In Memoriam: Capois

November 7th, 2019 by Laurie Brush

Capois’s Story:
We brought our big beautiful boy home when he was just 6 wks old. Even though the time we had with him was not near long enough. We enjoyed the wonderful 8 years we had together. It would take me days to go through all of the wonderful things about Capois and the joy he constantly brought into our lives. He was an ambassador to his breed. The first day that we had to come home without you greeting us at the door was incredibly painful. The silence since you have been gone has been deafening. It has only been a little over 10 months since you were called home. And I am just now able to write this. It has gotten easier. But the missing you part will most definitley never go away. It took months for me to be able to go through your things. Your bed is still next to ours. But I have a good plan in mind of where it will go. There are so many things to miss about you. The keep away games you played with your tennis ball or always making sure you had a ball to greet people with. The way you intently watched tv and some of the commercials you were sure to let us know you hated. We miss how you wanted to be friends with whoever you would meet, human or animal. People would always compliment on how handsome,funny and smart you were. They didn’t even know the half of it. You were like an old soul. We will miss you always running after the garden hose, taking our socks, barking at the television, always ready to go for a car ride. You were always excited to go anywhere for a bath and even to the vet! You found joy in just about anything. A cue all of us humans should take from our furry companions. I miss so many things about you. The symptons of your cancer came on so suddenly and within days we had to make the heart wrenching decision to let you go with peace and dignity. I am very grateful to all of the staff and to Dr. Laurie for her willingness to come over late into the night to help with your passing. You helped to keep me calm and answer my questions all while explaining each step and for giving us a few moments alone after. Even as we loaded him into your vehicle and said our last goodbyes. You saw that I was lost and falling apart. So you offered a hug. Thank you for your compassion. And we are so glad people like you exist. Tomorrow November 6th would have been Capois 9th birthday. No matter how painful this has been. I would do it all over again for him. People often say “He was lucky to have you” But I truly feel “WE” were lucky to have him. So this is a Happy Birthday to our big beautiful boy. And one day we will see you again… Just on the other side of the Rainbow Bridge.


In Memoriam – Rusty

November 7th, 2019 by Laurie Brush

Rusty’s Story:
We got Rusty as a puppy and he was such a cute puppy. He was a red heeler and irish setter mix. He was a very protective dog of all of us. Rusty could catch a frisbee and loved the water. He was more than my dog, he was my friend. My nickname for Rusty was rusty boy. I would talk to Rusty like he was a person. He acted like he understood me. We had Rusty for 15 wonderful years. We really miss him, he was part of our family. I know he is at the rainbow bridge with our other animals.

It made it nicer to have Heaven at Home. They are a great place. Very caring and understanding


Knowing When It’s Time to Say Goodbye

October 28th, 2019 by Heaven At Home Staff

Making the decision to euthanize a pet is the hardest thing a pet parent has to do. However, deferring or avoiding the decision can allow a degree of suffering that no one would deliberately wish on their loyal companion. Natural death is rarely humane. But how do you know when the kindest act you can offer is to plan to say goodbye? How do you know when your beloved companion is ready to cross the “Rainbow Bridge”?

Some people have a difficult time with the thought of euthanasia. They might feel like they’re “playing God,” and feel besieged by guilt. It’s important to remember that the illness, disease, or injury is causing the end of life, not you. Here are some of the key questions to ask yourself:

  • Has your pet lost his/her quality of life?
  • Is your animal suffering?
  • Can you maintain your pet’s normal routines?
  • Are there behavioral problems that compromise the safety and well-being of your pet or others?
  • Are there human limitations (emotional, timing, or financial) that you must consider? While it may be difficult to admit that any of these limitations may be the reason you are considering euthanasia, they are among the most common reasons for euthanasia.
  • What do you think your pet wants?  

Quality of Life Assessment Help

Your routine veterinarian, or the Heaven at Home Pet Hospice team, may be able to assist you in assessing the quality of life of your senior pet, but we can’t make the decision for you. Pet parents play a pivotal role in assessing a pet’s quality of life because they are direct observers of the day-to-day signals of their pet’s condition. Your veterinarian team can help you manage aspects of pain, reduce suffering, and make changes that help in daily care.

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Many of Heaven At Home’s clients have found assistance and comfort by using the resources and assessment tools of  Ohio State University’s “Honoring the Bond” program. The 2019 edition of “How Will I Know” addresses making difficult medical treatment decisions, dispells many euthanasia myths, and offers a  comprehensive assessment questionnaire, together with anticipatory grief advice for pet parents, companion animals, and children.

In addition, our team finds this short “Quality of Life” Scorecard below helpful for our clients.

Contact us if you’d like assistance in your assessment, or feel ready to plan a peaceful and compassionate end to your fur friend’s life story.

Knowing when to say goodbye is hard, but with the right support, advice, and planning, it can be a beautiful final gift to give your beloved pet for his or her years of loyal companionship.

Quality of Life Scorecard

Score patients using a scale of 1 to 10. (1=no/disagree; 10=yes/agree).

Score
Criterion
1 – 10
HURT – First and foremost on the scale:  Is pain control adequate? This includes breathing ability.  Is the pet’s pain successfully managed? Are extra measures like oxygen necessary?
1 – 10
HUNGER – Is the pet eating enough and getting proper nutrition? Is hand-feeding necessary?  Does the patient require a feeding tube?
1 – 10
HYDRATION – Is the patient appropriately hydrated? Can they drink enough on their own, or do they require supplementation via subcutaneous or intravenous fluids?
1 – 10
HYGIENE – Can the patient keep themselves clean?  Does it require assistance?  (Patients should be brushed and cleaned, particularly after elimination. Appropriate bedding to avoid pressure sores, keep any wounds clean/dressed, etc).
1 – 10
HAPPINESS – Does the pet express joy and interest? Is the pet responsive and interactive to things around him or her (family, toys, etc.)? Is the pet depressed, lonely, anxious, bored or afraid? Can the pet’s hospice area or bed be close to the family activities and not be isolated?
1 – 10
MOBILITY – Can the patient get up and about?  Does the pet need human or mechanical assistance (e.g., a cart)? Does the pet feel like going for a walk? Is the pet having seizures or stumbling?
1 – 10
MORE GOOD DAYS THAN BAD – Do the good hours or days outnumber the bad ones?  When bad days outnumber good days, quality of life might be compromised. When a healthy human-animal bond is no longer possible, the caregiver must be made aware the end is near. The decision needs to be made if the pet is suffering. If death comes peacefully and painlessly, that is okay.
*TOTAL
*A total over 35 points generally represents acceptable life quality

 

Adapted from Villalobos, A.E., Quality of Life Scale Helps Make Final Call, VPN, 09/2004, for Canine and Feline Geriatric Oncology Honoring the Human-Animal Bond, by Blackwell Publishing, Table 10.1, released 2006.


The Elements of Animal Hospice Care

October 24th, 2019 by Heaven At Home Staff

Nine years ago, a mere 30 veterinarians gathered to discuss ways to help bring comfort to aging pets and help pet parents know when it’s time to say goodbye. That was the dawning of the International Association for Animal Hospice and Palliative Care (IAAHPC). Earlier this month, ten times that number gathered in Chicago to learn about trends in the emerging field.

“Research shows that more and more Americans are opting for pet hospice,” said Dr. Laurie Brush, founder of Heaven at Home Pet Hospice and early graduate of the IAAHPC’s new certification program.

“I got involved in home hospice in the early days because I firmly believe in pro-active comfort management and helping pet parents make small changes that can greatly improve a pet’s comfort.”

To celebrate the upcoming National Animal Hospice awareness day November 2nd, we’re sharing some of the elements involved in “Animal Hospice.”

It’s More Than Home Euthanasia Services

Animal hospice and palliative care provide comfort to companion animals as they approach the end of life. Services from the veterinarian team may include treatment for pain and anxiety management plus nutritional management specific to the pet’s condition. The primary goal is to relieve – or avoid – suffering.

The veterinarian team can also help pet parents assess the pet’s quality of life and teach pet parents ways to improve end-of-life care. Good pet hospice care is a team effort.

Things to Consider in Pet Hospice

 Pet parents can manage many aspects of pet hospice themselves, while they will need veterinarian assistance with other aspects. These are the key areas to consider:

  • Environmental Assessment: Review mobilizing, feeding area, litter box, bedding, and enrichment.
  • Mobility Support: Consider non-slip mats, carpeted stairs, ramps, slings, harnesses, wheel carts.
  • Toileting Solutions: Use incontinence pads, diapers/belly bands, and consult vet for stool softener, catheterization.
  • Pain management – Monitor pain signals and medication together with vet; use multi-modal approach (alternative therapies & environmental supports.)
  • Nutrition: Devise superior diets specific to illness with vet, ask for appetite stimulants if needed.
  • Behavior Modification: Discuss medication and strategies for managing anxiety, restlessness, vocalization, sleep disturbance, and cognitive dysfunction.

Together, pet parents and hospice veterinarians can dramatically increase the quality of end-of-life care a pet receives.

 

Heaven at Home Pet Hospice offers private hospice consultation, but also periodically hosts group workshops and webinars. Contact us for more information.


In Memoriam: Murphy Command

October 24th, 2019 by Laurie Brush

Murphy’s Story:
It was March of 2007 when we decided we needed a “keeper dog” at our house. After raising and training a PAWs Puppy for 17 months, we knew it was time to add a dog of our own to the family. I made many “puppy visits” to find just the right fit pup for us. I had my eye on a darker, smaller Golden, but a larger guy (biggest in the litter) with a blue collar kept returning to my side/lap/etc…over and over again. So, that was that…..Murphy picked us as his family! From the start he was so smart and loved to learn. He was gentle, laid back, and so eager to please. He had the perfect temperament for visiting and hanging out in my second grade classroom. He was our gentle giant….carrying 110-115 pounds his whole adult life and tall enough to put his muzzle on the table and check out “dinner”. His size could be intimidating which wasn’t always a bad thing…especially when walking him alone at night! He loved “stuffies”, peanut butter, playing fetch, sharing snacks, people/kids, other dog friends, car rides, Beach days, “guarding the yard”, going to the trails, and just living the Golden Life! Each of our family members had a special bond with his gentle spirit! He was such a good listener and shared unconditional love with all who knew him. He was the best “neighborhood dog”…always trotting over for a visit with all who passed by!
It’s been over 4 months since we made the heart wrenching decision to say goodbye and I finally feel able to write this! June 19 was by far one of the most difficult days for our family! Our strong, beautiful 12 1/2 year old Murphy had been failing for a few days….no appetite, struggling to go outside for breaks, and just not feeling well. I tearfully contacted Heaven at Home. I cannot express how wonderful this Hospice for pets was for our family! When Dr. Tay arrived she explained that she felt our boy was full of Lymphoma. After explaining our options to us, we made the hard decision for a compassionate ending. We could not have asked for a more peaceful passing for our Murphy. He was in his favorite place surrounded by his “people” and left us in quiet dignity. We are so grateful that Heaven At Home was an option and will share our experience with any pet owners facing this hard decision.

Thank you Heaven At Home for providing this special service. Every person we dealt with was compassionate, understanding, caring, and took time to listen! I highly recommend using this service for your pets end of life needs!


Better Ways to Say Goodbye: Pet Hospice & Euthanasia

September 30th, 2019 by Heaven At Home Staff

It’s a tough subject, but our companion animals age faster than we do. It’s hard to see them suffer, and even harder to imagine life without them. What if in their final chapter you could reduce their pain? What if, when the time was right, they could end their life story in the comfort of their favorite place, with the people they love?

“Those are the questions that fueled the rise of the home hospice movement not all that long ago,” said Dr. Laurie Brush, founder of Heaven at Home Pet Hospice.

“Answering those questions became the mission of the International Association for Animal Hospice and Palliative Care, and my team’s mission as well.”

IAAHPC celebrates its 10th anniversary this October at its annual conference, where specialized veterinarians like Dr. Brush join together to learn new ways to bring comfort to aging pets and give them compassionate and increasingly sophisticated home care.

“By integrating palliative services early in the management of chronic or life-limiting disease, we can now ameliorate needless suffering and even extend a pet’s life in some cases,” Dr. Brush said.

For example, finding ways to support or improve mobility through cold laser therapy, supplements, management of pain medication and environmental accommodations can make a world of difference to an arthritic pet. Early intervention and management of diseases such as diabetes can also give Fido or Felix a new lease – or leash – on life.

In addition to raising awareness of options, the IAAHPC has also founded a hospice and palliative care certification program for licensed veterinarians and veterinarian technicians. Dr. Brush was among the program’s first 100 graduates worldwide. The 100-hour AHPC Certification establishes a standard of care that reflects excellence. The American Veterinary Medical Association (AVMA) now advises pet parents to work with AHPC-certified providers for hospice and palliative care.

Dr. Brush points out that AHPC veterinarians don’t seek to replace a pet’s routine care veterinarian, but to work with them for continuity of care.

“We’re trained specifically to provide both the technical and emotional support required to give the human-animal bond the dignity it deserves during a pet’s sunset years and final farewell. Every pet deserves a compassionate and peaceful, pain-free passing.”


In Memoriam: Belle McCready

September 20th, 2019 by Laurie Brush

Belle McCready’s Story:
“The Puppa,” Belle McCready was our first family pet. She moved in and took over. Belle was small for a bichon, but her personality was enormous. She was loved so much and she will be missed every single day. I’m thankful for the 14 wonderful years with our beloved Belly Buttons. Run free Puppa, We love you and we miss you so much. We will be reunited in heaven.

It was fate that I found Heaven at Home. I knew I was going to have to make a tough decision regarding our little bichon and I also knew how scared she became just pulling into the vets parking lot. I didn’t want her final moments to be stressful and afraid. Then I saw the Heaven at Home car in front of me on Patterson. I remembered the name and called. The staff was so caring and comforting, I was distraught and they understood and made me feel better. Dr. Laurie Brush is so sweet. She was a reassuring voice with great words of wisdom. I highly recommend this service if you’re in a tough position as we were.


Pets in Pain Part II

September 20th, 2019 by Heaven At Home Staff

As part of pet pain awareness month, we published an article earlier this month about identifying and managing pain in members of your fur family. In this second installment, we’ll share a handy infographic to help identify pain in cats and dogs and include the American Animal Hospital Association’s article summarizing its guidelines in layman’s terms.

Pain Management Approach for Senior Companion Animals:

The Heaven at Home team takes a “multimodal” approach to helping manage pain in palliative pets. We are firm supporters of the AAHA/AAFP Pain Management Guidelines for Dogs and Cats, and subscribe to the “Continuum of Care” philosophy inherent in it. This means that pet parents and routine care veterinarians are part of the pain management planning process and that pain management should include anticipation, early intervention and evaluation.

During home visits, one of the team’s veterinarians will evaluate your pet’s condition and assess things that can be changed in the home environment to help your pet stay a part of the family. They will review records from your routine care veterinarian if available, and give you pain assessment guidelines so that you can also monitor and rate your pet’s pain behaviors. Together, we then develop a pain management plan for your pet. The plan may include a number of elements depending on the underlying cause of pain, which could be from arthritis, cancer, or any number of life-limiting illnesses.

From AAHA: 9 Things You Need to Know About AAHA’s Pain Management Guidelines:

Pets can’t tell us when something hurts—in fact, they can be experts at hiding pain. Cats are particularly adept at masking injury and illness because they instinctively hide signs of weakness from potential predators. Too often, “bad behavior” in both dogs and cats—like urinary or fecal “accidents,” aggression when handled, or refusing to follow commands to climb the stairs—actually has an underlying medical cause.

Because pain management is central to veterinary medical practice—and because there have been rapid advances in the field—AAHA collaborated with the American Association of Feline Practitioners (AAFP) to create the AAHA/AAFP Pain Management Guidelines for Dogs and Cats.

What you need to know

  1. Behavioral changes are the principal indicator of pain. Pay close attention to any changes in your pet’s normal behavior. For instance, what we sometimes attribute to “old age” could actually be arthritis. A cat eliminating outside the litter box might simply be because he’s unable to climb into it.
  2. Know the warning signs. Your dog or cat might be in pain if you notice decreased activity or appetite, lethargy, vocalization, restlessness, aggression, less interaction with pets and people, dilated pupils, or reacting with a flinch to touch in a sensitive area. Signs of pain in cats may also include flattened ears, an elongated muzzle, decreased grooming, or hiding. If you see any signs of pain, call your veterinarian.
  3. Reduce risk factors. You can help prevent pain with regular visits to the veterinarian for dental care and by helping them maintain a healthy weight, since decaying or otherwise damaged teeth can cause a serious toothache and obesity can lead to aching joints. Nutrition and exercise will go a long way to a healthier pet.
  4. If your pet is in pain, keep everyone calm. Unfortunately, pain can cause a pet to lash out at even the most well-meaning caregiver because fear and anxiety can amplify pain. Be as gentle as possible when handling your pet and speak soothingly, but also be careful not to get hurt in the process.
  5. Your pet may be experiencing several pathways of pain. Your veterinarian may recommend multiple pain medications to be given at the same time. That’s because pain can be controlled in many ways to decrease soft tissue, bone/joint, and nerve pain.
  6. There’s more to pain relief than medication. Modern veterinary medicine involves an integrated approach to pain management, not just prescribing analgesics (painkillers). Cold compression, therapy lasers, acupuncture, physical therapy, weight optimization, and adjustments to the home environment can be complementary options for alleviating pain.
  7. Lifestyle changes can have a huge effect on chronic pain. When a cat or dog suffers from chronic pain, changes in your home can make life easier for everyone. Soft bedding, easy access to food bowls and litter boxes, gates to limit access to stairs, and nonslip rugs can make a big difference in your pet’s day-to-day wellness.
  8. Your veterinary team will routinely evaluate pain at every appointment. Recording a pet’s pain score is considered the “fourth vital sign” after the standard temperature, pulse, and respiration measurements. Be sure to mention any unusual or concerning behavior.
  9. Pain management is a team effort. At home, you are the eyes and ears of your veterinarian, and you’re always the voice for your pet. Never overstep your role by administering pain medications meant for people or another pet, as there can be life-threatening consequences. By recognizing pain quickly and seeking treatment as soon as possible, you’ll alleviate your pet’s suffering and strengthen the bond you share.

Contact the team at Heaven at Home if you need help managing your senior pet’s pain.


In Memoriam: Tribute to GRAYCIE the Cat

September 19th, 2019 by Laurie Brush

How do you say good-bye to the best little buddy you’ve ever known? How do you say good-bye to the one that’s brought you so much joy, that’s loved you unconditionally, that greeted you every time you came home, and sat in your lap every morning for coffee, that always wanted to be right where you were, and that slept by your pillow at night? How do you say good-bye to a pet that’s been a part of your family for nearly as long as you’ve been married, that you got a week before 9/11- yes, the 9/11- when she was only about two months old and sucked on your shirt and slept snuggled into your neck when you first got her?

How do you say good-bye to the one that saw you through deployments to Iraq and Afghanistan? How do you say good-bye to the one that’s literally held your hand with her paw and comforted you when you were sick, especially when you went thru Breast Cancer? The one that’s comforted you through every disappointment and tear you’ve shed? The one that’s been so playful and affectionate? The one you’ve had so many good times with? The one you talked to all throughout your days, the one you told of your comings and goings? How do you say good-bye to the one you’ve told all of your secrets to, the one that understands you like no other, the one that truly brought out the best in you? The one that is the definition of loyalty??? The one that made you smile and gave you hope, that made you somehow try to see the world thru the innocence of her?

How do you say good-bye to the one that drank out of a Snoopy bowl even though she was a cat? The one that needed just a spoonful of food or treats every time you walked past her bowl because it was an act of love? The one that pawed the blinds in the morning because she wanted to look out and head butted your hand in your sleep because she wanted a pet? The one you adored and that adored you back? The one that actually liked to hear you sing? The one that helped you pack your bags when you had to be away, that helped prepare you for your race, and that helped you write in your journal? The one that you had so many stories about and that brightened all of your days? The one that made you smile when nothing else could, and lowered your blood pressure? The one that was smarter and more compassionate than all other animals? The one that you had 20 nicknames for and that humored you? The one that was always so curious and took seriously her job to keep the penguins away? The one that wrangled a hamster and then helped capture a bird that flew in the RV? That kept the mice and other rodents away? The one that was a guard cat, and even growled at a stranger knocking on the front door? The one that was always in your business because she loved you that much? The one with a thousand nap spots?

How do you say good-bye to the one that’s been there for every milestone and success you’ve celebrated over the last 18 years? The one that was your best friend?! The one that recently discovered she loved potato chips and the smell of chocolate? The one that was just so beautiful- both on the outside and deep in her spirit???

I know she is just a pet, and I sympathize even more with those that suffer greater loss thru spouses, children, and parents. Still, it’s hard. She was a part of our family. It hurts. And it’s just so very painful. My heart feels shattered into a million pieces.

I’m so glad I had so many long days with her since June 2014, when I left my job at Ft. Campbell. I always dreaded this day, and I always prayed I’d outlive her because I worried she wouldn’t understand why I abandoned her if I didn’t. It’s going to be so empty without her. There will forever be a void.

I always envisioned her going naturally in her sleep, and that would have been easier to take. However, we found out on December 20 that she had a huge cancerous mass in her bladder. It was fast growing and it would have been inoperable even if caught earlier. The vet gave us a timeline of 3-6 months, maybe 9 with some medication.

True to how she found a home with us, she has been persistent. She has the best little personality. She is so snuggly, has the best little meow and purr. And now the time is here. She made it 8 months, and I do believe it was purely out of her deep love.

How do you make the decision to send her to the Rainbow Bridge when all you want is one more good day with her? How do you let her know this is your way of holding her paw??? How do you repay her for the countless times she has comforted you? How do you keep the tears from rolling knowing that this time she can’t dry them? I hope you know you were my heart, my Graycie Girl.

We can’t fathom another pet. Our world will never be quite the same. You were absolutely- hands down without a doubt- the best cat ever!!! We wish we could keep you forever; instead you’ll forever be in our hearts and memories.

We have to try to carry Dr Seuss’s advice into the days ahead: “Don’t cry because it’s over; smile because it happened.” RIP, my sweet angel 🐱, as I sing you into Heaven with your favorite song of mine, “I’ll Fly Away”. I have to believe you’ll be there to greet us when it’s our time to make the journey. We loved you with a love beyond comprehension!!! Now, we close this chapter.

We are full-time RV’ers. We knew for 8 months that our Graycie Girl had an inoperable tumor in her bladder. We searched out a veterinarian service every place we traveled just so we knew we had someone on standby. Ultimately, we wanted an in-home service. Add the fact, it turned out that a friend of ours knew Dr. Brush. The compassion of everyone involved made a difficult situation bearable. And her paw print arrived exactly 2 weeks after she went to the Rainbow Bridge! Thank you so much!


How Can You Tell if Your Pet is in Pain?

August 30th, 2019 by Heaven At Home Staff

September is Animal Pain Awareness month.

Our companion animals often instinctively hide their pain. It’s a habit that has evolved as a survival mechanism to prevent predators from targeting them.

“Pain in dogs and cats can be difficult to measure,” said Dr. Laurie Brush, founder of Heaven at Home Hospice, which provides palliative and euthanasia services throughout West Michigan.

“The clues can be subtle. Your dog may be reluctant to climb stairs or show decreased activity, or may simply stop initiating play,” she said. “In the case of cats, a reluctance to jump up onto surfaces is a sign of discomfort.”

The International Veterinary Academy of Pain Management (IVAPM) was created to educate vets and pet parents alike in the expanding field of pain prevention, management and treatment.

According to IVAPM, the most common signs of pain in your pet are:

  • Decreased activity – Take notice if your pet is not playing as much as usual
  • Not going up or down stairs – This could be an early sign of osteoarthritis
  • Difficulty standing after lying down – is a sign of osteoarthritis
  • Over grooming or licking a particular area – can be a sign of referred pain
  • Decreased appetite – this can signal mouth pain
  • Reluctance to jump up onto surfaces – this especially applies to cats
  • Behavior changes – such as growling at fellow companion animals or withdrawal

Pain Management Options:

There are a variety of complementary treatment options depending on the source of pain, including physiotherapy, cold laser, acupuncture and nutritional supplements. In addition, there are many types of medication that can help manage your pet’s pain and improve their quality of life. Some examples are:

  • NSAIDs – There are special NSAIDs designed for dogs that interfere with the body’s production of inflammatory molecules and are often prescribed for mild to moderate pain.
  • Opioids – Just like humans, pets may be prescribed opioids to address severe pain from arthritis or advanced cancer.
  • Corticosteroids – Cortisone and synthetic cortisone-like drugs such as prednisone are potent anti-inflammatory medications that can deliver dramatic relief, though not without side effects.
  • Gabapentin – Is a popular choice for managing chronic neuropathic pain.

Don’t let your pet needlessly suffer. Be observant for signs of pain and talk to your vet.


 
Compassionate home care for your companions!
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