Senior Dog & Cat Tips

At-Home Pet Euthanasia: Ways to Say Goodbye

June 14th, 2017 by Heaven At Home Staff

Owner with aging dog before euthanasia depicting home euthanasia services in Grand Rapids, MIHeaven at Home Pet Hospice knows there’s no easy way to say goodbye to your loyal fur-family member. However, through helping hundreds of Grand Rapids and West Michigan pet owners provide peaceful passings, Dr. Laurie Brush feels there’s therapeutic value to celebrating the life of your pet during a euthanasia home visit.

“Death is hard to talk about,” Dr. Brush says. “But it doesn’t need to be fraught with struggle. This might be the worst day of your life, but it doesn’t have to be the worst day of your fur-baby’s life. On the contrary, we can help your pet pass comfortably with dignity and compassion.”

By performing home euthanasia for companion animals, Dr. Brush’s goal is to prevent animals from experiencing the stress, and sometimes fear, of trips to the vet when unwell.

“Our service allows pets to be with their family one last time in a familiar, comfortable environment, surrounded by their favorite people, toys, bed, and blankets.”

Dr. Brush feels it’s important that clients are prepared for the process of euthanasia, and that they’ve had a chance to ask questions, complete paperwork, decide on burial or cremation options and otherwise be prepared prior to the time so they can focus on comforting their fur-baby and celebrating his or her life.

Planning for Pet Euthanasia at Home

While there’s no easy way to say goodbye, there are ways you can prepare for your pet’s passing in advance. Bringing treats, sharing stories, and thinking of ways to make your pet comfortable will all work together toward a loving departure. The following are a few considerations:


  • There Are Forms to fill out: At the time of our house call we initially take care of the legal paperwork. A consent form is signed by the legal guardian as well as verification that your pet has not bitten or scratched anyone in the past ten days, to comply with the Rabies law. (If there has been a bite or scratch, we can still proceed, but Rabies testing and additional paperwork will be required so we usually try to discuss this in advance.) Other forms will ask you to confirm the type of cremation you have selected if that applies. 
  • Consider Your Other Pets: One advantage of at-home euthanasia for dogs and cats is that it helps the other animals in your home to know that their friend has passed because other pets will grieve for their friend too. They often know when another pet is sick or failing. It is thought that their noses will know that another pet family member has died. Giving them the opportunity to see and smell the deceased pet prevents them from continually searching for the pet who is no longer there.
  • Decide Who Will Attend: If you’d like your entire family present to say goodbye, we can schedule a time to accommodate that. If you have children, explain what’s happening in advance to help them prepare for the loss of their friend. The American Humane Association recommends books such as Fred Rogers’ When a Pet Dies as a way to provide comfort and understanding for children. We have other resources on our website we often recommend such as which has a good resource section for Pet Parents on kids and grief. Among other things, they suggest books such as “Dog Heaven” by Cynthia Rylant; “Cat Heaven” by Cynthia Rylant and “A Special Place for Charlie” by Debby Morehead.
  • Communicating with Children about Euthanasia: It is best to speak in honest terms, at an appropriate level of detail for the child’s age. Very small children need to know that this is final – the pet isn’t going to wake up or come back. To say that the pet “went away” or is “in heaven” without offering any other details can also confuse children. Older children need to know the reasons why this decision is being made, and why it is humane for the suffering animal.
  • Choose the Location: Many of Dr. Brush’s clients choose a pet’s “favorite” location in the home or yard to host the passing. This helps soothe the pet. Sometimes that means she’s found herself cuddling up in a closet to conduct the procedure; other times, enjoying a sunny day by a favorite tree.“What’s important is that the last resting place of the dog or cat is where they are comfortable. I think we’d all like to be in our favorite place when we die,” she said.


What To Expect In The Process of Euthanasia

Some veterinarians use a slightly different process for euthanasia, but at Heaven at Home, we always use a two-step procedure.

First, a mixture of medication is administered just under the skin with a small needle to help the pet relax. This sedative is used to create a deep, pain-free sleep for the animal that is peaceful for their owners to witness. This can take up to 15 minutes to have its full effect, and this time can be spent comforting your pet, remembering special times, or just sitting quietly, as you choose.

Once the doctor is sure that your pet is completely relaxed, and not feeling any pain, a final injection of pentobarbital is discretely administered. The Doctor will always tell you before performing this final injection.

Pentobarbital is a liquid barbiturate that will be given at a lethal dose. Because this solution has an anesthetic effect and depresses the central nervous system, your pet will continue to be unconscious and pain-free.

Once the solution has been administered, the Doctor will listen to your pet’s heart and will inform you when your pet has passed on.

When the muscles relax, there may be some body fluids or stool that passes. We are always prepared for this and will have some absorbent waterproof pads to help keep your pet, and surfaces under your pet, clean. Your pet’s eyes may not stay closed, but if this is uncomfortable for family members, we can help to close them. Sometimes, there are twitches or movements and/or sounds as the air and energy leave your pet’s body.


After Euthanasia

There are a few options for taking care of the deceased pet’s body. Heaven at Home can help you wade through these options, and can coordinate your pet’s cremation with a local crematory. Some people prefer to bury their pets. Local regulations and guidelines can be confirmed with the county where you plan to bury the pet. If cremation is chosen, Heaven at Home will take your pet after the euthanasia and arrange for cremation. We often work with  Sleepy Hollow Pet Cemetery, which offers both burial and several levels of cremation:

Some of the options at Sleepy Hollow include:

  • Private Cremation –Your pet is individually cremated. Cremains will be returned to the owner.
  • Semi-Private Cremation –Two or more pets are cremated at the same time, but kept separate and a barcode system is used to identify your pet. Cremains will be returned to the owner.
  • Memorial Cremation – Your pet is cremated with other pets. Cremains are interred at Sleepy Hollow

It usually takes about a week, give or take a few days, for cremains to be returned to Heaven at Home. Then we will contact you to make arrangements to get your pet home to you. Cremains are placed in a small floral tin unless a different urn is purchased.


Other Forms of Commemoration:

Heaven at Home and partner vendors such as Sleepy Hollow can help keep your companion close in spirit with cast paw prints, commemorative jewelry, and other items. Keepsakes can be especially helpful during the grieving process.

You may also find one of the following helpful: Planting a tree in your pets’ memory in a location they loved; donating to an animal protection organization or animal health research entity in their name; crafting a commemorative plaque; and creating a commemorative photo album.


Understanding Grief and Loss

Losing a pet is losing a family member for our clients. Grief and even feelings of guilt are expected after the loss of a pet. To move through the healing process, be certain to be kind to yourself, and talk about your feelings, emotionally and constructively, with others. Using a journal to explore your feelings will help ease the pain over time.

If the grief and sense of loss are overwhelming or prolonged, counseling and support is available from several sources, both online and off-line. For a variety of pet grief support articles, visit our friends at Veterinary Wisdom:

Our local pet loss support group in Grand Rapids meets about once a month and is facilitated by Ginny Mikita. Please contact Ginny by phone at (616) 460-0373 or by email at if you are interested in participating.

There is also a pet loss support group in Muskegon by Clock Timeless Pets.

Please Contact Us for more information about either of these groups.

Be aware that pets may also grieve for the loss of their companion, too. They may exhibit grief by: not eating, not enjoying formerly favorite activities, or mild lethargy. Providing them with extra TLC and interaction with other pets may help to ease the transition for them. These behaviors should be mild and short-lived. If they persist or are dramatic, seek veterinary support.


Know You Did The Right Thing

Whatever you’re feeling, and however natural feelings of guilt may be, it’s important to understand the beautiful gift you’ve given your pet.

“A peaceful, pain-free passing is the greatest gift you can give your fur-family member at the end of a well-lived life,” says Dr. Brush. “No one wants their pet to suffer.”





Pain Management for Arthritis in Dogs and Cats

May 2nd, 2017 by Heaven At Home Staff

dog with arthritis suffering pain to illustrate pain management tips for arthritic dogs and cats in grand rapids miOne of the toughest things our West Michigan dog and cat owners encounter is dealing with that scourge of aging pets, arthritis. In making her palliative care rounds, pet hospice veterinarian Dr. Laurie Brush hears stories of how the once sunny and agile ‘Bessie the Boxer’ can no longer play ball or manage the stairs. Tommy the Tabby cat won’t allow a cuddle. And Lucy the Lab is absolutely miserable with her hip dysplasia.

The culprit is arthritic pain, and if your dog or cat is dealing with it, they can transform from playful pals into crotchety companions.

“Clients may see a personality change. Their pet may become aggressive, or not interact the way they used to,” Dr. Brush explains. “Our treatment goal is to reduce suffering in ways that will not compromise the animal’s overall health. This requires what is known as multi-modal pain management.”

In other words, NSAIDs (Non-steroidal anti-inflammatory Drugs) alone will not combat suffering. In fact, for many aging pets, NSAIDs are the least promising intervention because they can exacerbate poor kidney or liver function in aging pets, and because they may not get to the root cause of the pain.

“There are incredibly successful strategies available today for pain management in arthritic pets, such as cold laser therapy, PolysulfateD Glycosaminoglycan (PSGAG) injections, and orthopedic interventions that can be implemented in the home. Cold laser therapy can result in dramatic improvements in some cases,” Dr. Brush said.

Pet owners can take comfort in knowing they can truly help their pets enjoy their sunset years and reduce suffering.

“I believe in empowering pet owners with at-home interventions to help keep their fur babies comfortable,” she said.

But first, it’s important to understand some of the contributing factors to dog and cat arthritis.

What Causes Arthritis in Dogs and Cats?

Degenerative Arthritis Due to Old Age:

Osteoarthritis, also known as degenerative joint disease (DJD), is defined as the progressive and permanent long-term deterioration of the cartilage surrounding the joints. Arthritis is the medical term for inflammation of the joints, while osteoarthritis is the term referring to a form of chronic joint inflammation caused by deterioration of joint cartilage. Older dogs are at the highest risk.

Additional conditions that can result in painful arthritic changes and decreased function: 

  • Obesity
  • Hip dysplasia
  • Cruciate ligament and meniscus damage in the stifle (knee)
  • Osteochondritis dissecans (OCD)
  • Spondylitis (a degenerative condition of the joints in the spinal column)
  • Other joint injuries due to trauma

How Prevalent Is Arthritis in Dogs and Cats?

Most dogs begin showing arthritic symptoms at 6 or 7 years old. While some arthritis can be prevented by maintaining an ideal body weight in one’s dog or cat, most dogs will experience some sort of arthritic pain as they grow into old age. Large breed dogs (generally over 50 lbs.) are more susceptible to arthritis and will show signs sooner than smaller breeds of dogs. Over 90% of geriatric cats and one out of every 5 dogs over the age of 7 have arthritis.

  • Labs, German Shepherds, and large breed dogs, in general, are genetically prone to suffer hip dysplasia as they age, which can make them miserable.
  • Signs of arthritis in dogs include limping, slower movements, unusual gait or hunched appearance, reluctance to jump up or use stairs.
  • In cats, arthritis symptoms may be more subtle, such as difficulty using the litter box, tiredness, and a reluctance to jump up to heights they used to have no trouble with. Their gait may become minced or tippy-toed.

Home Intervention Tips: Gait, Weight, Omegas and Foam:

  •  Gait – Improper gait due to unclipped toe nails (dogs) or claws (cats) can exacerbate existing arthritis, and is even believed to contribute to Osteoarthritis. Be sure to keep your pets nails/claws clipped.
  • Weight – Maintaining a healthy weight can avoid undue wear and tear on joints and prolong pain-free spells. It’s extremely important that pets with arthritis be kept as lean as possible. Extra weight puts added stress on the joints, and makes it harder for your dog or cat to get proper exercise.
  • Omega 3 and 6 Fatty Acids – Either through diet or as a supplement, Omega 3 and 6 (eg Fish Oil) can help reduce inflammation naturally in pets.
  • Foam – Norsk Reversible foam floor padding will help dogs get traction on slippery surfaces, reducing the risk of painful falls and decreasing the pressure on sore joints. Dr. Brush recommends placing the mats color-side down to give your pet the best traction. You can find them here.
  • Orthopedic beds – Orthopedic pet beds range in price from $50 at big box stores to hundreds of dollars at Orvis or Dansk. Dr. Brush highly recommends orthopedic pet beds to give your pet relief.


Home Hospice Pain Management Services:

Dr. Brush takes a “multimodal” approach to helping manage arthritis pain in pets. During home visits she will assess your pet’s condition, assess things that can be changed in the home environment to help your pet stay a part of the family, review records from your routine care veterinarian if available, and develop a hospice care plan fopr your pet. That plan may include the injection of a disease-modifying osteoarthritis drug belonging to the PSGAG family, cold laser therapy, additional pain medication if indicated, and environmental enhancements or supplements such as foam padding and nutritional supplements. Clients who choose to can be trained to administer injections to reduce the number of visits required.

What Are “Disease Modifying Osteoarthritis Drugs” – PSGAG Injections

PSGAG stands for polysulfated glycosaminoglycan, which is considered a “disease-modifying osteoarthritis” drug or DMOD.  Once injected, the PSGAG is distributed into joint fluid and cartilage. Although the exact mechanism of action is not completely understood, PSGAG inhibits enzymes that contribute to cartilage degradation, thus slowing cartilage breakdown in OA joints. By blocking cartilage degradation, PSGAG helps decrease inflammation—an important source of pain. PSGAG also contributes to cartilage healing by providing the body with the building blocks of cartilage. Finally, this medication improves the consistency of joint fluid, providing better joint lubrication, improving joint mobility, and increasing comfort in dogs and cats with OA.

 PSGAG Characteristics:

  • Limits cartilage deterioration
  • Promotes new cartilage formation
  • Thickens the joint fluid – thus acting as a better lubricant
  • Increases blood flow and reduces joint inflammation
  • By virtue of these actions, it provides pain relief for a much longer period of time
  • Treats all joints of the body at the same time

Pet owners can consult with Dr. Brush to determine if a series of PSGAG injections are suitable for their pet. Dr. Brush can also teach pet owners to administer injections themselves to decrease trips and fees since the initial course of injections is usually given once weekly for 4 weeks.


Cold Laser Therapy for Dogs and Cats:

Cold laser therapy is one of Dr. Brush’s favorite treatments for arthritic pets.

“It’s not painful to the pet and we usually see quick results,” Dr. Brush says.

Laser therapy is popular with veterinarians because it’s a pain-free, noninvasive treatment with multiple applications. It can provide pain relief and improve healing in cases of arthritis, acute and chronic pain, back injuries, strains, and sprains, inflammation, and edema, wound healing, and more. When used to treat acute or chronic pain (such as with arthritis), pain medications can often be reduced or eliminated after laser therapy treatments.

The type of cold laser used by Heaven at Home Pet Hospice emits billions of photons of light that are absorbed and transformed into chemical energy by the body to promote faster cell regeneration and healing. The process, known as photo-biotherapy, stimulates protein synthesis and cell metabolism, which improves cell health and functionality.

How Laser Therapy Works:

There are three key ways in which photo-biotherapy can reduce, eliminate or prevent pain in your cat or dog:

  • Inflammation is reduced through vasodilation (opening of blood vessels), and by activating the lymphatic drainage system, thus draining swollen areas. Swelling caused by bruising or inflammation is reduced which alleviates pain.
  • Laser therapy stimulates nerve cells that block pain signals from being transmitted to the brain.
  • Laser therapy stimulates the production of high levels of endorphins, which are pain-killing compounds naturally produced by your pet.

While cold laser therapy is not indicated in every case it is very often an additional adjunct treatment worth trying.

Many pet owners have seen dramatic improvements in their dogs and cats who underwent the treatment. In most cases, pets feel better within 12-24 hours of treatment.

Don’t Try This At Home:

Heaven at Home staff and other trained professionals use pro laser gear that’s been industry tested, such as the ML830, FDA-cleared, Class 4 Therapeutic Laser.  Dr. Brush cautions well-meaning pet-owners against the “wild west” of internet laser sales, where an unregulated industry currently passes off various calibrations as being effective. 

“The research, and hence, our usage, is based on very precisely calibrated equipment that delivers exactly the intended amount of energy. While I wish there were proven, affordable, home versions of Cold Laser for pets, the industry is not there yet, so beware of internet ads hawking low priced lasers — they’re not proven,” Dr. Brush says.

For an at-home pain management consultation, Contact Us.


Senior Pet Tips: Managing Incontinence in Senior Dogs & Cats

March 1st, 2017 by Heaven At Home Staff

As pet home hospice veterinarians, we regularly help pet owners in Grand Rapids and West Michigan care for aging and terminally ill dogs and cats to keep these loyal companions comfortable during their final stages of life. One of the more common problems we face with these pets is incontinence.

There are a number of reasons why your canine companion or feline friend has become incontinent with advanced age or illness, ranging from changing hormones, spinal or nerve issues, infections or a particular illness, increased stress, or simply aging. Though a licensed veterinarian should be the one to make a formal diagnosis, below we’ve listed some of the common causes of incontinence in dogs and cats and potential steps to mitigate the problem.

Top Causes of Pet Incontinence

• Urinary Tract Infections – UTIs can cause pets to lose bladder control due to increased frequency and need to void. Bladder infections are more often seen in female dogs than in males, and affect all ages, but are especially prevalent in senior dogs.

• Hormone Imbalance – Just as our hormones fluctuate as we age, this process also happens within our pets. A hormone imbalance or deficiency in older dogs, especially spayed females, may lessen their ability to keep their urinary bladder sealed shut, resulting in leaks or bigger accidents. During the doctor’s visit, she may prescribe a medication to help with urinary sphincter control. If your pet responds well, he or she may need to take these medications for the rest of his or her life. Fortunately, side-effects are pretty rare and usually mild.

• Diseases - The most common diseases that cause incontinence include diabetes (usually results in excessive thirst, followed by a predictably excessive amount of urination), kidney or liver disease, polyps or cancerous growths in the urinary tract or prostate, and bladder stones.

• Canine Cognitive Dysfunction Syndrome (basically this is the dog equivalent of human Alzheimer’s disease) can lead to old dog incontinence problems too. Dogs with CDS can ‘forget’ the house training habits they’ve known since they were puppies. Studies show that about half of all dogs who are eight years or older show some signs of this condition. By age 11, it’s over 60%.

• Endocrine disorders – These disorders include Cushing’s Disease and Addison’s Disease.

• Stress-related Incontinence – Psychological or emotional issues like extreme stress or anxiety can also trigger old dog incontinence, although usually on a more temporary basis.

• Old Age – The aging process itself often means that muscles, nerves, and organs don’t work as well as they used to. Lack of muscle tone or weak nerve impulses can cause a loosening of the bladder sphincter (muscle at the ‘neck’ of the bladder, which holds it closed) and cause your pet to unintentionally dribble urine.

Causes of Incontinence Specific to Cats

• Feline Cognitive Dysfunction Syndrome – This age-related feline disorder has roots in neurological degeneration in cats age 10 or older and is a progressively debilitating condition whose signs resemble those associated in humans with Alzheimer’s disease and senile dementia.   In addition to signs of spatial disorientation, lack of interest in playing, excessive sleeping, and indifference to food and water, cats suffering cognitive dysfunction syndrome will frequently urinate and defecate outside the litter box.

• Feline Arthritis - Felines suffering from arthritis may show overall stiffness, swelling of the joints, lethargy, lameness, decreased flexibility and discomfort when you pet or handle them in certain positions. You may also notice subtle behavioral changes, including decreased activity and a hesitancy to climb stairs or jump up on things. Many of these cats forego the litter box due to the pain caused by getting in and out of the box.

Treatment for Your Incontinent Dog or Cat

Urinary incontinence can be the whole problem, but it can also be a symptom of another underlying health issue. It is important to diagnose the underlying cause of incontinence so that your pet (and you!) don’t suffer needlessly. There are many effective treatments for incontinence issues, ranging from medications and supplements to surgery. In cases where medications aren’t indicated, there are still strategies for preventing complications from incontinence.

• Antibiotics - Incontinent pets have a much higher incidence of bladder infections. It is believed that with the more relaxed opening to the bladder, it is easier for bacteria to migrate up the urethra and colonize the bladder. These dogs may need to be on antibiotics until the incontinence is dealt with.

• Preventing Urine Scald – Dogs with urinary incontinence frequently suffer from urine scalding. Urine is fairly caustic, and if it remains in contact with the skin for long periods of time, it can cause severe irritations. It’s best to prevent this by keeping the skin clean and dry, using waterless shampoo and absorbent, waterproof bedding. If this is not enough, scalded areas can be treated with topical or other medications prescribed as needed.

•Hormone therapy or a Medication to help tighten the urinary sphincter can be effective for both female and male pets.

• Feline-Specific Strategies – For cats, treatment at home may include the prescription of anti-anxiety drugs in the case of CDS, pain medication for arthritis, and environmental interventions such as altering litter boxes for increased accessibility. Using flat pans for litter will help your cat avoid painful association with the litter box. Sometimes nutritional supplementation can help felines with cognitive dysfunction syndrome.

• Surgery – In cases of incontinence due to bladder stones, a protruding disc or congenital abnormality, surgery has likely already been tried or discussed with your pet’s routine care veterinarian. Usually, pet owners will have explored these options prior to contacting Heaven At Home for palliative and home hospice care. Dr. Brush and the Heaven At Home team can work hand-in-hand with a pet’s routine care veterinarian to ensure continuity of care and complete records. In this case, the Heaven At Home team will perform home visits and help with environmental interventions.

Doggie Diapers

Pet Incontinence belly band diaper GigimodelflannelMany have found that doggie diapers help keep urine out of your dog’s bedding, your carpet, and your furniture. There are a number or dog-specific diaper options out there at pet stores.

One of Heaven at Home’s favorites types of doggie diaper are local, homemade pet bloomers and belly bands that are easy to use and custom-fit. Our friends at the Pet Shoppe Boutique  — Visit – in Grand Rapids make “Bloomers” for girl dogs and “Belly Bands” for boy dogs that we’ve had a high success rate with. One of the reasons this type of doggie diaper is especially effective is that the strong velcro closure ensures a snug fit and stays securely in place, preventing dangerous consumption of the disposable pads placed inside. At the same time, by placing disposable pads inside, the belly bands and bloomers are convenient to use. We recommend that clients who are managing dog incontinence equip themselves with at least three pair to always have a clean one ready.

Others have success using boy’s briefs to hold a diaper or pad in place, using the fly as a tail hole. There are also multiple varieties of doggie diapers that can be purchased at pet supply stores.

Whatever you use you need to be sure to change it as soon as possible when soiled to prevent discomfort or infection.

Warning – Do Not Allow Dogs To Eat Their Diapers – Dogs, in some unfortunate cases, have been known to eat their diapers when unattended. The absorbent material in disposable diapers may cause blockages and severe complications. It is recommended that you prepare a special room for your dog while you are away, rather than leave them unattended in diapers, especially if your pet has a track record of ingesting things they shouldn’t!

Easier-to-Clean Pet Bedding

Living with an incontinent pet means doing lots of laundry and having a fresh supply of bedding toppers. Orthopedic beds are an important source of comfort for senior dogs and cats and can be expensive, so we recommend topping them with inexpensive fleece blankets or other bedding that dries quickly and can tolerate whatever cleaning products you use to get the stains and stink out. The goal is to create clean, dry, comfort quickly and easily for your pet.

Try the following DIY Approaches:

  • Pet bed wrapped in a trash bag, then covered with blankets (Note: Some dogs may be unwilling to use bedding with plastic under it.)
  • Old towels
  • Old bathmats (great because of rubber back lining)

Washable Pee Pads

Medical supply companies sell washable pee pads in a variety of sizes. They feature a top fabric that wicks moisture away from the skin to help prevent sores and a bottom material that keeps leaks from getting onto bedding or furniture. This can help keep your pet comfortable despite accidents while napping. These are Dr. Brush’s preferred solution for dry bedding.


An Away Space for Easier Cleanups

We also recommend having a space for your pet that’s easy to clean, keeps them comfortable, and prevents them from roaming the house while you’re away, sleeping, or they’re otherwise unsupervised.

The best way to go about this is with a child gate partitioning their area of the house, along with some sort of waterproof barrier between the permanent bedding (cushion etc.) and the washable blankets. Be on the lookout at fabric stores and garage sales for good, cheap fleece blankets.

There are many causes for pet incontinence, and it is important to manage the symptoms to improve the quality of life for both you and your aging fur family member. We would love to help you find ways to make your pet’s sunset years filled with fond memories instead of constant struggle.

For an in-home consultation on pet incontinence strategies, Contact Us.





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