average life span for a domestic feline.

The trend for pets to live longer is one of the reasons for pet hospice care, says Dr. Scott Pickett with Best Friends Mobile Vet Clinic, which serves clients in Asheville, Black Mountain and Hendersonville.

“With our help, cats and dogs live longer than they used to,” Pickett says. “Because of that, we have a larger population of cats and dogs with geriatric issues.”

And while the care falls mainly to the veterinarians who visit pets at home, pet owners do get called on to shoulder part of the burden.  How much work is comfortable for the pet owner is a part of the decision to enter hospice care, Pickett says. Some animals may only require medication, but others may need hydration therapy and other forms of care that require pet owner participation.

Pickett says the key is to provide the care animals need until he and the owners decide that the animal has no quality of life.

“We give it whatever medical care we can give it as long as there is some quality of life,” he says. “Once the animal gets into end-stage mobility loss, it’s time to have that discussion. It’s almost inhumane to me to leave the animals in a situation where they are just existing.”

How the end of life is handled is up to the pet owner, Marchitelli says.

“Every pet is different, and every owner is different,” she says. “Sometimes the owners want the pet to die in the house, in a special room or in their favorite spot. Other times the owner may not want them to die in the house or for their kids to see it.”

Marchitelli says either she or Ballas will first sedate the animal to help it relax. After the pet has fallen asleep, an injection completes the process of ending the animal’s life.

Pickett says after the animal passes, he’s there to provide grief services to the pet owner as well.

“It’s always sad and emotional,” he says. “It’s hard when the animals have been in your care for years, having to be the one to put them down. We’re one of the few medical professions where we say goodbye and put to death some of our patients.”

Both Pickett and Marchitelli say they also take the pet and arrange for the body to be taken care of, whether by cremation or other means. Pickett says many of his clients save the ashes of their beloved pets.

For Lohwasser, recognizing when the time had come to put Patience down wasn’t easy.

“We were in Florida, and she wasn’t doing well, so we made the decision to bring her back here,” Lohwasser says. “When I went to check on her the next day, she wouldn’t even come out of her bungalow. … We knew it was time. Dr. Marchitelli came to the house and took care of her. … She put her in a basket and left me with her. Stephanie and I cried over her. But [Dr. Marchitelli] gave me as much time as I needed to take with Patience.”

Lohwasser says she felt the whole experience was more beneficial for the couple and their cat.

“I wouldn’t do it any other way because of the comfort level of the pet,” she says. “[The house] is their world, that’s their den, that’s their comfort zone. It was peaceful and comfortable and humane. And since I didn’t have to take her to the vet, I didn’t have to go through the world when I was grieving.”