Shirley Russell knew a lot about her dog, Cricket. She knew that the shaggy-haired Pumi loved to catch a ball before it bounced, that she loved being a therapy dog, and that she’d give her human friends a gentle tap on the arm if she wanted more petting.
So when emergency vets recommended hospitalizing the 12-year-old dog to give her, maybe, a few extra weeks in her six-year battle against cancer, Russell knew what needed to be done:
“I just looked at them and said, ‘I’m taking her home,” she said. “We sat in the chair until about midnight, then I put her in the bed and laid there holding her until 4:30 in the morning.”
Cricket died the next day with the help of in-home euthanasia.
“She was tired,” Russell said. “She had gone through a lot.”
But she wasn’t alone. For the past six years, Cricket has had the help of veterinary oncologist Alice Villalobos, a Torrance-based veterinarian who specializes in palliative and end-of-life hospice care for dogs and cats.
For Cricket, palliative care meant treating the cancer—the dog underwent four surgeries and four chemotherapy sessions for her recurrent tumors—and getting a slew of supplements and medications to keep the champion agility dog active and comfortable.
Hospice care meant preparing Russell for the days when nature would take its inevitable course—and guiding her about how to recognize her dog was “ready to cross the rainbow bridge.”
“In human medicine, physicians don’t generally refer to hospice until patients are about three days before death,” said Villalobos, who in January received the Shomer Ethics Award from the Society of Veterinary Medical Ethics for her contributions to both cancer and palliative care for pets.
“When we use the word ‘hospice,’ we want to make sure people know that we are going to support the pet and provide comfort care whenever they get the diagnosis of a life-limiting disease,” said the Hermosa Beach resident.
While palliative care is a growing niche in the world of pet care, it isn’t all that different for dogs and cats than it is for humans. The goal is to make patients comfortable so they can live out their days in peace, even in spite of incurable conditions. The only difference for pets is the added option of euthanasia when suffering becomes intolerable.
“Many times people say, ‘Let nature take its course,’” said Villalobos, who has been called the"Mother of Veterinary Hospice” by the SVME. “And then I’m contacted to help with that end-of-life decision. People want to know, ‘When is the right time to put my pet down?’”
To aid in this decision-making, Villalobos developed a Quality of Life Scale to help people determine if their pet has “acceptable life quality to continue with pet hospice.” Her guidelines have been shared and used by veterinarians and pet-owners worldwide.
“In the old days some doctors would just recommend euthanasia right away,” Villalobos said. “People would take a limping dog into the vet and they would come home without a dog. [Doctors] would choose to do euthanasia upon diagnosis.”
Veterinarians, she said, would often give patients two options when presented with a seriously sick pet: Euthanize the pet or opt for surgery, the latter of which is expensive and may not necessarily extend the animal’s life significantly.
“I’m trying to give people a third option—and that is hospice,” Villalobos said. “Hospice embraces the whole beginning right up to the end. It allows people time to grieve and gives me time to counsel the family members.”
For Ari Dane of Playa del Rey, Villalobos helped his 17-year-old chihuahua, Roxy, stay comfortable despite a trio of grim diagnoses including a chest tumor, heart problems and kidney disease.
“(Roxy) keeps bouncing back and she’s still here,” said Dane, who sees Villalobos about every six weeks. “She will perk up around mealtime, but most of the time she sleeps. It’s fading time.”
Under Villalobos’ direction, Dane adds more than 15 different medicines and supplements to Roxy’s food every day, all of which are meant to treat the tiny dog's myriad health issues. It’s a tedious, expensive process, but one that Dane wouldn’t give up.
“It’s a sad thing to watch her decline, but that’s the price of admission,” he said. “Roxy has been a part of the family for 17 and a half years. I wouldn’t want her to be treated any differently.”
Pets As family
In a society where people consider pets part of the family—and where half of all dogs that reach the age of 10 will be diagnosed with cancer, according to the American Veterinary Medical Association—it only makes sense that palliative care would become a part of the deal.
As of 2020, there were more than 800 members in the International Association for Animal Hospice & Palliative Care (IAAHPC), an organization dedicated to developing guidelines for comfort-oriented care to pets as they approach the end of life. The organization was founded in 2009.
“Veterinarians have been offering some measure of comfort care for animals as long as they have been caring for them, but the shift has come with families embracing pets as members of the family,” said IAAHPC President Tyler Carmack, a Virginia-based veterinarian. “They now wish their pets to have the same level of compassionate care at end of life as our human family members.”
Carmack said many providers and pet-owners shy away from discussing hospice and palliative care until their pets are already very sick. She hopes this will change as people become more aware of their options.
“As we open the communication about caring for pets as they enter their end-of-life stage, we allow more and more families to make the best possible decision for their pet and their family,” Carmack said.
Costs of care
Of course, caring for sick and dying pets isn’t cheap.
According to the Veterinary Cancer Society, cancer care costs for dogs ranges between $150 and $600 per dose of chemotherapy and between $1,000 and $6,000 for radiation. Pet insurance can help pay some of these costs, but many companies have a cap on annual or per-illness expenses.
On top of that, in-home euthanasia, the option most palliative care specialists prefer, costs about $250.
For many pet-owners, it’s a price that must be paid.
“You get them as a pup and you know that you’re probably going to outlive them,” Russell said. “It’s part of the package.”
For more information about Dr. Alice Villalobos and to get information on palliative care for pets, visit www.pawspice.com. Villalobos operates out of Harbor Animal Hospital. She plans to move her services to Redwood Animal Hospital in Redondo Beach in the coming months.