Season 1 Episode 11: All Dogs go to Heaven

Thanks for joining Hospice Nurse Penny and Halley (Hospice Social Worker) on the journey to #NormalizeDeath! Our guest is Dr. Faith Banks. Dr. Banks graduated from the Ontario Veterinary College at the University of Guelph in 1996, and has been practicing veterinary medicine in Toronto, Ontario ever since. She opened Toronto’s first mobile veterinary hospice service in 2012 which now includes a team of 7 veterinarians and 11 hospice care coordinators. She is amongst the first group of veterinarians to be named as a Certified Hospice and Palliative Care Veterinarian (CHPV) through the International Association for Animal Hospice and Palliative Care. She has written two chapters in a textbook called "Treatment and Care of the Geriatric Veterinary Patient." She is a guest lecturer at the Ontario Veterinary College for the Art of Veterinary Medicine course on animal euthanasia. She has completed the Pet Loss and Grief Companioning Certification course through Two Hearts Pet Loss Center, in addition to being certified as a Pet Loss Counsellor through the Association for Pet Loss and Bereavement. Two years ago, she opened Toronto’s first pet water cremation service to provide families with an eco-friendly, personalized aftercare option for their beloved pets. Her goal in providing compassionate in-home palliative, hospice, and end-of-life care is to allow people to strengthen and lengthen the bond they share with their much loved pet. When not working, Dr. Banks enjoys photography, travelling, reading, cottaging, collecting vintage flea powder tins and spending time with her friends and family. She shares her home with her husband, 3 children, and 3 Bernese Mountain Dogs. The website is: https://mmvhs.ca/ TikTok: @Dr.faithbanks Instagram: hospicevet (MMVHS) Thanks for joining Hospice Nurse Penny and Halley (Hospice Social Worker) on the journey to #NormalizeDeath! You can reach us at [e-mail], on all places you find podcasts are found. A video option can be found on YouTube at https://www.youtube.com/@DeathHappensInsiders Hospice Nurse Penny on the socials: @HospiceNursePenny Halley on Instagram, TikTok, and Facebook: @HospiceHalley Our intro music was composed by Jamie Hill (misfitstars.com)

Episode Transcript

(00:00):
- And that video was the one
that has had the most views for sure.
The title of it is better a month too
early than a day Too Late.
And there are many variations, you know,
better a day too early than aday too late, whatever it is.
The idea is that you don't wanna wait
until things are really,really bad with your pet.

(00:30):
- Welcome to The Death Happens podcast,
an insider guide to Dying.
We're your insiders.I'm Hospice Nurse Penny.
- And I'm Halle Hospice Social Worker.
Today with us, we have Dr.
Faith Banks, who has been aveterinarian since the mid
nineties, but more fascinating
to us is she's a certified hospice
and palliative care veterinarian.

(00:51):
So I'm super excited tohear more about that.
And she's in Canada, sowe have a whole other
litany of questions for her.
But before that, I think Penny'sgot some education for us.
- Yeah. So I thought it was timely
and relevant to talk aboutpets as they relate to hospice.
And there are a couple of topics
regarding pets when it comes to hospice.

(01:11):
The first is how people can
sometimes be concerned about their pets,
what will happen to their pets.
So for example, when wehave patients who live alone
or who have family thataren't really wanting
to take on the responsibilityof their little 10-year-old
dog or their five cats, you know, people

(01:32):
who are dying often will worryvery much about their pets.
So I was thinking it wouldbe good for us to kind
of talk about the socialwork role when it comes
to pet placement, when aperson is dying on hospice
and you are the expert for that. Hallie
- .
Well, I can certainly onlyspeak about my hospice,
but I am sure that social workers

(01:53):
across the country havetheir own resources locally.
So our hospice is connected
with a national organizationcalled Pet Peace of Mind.
And this organization helpspeople develop the worksheets
for us to work with the pet owner
and make sure we have theinformation on the pet,
the vet information on the pet,

(02:14):
so if they've had shotsor things like that.
And then try to work outfrom our hospice into local
communities to find out whomight be able to adopt this pet.
Part of pet peace of mind also is
to help keep the pet inthe home with the patient
until they're no longer with us,
because we know as experienced as we are,

(02:36):
how important people's pets are to them.
- Yeah, I love that so much.
I don't know if my agency works
with any specific organization.
I do know that is a priorityoften when somebody's
concerned about their pet.
And there have actually beenseveral of our clinicians
who will take their pet
- Oh yeah, . Yep. We've had

(02:56):
- That too. So,
- Uh, we've actuallyrehomed koi three times.
- Koy Fish.- Yep. Koy Fish, not just cats
and dogs. .
- And so are any of thosekoi in your pond, Halle?
- Uh, yeah. They they did end up in,
some of 'em ended up in mypond. Not all of 'em. .
- Well, that's so interesting.
You know, people love their pets

(03:17):
and it doesn't matter if they'redogs, cats, birds, or fish
or snakes or frogs or lizardsor anything else, .
But now speaking of clinicians
and pets here is where we havekind of a unpopular opinion.
And unfortunately it's notone, it's unpopular with us
as well, but we understand theneed for this is most hospice

(03:39):
agencies are now moving towards
or already have a policy aboutpets being contained when the
hospice staff comes to visit.
We've had multiple animalbites of our clinicians. Yeah.
Animals get very, uh, stressedout when you know, their,
their one is sick.
And when there are strangerscoming in and out of the home,
and even the nicest petscan turn on someone.

(04:02):
- Yeah. Problematic.
Especially I think whenthose pets, you know, on top
of being stressed in thestrangers, especially the aides
and the nurses, when you'reright there in their space,
in their physical spacetouching their owner,
their owner may wince orha be having pain Mm-Hmm.
. And theydon't know that it's
not you causing it.
- Well, and and anotherthing too is that, you know,

(04:23):
as a nurse trying to doprocedures that are supposed to be
sterile, like putting in aFoley catheter, uh, it's kind
of hard to perform thoseprocedures when you're, you know,
like having to brush the cat off the bed
so that you can do that.
So it's really a problemin that way as well.
And also, uh, problematicis the clinician who goes in

(04:43):
and says, no, the pet is fine.
I love the little puppy. Socute. Bring them out. It's okay.
You know? And then, andthen we have other staff
who go in there who are eitherwanting to follow the policy
or afraid of dogs. And I I know when
- I, or they're allergic for crying out
- Loud or, or allergic Yes.
Or allergic. Yeah.
And so then you have, you know,
you've set up this little triangle here

(05:03):
where you've got the patient saying, well,
but I won't say socialworker, the chaplain,
the chaplain said Fifi could be out
during our visits, you know?
Mm-Hmm. .Mm-Hmm. . And so,
and that's really hardbecause we have to, you know,
ask our clinicians to respecttheir, their colleagues so
that they're not setting 'em up
for failure with, with the Yeah.

(05:24):
With the family. Yeah.
- So boundaries reallyare not only important
for the clinicians not to get injured
or not to be fearfulof going into the home,
but they're really a kindness to the pet.
Mm-Hmm. anda kindness to the family
to not be stressed outthat their pet is causing a
distraction or causing an injury,

(05:44):
or worried about theirpet being stressed out.
It's just easier. We're notin the home for that long.
If you can just contain
that animal in a different space from us.
It's, like I said, not very long.
Maybe an hour at the most, most.
- Yeah. So when I worked atthe care center, uh, we had a,
an aide who had been actuallymauled by a dog in her youth.

(06:05):
Oh goodness. And wasterrified of, of dogs.
And we did allow pets at the care center,
most hospice care centers do.
And that's where youhave that, that's kind
of like the other side of this.
'cause you, you can't have 'emcontain 'em when you go into
the room, but you want theirpets to be able to visit.
It's such a sticky con, you know,
it's such a sticky situation.
But we would have

(06:25):
to assign a different aid whenthere was a pet in the room
because she was absolutelymortified of the animals.
And, you know, speaking ofit being a sticky situation.
So when we have somebody who'ssaying, I've got a little dog
and I'm really worried about it,
and then we're thinking, okay,
well maybe a staff membermight want that dog.
They're not gonna get the opportunity
to get to know the animal.

(06:46):
So it's, yeah. It'sreally, it's a challenge.
It's a challenge. I seeboth sides of it, honestly.
Uh, but I, but I, I
- Can, I can imagine if itwas gonna be someone adopting
that maybe you finish yourvisit in a formal way Mm-Hmm.
and thenset aside a different time
for just the pet interaction, not Yeah.
Because it's a pre-approvedprearranged, not

(07:08):
during the official hospice visit.
If that was gonna be anadoption situation, I could see
- That.
Yeah. Yeah, yeah. I know.It's just, it is, it's sticky.
And, you know, I I, I getit why people want people
to let their dogs and catsbe out during the visit.
But then also I work inquality and safety. Mm-Hmm.
. And Ihave seen the injuries

(07:30):
that our staff have sustained from animal
bites. Yeah. It's serious.
- Serious. I've had a dog come after me.
Luckily I had my big computer bag with me,
and the owner cameexactly at the right time.
But it was a very large dog.And I'm not scared of dogs.
And this,
I wasn't quite sure if I was getting outta
the house uninjured, so,
- Wow.

(07:51):
Yeah. Yeah. That is scary.
- Well, and another one last thing
before we finish up our introhere is I'm thinking about
pets and their owners.
And one of the things I alwaysrecommend for families is,
if possible, allow their pet to come
and be with the owner that'sdied right after they die.

(08:12):
Because pets can smell.
They, they deal
with grief in a much moresimple way and direct way.
And if they don't get that opportunity,
and sometimes it's not possible,maybe they're in a facility
and they're just not ableto, but if possible bring
that pet in, they're gonnatake like 30 seconds.
It's not like us grieving,
and they're gonna continueto grieve in a different way.

(08:32):
Mm-Hmm. . Butthat initial being able to be
and smell their be with
and smell their personis really gonna make
a difference in the pet's grieving.
And then saving a blanket, saving a pillow
with the owner's smell on it,especially if they're going
to another family member's house,
that's gonna really help them as well.
- Great point. And, andalso takes me back to how

(08:54):
challenging a situation it is to try
to have people contain their pets.
Because many pets wantto be vigilant. Yes.
You know, on the bed withthe dying person. I Mm-Hmm.
, you know, beforewe had our policy in place,
I had, uh, a man who was dying
and his dog was a GermanShepherd underneath the bed,
underneath the hospital bedfor a day, for two days.
Yeah. Would not leave, youknow? Mm-Hmm. .

(09:15):
So, it's such a tricky situation.
- It's, it's, yeah.
Well, let's get to, uh, faith,
super excited Dr. Faith Banks.
- Yay,- Dr.
Faith Banks, thanks so muchfor being with us. Welcome.
We so appreciate you spending the time.
- Thank you. Thank you for having me.
- As we know you are a veterinarian,

(09:37):
but we'd love to hear more about you.
So tell us a little bit about yourself.
- Sure. So, yes, I'm a vet.I live in Canada, in Toronto.
And so I went to vetschool almost 30 years ago,
and then sort of did what everybody
mostly does after you graduated.
I, you know, was interestedin small animal medicine.
And so I started working at a clinic in,

(09:57):
uh, Midtown Toronto.
And I did that atseveral different clinics
for about 16 years.
And then 12 years ago,
I started noticing changes in my older
Bernie's mountain dog.
Hmm. She was slowing down.
Uh, she wasn't sleeping wellat night, she was panting
and pacing all night long.

(10:18):
She was having mobilityissues, so losing muscle mass,
having trouble getting up
and walking around, havingaccidents in the house,
all these sorts of things thatjust got me a little bit more
interested in geriatriccare and pain management.
And so I sort of went downthat road of trying to
educate myself a little bit better on

(10:38):
how I could care for her.
And then I, I read anarticle about animal hospice,
and I thought, oh my goodness,
I've never heard of this before.
, I never knewthere was such a thing.
And it was pretty newback then, probably still.
But I, I read this article
and I thought, this is what I wanna do.

(10:59):
So I sent my, uh, husband a note
and I, you know, was so excited about it.
And so then I learnedeverything I could about animal
hospice and decided to make the change.
So I left regular practice
and I opened up a mobile servicein Toronto where I could go
to people's homes and helpthem better understand
and care for their own geriatric pets,

(11:21):
and also help them pass at home.
So perform in home euthanasia.
And so that's kind of how I got started.
And so it's been about 12 years since I
started that practice.
And now I have severaldoctors working with me,
and we have a team of hospicecare coordinators that speak
to our families

(11:42):
and just, you know, give themthe information they need
and maybe set them up for an appointment.
And so that was sort of what I started.
And then two years ago,I should, should also say
that I also started aservice, which is Aqua Mation,
which is water-based cremation for
- Pets. Oh. So I have those
- Two services that, uh,

(12:02):
that we offer familiesin and around Toronto.
- And you, you mentioned that so casually,
I'm guessing probably becauseit's been a little while since
you've been doing this, but I imagine
that was quite the shiftgoing from a clinic practice
that's very traditionalto this mobile situation,
which is fantastic.
I'm sure parents of these pets love this

(12:23):
- .
Yes. I mean, yes. It's been a while.
So I guess I'm sort of used to it.
I mean, when I tell peoplewhat I do, everyone's like,
oh my God, you have the worst job in the
world, . Um, especially
- When they think we,we can relate to that.
Yeah, yeah. To that response when
- They hear, right.
I mean, when they hear euthanasia is a big
part of our service.
Um, yeah. Which it's, they,
they think it is the worst thing ever.

(12:44):
And, you know, so many timesI open, people open the door
to let me into their house, and it's
the first thing out of their mouth.
You have the worst job ever. Oh.
By the time I leave,
they have such a differentfeeling, you know?
Mm-Hmm. .They, they're so grateful
and thankful, and I'm happy
and pleased with theservice that we provide.

(13:04):
And being able to be in theirhomes, as you know, is just,
it, it's completely different than having
to do this in a veterinary clinic. Mm-Hmm.
- . Yeah.
I, I can imagine the reliefthat they, the pets have too.
That they aren't beingtransported in their, you know,
more vulnerable times or at the very end

(13:25):
of their life. For sure.
- Absolutely. Yeah. I mean,for, for some of the pets,
it's very difficult, you know, mobility
or immobility, I should say.
Mm-Hmm. in ourlarger breed dogs, you know,
the giant breeds.
We see dogs that are, youknow, 160 pounds, 130 pounds.
I, I've euthanized a 223 pound dog. Wow.
- I think came that big.

(13:47):
- So big.
Yeah. It was, he was huge.
And, you know, they,they couldn't move him.
Uh, he didn't want to be moved, and
therefore they couldn't move him.
And so being able to be athome is so much less stress
for the pets and for their families.
- That's huge. So do youjust do small pets still?

(14:08):
Or, or do you do like more farm type pets,
like horses or anything like that?
- No companion animals.
I guess horses can be companionsas well, but dogs, cats
and pocket pets.
- Pocket pets.- Ooh. So, bunnies,
- Bunnies,- Bunnies are
- The typical ones that, that we see.
But, uh, ferrets or um, Guinea pigs, we

(14:29):
- See- A lot of hamsters that come
to our acclamation service for
their families want theirashes returned to them.
But we don't tend toeuthanize a lot of hamsters
'cause they tend to pass easily at home.
- Yeah. Easily on their own.
I know that Halley's got a listof questions, but, um, yeah.
Jump in . So, yeah.

(14:50):
So I'm thinking about whenyou go to somebody's home to
euthanize their pet andthey have other animals,
how do the other animals respond to you?
Do you typically have them bein the same area with the pet,
ask them to be removed?
Or how does that work whenthere are other, other animals
that are part of the family?

(15:11):
- Yeah, so I see that a lot.
You know, the, the strange thing
that happens sometimes is I open the door
and this really young lookingbouncy golden retriever
answers the door .
And I know I'm there tohelp a golden retriever.
And I think, oh, no.
But then I walk, youknow, a couple of steps
and see the, their olderone lying on the couch.
But I, I do recommendother pets be present.

(15:35):
I don't force it, butthey want to be there.
They want to be with their family.
They want to be with the other pet.
And I think it provides themwith understanding and closure.
You know, if, if you took thatolder golden retriever out
of the house and justnever returned with him.
Mm-Hmm. . Mm-Hmm.. Mm-Hmm. The
younger one wouldn't knowthat we've taken them
to the vet clinic for euthanasia.

(15:56):
Yeah. They just, they wouldprobably keep looking around
and wonder, you know, where did they go
and be quite anxiousand stressed about it.
And so having them be presentgives them that understanding.
It also provides comfort
for the families, having them there.
And so I always encourage it.
I've never had to have a familyremove a pet from the room

(16:19):
because they were, youknow, too bothersome.
And I usually just say topeople, if your pet is not going
to distract you from focusingon the one you're saying
goodbye to leave them,
and very quickly they calmdown, they settle down.
So, um, it's comforting, Ithink, to have them there.
- When you said thateuthanasia is a big part,

(16:39):
I imagine it probably is,
but it was just palliativecare for, for pets look like,
- So we, we do telemedicineconsultations now for families
that are, you know, I wouldsay a lot of them are sort
of struggling with decision making.
So some of it is helping themto understand what quality
of life looks like for a pet.
So instead of saying what used to be said,

(17:01):
and maybe still getssaid, sometimes go home
and you'll know when it's time.
Mm. I can't stand that .
So I have a quality oflife scale that goes
through 14 differentcategories that will sort
of help families understand
what is important when you're a dog,
what's important when you're a cat.
This will help you kind ofget into the mind of your pet

(17:21):
and, and help you make a an educated,
you know, understanding ofsort of where your pet is.
So that's one thing that we do.
And then the palliative care part is,
there are a lot of pets.
I think, you know, I, afriend of mine did a study
and she said about 50% of pets, dogs

(17:42):
and cats have not beento their veterinarian
within their last year of life.
Hmm. So that means these pets are not
receiving pain medication.
These pets are notreceiving any medication
for the anxiety they feel for sundowning
or, you know, cognitive dysfunction,
which is something wesee a lot in older pets.
These pets with kidneydisease are not receiving any

(18:05):
medication to help, youknow, with the, the toxins
and the, the dehydration
and all these things thatwe see, all the diseases
that you would see in, inpeople in the later part
of their life or thelast part of their life.
Pets are not receivingeither a lot of them.
And so by speaking to families
and understanding either whatthe disease is, if we know,

(18:26):
or what the symptoms
or signs are that their pets are
having, how can we help them?
And so there's a lot that wecan do without going crazy
and without spending a fortune.
But there's a lot thatwe can do to, to care
for our pets towardsthe end of their life.
- Is the scale that youuse The the home scale,

(18:46):
- I don't use that one.
I know it very well. And I know Dr.
Villalobos, who's the one who, who wrote
that scale many years ago.
But when I started this journey
of learning about geriatric care
and pain management, it wasone of our pieces of homework
to make a quality of life scale.
And so I put one together 12 years ago,

(19:07):
and I've fine tuned it along the way.
I haven't changed it very muchfrom what I did initially.
And it was based on that,
because that was the onlyone anyone had for pets.
Mm-Hmm. . And so it has some
of those same things, you know,happiness, mobility, hunger,
you know, that sort of thing.
But, you know, one of the things I added

(19:28):
several years ago was,will to live, you know,
what is your pet's will to live?
Because I sort of felt likethat was the voice of the pet.
And so, you know, whereasthe owner was kind
of making all these assumptions
and decisions about the pet, I sort
of felt like this was their like, voice.
And so that was something thatI added not that long ago.
- So I learned about the home scale

(19:49):
because my daughter got hermaster's in social work.
And the, what she did for her,
I don't know what, what's it called?
Halle, when you have to, youhave a project? Practicum.
Practicum. Uh, she went
to work at a veterinaryclinic doing grief counseling.
And so she is the one whotold me about the home scale.
And I couldn't help but think, wow,

(20:10):
why don't we have somethinglike that for humans?
, you know, like
- There isn't a qualityof life. Interesting.
- Mm-Hmm. There's a palliativeperformance not in the way.
Yeah. Yeah. There's a palliative
performance scale that's different.
That's what are they able todo, you know? But the, the hm.
Scale is really, there's moreto, there's, like you said,
there's, yours has 14 different things.

(20:32):
A Hmm. Scale has a lot too.
But when she told me aboutthat, I was like, huh, that is
so weird that we havenothing like that for humans.
Yeah. That is interestingto be able to kind
of evaluate their own quality of life.
Right. So Holly, I think we might need
to develop something like that.
- Yeah. - There, there are a fair number
of them out there in the veterinary world.

(20:54):
'cause I think a lot of differentpeople have sort of, uh,
taken the home scale and expanded on it.
You know, some have done more
of a checklist type of, uh, scale.
Some have done, you know, justlots and lots of sentences
and you sort of find theone that fits you best.
Um, there, there's all differentones that are available.
Uh, I have mine on mywebsite so anybody can,

(21:14):
can see it and use it.
And I recommend people use it
and then kind of put if,if they scored decently
and then, you know, fold it up
and put it away in your kitchen drawer.
And either a couple weeks later
or depending if you sortof think, oh, you know,
I feel like he's dropped a little bit
or, you know, there's beena change to, to pull it out
and have a look at it again.

(21:35):
- Well, I imagine with theinvention of medicine, just like
with humans, that we're ableto extend our pet's life
and it, there really is aneed for this palliative
time in a pet's life.
Whereas before they,
they really weren't,we weren't aware of it.
We didn't have the information,
and they weren't livingthis long, just like humans.

(21:56):
And I imagine also withyour quality of life scale,
that it really eases the burden
of the decision making for the euthanasia.
- Yes. I, you know, it, itjust takes all this stuff
that you, you can't sort ofput into words or a number,
and it just kind of brings it all together
and gives you this number tolet you know how they're doing.

(22:18):
And for so many familiesthat I've spoken to,
when we've gone through the, the scale
and come up with a number, some
of them are actuallyquite pleasantly surprised
how well their pet is doing .
And some of them, it really hits home
that things are not good
and they really need to, they,they need to make a decision
or do something a little bit more.

(22:39):
I'd say, I don't know,drastic is the word,
but something to reallymake a difference in,
in the way the pet is feeling.
- Maybe a little more intentional.
- Yeah.- Let's talk about that decision part
because you did a really great video.
Uh, and it was so timely
because my daughter washaving a very, very hard time,
and she's the one who, whotold me about the home scale,

(22:59):
but her cat was 19 years old,
and she just kept saying,I just, I feel like, well,
for one thing it was around Christmas time
and she had to schedule themobile vet and they were booked.
And so she didn't wanna wait too long.
And so she was just reallywrestling with that idea
of when's the right time.
And you did a fantasticvideo talking about like,

(23:22):
sooner is better than later.
So tell us a little bit about that.
- Sure. So that video, youknow, I have over 400 videos
that I've done, and they're alljust me sitting and talking.
They're, they're short.
But it's some stories of,
you know, families that I've helped.
And some of it is just my thoughts

(23:42):
and opinions on what I've done
and seen over the years in this space.
And that video was the one
that has had the most views for sure.
And so the title
of it is better a month Tooearly than a Day Too Late.
And there are manyvariations better a week,
too early than a day toolate, you know, better,
a day too early than a daytoo late, whatever it is.

(24:04):
The idea is that you don't wanna wait
until things are really,really bad with your pet.
Mm-Hmm. . Andyou know, I've said this
before, that in vet school,
when we learned abouteuthanasia, way back when, first
of all we didn't learn very much,
but we learned that it was,
it was the kindest thing that you can do.
It was a gift that you cando when a pet is suffering.

(24:27):
Mm-Hmm. . Andsince I've started doing this,
I've changed the waythat I think about it in
that we can prevent suffering.
Hmm. So why do we haveto wait until the pet is
a heap of bones lying on thefloor in their own feces,
hasn't eaten for weeks,is crying all night long.

(24:50):
Like, I, I can go on and on.
And, and this is, these arethings that happen to some
of these pets when theydon't have proper care.
And so why do we have towait until that happens
and then say, oh, now weshould choose euthanasia.
So, you know, a classic example is the dog
with osteosarcoma.
They have bone cancer.It is extremely painful.

(25:14):
They're 12 years old,
130 pounds.
We know that bone is going to break
and it is gonna be super painful.
And so why do we need to wait for
that dog to break its bone?
I'm not saying that the dayyou find out your dog has
osteosarcoma to euthanize,

(25:35):
because I don't thinkthat's a good idea either.
But I do think when you know the diagnosis
and you know the path the petis going to take, you know,
the trajectory of the disease, you know
what is going to happen.
Why wait until things are so bad?
Why not wait for, you know,
why not choose a day when there's sunshine

(25:56):
and they're still eating liver treats,
and the whole family can come around
and, you know, all the peoplein the neighborhood have come
to say goodbye and, you know, and,
and you just make it abeautiful special day.
So that is sort of mywhole thought process
on doing it early versus later.
- Penny, I feel your thoughts right now.

(26:16):
I know what you'rethinking. I just can tell.
So of course Canada has alittle bit different system,
but in Washington state,we also have the Death
for Dignity law or medical aid dying.
And this is so similar to somany conversations we've had
and have heard, we'veheard people say over
and over, well, you wouldn'tlet a loved one suffer.

(26:37):
If my animal's suffering,I euthanize them. Yeah.
And why would I let myparents suffer? Right.
When we're talking aboutpeople that aren't able to,
to participate in maidor death or dignity,
but this same conversation,
you're always gonna leave alittle bit of life on the table
to not have the suffering at the end.
- I love the way you just said that,
Halle leaving a little bitof life on Yeah. I haven't
- On the Haven. I like that too.

(26:58):
- Yeah. I, I like that.
I also think there's a benefit to there.
I mean, there's obviously the benefits
that you've alreadytalked about to having the
animal euthanized in their own home.
You don't have to transport them, but,
and hopefully, I know, no,
this is definitely not your practice
and hopefully no one you've ever known.
But I was just telling Hallethat I used to be a vet tech

(27:20):
and I actually worked for a couple of vets
who were abusive to the animals.
And one of them, the practice that he had
for euthanizing cats was to inject the,
I forget what it is, into
- The heart.
Heart used into a barbital. Yeah.
- Into the heart. Yeah.

(27:40):
And they would have amassive heart attack and die.
And I was just thought,God, if the owners knew
that you were doing that, they
wouldn't have brought their cat here.
It was really horribleto, to see that happen.
- So, so intracardiac injection
of pentobarbital is an acceptable route if
the pet is anesthetizedfirst or anesthetized.

(28:02):
Nobody. Americans don't likewhen I say anesthetized
, quite often peoplehave written on my TikTok,
you know, why do you say it like that?
- Why it like that?- Um,
so if they are given propermedication just prior to Mm-Hmm.
, therefore theydo not feel the injection

(28:23):
that is an acceptable route.
- Yeah. He didn't do that- First.
- Yeah, he didn't do that.Now, I think that might've been
how bun bun my bunny was, was
- Euthanized.
- Euthanized because hegave her some sedative first
and then he took her back.
Well, I don't know. 'causeshe, when he brought her back

(28:45):
to me, she was still living,
but she didn't live for very long.
Hmm. So I'm not sure exactly what he did.
Uh, but I mean, I,
and I trusted the vet,
so even though I had some bad experiences,
but at this particularvet, I really trusted him.
And, um, he went in theback, he gave her something,
he brought her back out tome, and then I held her,
and then she died in, in my hands.

(29:06):
But yeah, the vet that didthis to the cats was not,
he was not an anesthetizinganesthetizing them
first, unfortunately.
Right. So, but I mean, like, if,
if there is any trust issuesthat people have, and,
and I hear that too,like, people do worry,
like when their vet vet takes their animal
into the back, what are they doing?

(29:27):
So being there in the home
and doing it with them presentis probably something else
that really brings a lot of peace of mind.
- For sure. For sure. Imean, everything we do, the,
the families are right around us.
So there's no, and I reallydon't think there's any,
any need to take a pet to aback.
I get why it was done before.
And, you know, listen,when I graduated, we,

(29:51):
we suggested to families not even
to stay when we euthanized their pets.
Mm-Hmm. , youknow, it was gonna be sad.
And of course.
And, and so we, we,
we didn't really encouragethem to be there.
And so it's totally different now.
Like, I, I really, whenpeople talk to me about
how difficult they thinkit's gonna be for them
to be present, I mean,of course it will be,

(30:13):
but I really encourage them to,
to think hard about notbeing there at the end.
You know, put their pet first.
Not think about how much you're gonna cry
and you know, how you'll feel,
but just be there for your pet.
- I have told this to a lot
of people about grief in general,
and it seems to fit perfectlywith pet loss as well.

(30:35):
That if you, the moreyou're able to just express
that grief in the moment acutely,
that the less difficulty you'regoing to have down the road.
Um, it's still gonna be hardand there's gonna be waves.
But if you're able tojust let it out, like
so many other cultures around the world
where they can just be openabout their grieving, I think
that that has transitioned too,um, with veterinary care is

(30:58):
that if you're not there when it happens,
you're not seeing it,you're not able to kind
of wrap your brain around it.
Mm-Hmm. .Whereas if you're at home
or even at the vet's office
and you're there to witness it,
you know that it was peaceful.
And so that part of itis not a mystery. Mm-Hmm.
. And it's a, I think,
a great transition into part
of your bio talks aboutpet loss and grief.

(31:20):
And so I'd love to askyou a lot more about that
and what your service doesand what that looks like.
- Sure. What does that look like?
Well, we, we have, uh, we havepeople answering the phones.
I think that's the first thing.
The, my team of hospice carecoordinators are a bunch
of incredible women who

(31:42):
aren't looking at a clock, you know,
for the amount of time they're talking.
They're not trying to sell anything.
They're there to, to answer the questions
and have an ear for thefamily that is calling.
And I know that just picking up the phone
to dial our number isso, so hard for families
because it's the first step quite often.

(32:04):
So we, we have verycompassionate, caring people
that are answering the phone
or communicating with the family.
So I think that's the first step.
And so they feel confident, um, in,
in being in our capableand compassionate hands.
So I think that's the first part of it.
Our doctors as well are very caring.

(32:26):
I mean, it, it's a, I have tosay that it's a special type
of person that is drawn tothis type of work as mm-Hmm.
as, you know,uh, it's not for everybody.
You know, I, I speak toa lot of veterinarians
that say, no, thank you.
I would never do that. Not interested.
You know, when, when they seethat they have a euthanasia
in the calendar, coming intothe, the clinic that day,

(32:48):
and I used to be like this too.
It was like, oh my God.
Um, you know, that wasvery stressful. Mm-Hmm.
. But we lookat it so differently that,
that we can just provide such a beautiful,
wonderful service for families.
And we know what a difference it makes.
So I, I, I think the, the pet loss
and the owner grief part, partof it is just the, the people

(33:11):
that they're dealing within, in my service are really,
you know, I'm, I'm tooting my horn,
but they're, they're afantastic group of people.
And, um, and we're caringand we're all pet owners
and we've all been through loss.
And so we really understand the connection
and the bond that peoplehave with their pets,

(33:31):
and know that for so many,their pets are all they have.
I mean, Mm-Hmm., they, you know,
you work at home and your,your cat is sitting on your lap
or sitting on the chair right beside you.
You go for a walk and get your exercise.
Your dog is with you. You're social
out when you're going to the park.
It's because your dog is there.
And, you know, there's sucha huge part of our life and,

(33:52):
and we get that.
So I, I think that's a big part of it.
My team has done training on pet loss
to better understand sort ofthe emotions that people feel
and, and how we can help.
But we're not there to fix their problems.
We're not there to take away their pain.
We're there to listen and,you know, to, to walk by them,

(34:12):
but not, not to fix.
And so, you know, I thinkthat's also part of sort of
how we think about thingsand, and just be there for
after, you know, we followup with an email to families.
We follow up with a sympathy card,
we make a donation to the family.
So we have a lot of thingsthat we do specifically to show
that we get the significance of the loss,

(34:36):
- Which really is so important
because pet loss in particular is one
of those very disenfranchised griefs.
- Yes. - We know this commonly.There's a lot of them.
Um, sibling loss is anotherone. . Mm-Hmm.
. But, um, pet loss for sure.
I, I happen to help our,our bereavement department
with specifically pet loss when we get

(34:58):
community referrals for pet loss.
And so it's, it's great to hear
that there's more outthere, more resources.
I've been seeing moreand more support groups
and information
and training on beingable to support people.
Because like you said, sometimesit's their only family.
It's their only support. Yeah.
- Yeah. Yeah. It's a huge loss.
And, you know, before I startedthis program, uh, sorry.

(35:20):
This service, as I said,I had been in practice
for 16 years, and I mean,I understood pet loss,
but I didn't really, really,really get it until I did a,
a course that reallyhammered it home for me.
And it just totally changed
how I thought about it after that.
And it, it made such a difference

(35:41):
- When thinking about vetclinics, you're mentioning vets
that see that on the calendar.
Right. And , we, we, all three
of us live in this worldof end of life and dying
and normalizing it.
And that's why we're here,that's why we're doing this.
But you wouldn't, it makes sense.
Like in an emergency situation,you're going to have births

(36:02):
and deaths and everything,but in a normal clinic, having
emotionally for yourself togo through bringing in puppies
for their first shot, andyour next visit is euthanasia,
and then your next visitis annual shots for a dog
or whatever, and havingto switch back and forth.
I know when I interviewed my own vet,
we had this conversation aboutyou're not really trained

(36:24):
in how to deal with people.
You're not doing socialwork in vet school,
you're doing medicine in vet school.
And so you're also not only having to deal
with your own emotions,
but the, the poor peoplethat you're dealing with.
And so in this world where you are,
you're, you're prepared for that.
You're, yes. It's a differentfocus, like you said, you're,
you're thinking about it in a

(36:44):
different way. And I love that
- For sure.
I mean, listen, I, I alsodo realize that the families
that we help in our service,I'm meeting for the first time.
I'm, I'm showing up at their door,
and I, I've never met them before.
I don't have a relationship with them.
When you're in regular practice,
you may have had arelationship with that cat

(37:06):
and owner for 20 years.
Yeah. And you, you know, you fix
that cat when they got hit by a car.
You fix their leg
and you, you know, uh,treated them for pancreatitis
and you did this and you did that,
and you, you saw theowner's children grow up
and like you have arelationship with them.
And so when it comes timeto say goodbye, you know,

(37:27):
it is a very, veryemotional time for sure.
Mm-Hmm. . And Ido understand that I, you know,
my appointments are veryemotional for the families,
but I don't have that samesort of long-term connection
that regular vets have had.
And as you just said,you know, to go from that
into a new exam where you have to try

(37:49):
and win over this new puppy'sowner to, you know, that,
that you're so wonderfuland you're just mush inside.
I mean that Mm-Hmm. is really,
really challenging forveterinarians for sure.
- Yeah. You know, as you weretalking about the difference
between taking care ofthe animal for 20 years
and being the one togo in to euthanize them

(38:10):
who hasn't taken care of them.
I dunno, Halle, if you were thinking
the same thing as me Yep.
, but same hospice, you know, like,
people are always saying, it's so sad.
It must be so sad. Are youso sad you break? Like, no.
Um, this is, this isn't my family. Yes.
Um, I knew when thisperson came onto service
that they were dying.
That's the expected outcome. Yeah.

(38:32):
You know, and so if the, ifthe death goes well, you know,
then it's a job well done when they die.
And so, I, I really can relateto that idea of, you know,
that separation and the abilityto be able to do that work
because you are notclouded with the grief of
losing somebody that's important to you

(38:52):
because, you know,
you haven't been a partof their life forever.
- Yeah, for sure. I just,
so I have three Bernese mountain dogs,
and I just helped a family say goodbye
to their six-year-oldBernice mountain dog. Oh.
- Oh. It was- Heartbreaking. This dog was gorgeous.
I just talked about him on a video,

(39:13):
and the family was beyond devastated.
And so she said to me, is it harder
for you when it's a Bernie's mountain dog?
Which was interesting. And,you know, the second part
of it was, how do you do this?
And I said, you know, he's not my dog.
And so, you know, I can separate.
But of course, when I seeit as a burn mountain dog,
there's just a littlebit more of a, you know,

(39:34):
connection, I think.
- But I'm six years old. Yeah. You know,
- Six years old.
- Yeah. We, I think it's the same
for us when we have a20-year-old patient dying
of cancer versus a 80-year-oldpatient dying of cancer.
Right. That's a littlebit more of a oof, that's
- Yes, that- Hurts.
- Definitely. Definitely.
But I, you know, as, as yousort as you said, like, I,
I tell people, this is not my dog.

(39:55):
Um, you know, I appreciatethe, how sad the situation is,
but I'm here to make itbeautiful and perfect for you.
And so that's kind of where my focus is.
I'm not absorbing the,the emotions from it all.
I mean, my eyes well up all the time, but,
but I, I wanna make surethat, that, you know, it's

(40:16):
as perfect as I can make it.
- I love that you are on socialmedia talking about this.
You know, I, so probablyright around the time
that you became a hospicevet, uh, I was a hospice nurse
and had been for a long time.
And my cat got, he had,um, thyroid condition.

(40:38):
Mm-Hmm. .And he was 10 years old.
And my daughters werelike, we have to treat him.
We don't want him todie. I was like, okay.
The pills were a buck a day,
so $30 a month back then,didn't have a lot of money.
So I was like, oh, it'sgonna be $30 a month.
And they were like,we'll pay for it .
I said, okay, I'll do it. I'll do it.
We'll do this medication.
Well, one of the sideeffects I'm sure you know,

(41:00):
is it can cause liver failure.
And so he actually did starthaving liver failure Mm-Hmm.
And we had to stop the medication.
And so at that time, I said,okay, Ross is on hospice now.
And I had never heard of animal hospice.
I just didn't exist at that time. Yeah.
And basically what that meant was Ross
just spent his day sleeping ona rug in front of the dryer,

(41:22):
and he ate whatever he wanted,
and we just, you know, loved on him.
And, and then, then when the time came,
and it was evident, mydad had recently died,
my son was visiting from,uh, Japan where he lived,
and it, it had been hiscat when he was a teenager.
And so it was kind of like,
there was just somethingabout looking at him one day

(41:43):
and knowing it was time and, and,
and taking him in there,
there were no mobile vets back then,
and taking him in, having him euthanized.
But, so then when I startedto hear about pet hospice,
I was like, dang, that's, that's awesome.
I actually thought of that on my own too.
, I'm a pioneer. Yeah.
But I, I love that you're,that you're, you know,

(42:04):
talking about it on social media
so people can, can be aware of it. Mm-Hmm.
- I think thatit's a shift in, you know,
to me it, it's just a shift in the way
that I think about caring for a pet.
You know, it's shiftingfrom let's fix, let's,
let's do blood work again.
Let's take more X-rays. Mm-Hmm.
, you know, shiftingfrom that to just caring,

(42:26):
from curing to caring.
Mm-Hmm. .And, and so that's sort
of the big shift, um, inthe way that I think about
how we care for those pets.
And, you know, I hadsomebody not that long ago
who had a cat with kidney disease,
and she read everything there was
to read about kidney disease,
and she was doing everything she could.
And it got to a point
where her cat would runevery time she would

(42:49):
see the owner get up.
Oh. Because she thought shewas gonna be, you know, pilled,
that she was gonna be stuckwith a needle for fluids.
And, and it got to a pointwhere the owner felt like,
you know, she had no connectionwith the cat anymore.
And it was heartbreaking for her.
And so she made thedecision to stop treatment.
And, you know, it was really hard for her,
but I, I supported herand I understood it.

(43:11):
And she got to enjoy thelast while with her cat and,
and have that connectionand that bond again.
And that was so important.
So it's, it's, you know, a change in
how we think about things.
And the, the social mediapart for me. So, you know, Dr.
Sammy Winemaker, I loveSammy, who's on social media.
So we went to high school together,
we were oh my god friends,and she was my age.

(43:34):
We were in high school together.
And, uh, and I started following her
and I really just loved it.
And we connected again.
And she sort of encouragedme to, to do it.
And I thought, okay, so I, you know,
sat here and, and started.
And I really enjoy thinking of the
topics to talk about.
And I love the responsesof people saying, you know,

(43:57):
I've been following youfor the last few months
and you helped prepare me somuch for the end with my cat.
And I, you know, it wasso much better for me
and less stressful, and I get it.
And I understood it. And,you know, when this happened
during the euthanasia, I was prepared.
And, you know, to meit's the being prepared
and having a plan andunderstanding makes a huge,

(44:20):
huge difference for people.
And I love that part of it.
- Well, I wanna give a little bit of time
for the acclamation part,
because that's even new for people.
Yeah. And so could you speaka little bit about, I, I know
what it is, but for the listeners,
can you speak a little bit about that?
- Sure. So Aqua Mationis water based cremation.
And so the way that I describe it is that,

(44:42):
and, you know, I, I startfrom a place of, neither
of these are reallypleasant to think about.
So with flame cremation, or fire
or regular cremation, you use fire
to reduce the body to bone.
So at the end of theprocess, you have bones
with water cremation.
It's the same. It's a specialmachine that uses water

(45:05):
and alkali salt time and temperature.
And at the end, which is forus, 17 hours for our pets,
17 hours later when we openthe machine, we have bones
in both situations.
The next step is to process the bones.
So we have to dry our bones first,
which they're individuallysort of per perpe placed on

(45:28):
a drying, uh, rack.
And then those bones are processed
or ground using a specialmachine called a cremator.
And at the end you havesort of a powdery substance,
which are bones.
And so that's what ashes are.
Ashes are processed bones.
And so we provide that forthe families that we service

(45:52):
through our vet service
and also some other, I mean,people can find us and use us.
You don't have to comethrough our vet service pets
that have passed at homeor at another clinic.
Um, and they wanna use ourservice. They certainly can.
It's a more eco-friendly type of care.
And for us, it means thatthe pet stays in our care

(46:14):
throughout their end of life.
So if we have euthanizedtheir pet, my team cares
for them the whole way.
So there isn't sort of another company
that is picking up theirbodies and processing them.
And so people really likethat part of it as well.
So I have a team of three women
that work at my acclamation center

(46:35):
and care for these pets beautifully.
You know, I, I say wecall them by their name.
They're not a number.
And, um, it's just really sort of caring,
specialized aftercare.
We do memorial items, nose,ink, prints, and paw prints,
and little resin, you know,paw prints with fur in them.

(46:56):
And, you know, we haveall these different things
that people can
or cannot, you know, theycertainly don't have to.
Um, but they have different options of,
of different memorial itemsif, if they're important.
And for people who want tohave their pet's ashes returned
to them, which in our serviceis about 70% of the families,
uh, they are able to do whatwe call private acclamation.

(47:19):
And so they're able to have their pet's
ashes returned to them.
- Love that. If down the roadyou want a different green
option, be sure to talk toKate Spade at Recompose.
- Katrina. Katrina,
- Sorry, Katrina. Katrina. Katrina's seen
- That. Yes, I've seen
- That.
Yeah. We, we actually interviewedher yesterday about, um,
oh, very human body compost thing.

(47:40):
Yeah. Yeah, that's exactly
what I was thinking too. Like, Hmm.
- It would just take a lot longer.
But it's funny, you both ofthese innovative smart women
CEOs with women groups, I love it.
- Yes. Yeah. And beingenvironmentally friendly. Yes. Right.
Eco-conscious. I love it.
That's great. Mm-Hmm, ,
- You need a lot ofspace for that. I believe

(48:02):
- It's a little more space.
Yeah. And it takes longer.
- It does take, it takes three to, well,
for humans, three to four.
But Katrina was telling us
that farmers have beendoing livestock composting.
Yeah. And that's where sheactually got the idea for,
for doing it for humans was Right.
She had heard about how they do it for

(48:23):
- Interesting.
Yes. I've seen, I have seen that.
- Seen . Interesting.
Well, we're, we're gettinglow on our time with you,
and I wanna make sureI offer anything else
that you wanna tell us aboutthis that we haven't asked you
or covered or, you know,normally we ask like, what's a,
a great experience or a unusual
request, or something like that.
But you know, it's up toyou. The floor is yours.

(48:45):
- Well, I've, I mean,we have had people that,
not many, but we've had the request
to remove a tail from a cat.
We've had a request toremove an ear from a dog.
We recently, we have someonewho started working with us
that he is doing aftercarefor some pets that the,

(49:08):
the families find him.
And so he will remove the,
- The - Skin or pelt or fur,however you wanna call it, so
- They can, does it do like taxidermy
for these things? Well,
- That one's not doing taxidermy.
They're just keeping the fur like a
little rug kind of thing.
Um, from the cat. We have pets.
We've had a couple in our service
where the families havedone freeze drying.

(49:31):
- I have seen videos of that.That is fascinating. I'm not
- Of their- Animals.
I would like it,
- They freeze dry the animal.
- Yes. So it's similar in,in looking like taxidermy.
Mm-Hmm. in that, you know,
it looks like your pet,whereas taxidermy, the, the,
the skin is placed over a form.

(49:52):
So like Mm-Hmm. i'll shape.
Whereas freeze drying is morelike it, it's all your pet.
And so they sort of curl themup in a little snugly position
and you know, you canplace them on the bed.
It takes a couple ofmonths for the process.
But, uh, we've had a fewpeople that have had that done.
Certainly some people wantto have their pets, uh,

(50:14):
skeletons return to them.
And so you used Dermot beetles for that.
So there are all sorts of things,
and I sort of startedsaying different, not weird.
- Yeah, I- Like that.
- Okay. But, and we're all pet owners.
I wanna know if you guyswould ever consider,
like Bernie's mountain dogs are huge.
You could have a nice rugin front of your heart.

(50:35):
Would that ever cross yourmind to No. Yeah. Same.
I just feel like, I mean,and I love my cat's fur.
She's a little brown tabby,
and she's got beautifulmarkings and everything.
It just, to me, it's toodifferent, too, too different. We
- Do at, at our, um, atthe euthanasia appointments
that we do for families, wedo two memorial items for them

(50:58):
that are included in our service.
So we bring some clay
and we do a little pawprint impression for them,
and if they want, and thenwe also shave a little bit
of fur from their pet,and we have a little
container that we put it in.
So many people like that. Mm-Hmm.
certainly going, you know,
for the whole thing is nextlevel, but reach their own,

(51:19):
- Teach their own. Yeah.
- I, I, yeah.- Yeah.
Well, my, my, um, little cattle dog,
puppy shed so much hair.
I can't even imaginewanting to keep more of it
after he dies someday.
, I'll just be glad to
- Be done. It's alreadyall over your house.
- It's everywhere.. Yeah. Most people,
- Most people with shorthaireddogs don't want the fur
and they make the same joke,

(51:41):
which is they'll be findingthe fur for months to
- Come. . Yeah. Yeah.
- I, I know it's comingbefore, but I, I ask anyways.
It's usually cats
and longer hair dogs that,
that want the little sample of fur.
And, you know, each colorrepresented. Oh yeah.
- Mm-Hmm. .Mm-Hmm. .
Well, we've talked alittle bit about the fact
that you make videos, let the people know

(52:02):
where they can find you.
And I know I did see in your bio,
there's a li a couplechapters in a book too.
So if you wanna share that
- So you can find me on TikTok at Doctor
Faith Banks.
My, do you want me to share all of my,
- Wherever you want, wherever you want,
- Want people to find it, wherever.
We'll also put it in the show notes too,

(52:23):
if you've sent it to us.
- Sure,- Yeah. Yeah.
- Our website is
www.mhs.ca
and that's where thequality of life scale is
that we spoke about.
So I think that's a really helpful thing
for listeners hospice.
That is our handle for Instagram.

(52:44):
- Okay. Well, Dr.
Faith, thank you so,so much for being here.
It was just like talking
to another hospiceclinician. We love it. Yeah.
- Yeah. And getting
- This information, Ireally hope that Hospice
of Veterinary work spreads and gets bigger
and more acceptable slash known, I think,
and available people don'teven know about it. And

(53:06):
- Available. Available.
- Yeah. There, there is,there's a large group of us, uh,
not so many in Canada.
Uh, definitely in the USthere are a fair number.
And every year we have aconference for all of us,
the International Association
for Animal Hospice and Palliative Care.
Awesome. Awesome. All like-minded people.
It's, you know, I'm sure youfeel it when you, you know,

(53:27):
meet other, uh, hospice nurses
and you feel like these are my people.
And, and so it, it's prettyamazing to, um, to get together
and, and, and talk about all of this
and learn from each other as well.
- I love it. Well, thankyou so much. Thank you
- So much.
- Thank you. Thank you
- Another great guest in the books.
- Another one. I just, yeah.

(53:48):
I keep thinking like somedaywe're gonna have just a normal
guest, but I don't thinkthere's such a thing.
- , actually, it'sanother great guest in the can,
I guess they say in the biz, right?
show business. I, so I
- Really was just like talking to
another hospitalist commission.
I mean, so much of it's parallel.
- It is, it, it really is it.And yeah, just, it really was.
So much of what she saidjust resonated for me

(54:11):
and for you I know ashospice clinicians for,
for humans and human death.Fascinating for sure.
- Mm-Hmm?- . Fascinating.
- Well, after this, we haveKatrina coming up next,
and then we'll have ourend of the season wrap up.
Can you believe seasonone's already done almost
- So fast.
It just flew right by

(54:31):
- .
All right. Until nexttime. Remember to live
- Because someday you'll all be dead.
We'll all be dead. So not justyou, but all of us will be.
All of us.