Wednesday, November 9, 2011

Hospice for Dogs and Cats - Congestive Heart Failure Story

 Hospice for Pets

Lady, a 16 year old spayed female Bichon Frise, was first diagnosed with congestive heart failure (CHF) 10 months prior to our first meeting.  The 4-legged child of 2 nurses, she was in good hands from the start!  As with most early-diagnosed CHF pets, proper medication and instructions from her regular veterinarian ensured her a good quality of life.  Her parents, Kim and Jim Griffin, were well educated on the “Rest plus 3-D’s” of heart disease treatment – Rest ensures lower demand on the heart, Diruetics (like Lasix) help reduce fluid accumulation, Dilators (usually Enalapril) help dilate vessels, and Dietary restriction of sodium reduces total retained fluids.  

Lady’s owners were consistent with the medication and were very happy with her quality of life.  Although she was considered a geriatric pet by this time, they maintain she still had energy to play fetch and even tussle with your younger sibling.  It wasn’t until 10 months after her diagnosis that she started to show signs of slowing down.  She began to tire quickly and cough, especially after any type of exercise.  As nurses, the Griffins knew this was a sign that her heart and lungs were overloaded with fluid.  Lady was becoming increasingly hard to pill, however, and they were very worried about her getting the proper medication to allow her heart to function.  She still had a good quality of life and they were not ready to take that from her.  That’s when I stepped in.

During the first home hospice visit, we discussed Lady’s average daily routine and addressed any issues that might be contributing to her dislike of the pills (bad teeth, neck pain, etc).  We determined it would be best to switch Lady to injectable medications to decrease the anxiety associated with the oral pills.  As nurses, Mr. and Mrs. Griffin were very comfortable with this option and readily agreed.  Luckily, Lady tolerated the injections quite well!  She received daily doses of Lasix and vitamin B-12 while discontinuing the other medications in order to focus on quality of life.  Her parents we well versed on the end-stage of congestive heart failure and even rented an oxygen tank in the event Lady began to have difficulty breathing.  They also kept injectable pain medication on hand in case Lady showed any signs of discomfort.  The sole purpose of this period of time was to ensure Lady did not suffer while they awaited my arrival for an in-home euthanasia, whenever that may be.

Two months later I received the call we all knew was coming, Lady was ready.  She had some difficulty breathing but the biggest sign for the owners was her disinterest in her favorite treat, her mom’s meatballs.  They knew it was time.  I arrived a few hours later and Lady passed peacefully in her parents’ arms.   

This case illustrates the importance of in-home hospice care, when appropriate.  Lady’s owners were willing, able, and educated enough to feel confident in their ability to treat and evaluate their little one’s condition.  Although not right for every family, the ability to think outside the box and to search for new alternatives to care is incredibly important in this rapidly evolving area of geriatric medicine.  This is best summed up in the words of the owners, “We wouldn’t change a thing.  Having Lady in her home until the very end was the best gift we ever gave her.” 

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Blog written by:
Dr. Dani McVety
Lap of Love Veterinary Hospice and In Home Euthanasia

Dr. McVety services all towns in and around Hillsborough and Pasco counties including Tampa, Seminole Heights, Carrollwood, New Port Richey, Wesley Chapel, Brandon, and surrounding areas.

Lap of Love - - was founded by Drs. Dani McVety and Mary Gardner to provide at-home veterinary hospice and euthanasia care and services. Veterinary hospice is an adjunct service provided to clients, and is not designed to replace the care of a general veterinary practitioner. Lap of Love currently operates in Florida, North Carolina, and Tennessee with planned expansion to additional states in the coming months.

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