July 25, 2025 • 31 mins
How do you know when it’s time to stop treating your pet? In this heartfelt conversation, Gail Pope and Karen Wylie explore the emotional, physical, and spiritual crossroads that many pet parents face when caring for a chronically ill or aging animal.
Together, they reflect on what “treatment” really means—from medications and vet visits to special diets and home care routines—and how stopping treatment isn’t the same as giving up. You’ll hear honest stories from their personal caregiving journeys, including moments when their animals signaled it was time to shift from doing to simply being.
They also discuss the toll of long-term caregiving, how to listen for your pet’s perspective, and what it feels like when outside voices (even well-meaning veterinary staff) weigh in on your decisions.
If you're wrestling with guilt, fear, or overwhelm, this conversation offers comfort, clarity, and companionship. It’s not a step-by-step guide—but a gentle space to pause and ask: What matters most to my pet… and to me?
📌 Related Resource: Blog post: "Knowing When to Stop: A Pet Parent’s Guide to Letting Go of Treatment, Not Love"
💬 If this episode touched your heart, you’re not alone. The BrightHaven Caregivers’ Hub is our supportive membership community for pet parents navigating caregiving, anticipatory grief, and all the moments in between.
We gather to share stories, ask questions, and care for each other as we care for our animals. If you’re walking this path, we’d be honored to walk it with you.
🔗 Learn more about the Hub: https://brightpathforpets.com/caregivers-hub/
📌Thanks for listening! Don’t forget to subscribe and leave a review 🐶⭐🐱
Learn More from BrightHaven Caregiver Academy For free resources, upcoming workshops, and a supportive community dedicated to navigating life with your aging or ill pet:
- Visit our website: brightpathforpets.com
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Disclaimer: This content is for educational purposes and not a substitute for professional advice. We are not veterinarians. While we do not provide medical diagnoses or treatments, we are experienced holistic caregivers. Our support focuses on helping you assess the situation, understand your options, and find clarity and calm in the middle of distress.
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
(00:01):
Welcome to Peace of Mind for Pet Parents, the podcast by BrightHaven Caregiver Academy.
I'm Gail Pope and I'm Karen Wylie and together we're here to support you in navigating life with your aging or ill pets.
We know how deeply you care for your beloved companions, and we're here to offer guidance, understanding, and resources for this meaningful journey.
(00:25):
Each episode we'll explore topics that address the daily challenges, emotional realities, and choices you face as a pet parent helping you and your pets find peace, comfort, and joy.
Whether it's making sense of a new diagnosis, adjusting to changing needs, or simply seeking a place to feel understood, you're not alone.
(00:47):
Thank you for being here with us.
Karen Wylie (00:50):
Hello and welcome back to Peace of Mind for Pet Parents.
I'm Karen Wylie here, as always, with my friend Gail Pope.
Today we're going to explore an issue, a question suggested to us by one of our listeners, and that is when you are providing palliative or hospice care to a pet, when do you decide to stop treating your pet?
(01:18):
I think that's one of the toughest for any of us, Gail, don't you think?
Especially when we are treating our pets, whether it's every day for a chronic condition or a difficult to manage one, it doesn't always have to be a terminal condition, but while we are continuing treatment.
It's like we're continuing the hope that we have, that maybe things are going to turn around or they can be with us forever.
(01:47):
The treatment is not just something outside of ourselves.
It's also highly emotional but it seems like one of the first things we need to do is define
"What treatment is?" Or
"When we talk about treatment, what can it encompass?"
Gail Pope (02:02):
You do like big questions, don't you?
Karen Wylie (02:04):
I throw it to you right away.
Gail Pope (02:07):
Actually, the first thing that I'm thinking about is that you started the conversation talking about when you're offering hospice or palliative care at the end of an animal's life.
But really I think for our audience, a lot of people aren't familiar necessarily with those terms.
(02:28):
What I want to say fits together in two ways because they're generally seeing a vet who may be and probably most generally as a conventional vet, or maybe integrative or possibly holistic, but they still may not have encountered the words hospice and palliative care.
So I think the essence of actually when to stop treating.
(02:55):
It's interesting because, now you're going to laugh, I never stopped treating.
I follow probably because over the years as the animals have led the way for us, what I've realized is that working with homeopathy, and I'm not suggesting the whole world switched to homeopathy, but it's healing for the highest good has become the motto.
(03:20):
I'm not thinking about treating a symptom, I'm treating the being
Karen Wylie (03:25):
Right, the whole animal.
Gail Pope (03:27):
So my veterinarian is prescribing based on what's happening.
As the animal's situation changes or starts to decline, we're still working towards helping that symptom improve.
And again, there's sometimes a point of time where there may be an acute situation which changes things but still healing for the highest good.
(03:55):
If that symptom can't be resolved, for instance if it's pain, then you may be at a point that you do decide to stop actual treatment.
I know that's a tangled web but I just see us as supporting and treating all the way through to the last breath.
Karen Wylie (04:14):
I think the whole question is complicated and all tangled together.
Gail Pope (04:20):
I realized it's very tangled but it seems to be very clear.
It's a clear cut question that we are hearing over and over again from people whose vets have said, "I can do no more. It's time to stop treatment."
Which indicates that is a very conventional approach instead of a Wholistic, with the W in front, that actually embraces the whole being because generally the treatment is focused on symptoms.
(04:53):
Obviously again, that's not always the case, and sometimes there is a more wholistic approach.
Then maybe that treatment window actually starts to close as you get closer to the end of life, and the journey— the way forward becomes very much clearer.
If that makes any sense.
Karen Wylie (05:12):
Oh, it does make a lot of sense especially within the context of conventional veterinary care.
When our vet says, "I don't really have anything more to offer in terms of treatment."
Because then there's only one other procedure that they have to offer and that's euthanasia.
That's often when you get contacted for consultations because people are looking for something that the conventional viewpoint doesn't include.
(05:43):
That's starting to look at the integrative, the holistic but treatment means so many different things to a caregiver.
Sometimes it's how many trips to the vet can you make?
Both in terms of time needed out of work or the money that's needed.
It could be learning new skills, like how to give subcutaneous fluids.
(06:08):
How to get over the qualms of inserting a needle into your baby's skin and understanding what that bubble looks like, and watching the mls.
Watching very carefully how much you're giving.
There's all these different aspects.
It's not just sub-Q fluids it's learning your role in it.
So part of stopping treatment or continuing treatment also involves you personally and your comfort level or lack of it (06:29):
pilling, medications...
Gail Pope (06:42):
It's endless.
Karen Wylie (06:43):
It is!
Special diets, being able to afford some of those special diets, being able to get those diets in their little mouths.
And when, we often say at end of life, offer and never force food.
So you have to observe what's happening and make decisions.
So I think even what people would call treatment is very different.
Gail Pope (07:09):
It's a huge umbrella.
And again, it varies.
I think there are two other important factors in here (07:16):
obviously, the first one is the animal themselves.
Their emotional and physical state, who are they and how are they doing with this method of treatment, whatever that may be.
Maybe we should try something different, maybe that will lead to a slightly different lane.
Karen Wylie (07:37):
I guess I'm going to circle back to what you were saying a little earlier, which is there have not been situations or that many situations where you have chosen to stop treating.
You have changed your treatment but you have still continued treating all the way through.
Generally, I'm certainly more like that than not, but there have been times I do stop.
(08:00):
It's largely, if not entirely, because of the pet's perspective and how I perceive it.
About 25 years ago, I had a cat that was diagnosed with diabetes when he was about 11 or 12 years old.
We didn't know as much about how to treat diabetes or how to stick their little ears and their paw pads and everything back then.
(08:22):
Now you don't have to do any of that which is so wonderful.
But back then monitoring the blood sugar of your pets was really— you had to get really good at it for it not to be very painful.
And as a diabetic myself, pricking is never not painful.
You get used to it but how do you explain it to our babies?
(08:44):
It's just going to be a minute.
But that cat chose to start hiding twice a day, right before he was to be fed.
That was a real big signal to me because he had been a very social guy involved in every aspect of life.
(09:06):
Suddenly, 45 minutes to an hour before dinner time would be coming, he would be under the furniture.
I'd be having to run around, getting on the floor, looking under everything.
"Where is he?"
It really then was, "My God, how do I stop doing this?
(09:28):
Maybe I could put him in a cage?
I could keep him in one room?
So I could find him to prick and get the blood sugar levels so I would know how much insulin to give him."
It really was getting so erratic that he had a stroke, his blood sugar spiked.
That was probably over two to three week span once I had started trying to monitor the blood sugar and giving the various amounts of insulin based on the blood sugar levels and so forth.
(09:59):
So he pretty much decided for me what he opted out.
When I've had cats with advanced kidney disease but they're eating, drinking, playing, their body is warm, they're laying with everybody, they're enjoying their lives, and then they stop eating and they don't even really want any fluids.
(10:23):
So I start monitoring their behaviors as they start pulling away.
Gail Pope (10:29):
But what you're underlining over and over again is that our animals will lead the way.
They lead the way for us, and based on our knowledge, our understanding, the tools that we have at our fingertips, we all choose different tools.
We just have to put the whole lot into a pot and do our best, do it with love and make decisions along the way about what to do, what not to do, and how to do it.
(10:58):
It's a tough journey.
It's such an emotional journey.
It's really emotional for the caregiver but of course the animal is also understanding our emotions as well.
So it's almost doubly hard for them to see how we struggle with the worry and the concerns.
Karen Wylie (11:15):
Yes and there have been many times I have felt like they chose a route that would make things easier for me.
You know, where they're 17, 18, 19 years old, they're on getting some fluids multiple days a week.
(11:35):
Everything's going well until it's no longer going well.
So I do monitor their behavior, what they're eating, what they're drinking, and when they're making choices, I feel like they are making choices with where we've taken them as far as we can take them and then I honor that.
So I guess all I was saying, I am like you in most areas where I don't give up on most of them.
(11:59):
But if I am getting strong signals then, "It's okay, this may kill me to not do anything, but okay, my hand is forced."
Gail Pope (12:13):
Think of it as who we are.
We're all different.
We all make different decisions for ourselves, so why shouldn't our animals have the ability to do the same?
Karen Wylie (12:23):
Oh, and they do.
Gail Pope (12:24):
Yes, they definitely do.
Karen Wylie (12:26):
You brought up earlier the emotional landscape of the caregiver.
You can reach a point of "It's just too much, and at what point is it too much?"
In terms of the number of pills a day, the number of feedings a day, not being able to leave your home overnight because during the day, you monitor your sick cat and or multiple cats.
(12:54):
I know you've been there, done that.
I have too.
Right now I don't have anyone who's, I always feel I need to knock on one of these little wooden bookshelves anytime I say that, but I don't have to worry if I wanted to go leave for the weekend.
I wouldn't have anyone I was worried about leaving.
That hasn't always been how my life is.
(13:15):
I know right now you have babies that you're taking care of very carefully.
So you can't leave either.
Gail Pope (13:22):
Yes, it's difficult.
There, every single situation for every human is different.
If you have a full-time job and you have an employer that is not an animal person, you may not even be able to take the time off work.
Then you've got a whole other emotional battle ahead of you.
That's really tough.
I worked one time with a lady who was in that situation.
(13:45):
She was actually taking her dog to work with her each day.
She'd pulled down the backseat of her car and created a place for him there.
She started taking multiple cigarette breaks— she wasn't even a smoker but she'd take a packet of cigarettes, pop outside for a few minutes to check her dog.
We all work differently with situations, but that's always stayed with me.
(14:08):
She was quite amazing, quite amazing.
Karen Wylie (14:11):
It is amazing to devote yourself to a human or an animal in need of vigilant care and monitoring.
One of the differences, of course, with our pets is that we don't have Medicare or Medicaid covering the hospice care or the treatments if it is hospice care at end of life.
(14:33):
It's a lot easier to get respite care for a human than to get someone to care for a sick pet.
It seems to me, Gail, that we're at a point where we should start looking at the reasons why we might consider stopping treatment.
So
(14:53):
I guess the first thing would be is the treatment actually helping?
Gail Pope (14:57):
Again it's looking at the animal in daily life and monitoring the changes.
Are they eating a little less?
Are they less active?
Is their energy lower?
How are they behaving?
Are they having side effects to a treatment that they didn't have before?
Something like that.
So if something isn't quite gelling right, maybe time to meet with your veterinarian and just talk about the changes you're seeing and see what their advice is.
(15:23):
It may be less of that medicine, it may be a different medicine, or who knows, it could be all sorts of things depending on the type of healthcare program you're going.
Karen Wylie (15:34):
But it doesn't necessarily mean that everything, that all treatment is stopping.
It could just mean a change in the treatment.
Gail Pope (15:39):
Yes, exactly.
It could certainly, and this is really the time when it's possible that the conversation about palliative care particularly.
Because if you were working towards a healing protocol before and we are not actually seeing the healing getting better for the symptoms then it may be a time to start thinking a little about palliative care.
(16:07):
Because that can be very important.
And again, slipping in under the umbrella comes the word hospice.
I know a lot of people are still very scared of the word hospice because instantly they're thinking of the future and a possible death.
But as in human hospice, so many animals who actually start being treated as hospice patients, they blossom, they bloom, and they come back to better life.
(16:34):
So it is a path that is very well worth exploring in certain situations.
In some, it's not, it just doesn't, it doesn't become appropriate.
Again, there's no one size fits all for any of this work.
Being a caregiver is a very challenging road.
Karen Wylie (16:52):
It really is.
Which kind of ties back to what we were talking about last week about regretting some when we're looking back.
And so this is part of that because we often feel we need to explore every road, every path and not give up until we have explored all of them.
Some of the paths in terms of treatment paths might actually make us think that our pet's a little worse off than they were prior to starting the treatment.
(17:21):
But like you're saying, that doesn't mean all treatment has to stop.
It just would be something to make sure your veterinarian was aware of your observations and what you could describe that your pet was doing that made you feel it was actually making things worse and then something else could have been tried.
Gail Pope (17:38):
And again, it's such a difficult thing but we have to follow our beliefs and be true to our own heart, to our own understanding because I think a lot of people do that.
They're very focused on their treatment protocol and the way forward, and they stick to it.
(17:58):
Other people panic because what they were doing didn't seem to be working.
So they step to different philosophies, different types of medicines, and so they chop and change and they do all sorts of different protocols to try to heal.
Sometimes that can work really well and be a great decision and sometimes the poor animal, like as in, in the human field of medicine, it can be overwhelming, exhausting, and not what's needed.
Karen Wylie (18:27):
Right.
Gail Pope (18:28):
It's a tricky road.
Karen Wylie (18:30):
It's a very tricky road and so much of it really comes down to the animal's quality of life.
When you and I are talking about quality of life, we're not talking about let's fill out a quality of life assessment so we can know if they're ready to die.
Gail Pope (18:47):
No, there's a subtle difference there.
Karen Wylie (18:49):
There's a just not-so-subtle difference.
Our quality of life tool is to actually focus on what do they need to live?
How are they living day to day?
Are they still immersed in the love and connection of our relationship?
Or are they pulling away?
Are they still independent and highly mobile?
Or has their physical activity changed?
(19:11):
But none of those mean they're anywhere close to death's door.
Gail Pope (19:15):
Yes, exactly.
Karen Wylie (19:16):
So it's not measuring quality of life to see if it's time to euthanize.
Let's just take a look at keeping track of what their quality of life day to day really is.
Gail Pope (19:26):
Yes.
When you do that, then you become very aware of the little imbalances that may be there.
They're generally something that's pretty simple.
You can actually make a few little changes to the daily routine, to the diet, to all sorts of things, to the amount of exercise, the lack of it, or the need for more.
Some of those things that come into balance and you've got an animal now that's glowing, seeming better.
(19:51):
So yes, I think we're all different.
Let's face it, you and I are different.
We treat our animals differently.
We each follow different paths.
And that's okay.
We support that because everybody has to have their own way.
Karen Wylie (20:04):
Yes.
Our quality of life care tool is on the BrightPathForPets.com website for anyone who would like to download it and use it because we encourage measuring love and connection.
Yes, it's going to take L-I-V-I-N-G, love and connection, independence, and mobility.
(20:27):
Their vitality and joy in day-to-day living.
Yes, their intake of food and water is important.
Their ability to live and be with you in a nurturing environment.
Finally, your own growth as a caregiver and being able to adapt to changes that might be needed in the treatment of your pet.
(20:48):
So it's a bit of a quality of life care assessment, not just for your pet, but we're trying to bring you into the equation as well.
I think there's often so many elephants in the room, as we call it, but how much a treatment is costing is becoming a bigger and bigger issue for everyone?
I don't think we have any figures for cost increases in 2024, but as of 2023, in the five years from 2018 to 2023, veterinary costs were up 40%.
Gail Pope (21:21):
Oh my God.
Karen Wylie (21:22):
So this becomes a factor in whether treatment can be pursued or perhaps how long it can be pursued.
And again, that's in the conventional world because there's a lot of homeopathic or holistic treatments, remedies and so forth that are much less money.
Gail Pope (21:41):
Yes, that's true.
That's very true.
Karen Wylie (21:44):
We've already talked about the time factor for our caregivers and how many years the treatment might be going on and how that balances or does not balance with the rest of their lives because their energy matters too at some point.
The caregiver who suggested this topic for us was talking about how she only really was realizing.
(22:12):
How her life used to be so focused on that one animal when all of a sudden she wasn't medicating multiple times a day and carefully feeding and could go out for dinner at night with her husband.
All these different changes that most of us would consider day-to-day normal life.
(22:33):
They hadn't been part of her day-to-day life for for many years.
Gail Pope (22:37):
I think the word caregiver is probably a really important word.
I hadn't really considered it carefully before.
I'm an animal mom.
I have cats, dogs— yes, I guess I'm a caregiver but I don't think I ever really stopped and looked at what that word really meant.
It's only with the experience that I've had over the last four or five decades that I'm actually really even now realizing how difficult a job this is.
(23:08):
It should be listed on the different jobs because it really is a job you need training for.
You can't just step into being a caregiver when your animals young and strong and healthy.
It's about love and kindness and diet and following the right path and having fun.
But as time changes or age changes, illness can hit us at any time of life.
(23:32):
Then your job as a parent starts to change whether this is a child on two legs or a child on four legs.
Yes, the word caregiver I think is very loaded because it, it sounds very loving and kind.
But it's deep and it's responsibility at its highest.
Karen Wylie (23:53):
Yes.
It is different from caregiving for a human because in most cases we have the human's stated preferences to guide us.
Often, where they've actually written it down in a living will or end of life documents that they start requiring you to acknowledge at every doctor's appointment.
(24:15):
But as an animal caregiver, we are doing our best to understand and act on behalf of another being.
That extra layer of complexity that is certainly a human caregiver caring for someone who has become comatose or where they can no longer voice what they want is certainly they that's on a par with that.
(24:39):
That same kind of worry, "Am I doing the right thing? Am I doing what they would want?"
But I think that's a level of stress that pet caregivers have all the time, that human caregivers don't.
I think may enter into our regrets and our guilt and everything else we second guess.
I guess the last thing I was thinking of when we're going to talk about this topic is wondering how your vet will support what you want to do— depending on your relationship with the vet or lack of it.
(25:13):
If there's someone you know and you feel comfortable with and you could share where you're at in making your decision.
I don't know that most people actually have that kind of relationship with that kind of vet.
Gail Pope (25:27):
Again, that totally underscores the responsibilities that are there for a caregiver because you may be able to talk to your vet and have that deeper conversation.
I'm sure a lot of people can, and I'm sure a lot of people can't or won't.
You may have close family and friends that you can talk to or a next door neighbor that really cares and can help you work your way through all these thoughts.
(25:52):
But again it's so hard.
It's so hard.
Karen Wylie (25:55):
And the example I thought of about the veterinary relationship is a couple years ago with Mr. Hope, and it was in his last few months of life.
He was there for his regular monthly blood pressure check and just generally listening to everything.
My vet mentioned at that time, she thought she heard some fluid in his lungs.
Gail Pope (26:16):
Oh yes, yes, that's right.
Karen Wylie (26:18):
So she said, "What I'd like to do is get a couple x-rays so I can see it. Understand if I'm right that I'm hearing, I'm seeing what I thought I was hearing."
And she said, "Then I'll have a better sense of how much Lasix to start him on."
And I said, "Okay, yes, let's do that."
So she sent one of her nurses in for me to read the documentation and permission that, "Yes, I'm going to pay for the procedure."
(26:42):
And she said to me, and someone who— a tech nurse I've worked with for years, liked very much.
But she said, "This is a very painful disease."
And I looked at her and I'm thinking he has Hypertrophic cardio, kidney disease and high blood pressure.
I said, "Yes, if he threw a blood clot, certainly there'd be pain. But I would deal with that when it happens. It's okay."
(27:07):
And she said, "No, I'm not talking about saddle thrombus. I'm saying that what he has right now is very painful."
We hadn't even done an x-ray yet to see if there was any fluid in his lungs but she was clearly communicating her disapproval of me bringing him every month to see if there was anything we needed to adapt.
(27:33):
I signed the paper and I just said, "Thanks so much for all your help."
And ended the conversation.
A few minutes later my vet came in and the first thing she said, "He's not ready to leave the planet any time soon but I did see there is a little bit of fluid in his lungs, so you know, we're going to start him on Lasix and you monitor him for a couple weeks and let's see how he's doing."
So to my vet, she was very open to, "Okay, let's just add a medication and we'll just keep track of him."
(28:00):
But to her nurse who’d been with her for 20 years, she saw the treatment road I was going down as something to not approve of.
So I just bring that up because sometimes it's not just your vet and your vet's opinion of what you're doing.
But the staff can also influence how you feel about what you're doing and other people in your life.
Gail Pope (28:25):
The loved ones and not everybody is going to have the same approach to age or illness.
And yes, it's a puzzle.
Karen Wylie (28:34):
It's a puzzle.
It is.
Then people can begin getting pressure from family members or coworkers of when are you going to euthanize?
So it can be a lonely road and you've got to feel good about what you do as you make those changes along the way, like you were talking about earlier.
Gail Pope (28:53):
I think one of the most important things is that the love that you share with your animal is the most precious part of the entire journey, and sharing that love and concern with them rather than worrying endlessly.
(29:16):
They know we are worrying.
They know that things aren't right.
So when we don't share with them, it only increases their stress.
Because they're worried about us.
Honoring that partnership and the love, the deep love that sits inside it, I think is perhaps most essential part whatever route is chosen.
Karen Wylie (29:36):
And like you're saying, they know what's going on with us before we know what's going on with us.
They know we've shown that we love them in a thousand other ways.
They're very clear about that.
It's not the treatments we choose to continue or the treatments we may decide to adapt or stop in any way has anything to do with how much we love them.
Gail Pope (29:57):
It's all about love.
Karen Wylie (29:59):
It's all about love.
It begins and ends with love.
Gail Pope (30:03):
We're done.
Karen Wylie (30:04):
I think we're done.
I don't think there's any more to say other than our executive producer— you can tell by the wobbly monitor.
Callie's indicating that, "Okay, mom, you guys have talked enough. Now you need to attend to me."
So with that...
Gail Pope (30:18):
Just goodbye...
Karen Wylie (30:20):
We'll say, we hope our discussion today may have given you some permission to reflect on what you're doing with your pet, to ask maybe is it time to stop treating or start a new path, whatever that might be.
We hope you'll be able to join us this Thursday at 10:00 AM Pacific, 1:00 PM Eastern for our Cuppa and Conversation that we have every week.
(30:45):
It's free and open to everyone who would like to join us.
We never know what the topics are because it's whatever people would like to talk about who are there.
So, we invite you to join us and hope you can be with us.
We thank you for being with us and look forward to seeing you next time.
Bye-bye.
Gail Pope (31:02):
Goodbye.
Thank you so much.
Thank you for joining us on Peace of Mind for Pet Parents.
We hope today's episode has offered you support and insight as you care for your aging or ill pets.
Remember, it's not just about the end.
It's about living well at every stage of life.
To continue your journey with us, explore more resources at BrightHaven Caregiver Academy's website— BrightPathForPets.com, where you'll find guides, assessments, and a caring community of pet parents like you.
(31:39):
Until next time, may you and your pets find comfort, connection, and peace in every moment.
Take care.
Welcome to Peace of Mind for Pet Parents, the podcast by BrightHaven Caregiver Academy.
I'm Gail Pope and I'm Karen Wylie and together we're here to support you in navigating life with your aging or ill pets.
We know how deeply you care for your beloved companions, and we're here to offer guidance, understanding, and resources for this meaningful journey.
(00:25):
Each episode we'll explore topics that address the daily challenges, emotional realities, and choices you face as a pet parent helping you and your pets find peace, comfort, and joy.
Whether it's making sense of a new diagnosis, adjusting to changing needs, or simply seeking a place to feel understood, you're not alone.
(00:47):
Thank you for being here with us.
Karen Wylie (00:50):
Hello and welcome back to Peace of Mind for Pet Parents.
I'm Karen Wylie here, as always, with my friend Gail Pope.
Today we're going to explore an issue, a question suggested to us by one of our listeners, and that is when you are providing palliative or hospice care to a pet, when do you decide to stop treating your pet?
(01:18):
I think that's one of the toughest for any of us, Gail, don't you think?
Especially when we are treating our pets, whether it's every day for a chronic condition or a difficult to manage one, it doesn't always have to be a terminal condition, but while we are continuing treatment.
It's like we're continuing the hope that we have, that maybe things are going to turn around or they can be with us forever.
(01:47):
The treatment is not just something outside of ourselves.
It's also highly emotional but it seems like one of the first things we need to do is define
"What treatment is?" Or
"When we talk about treatment, what can it encompass?"
Gail Pope (02:02):
You do like big questions, don't you?
Karen Wylie (02:04):
I throw it to you right away.
Gail Pope (02:07):
Actually, the first thing that I'm thinking about is that you started the conversation talking about when you're offering hospice or palliative care at the end of an animal's life.
But really I think for our audience, a lot of people aren't familiar necessarily with those terms.
(02:28):
What I want to say fits together in two ways because they're generally seeing a vet who may be and probably most generally as a conventional vet, or maybe integrative or possibly holistic, but they still may not have encountered the words hospice and palliative care.
So I think the essence of actually when to stop treating.
(02:55):
It's interesting because, now you're going to laugh, I never stopped treating.
I follow probably because over the years as the animals have led the way for us, what I've realized is that working with homeopathy, and I'm not suggesting the whole world switched to homeopathy, but it's healing for the highest good has become the motto.
(03:20):
I'm not thinking about treating a symptom, I'm treating the being
Karen Wylie (03:25):
Right, the whole animal.
Gail Pope (03:27):
So my veterinarian is prescribing based on what's happening.
As the animal's situation changes or starts to decline, we're still working towards helping that symptom improve.
And again, there's sometimes a point of time where there may be an acute situation which changes things but still healing for the highest good.
(03:55):
If that symptom can't be resolved, for instance if it's pain, then you may be at a point that you do decide to stop actual treatment.
I know that's a tangled web but I just see us as supporting and treating all the way through to the last breath.
Karen Wylie (04:14):
I think the whole question is complicated and all tangled together.
Gail Pope (04:20):
I realized it's very tangled but it seems to be very clear.
It's a clear cut question that we are hearing over and over again from people whose vets have said, "I can do no more. It's time to stop treatment."
Which indicates that is a very conventional approach instead of a Wholistic, with the W in front, that actually embraces the whole being because generally the treatment is focused on symptoms.
(04:53):
Obviously again, that's not always the case, and sometimes there is a more wholistic approach.
Then maybe that treatment window actually starts to close as you get closer to the end of life, and the journey— the way forward becomes very much clearer.
If that makes any sense.
Karen Wylie (05:12):
Oh, it does make a lot of sense especially within the context of conventional veterinary care.
When our vet says, "I don't really have anything more to offer in terms of treatment."
Because then there's only one other procedure that they have to offer and that's euthanasia.
That's often when you get contacted for consultations because people are looking for something that the conventional viewpoint doesn't include.
(05:43):
That's starting to look at the integrative, the holistic but treatment means so many different things to a caregiver.
Sometimes it's how many trips to the vet can you make?
Both in terms of time needed out of work or the money that's needed.
It could be learning new skills, like how to give subcutaneous fluids.
(06:08):
How to get over the qualms of inserting a needle into your baby's skin and understanding what that bubble looks like, and watching the mls.
Watching very carefully how much you're giving.
There's all these different aspects.
It's not just sub-Q fluids it's learning your role in it.
So part of stopping treatment or continuing treatment also involves you personally and your comfort level or lack of it (06:29):
pilling, medications...
Gail Pope (06:42):
It's endless.
Karen Wylie (06:43):
It is!
Special diets, being able to afford some of those special diets, being able to get those diets in their little mouths.
And when, we often say at end of life, offer and never force food.
So you have to observe what's happening and make decisions.
So I think even what people would call treatment is very different.
Gail Pope (07:09):
It's a huge umbrella.
And again, it varies.
I think there are two other important factors in here (07:16):
obviously, the first one is the animal themselves.
Their emotional and physical state, who are they and how are they doing with this method of treatment, whatever that may be.
Maybe we should try something different, maybe that will lead to a slightly different lane.
Karen Wylie (07:37):
I guess I'm going to circle back to what you were saying a little earlier, which is there have not been situations or that many situations where you have chosen to stop treating.
You have changed your treatment but you have still continued treating all the way through.
Generally, I'm certainly more like that than not, but there have been times I do stop.
(08:00):
It's largely, if not entirely, because of the pet's perspective and how I perceive it.
About 25 years ago, I had a cat that was diagnosed with diabetes when he was about 11 or 12 years old.
We didn't know as much about how to treat diabetes or how to stick their little ears and their paw pads and everything back then.
(08:22):
Now you don't have to do any of that which is so wonderful.
But back then monitoring the blood sugar of your pets was really— you had to get really good at it for it not to be very painful.
And as a diabetic myself, pricking is never not painful.
You get used to it but how do you explain it to our babies?
(08:44):
It's just going to be a minute.
But that cat chose to start hiding twice a day, right before he was to be fed.
That was a real big signal to me because he had been a very social guy involved in every aspect of life.
(09:06):
Suddenly, 45 minutes to an hour before dinner time would be coming, he would be under the furniture.
I'd be having to run around, getting on the floor, looking under everything.
"Where is he?"
It really then was, "My God, how do I stop doing this?
(09:28):
Maybe I could put him in a cage?
I could keep him in one room?
So I could find him to prick and get the blood sugar levels so I would know how much insulin to give him."
It really was getting so erratic that he had a stroke, his blood sugar spiked.
That was probably over two to three week span once I had started trying to monitor the blood sugar and giving the various amounts of insulin based on the blood sugar levels and so forth.
(09:59):
So he pretty much decided for me what he opted out.
When I've had cats with advanced kidney disease but they're eating, drinking, playing, their body is warm, they're laying with everybody, they're enjoying their lives, and then they stop eating and they don't even really want any fluids.
(10:23):
So I start monitoring their behaviors as they start pulling away.
Gail Pope (10:29):
But what you're underlining over and over again is that our animals will lead the way.
They lead the way for us, and based on our knowledge, our understanding, the tools that we have at our fingertips, we all choose different tools.
We just have to put the whole lot into a pot and do our best, do it with love and make decisions along the way about what to do, what not to do, and how to do it.
(10:58):
It's a tough journey.
It's such an emotional journey.
It's really emotional for the caregiver but of course the animal is also understanding our emotions as well.
So it's almost doubly hard for them to see how we struggle with the worry and the concerns.
Karen Wylie (11:15):
Yes and there have been many times I have felt like they chose a route that would make things easier for me.
You know, where they're 17, 18, 19 years old, they're on getting some fluids multiple days a week.
(11:35):
Everything's going well until it's no longer going well.
So I do monitor their behavior, what they're eating, what they're drinking, and when they're making choices, I feel like they are making choices with where we've taken them as far as we can take them and then I honor that.
So I guess all I was saying, I am like you in most areas where I don't give up on most of them.
(11:59):
But if I am getting strong signals then, "It's okay, this may kill me to not do anything, but okay, my hand is forced."
Gail Pope (12:13):
Think of it as who we are.
We're all different.
We all make different decisions for ourselves, so why shouldn't our animals have the ability to do the same?
Karen Wylie (12:23):
Oh, and they do.
Gail Pope (12:24):
Yes, they definitely do.
Karen Wylie (12:26):
You brought up earlier the emotional landscape of the caregiver.
You can reach a point of "It's just too much, and at what point is it too much?"
In terms of the number of pills a day, the number of feedings a day, not being able to leave your home overnight because during the day, you monitor your sick cat and or multiple cats.
(12:54):
I know you've been there, done that.
I have too.
Right now I don't have anyone who's, I always feel I need to knock on one of these little wooden bookshelves anytime I say that, but I don't have to worry if I wanted to go leave for the weekend.
I wouldn't have anyone I was worried about leaving.
That hasn't always been how my life is.
(13:15):
I know right now you have babies that you're taking care of very carefully.
So you can't leave either.
Gail Pope (13:22):
Yes, it's difficult.
There, every single situation for every human is different.
If you have a full-time job and you have an employer that is not an animal person, you may not even be able to take the time off work.
Then you've got a whole other emotional battle ahead of you.
That's really tough.
I worked one time with a lady who was in that situation.
(13:45):
She was actually taking her dog to work with her each day.
She'd pulled down the backseat of her car and created a place for him there.
She started taking multiple cigarette breaks— she wasn't even a smoker but she'd take a packet of cigarettes, pop outside for a few minutes to check her dog.
We all work differently with situations, but that's always stayed with me.
(14:08):
She was quite amazing, quite amazing.
Karen Wylie (14:11):
It is amazing to devote yourself to a human or an animal in need of vigilant care and monitoring.
One of the differences, of course, with our pets is that we don't have Medicare or Medicaid covering the hospice care or the treatments if it is hospice care at end of life.
(14:33):
It's a lot easier to get respite care for a human than to get someone to care for a sick pet.
It seems to me, Gail, that we're at a point where we should start looking at the reasons why we might consider stopping treatment.
So
(14:53):
I guess the first thing would be is the treatment actually helping?
Gail Pope (14:57):
Again it's looking at the animal in daily life and monitoring the changes.
Are they eating a little less?
Are they less active?
Is their energy lower?
How are they behaving?
Are they having side effects to a treatment that they didn't have before?
Something like that.
So if something isn't quite gelling right, maybe time to meet with your veterinarian and just talk about the changes you're seeing and see what their advice is.
(15:23):
It may be less of that medicine, it may be a different medicine, or who knows, it could be all sorts of things depending on the type of healthcare program you're going.
Karen Wylie (15:34):
But it doesn't necessarily mean that everything, that all treatment is stopping.
It could just mean a change in the treatment.
Gail Pope (15:39):
Yes, exactly.
It could certainly, and this is really the time when it's possible that the conversation about palliative care particularly.
Because if you were working towards a healing protocol before and we are not actually seeing the healing getting better for the symptoms then it may be a time to start thinking a little about palliative care.
(16:07):
Because that can be very important.
And again, slipping in under the umbrella comes the word hospice.
I know a lot of people are still very scared of the word hospice because instantly they're thinking of the future and a possible death.
But as in human hospice, so many animals who actually start being treated as hospice patients, they blossom, they bloom, and they come back to better life.
(16:34):
So it is a path that is very well worth exploring in certain situations.
In some, it's not, it just doesn't, it doesn't become appropriate.
Again, there's no one size fits all for any of this work.
Being a caregiver is a very challenging road.
Karen Wylie (16:52):
It really is.
Which kind of ties back to what we were talking about last week about regretting some when we're looking back.
And so this is part of that because we often feel we need to explore every road, every path and not give up until we have explored all of them.
Some of the paths in terms of treatment paths might actually make us think that our pet's a little worse off than they were prior to starting the treatment.
(17:21):
But like you're saying, that doesn't mean all treatment has to stop.
It just would be something to make sure your veterinarian was aware of your observations and what you could describe that your pet was doing that made you feel it was actually making things worse and then something else could have been tried.
Gail Pope (17:38):
And again, it's such a difficult thing but we have to follow our beliefs and be true to our own heart, to our own understanding because I think a lot of people do that.
They're very focused on their treatment protocol and the way forward, and they stick to it.
(17:58):
Other people panic because what they were doing didn't seem to be working.
So they step to different philosophies, different types of medicines, and so they chop and change and they do all sorts of different protocols to try to heal.
Sometimes that can work really well and be a great decision and sometimes the poor animal, like as in, in the human field of medicine, it can be overwhelming, exhausting, and not what's needed.
Karen Wylie (18:27):
Right.
Gail Pope (18:28):
It's a tricky road.
Karen Wylie (18:30):
It's a very tricky road and so much of it really comes down to the animal's quality of life.
When you and I are talking about quality of life, we're not talking about let's fill out a quality of life assessment so we can know if they're ready to die.
Gail Pope (18:47):
No, there's a subtle difference there.
Karen Wylie (18:49):
There's a just not-so-subtle difference.
Our quality of life tool is to actually focus on what do they need to live?
How are they living day to day?
Are they still immersed in the love and connection of our relationship?
Or are they pulling away?
Are they still independent and highly mobile?
Or has their physical activity changed?
(19:11):
But none of those mean they're anywhere close to death's door.
Gail Pope (19:15):
Yes, exactly.
Karen Wylie (19:16):
So it's not measuring quality of life to see if it's time to euthanize.
Let's just take a look at keeping track of what their quality of life day to day really is.
Gail Pope (19:26):
Yes.
When you do that, then you become very aware of the little imbalances that may be there.
They're generally something that's pretty simple.
You can actually make a few little changes to the daily routine, to the diet, to all sorts of things, to the amount of exercise, the lack of it, or the need for more.
Some of those things that come into balance and you've got an animal now that's glowing, seeming better.
(19:51):
So yes, I think we're all different.
Let's face it, you and I are different.
We treat our animals differently.
We each follow different paths.
And that's okay.
We support that because everybody has to have their own way.
Karen Wylie (20:04):
Yes.
Our quality of life care tool is on the BrightPathForPets.com website for anyone who would like to download it and use it because we encourage measuring love and connection.
Yes, it's going to take L-I-V-I-N-G, love and connection, independence, and mobility.
(20:27):
Their vitality and joy in day-to-day living.
Yes, their intake of food and water is important.
Their ability to live and be with you in a nurturing environment.
Finally, your own growth as a caregiver and being able to adapt to changes that might be needed in the treatment of your pet.
(20:48):
So it's a bit of a quality of life care assessment, not just for your pet, but we're trying to bring you into the equation as well.
I think there's often so many elephants in the room, as we call it, but how much a treatment is costing is becoming a bigger and bigger issue for everyone?
I don't think we have any figures for cost increases in 2024, but as of 2023, in the five years from 2018 to 2023, veterinary costs were up 40%.
Gail Pope (21:21):
Oh my God.
Karen Wylie (21:22):
So this becomes a factor in whether treatment can be pursued or perhaps how long it can be pursued.
And again, that's in the conventional world because there's a lot of homeopathic or holistic treatments, remedies and so forth that are much less money.
Gail Pope (21:41):
Yes, that's true.
That's very true.
Karen Wylie (21:44):
We've already talked about the time factor for our caregivers and how many years the treatment might be going on and how that balances or does not balance with the rest of their lives because their energy matters too at some point.
The caregiver who suggested this topic for us was talking about how she only really was realizing.
(22:12):
How her life used to be so focused on that one animal when all of a sudden she wasn't medicating multiple times a day and carefully feeding and could go out for dinner at night with her husband.
All these different changes that most of us would consider day-to-day normal life.
(22:33):
They hadn't been part of her day-to-day life for for many years.
Gail Pope (22:37):
I think the word caregiver is probably a really important word.
I hadn't really considered it carefully before.
I'm an animal mom.
I have cats, dogs— yes, I guess I'm a caregiver but I don't think I ever really stopped and looked at what that word really meant.
It's only with the experience that I've had over the last four or five decades that I'm actually really even now realizing how difficult a job this is.
(23:08):
It should be listed on the different jobs because it really is a job you need training for.
You can't just step into being a caregiver when your animals young and strong and healthy.
It's about love and kindness and diet and following the right path and having fun.
But as time changes or age changes, illness can hit us at any time of life.
(23:32):
Then your job as a parent starts to change whether this is a child on two legs or a child on four legs.
Yes, the word caregiver I think is very loaded because it, it sounds very loving and kind.
But it's deep and it's responsibility at its highest.
Karen Wylie (23:53):
Yes.
It is different from caregiving for a human because in most cases we have the human's stated preferences to guide us.
Often, where they've actually written it down in a living will or end of life documents that they start requiring you to acknowledge at every doctor's appointment.
(24:15):
But as an animal caregiver, we are doing our best to understand and act on behalf of another being.
That extra layer of complexity that is certainly a human caregiver caring for someone who has become comatose or where they can no longer voice what they want is certainly they that's on a par with that.
(24:39):
That same kind of worry, "Am I doing the right thing? Am I doing what they would want?"
But I think that's a level of stress that pet caregivers have all the time, that human caregivers don't.
I think may enter into our regrets and our guilt and everything else we second guess.
I guess the last thing I was thinking of when we're going to talk about this topic is wondering how your vet will support what you want to do— depending on your relationship with the vet or lack of it.
(25:13):
If there's someone you know and you feel comfortable with and you could share where you're at in making your decision.
I don't know that most people actually have that kind of relationship with that kind of vet.
Gail Pope (25:27):
Again, that totally underscores the responsibilities that are there for a caregiver because you may be able to talk to your vet and have that deeper conversation.
I'm sure a lot of people can, and I'm sure a lot of people can't or won't.
You may have close family and friends that you can talk to or a next door neighbor that really cares and can help you work your way through all these thoughts.
(25:52):
But again it's so hard.
It's so hard.
Karen Wylie (25:55):
And the example I thought of about the veterinary relationship is a couple years ago with Mr. Hope, and it was in his last few months of life.
He was there for his regular monthly blood pressure check and just generally listening to everything.
My vet mentioned at that time, she thought she heard some fluid in his lungs.
Gail Pope (26:16):
Oh yes, yes, that's right.
Karen Wylie (26:18):
So she said, "What I'd like to do is get a couple x-rays so I can see it. Understand if I'm right that I'm hearing, I'm seeing what I thought I was hearing."
And she said, "Then I'll have a better sense of how much Lasix to start him on."
And I said, "Okay, yes, let's do that."
So she sent one of her nurses in for me to read the documentation and permission that, "Yes, I'm going to pay for the procedure."
(26:42):
And she said to me, and someone who— a tech nurse I've worked with for years, liked very much.
But she said, "This is a very painful disease."
And I looked at her and I'm thinking he has Hypertrophic cardio, kidney disease and high blood pressure.
I said, "Yes, if he threw a blood clot, certainly there'd be pain. But I would deal with that when it happens. It's okay."
(27:07):
And she said, "No, I'm not talking about saddle thrombus. I'm saying that what he has right now is very painful."
We hadn't even done an x-ray yet to see if there was any fluid in his lungs but she was clearly communicating her disapproval of me bringing him every month to see if there was anything we needed to adapt.
(27:33):
I signed the paper and I just said, "Thanks so much for all your help."
And ended the conversation.
A few minutes later my vet came in and the first thing she said, "He's not ready to leave the planet any time soon but I did see there is a little bit of fluid in his lungs, so you know, we're going to start him on Lasix and you monitor him for a couple weeks and let's see how he's doing."
So to my vet, she was very open to, "Okay, let's just add a medication and we'll just keep track of him."
(28:00):
But to her nurse who’d been with her for 20 years, she saw the treatment road I was going down as something to not approve of.
So I just bring that up because sometimes it's not just your vet and your vet's opinion of what you're doing.
But the staff can also influence how you feel about what you're doing and other people in your life.
Gail Pope (28:25):
The loved ones and not everybody is going to have the same approach to age or illness.
And yes, it's a puzzle.
Karen Wylie (28:34):
It's a puzzle.
It is.
Then people can begin getting pressure from family members or coworkers of when are you going to euthanize?
So it can be a lonely road and you've got to feel good about what you do as you make those changes along the way, like you were talking about earlier.
Gail Pope (28:53):
I think one of the most important things is that the love that you share with your animal is the most precious part of the entire journey, and sharing that love and concern with them rather than worrying endlessly.
(29:16):
They know we are worrying.
They know that things aren't right.
So when we don't share with them, it only increases their stress.
Because they're worried about us.
Honoring that partnership and the love, the deep love that sits inside it, I think is perhaps most essential part whatever route is chosen.
Karen Wylie (29:36):
And like you're saying, they know what's going on with us before we know what's going on with us.
They know we've shown that we love them in a thousand other ways.
They're very clear about that.
It's not the treatments we choose to continue or the treatments we may decide to adapt or stop in any way has anything to do with how much we love them.
Gail Pope (29:57):
It's all about love.
Karen Wylie (29:59):
It's all about love.
It begins and ends with love.
Gail Pope (30:03):
We're done.
Karen Wylie (30:04):
I think we're done.
I don't think there's any more to say other than our executive producer— you can tell by the wobbly monitor.
Callie's indicating that, "Okay, mom, you guys have talked enough. Now you need to attend to me."
So with that...
Gail Pope (30:18):
Just goodbye...
Karen Wylie (30:20):
We'll say, we hope our discussion today may have given you some permission to reflect on what you're doing with your pet, to ask maybe is it time to stop treating or start a new path, whatever that might be.
We hope you'll be able to join us this Thursday at 10:00 AM Pacific, 1:00 PM Eastern for our Cuppa and Conversation that we have every week.
(30:45):
It's free and open to everyone who would like to join us.
We never know what the topics are because it's whatever people would like to talk about who are there.
So, we invite you to join us and hope you can be with us.
We thank you for being with us and look forward to seeing you next time.
Bye-bye.
Gail Pope (31:02):
Goodbye.
Thank you so much.
Thank you for joining us on Peace of Mind for Pet Parents.
We hope today's episode has offered you support and insight as you care for your aging or ill pets.
Remember, it's not just about the end.
It's about living well at every stage of life.
To continue your journey with us, explore more resources at BrightHaven Caregiver Academy's website— BrightPathForPets.com, where you'll find guides, assessments, and a caring community of pet parents like you.
(31:39):
Until next time, may you and your pets find comfort, connection, and peace in every moment.
Take care.
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