New England Pet Hospice

The Importance of a Meaningful Goodbye

noreply@blogger.com (New England Pet Hospice) — Fri, 05 Jul 2013 02:02:00 +0000

By Rev. Eliza Blanchard

Interfaith Spiritual Advisor

Why do final goodbyes hurt so much?

It is tempting to avoid them, sneak out the back way. Goodbyes mean that an end to what we cherished is real. We fear what others will think if we make “such a fuss” over a pet. We are afraid we’ll give way to our deepest grief. We’ve never lost one so dear, so how does this work?

There are lots of reasons why we just don’t want to think about the end.

As a minister, I’ve worked with many grieving people as they struggle to create a farewell for loved ones. With some guidance most people find the experience hard but helpful. At New England Pet Hospice and Home Care, I’ve also helped folks at the end of life or with funerals and memorials for their beloved animal companions. They too find the experience enriching, especially as they recall their favorite moments with their friends, and realize that their love is not gone, that it endures always.

In my experience making the most complete goodbye helps.

Why? Because goodbyes are a way to honor the dead, to hold our feelings about our beloved, and to celebrate the gift that relationship is. In saying goodbye, we give meaning to mortality, and we gain wisdom about the meaning of life.

Fully saying good-bye creates meaning

Because it gives a shape to a heart-breaking welter of emotions. For many, creating a complete good-bye is like telling a satisfying story: what I’m calling a “complete goodbye” includes a beginning (how we got here), a middle (what the journey’s been like, and what have been the highlights), and an end (what this precious life meant and why this being will be missed). This may feel formal, and that’s exactly right - a form gives shape to our sorrow and our loss. And a shape helps us hold onto what’s valuable about having those feelings. Honoring the relationship and being thankful for the positive things may even help resolve the mixed feelings, which can include guilt or failure, some mourners have.

Whatever tradition you come from or love can be a source for readings, blessings, music, and rituals you might include; it depends on how formal a farewell you want. Most importantly, your own words, tears, and stories are the most important elements of a goodbye to one you love.

Resources:

Douglas, Barbara Rosenfeld. Gently Into the Night: A Guide to Creating Your Pet’s Memorial Service. www.heartsoulpet.com, 2012
Kowalski, Gary. Goodbye, Friend: Healing Wisdom for Anyone Who Has Ever Lost a Pet. Stillpoint Publishing: Walpole, New Hampshire. 1997.Greene,
Lorri A, and Jacquelyn Landis. Saying Good-bye to the Pet You Love. New Harbinger Publications, Inc.:Oakland, CA. 2002.

WANT TO USE THIS ARTICLE IN YOUR EZINE OR WEB SITE? You can, as long as you include this complete blurb with it: “New England Pet Hospice & Home Care supports those caring for ill, elderly and special needs animals at home following the human hospice and palliative care models of interdisciplinary care. Learn more and get your FREE subscription to Wag & Purr: Your Guide to Comfort Care for Pets at www.NewEnglandPetHospice.com"

Side Effects of Chemotherapy

noreply@blogger.com (New England Pet Hospice) — Sat, 08 Jun 2013 02:00:00 +0000

by Michelle Spencer
Veterinary Technician, Oncology Specialist

In this article, we discuss common side effects of chemotherapeutic agents and how your veterinary team can work to combat them.

When deciding whether or not to treat your pet’s cancer with chemotherapy, it is very important to keep two things in mind:

· Quality of life is the driving force behind veterinary oncology
· Cancer treatment is fluid and there is room for assessment at each step in the road

The occurrence and severity of side effects from chemotherapy in veterinary medicine are significantly less than those found in human medicine. To understand this discrepancy, it helps to look at the goals in veterinary oncology vs. those in human oncology. Veterinary oncology focuses on quality of life, while human oncology tends to focus on quantity of life. For that reason, chemotherapy dosing, schedules and protocols are less intensive in veterinary medicine, often resulting in less severe side effects. Research shows that less than 5% of veterinary oncology patients experience severe side effects requiring hospitalization.¹Most side effects can be managed at home with oral medications and generally last only a few days.

Common Side Effects

Most chemotherapeutic agents work by killing or inhibiting the growth of rapidly dividing cells. However, most agents do not have the ability to discriminate between cancer cells and other healthy, rapidly dividing cells within a pet’s body. It is the destruction of these healthy cells that tends to cause the most common side effects.

Gastrointestinal

Healthy cells in a pet’s GI tract turnover frequently, about every 3-5 days. Because chemotherapy can kill these rapidly dividing cells, your pet my experience GI side effects 3-5 days after treatment including vomiting, diarrhea and inappetence. Most of these side effects are self limiting and resolve within a couple of days. However, should your pet experience vomiting multiple times per day, vomiting multiple days in a row, prolonged inappetence, prolonged diarrhea or bloody or tarry diarrhea, notify your veterinarian immediately.

If your pet experiences an episode of vomiting, you will likely be asked to pull food and water away from your pet for 12 hours and then slowly reintroduce it. Your pet may be given antiemetics such as Cerenia, Zofran or Reglan. These will help to combat nausea and vomiting and can usually be taken at home.

If your pet experiences a minor bout of diarrhea, an antidiarrheal such as Flagyl may be given at home. For more severe cases, your pet may need rehydration and injectable medications at your clinic.

Discuss episodes of inappetence with your oncologist. Occasional bouts may be cured by enhancing your pet’s meals with chicken broth, tuna juice, etc. Chronic inappetence should be examined and may be cured with oral medications such as mirtazapine.

Some agents such as piroxicam may cause gastric ulcers. Your veterinarian can give you medications such as carafate to help prevent ulcers by coating the GI tract with a protective barrier.

Bone Marrow Suppression

Your pet’s bone marrow is responsible for the production of blood cells. Because it is a site of rapidly dividing cells, it is a prime target for the effects of chemotherapy treatment. Most side effects arise when your pet’s bone marrow is unable to produce enough platelets (thrombocytopenia) or neutrophils (neutropenia). A lack of platelets can reduce the ability of your pet’s blood to clot properly. This can result in uncontrolled bleeding. A lack of neutrophils reduces your pet’s ability to fight infection. Common indications of infection are lethargy and a fever above 103°. If your pet is neutropenic, but otherwise feeling well, a prophylactic course of antibiotics may be prescribed. Should your pet develop an infection in their blood stream (sepsis), they will be hospitalized for intensive supportive care such as IV antibiotics and fluids. Sepsis is a dangerous situation and should not be taken lightly.

Because of the lifespan of these cells and the rate at which the bone marrow produces replacements, your pet is most likely to experience a drop in platelets or neutrophils about 5-10 days post treatment. During this time, you will be asked to bring your pet to the clinic for a Complete Blood Count to thoroughly evaluate these and other blood cells. This test is extremely important, and should not be missed.

Less Common Side Effects

Alopecia

Though hair loss is much less common in cats and dogs than humans, some breeds may lose hair, especially eyebrows and whiskers, during treatment. Non-shedding breeds are at greater risk for hair loss. Hair growth generally returns, but hair texture and color may differ.

Cardiotoxicity

Some agents, such as doxorubicin, may cause irreversible changes to a pet’s heart. A risk vs. benefit discussion should take place with your oncologist prior to treatment. If your pet is treated with an agent known to cause cardiotoxicity, expect them to have frequent ultrasounds of their heart (echocardiograms).

Allergic Reactions

Some pets may experience an allergic reaction to a chemotherapeutic agent. Though the most common culprit tends to be l-asparaginase, it is possible to have a reaction to any drug. These reactions can range from minor to severe, though the latter is quite rare. Normally, they can be treated with a few minor injections and some monitoring at your clinic. If you expect that your pet is experiencing an allergic reaction, call your clinic or visit an emergency hospital immediately.

Prior to treatment, discuss possible side effects of chemotherapy with your veterinary oncologist. Together, you can proactively formulate an action plan to provide your pet with relief.

Thank you for joining us for our third installment on companion animal cancer. In our next article, we will discuss veterinary radiation oncology and how it can benefit your pet.

¹Clinical Oncology Service, Veterinary Hospital of the University of Pennsylvania (VHUP)

What Happens After Death?

noreply@blogger.com (New England Pet Hospice) — Mon, 27 May 2013 01:57:00 +0000

By Rev. Eliza Blanchard, Interfaith Spiritual Advisor

Sometimes I’m asked what happens to the soul of a pet when it dies. I don’t discriminate between species in life or in death: we all want to know where our best beloveds are, that they are free of pain,that they are safe, happy, loved.

I assure people that their animal companions are loved, that they will always be loved, and that I’m as sure as I am of anything in this world that they are free from all suffering. Where those spirits are, I say, I don’t know. I can’t prove that there is a heaven, an afterlife, or rebirth. Many people believe that life leads to one of those states of being. Some believe that heaven is reserved for humans, while others believe their pet has joined other family members there. And for some, the death of a beloved challenges belief, bringing forth confusion or doubt.

Having doubts is normal, especially when mourning. We wonder why illness exists, why loved ones suffer, or why loved ones die. We may even fight mortality, reject it, or get angry at Whomever made such a world. Often such questions lead us to examine our values, review what’s important, and what commands our devotion. Here is an opportunity to seek out a trusted, friend, clergy, or counselor – someone to listen thoughtfully and reflect with you.

Our struggles can help us renew meaning.

I am sometimes asked what I believe about the souls of animals. I believe that - as physics teaches us - the energy doesn’t disappear. It can live on in and through us, as abiding spirits, as heavenly companions, as stardust, or as new beings born in another country. If you have lost a beloved pet, take the time to imagine where such a vibrant spirit is right now. Where did that vibrancy and affection get channeled? How might it move through the universe? Where might it find a home? How do you stay attuned to it? It is through that connection that our love is everlasting.

Know and cherish is the extra-ordinariness of life and the humility imposed by mortality. Bow to the mystery of existence. I believe in our powers of reason and in the greater understanding that science often leads us to.

Beyond the limits of reason is where
our deepest questions lie.

What I have witnessed many times is that

Love is the Answer.

Rev. Eliza Blanchard serves as Interfaith Spiritual Advisor to New England Pet Hospice & Home Care. An ordained Unitarian-Universalist Minister, Eliza helps those of all faiths as well as those who follow no particular religious tradition find hope, meaning, and peace while caring for and mourning the loss of our beloved animal companions.

What You NEED to Know About Cancer Treatments

noreply@blogger.com (New England Pet Hospice) — Thu, 09 May 2013 01:52:00 +0000

By Michelle Spencer, Veterinary Technician, Oncology Specialist

Welcome to our series on companion animal cancer. In the previous article, we discussed events that typically occur after your pet has been diagnosed with cancer. In this article, we answer some questions about chemotherapy treatments and present tips on how to find the best oncology team for your pet.

Choosing a treatment facility

Veterinary oncology is still a growing field. In some cases, usually due to geographical or financial concerns, your choices may be limited. If you do have the opportunity to choose from more than one treatment facility, ask yourself a few questions:

Is your doctor a board certified Veterinary Oncologist?
How far away is their office? How well does your pet handle the trip? Will you be able to travel there weekly, monthly, etc? Do they have hours that will accommodate your schedule?
Do they offer financial plans, counseling, assistance?
Will your pet remain with you during treatments? Will you drop your pet off for the day for treatment?

Chemotherapy

The word itself makes you cringe. But, remember, the goal of cancer treatment in pets is to control or eradicate cancer cells while preserving a good quality of life. Cancer treatment is fluid and there is room for assessment at each step in the road.

Some cancers normally respond very well to chemotherapy, while others do not. Your veterinary oncologist will be your most reliable source of information on this subject and will guide you through the decision making process.

Chemotherapy typically comes in the form of pills or liquid injectables. Intravenous, intramuscular and subcutaneous injections must be given at your veterinary office by qualified doctors and technicians. Some injections take just minutes, while others are delivered over a period of hours. At some clinics, you may be allowed to stay with your pet if they are receiving a short injection. Intravenous chemotherapy can be dangerous if it leaks outside of a vein, so it is best for your pet to remain calm and still during treatment. If your presence seems to excite your pet, the staff may ask you to wait outside for a bit while the treatment is in progress. In rare instances, some pets may require medication to help them relax during the injection.

If your pet is receiving a treatment that is given over a number of hours, you will be asked to leave them at the facility during that time. Normally, in such cases, there are rules and regulations in place to keep both you and your pet safe during lengthy chemotherapy infusions. For instance, only a qualified staff member can attend to urine, feces and vomit should they occur during an infusion.

Chemotherapy treatments tend to follow a proven protocol or schedule. You should be presented with a schedule prior to treatment. The schedule should also include information about when certain blood tests must be run. While these blood tests normally do not indicate the cancers response, they will provide critical information about how your pet’s organs are handling treatment and alert you to infections.

Some pets may also qualify for a clinical trial. Normally, your veterinarian will present this option to you if they think it may be appropriate for your pet. Occasionally, some companies will provide you with free or discounted medications for participating in their trial.

Speaking with your veterinarian about the common and not so common side effects of chemotherapy and the proper precautions needed when cleaning up after a pet who has recently received a chemotherapy treatment, is a very important step. These issues will be addressed further in an upcoming article.

In our next article, we will discuss common side effects of chemotherapy agents, and the medications used to treat them.

OUCH! That Hurts - Identifying Pain

noreply@blogger.com (New England Pet Hospice) — Fri, 19 Apr 2013 01:51:00 +0000

By Amanda Brown, Certified Veterinary Technician

A newly diagnosed illness can be very traumatic for both the family involved and the animal. Pain management is key in the success of healing and well being for the ill or dying. Often times we are not aware that our beloved pet is in any amount of pain until they begin exhibiting signs of abnormal behaviors or signs of discomfort. Instinctively, animals will disguise pain to avoid becoming prey in the wild, so it is not until the pain has become so severe to the animal that we notice changes in their behavior. You, as the pet owner, are most equipped in determining whether noticeable routines and functioning of the animal are related to pain or social manners.

Pain triggers a series of physiological changes that increase stress. These changes can affect all major body functions and may trigger abnormal body responses. These modifications to normal body function can decrease the body’s immune system and its ability to work effectively. For example, potential side effects of stress in animals include loss of appetite; increased heart rate; delayed wound healing; and/or a sudden onset of infection.

According to the AAHA Pain Management Guidelines for Dogs and Cats these are common signs of pain:

GENERAL SIGNS	SPECIFIC SIGNS
Loss of normal behavior	Decreased appetite, decreased activity, lethargic, decreased grooming (cats)
Expression of abnormal behaviors	Inappropriate elimination, vocalization, aggression, decreased interaction with other pets or family members, altered posture, restlessness, hiding (especially in cats)
Reaction to touch	Increased body tension or flinching, injured area and touch of regions may illicit reaction
Physiologic parameters	Elevations in heart rate, respiratory rate, body temperature, and blood pressure; pupil dilation

No animal should need to prove that they are in pain, which is why we as veterinary professionals have developed what we call a Multimodal approach to pain management. Multimodal Pain Management (MPM) is a tactic that takes advantage of the synergistic affects obtained by combining two or more classes of drugs to alter more than one phase of the pain pathway.

MPM is the best way to approach pain management, and provides comfort not only to the animal, but the pet owner as well. Observation, touch, and knowledge of how pain can be displayed combined with how to defeat pain, will now make dealing with an otherwise disheartening situation easier.

The AAHA Pain Management Guidelines also note the following overlooked causes of pain:

Learning to recognize pain in your pet is one of the most important things you can do for him or her. Pain indicates injury, illness, and decline. Picking up on it early can make a very big difference in your pet's comfort and prognosis.

If you think your pet may be in pain, talk to your vet about options for treating it. Sometimes the only way we can determine if an animal is in pain is to treat for pain and see what happens. You may be surprised! Your couch potato may become more active, your grumpy old man may become more friendly, and that occasional hitch in her giddy-up may lessen or disappear.

Diagnosis Cancer: Now What?

noreply@blogger.com (New England Pet Hospice) — Wed, 03 Apr 2013 05:00:00 +0000

By Michelle Spencer, Veterinary Technician

Welcome to our series on companion animal cancer. In this article, we address what normally happens after your pet has been diagnosed. In future articles, we will address the ins-and-outs of conventional treatments, alternative treatments and palliative care.

A diagnosis of cancer in your pet can be terrifying. But remember, you are not alone. Your veterinary team and New England Pet Hospice & Home Care are here to support you every step of the way.

Step One: Staging

Staging is the act of running a series of medical tests to obtain additional information. Staging allows your veterinarian to see the extent of cancer spread throughout your pet’s body and to assess your pet’s ability to handle certain treatments.

Three types of medical tests are typically run during the staging process:

Imaging: The mode of imaging chosen will depend upon the type and location of the cancer. It may include x-rays, an ultrasound, an MRI or a CT scan. Imaging shows not only the spread of cancer, but also the integrity of internal organs. For instance, while an echocardiogram may not show spread of cancer to the heart, it may show an abnormality in the heart muscle, which may affect the your pet’s tolerance for treatment. In that case, special precautions may need to be taken or another treatment option chosen.

Blood Work/Urinalysis: Typically, a Complete Blood Count (“CBC”), Serum Chemistry and Urinalysis will be run. These tests are not used to diagnose cancer (except certain blood cancers) but provide information about the cancer’s behavior, any infection and how well your pet’s organs are functioning. For instance, while a pet’s liver may look healthy on an ultrasound, an abnormal blood test measuring liver function may reveal an issue.

Additional Cytology (cell investigation): Your veterinarian may need to look at additional cells under the microscope to get more information about your pet’s disease. This may involve a needle aspirate (a quick and simple procedure under local anesthesia), a biopsy or even surgery.

Step Two: Treatment Options

After gathering further information about your pet’s disease, your veterinarian will present you with treatment options.

Some cancers respond very well to conventional treatments, such as chemotherapy and/or radiation therapy, while others simply do not. Your veterinary medical oncologist and veterinary radiation oncologist are the best sources of information about treatment options, but always keep in mind:

1. The goal of cancer treatment in pets is to control or eradicate the cancer cells while preserving a good quality of life. Your veterinary oncologist relies on you to assess your pet’s daily quality of life at home and communicate that information often. Remember, quality of life is the driving force behind veterinary oncology, and you are your pet’s voice.

2. You and your pet are not trapped. Cancer treatment is fluid and there is room for assessment at each step in the road. If, for instance, you begin treatment and your pet experiences side effects, you, along with your veterinarian, may decide that you will no longer use that type of medicine or even that you no longer wish to proceed with that form of treatment. On the flip side, you may cautiously begin treatment and, after seeing a positive reaction, decide that it’s appropriate for your pet to continue or pursue more aggressive treatment. Remember, you always have choices.

Making decisions about whether and what type of treatment to pursue can seem overwhelming. In the next issue of Wag & Purr, we will talk about how to make decisions in times of crisis and confusion that will feel right to you both in the moment and when you look back on them.

Michelle Spencer is a Veterinary Technician with New England Pet Hospice & Home Care. Michelle has been a Veterinary Technician for 12 years, much of it devoted to the field of oncology, including more than five years at New England Veterinary Oncology Group as a Medical Oncology Technician, at Dana-Farber Cancer Institute as a Clinical Research Coordinator, and more than 5 years at Massachusetts Veterinary Referral Hospital as a Critical Care Technician.

WANT TO USE THIS ARTICLE IN YOUR EZINE OR WEB SITE? You can, as long as you include this complete blurb with it: “New England Pet Hospice & Home Care supports those caring for ill, elderly and special needs animals at home following the human hospice and palliative care models of interdisciplinary care. Learn more and get your FREE subscription to Wag & Purr: Your Guide to Comfort Care for Pets at www.NewEnglandPetHospice.com"

The Rainbow Bridge and a Glass of Water

noreply@blogger.com (New England Pet Hospice) — Thu, 14 Feb 2013 02:29:00 +0000

Two days ago, I was on a pet loss bulletin board and someone posed this dilemma:

“Here’s the problem I have with the whole Rainbow Bridge thing – what if my husband dies first? Does my dog go with him to heaven? So when I get there, no one I waiting for me? Or does he wait for me to get there and my husband has to be without him until I get there? And what about my childhood dog? Is he with my parents – or waiting for me and my sister?”

[If you have no idea what the Rainbow Bridge is, the thumbnail sketch: some believe, literally or figuratively, when an animal passes, it waits in a big field by a rainbow bridge for its human to pass away. When the human dies, human and animal are reunited in this “pre-heaven” and cross the rainbow bridge to the afterlife together. It’s a lovely poem by an unknown author that can be read in its entirety here.]

I have been thinking about this person’s comment (and the many similar ones that were posted as follow up messages) ever since.

I think of it this way: our bodies and those of our animals are merely containers for our essence/soul/spirit/energy/love/whatever you want to call it. Like water in a glass, when we are stuck in the container, we can only be in one place at a time and only in one very rigid form.

But release the water from the glass and what happens? It transforms. It is still the same water, but can be many places at once. It can be many different forms, from tiny droplets to giant puddles. It flows, separates and reconnects. It is here, but also there. It is many things while still being the same thing. And I believe the same is true of our spirit when it is released from the confinements of our physical body.

So if you ask me, do I personally think you will be reunited with your beloved animals when you pass from this life? I will say yes. They are waiting for you – and also for every one else who touched their life and whose life they touched. They will go with you and they will wait for the others - at the very same time. They don’t have to choose and no one has to make that journey alone.

At least, that’s what I think. There are many ideas about what, if anything, comes next and the truth is, none of us really knows. It’s not about finding the one Truth, but about finding our own truth.

What do you think?

Just Do It (without Regret)!

noreply@blogger.com (New England Pet Hospice) — Sat, 02 Feb 2013 13:08:00 +0000

I have often heard and repeated the saying, "You never regret the things you do, only the things you don't." I believe it with my whole heart.

But every belief is tested - usually more than once.

For me, this happened a few years ago
with a woman who was more than an acquaintance but not quite a close personal friend. You know what I mean - you care for the person and always get along beautifully, but you probably wouldn't invite her to your wedding and you wouldn't call her if you were diagnosed with a terminal illness.

Well, her father died tragically and unexpectedly in a car accident at a too young age. I was heart broken for her, and following the wisdom of the quote, went to the funeral. We hadn't seen each other in years. I had known her father a bit and held him in very high regard but we weren't close.

After the graveside service, I caught the friend's eye and went over to greet her, giving her a big hug.

And burst into tears.

As you might imagine, I see a lot of death in this work - human and animal - and I don't usually burst into tears. I am used to being the strong one for the person in need.

I was mortified.

But then, something even worse, I blurted out, "I'm so sorry; I loved him, too."

The moment it was out of my mouth, I regretted it. Who the heck was I to say such a thing? True, I did genuinely care for the man, as he was one of those truly special people who exuded warmth, grace and a genuine heart. I really did love him, even though I hadn't known him that well, but I felt like an idiot and wondered what she would think of me saying such an intimate thing. How could I, an almost stranger, dare to suggest that I was anywhere near as affected by his death as she was? How dare I refer to my own pain in her time of loss?

I promised to visit during Shiva. I didn't.

I promised to stay in touch. I didn't.

I was completely shamed by my actions at the funeral and my failure to do the right thing afterwards, feeling they were selfish, self-absorbed and utterly out of proportion to what I should have been feeling and what I should have said to comfort my friend in her time of grief and enormous loss. Honestly, I couldn't face her and wished I could have a do-over, so I could say the right thing and be the friend I should have been.

Fast forward 6 years when I reconnect with the friend over a walk in the woods with our dogs. We walk and talk and guess what she says?

"You know my father's whole funeral was a blur to me. I remember almost nothing about it, but I remember you being there. For some reason, I picked you out of the crowd and seeing you there meant so much to me. I don't really remember the words that were said at the service or who all came, but I remember hugging you, sharing tears and being touched by what you said. Knowing how many people loved my Dad, from the woman at the checkout line right on down, was huge. I cannot thank you enough for being there."

The moral of the story?

You never know who you will affect or how you will affect them. All you can do is show up, be genuine and follow your heart.

Trust that your heart will lead you to the right place and the right thing, even when your brain tells you otherwise.

Skiing on the Grass

noreply@blogger.com (New England Pet Hospice) — Fri, 18 Jan 2013 16:51:00 +0000

I'm guessing if you saw conditions like this when you arrived at a field to cross-country ski, you would hang up your skis and walk instead.

But not me. Oh no. Over my life, I have routinely been called stubborn, dogged and even occasionally STUPID (though I prefer "determined" and "persistent", don't you?). These qualities - or flaws as some might call them - have lead me many places I never would have reached without them (a hospice for pets?? what are you crazy?) and some others we don't need to mention here. Those of you who know me won't be at all surprised to know that I insisted on skiing today anyway.

For those of you who aren't likely to take these chances, I offer

The Top 5 Lessons I Learned Skiing on Grass

1. Not all gifts are in the sunshine. It's easy to think the best things will be found in the light, but sometimes what you are really seeking is found only in the shadows where it waits for you, protected, perfect, and undisturbed.

2. No matter what your religious or spiritual beliefs, there is one universal truth: your iPod has magical powers and insight. For example, when it randomly plays the theme song to Rocky just as you are at the base of an icy cliff you must scale and reaches the climax of the song right when you reach the summit. Yup, I swear it happened just like that (ok, maybe a hill, not a cliff but I sure felt like Rocky at the top of the stairs when I conquered it!).

Or "Carry On" plays just as you reach this lovely place on the trail:

Carry on, carry on!

Fill your iPod with songs you love (even the ones you are embarrassed to admit you do) and put it on shuffle. You'll see what I mean.

And fill your life with experiences, people and things that speak to you, then let go of control. I bet you will find that the right thing will happen, in just the right way and at just the right time.

3. Everyone should have the Rocky theme song on their iPod. Everyone.

4. You will fall 100% of the time you lean backwards and try to choose what feels safe over taking a chance.

Bend your knees, lean into the the uncertain future, take a risk. That's where the whooo-hooos are.

5. Everything - every perfect stretch of effortless gliding and every slug through the mud - is better with a friend. Especially if that friend is a dog.

Quote for the Day: The World is Speaking to Us

noreply@blogger.com (New England Pet Hospice) — Wed, 16 Jan 2013 13:19:00 +0000

the whole world is speaking to us. We need only be quiet for a moment and listen. The vast community of the universe will support and guide us if only we will respond graciously to its affectionate concern.

~ Thomas Berry

Lessons from Hospice: Nurture the Soul

noreply@blogger.com (New England Pet Hospice) — Thu, 27 Dec 2012 14:47:00 +0000

Our work at New England Pet Hospice teaches us something new every day. I consider open-mindedness and open-heartedness the most critical character traits for all of our staff members, no matter what role they play in the organization.

This work and what it teaches us is a gift; we must be open to receive it, open to learn from it, and open to share it.

The events at Sandy Hook are a tragedy in every sense of the word which has touched the hearts and minds of all of us. Like you, I have received so many e-mails from people who have a "spin" to put on it - whether it is gun control, care for the mentally ill, more funding, less funding, increased security, better preparedness, on and on.

I understand the human need to make meaning, especially in the face of extreme tragedy - it's a huge part of what we do at New England Pet Hospice - and I know that many of these issues need to be raised and addressed, but (probably like you) I find myself irritated that people would use the tragedy as a way to promote an agenda.

Just before Christmas, I got an e-mail that was a little different. It was a quote from the father of a Columbine victim's father, pleading with Congress to reinstate school prayer and religion in the classroom to combat the violence in our schools and society. This isn't my personal view, so I read it and deleted it.

A few days later, I got my copy of the Clinician's Brief - a peer-reviewed journal for veterinarians by the North American Veterinary Conference. It contained "A Case Study in Hospice Care" that left me fuming. The "hospice" care provided was medication, two home check ups by the vet and home euthanasia. Over the course of a year, the dog saw the "hospice" vet exactly 3 times. The owners took the dog to the emergency clinic twice for seizures and an acute cough. No other care was provided.

(The care that was provided to that darling dog and his family was not hospice in any sense of the word. I ask our vet friends out there to read the article and tell me if anything this so-called hospice vet did is any different than what they do every day for every patient. It was simply mobile veterinary care.)

So what do a plea for school prayer and a mislabeled case study have to do with each other?

The very most important thing we do at New England Pet Hospice: Nurturing the Soul

The plea for school prayer highlights what is missing in our school system and in our culture - any attention to the soul, the heart, the nature of the child and the individual. We educate about math, science, reading, and writing. We teach home economics, art, music, and anti-bullying.

But where - and when - do we teach our children and ourselves to look into our own heart? To find what grows there and nurture it? To love, trust and respect ourselves? To take the quiet time we all need to connect deeply with our innermost wisdom and yearnings?

What is lacking in a culture that values things over love? Doing over being? Intellect over caring? The biggest and flashiest over the most important?

What is missing in a hospice model that provides medication, information and treatment? That visits once every three months? That waits for the call , makes appointments when convenient and expects euthanasia to be the outcome for every animal?

It's all about the SOUL

We don't take time to nurture it.

We lack an appreciation for how much it matters.

We miss out on the heart and meaning of it all.

Time and again, the families we serve at New England Pet Hospice tell us what we bring that matters most is care, compassion and time. We take the time to get to know their animal and their family as individuals. It's not the amount of time they have with their animal, it's not even about how good that time was, and it's most definitely not about how the animal dies.

It's about how we connected deeply with their animal and with them. Soul to soul. Heart to heart. With respect and with genuine love. And how we supported them in doing the same.

This is the key to hospice and palliative care. It is, hands-down, the very most important thing we do at New England Pet Hospice.

And I have no doubt our culture, our world, and our lives would change dramatically if we all brought this gift into everything we do, every day.

Nurture your soul. It matters. Really.

Quote for the Day

noreply@blogger.com (New England Pet Hospice) — Mon, 24 Dec 2012 12:45:00 +0000

Christmas gift suggestions:

To your enemy, forgiveness.

To an opponent, tolerance.

To a friend, your heart.

To a customer, service.

To all, charity.

To every child, a good example.

To yourself, respect.

~Oren Arnold

Quote for the Day

noreply@blogger.com (New England Pet Hospice) — Sun, 02 Dec 2012 18:33:00 +0000

“The most beautiful people we have known are those who have known defeat, known suffering, known struggle, known loss, and have found their way out of the depths. These persons have an appreciation, a sensitivity, and an understanding of life that fills them with compassion, gentleness, and a deep loving concern. Beautiful people do not just happen.”

~ Elisabeth Kübler-Ross

Quote for the Day

noreply@blogger.com (New England Pet Hospice) — Wed, 28 Nov 2012 11:00:00 +0000

"I would much rather have regrets about not doing what people said, than regretting not doing what my heart led me to and wondering what life had been like if I’d just been myself."

~ Brittany Renée

Elderly and Special Needs - You Call that Hospice?

noreply@blogger.com (New England Pet Hospice) — Sun, 25 Nov 2012 14:11:00 +0000

At New England Pet Hospice, we care for elderly and special needs animals as well as those who have a terminal diagnosis. This is one of the few areas we differ from the human hospice model. In human hospice, the patient must be diagnosed with a terminal illness with less than 6 months to live (some hospices accept patients with a 12 month prognosis).

Why the different standard?

Because of euthanasia. It is widely accepted that the vast majority of pets in our country will be put to sleep (except for those who die of traumatic injury). This has a direct impact on our elderly and special needs animals in many ways, but especially in three ways:

1. Quality of Life. The Quality of Life scales used to judge when a terminally ill animal is ready for euthanasia are equally applied to our animals who are elderly or have special needs. And all of our elderly and special needs animals will "fail" that test at some point (or points) in their life, almost always within a year and often within a few months. While some families may have the knowledge and muster the strength to carry on without support, many - or perhaps even most - will not.

2. Practical Care. At the practical level, if the family cannot or does not feel they can provide the proper care for the elderly or special needs animal, the animal will likely be euthanized. There are key junctures when attentive, in-home support can be critical to preserving the animal's well-being. Often this arises if the animal faces mobility issues, develops incontinence, or has eating or drinking difficulties. The family may solve mobility issues with a wheelchair, for example, but when the animal is leaking urine and defecating around the house, it may be (or seem like) too much to manage.

As a hospice, we manage mobility, incontinence, and nutrition issues every day. We know the tips, tricks and equipment that can turn an overwhelming situation into a manageable one. Euthanizing an animal due to practical care concerns may end the animal's life prematurely and is brutal on the family who are often overwhelmed by feelings of guilt, regret and incompetence. Learning after the animal passes that if only they had known about x, y or z, their animal may have been able to live longer only exacerbates these feelings.

There are certainly times when practical care simply is impossible, but it is not often and even then at least with hospice care the family and animal know we have exhausted all possible options and there are professional caretakers to assure the family that they did all they could.

3. Societal Pressure. "Granny really is showing her age. She's had a good life, don't you think it is time to let her go? Why are you being so selfish to force her to keep living?"

As a society, our attitude toward our elder citizens is not good, but even so, there isn't societal pressure to end a life when the person reaches their senior years. The fact that Massachusetts recently failed to pass the Right to Die Act underscores this.

But it's OK, and in fact the norm, that when an animal gets older, our society tells the pet parent it is their moral obligation to euthanize the animal.

Similarly, we don't treat our human citizens with special needs very well in our culture, but we also don't assume that their life isn't worth living as we do with animals. Famous advocates like Helen Keller, Christopher Reeve, Matthew Sanford, Marla Runyan, Michael J. Fox, and Stephen Hawking to name a (very) few show us how little disability matters. According to the 2000 census, 19% of Americans over the age of 5 have a disability -- that's equal to 49.7 million people or 1 in 5 Americans -- and half of these have a severe disability. These individuals make important, significant and valuable contributions to our society. Can we imagine that our special needs animals do also?

We are in awe of the technology that allows amputees to run like the wind, computerized exo-skeletons that promise new mobility for those who are paralyzed and cochlear implants that allow the deaf to hear. Yet we are stunned and incredulous when we see a dog in a very low tech but life changing wheelchair. We question whether it is a waste of money, fair to the animal, and an owner "going overboard."

The clear message from those around us is that our elderly and special needs animals deserve to die, are not worthy of our time and resources and serve only our own selfish needs.

Nothing could be further from the truth but from the perspective of those around us, even those closest to us, our elderly or special needs animal may as well have a brutal and aggressive form of cancer. The pressure to euthanize is often at the same level.

In a recent survey of New England Pet Hospice clients who had an animal pass in the last two years, we heard over an over again that clients were so relieved to hear us say they weren't crazy for not wanting to euthanize their animal immediately and that the additional time they had with their animal (whether the animal ultimately died naturally or by euthanasia) was a gift they will always treasure.

We love your animal for who they are and wherever they are on their unique journey in this world. And until aging and special needs are no longer imminently terminal conditions for our beloved animals, we at New England Pet Hospice will care for them lovingly.

But What if I DON'T Feel Thankful?

noreply@blogger.com (New England Pet Hospice) — Thu, 22 Nov 2012 05:26:00 +0000

Thanksgiving marks the beginning of the Holiday Season that can be devastatingly hard for those who are struggling with loss. And Thanksgiving itself might be the worst holiday of all of them. Not only are you required to be happy, but also to be thankful. If you have lost an animal recently, those around you may expect you to be especially thankful for the time you shared with your beloved companion.

But here's the truth: it is perfectly normal to have a hard time mustering thankfulness when you are caring for an ill animal or mourning.

The expectation that you must be thankful too often causes people to feel shame and guilt.

Your animal is the love of your life and a hugely important to you. It is easy to start wondering, "What is wrong with me that I'm not thankful for the time I had with such a special creature? Am I so self-consumed and ungrateful that on this, the day set aside for such things, I can't feel thankful for the wonderful gift of my beloved animal?"

Sometimes the pressure and guilt is too much and you are shamed into feigning thankfulness, even though you can't actually feel it. You don't feel like you can admit your true feelings to those around you. And you end up feeling alone and isolated.

Consider this post your Get-Out-of-Thanksgiving-Jail-Free Card! We know you love and cherish your animal. We know you are grateful for your time together. And we also know that sadness over your animal's illness or loss may eclipse feelings of thankfulness. Time and distance will ultimately give you the perspective to feel thankful genuinely, and it's OK if it is not today. There is nothing wrong with you - or even unusual.

Unfortunately, the same time that will help you feel genuine gratitude, also causes people to forget their own great anguish after loss and how they actually felt. Time dulls the hurt - for better and for worse. The fact that those around you don't remember feeling this way, doesn't mean that they didn't.

You are not alone.

There is nothing wrong with you.

You are grieving. You deserve compassion, not judgment; love, not shame; understanding, not doubt. Seek out those who will put their arms around you no matter what, who may not understand, but won't shame you into feeling something you don't because of the date on the calendar.

Enjoy the turkey, the pies, a nap and a day of rest. Those things will help you heal. Give yourself permission to leave the thankfulness for another day.

Homecooking Made Easy!

noreply@blogger.com (New England Pet Hospice) — Sun, 30 Sep 2012 13:37:00 +0000

     Animals are resilient. They survive on many kinds on diets, but they thrive best on a species-appropriate diet filled with fresh, quality ingredients. We notice a huge difference in health, vitality and energy when animals are fed a good diet. Many of us at New England Pet Hospice feed our own animals home cooked food.

      It is natural to assume this is expensive, time consuming and more hassle than it is worth - I did too when I heard about it, but now I am a convert! Home cooking will be more expensive than kibble, but less expensive than premium canned food. It is very, important, however that home cooked is prepared carefully and in proper balance. We see too many dogs fed meat only or unsupplemented meals that can cause problems in the long run. Often problems related to nutritional deficiencies develop over time, so it is easy to miss problems in the diet.

      There are many excellent books and resources available on homecooked diets, but in the end, they essentially boil down to the same recipe - which is simple and affordable.

Click here to read more and get the recipe

Quote for the Day

noreply@blogger.com (New England Pet Hospice) — Sat, 29 Sep 2012 22:54:00 +0000

All that is harmony for you, my Universe, is in harmony with me as well. Nothing that comes at the right time for you is too early or too late for me. Everything is fruit to me that your seasons bring, Nature. All things come of you, have their being in you, and return to you.

~ Marcus Aurelius Antoninus

Quote for the Day

noreply@blogger.com (New England Pet Hospice) — Tue, 25 Sep 2012 11:42:00 +0000

A man is ethical only when life, as such, is sacred to him, that of plants and animals as that of his fellow men, and when he devotes himself helpfully to all life that is in need of help.

~ Albert Schweitzer

If You Could See What I See

noreply@blogger.com (New England Pet Hospice) — Sun, 01 Jul 2012 06:10:00 +0000

When I conceived of New England Pet Hospice so many years ago, I envisioned a company in which people with huge hearts and committed souls found a meaningful way to be of service to both animals and people. A place where hard work was also heart work. Where being sensitive, passionate, and vulnerable were valued and important traits. Where teamwork, camaraderie, and love would be the driving forces in all we do.

I am incredibly proud and humbled to say much of this has come true - for better and for worse. Never in a million years could I have imagined the huge impact we would have on the families who so graciously allow us into their lives and into their homes in heartbreaking times. Nor could I have ever envisioned the incredible group of people who would be drawn to do this work with me. Their knowledge, skills, passion, courage, conviction and compassion routinely amaze and impress me.

     But with success and growth comes those few people who wish us to be something we are not, want more than we have to offer, or who need someone to blame for something that is outside of our control.

     It breaks my heart when this happens, because if you could see what I see:

     You would see smart, talented, accomplished professionals sacrificing personally and professionally for the opportunity to be of service.

     You would see the purest form of love and giving.

     You would see a determination to be better every day in everything we do.

     You would see hundreds of hours of training, education, and sharing.

     You would see late nights and early mornings, holiday crises, and weekend scrambling.

     You would see risk, responsibility, vulnerability and humility.

     You would see an organization determined to remain open and emotionally attached, refusing to become jaded or cynical, fueled by hope and the belief that we can do something important and lasting, that we have the capacity to make a difference.

     This company and all those involved in making it thrive and grow, develop in ways that simply astound me. I know that something bigger than any of us brought us together and set us on this path. And I for one can't wait to see where it takes us tomorrow, next year and many years into the future!

Quote for the Day

noreply@blogger.com (New England Pet Hospice) — Thu, 31 May 2012 11:53:00 +0000

Today, just today, entertain the notion that it's not all up to you. Creating comfort is your practice. Choosing the magic of uncertainty is your human obligation. Make a space for your hopeful soul today by honoring your body. Allow in the goodness of truly believing that there's nothing to say, nothing to do, but to wait for what you absolutely know deep down is your next move.

~ Jen Lemen

Hopeful World

Quote for the Day

noreply@blogger.com (New England Pet Hospice) — Tue, 17 Apr 2012 11:18:00 +0000

In honor of Lucy and with much love for Dolly:

The creation of a thousand forests is in one acorn.

~ Ralph Waldo Emerson

Death is Not a Dirty Word

noreply@blogger.com (New England Pet Hospice) — Sun, 04 Mar 2012 12:38:00 +0000

     For as long as we have records, people have been afraid of dying – partly because we didn’t have good pain strategies and partly because many feared the unknown or their own beliefs about what comes after death.

     But it has only been in the last 100 years that the dying process itself has become so foreign and invisible to us that the unknown about the dying process causes us so much fear and anxiety.

     Less than 100 years ago 80% of all people died in their own homes, the average life expectancy was 50 years and the infant mortality rate was 24 times higher than today: more than 16% of children died before their first birthday. People may not have liked it, but they were very familiar with death and the dying process. Parents knew the anguish of losing a child; children witnessed the decline and death not only of grandparents, but also of siblings and parents; and the primary caretakers through illness and death were close family members in the home.

     Today, almost 70% of people die in institutions (hospitals and nursing homes) and the average life expectancy is close to 80 years. We do not witness or participate in the dying process often in our lifetimes.

     Dying has become a mystery to us and the rituals we once had of washing the body, preparing for burial and the burial itself have been transferred into the hands of strangers.

     In addition, medicine has come so far that we expect it to prevent death, stop the aging process and keep us eternally happy, healthy, comfortable and young. Aging and death are seen as failures of the medical community and our own will.

     Death has become a dirty word.

     We are awkward around the dying and bereaved. We don’t know what to do or say. We avoid witnessing dying and prefer that others do not discuss it.

     But we are making a big mistake.

     Death comes to all of us and everyone we know and love at some point. Our ostrich approach to dying benefits no one, least of all ourselves and our children.

     Those who have witnessed the peaceful death of a loved one – human or animal – are universally transformed in any number of ways, almost always in a positive way. Most feel a deeper and stronger connection to the one who has passed, a reduction in anxiety about dying ourselves, an appreciation of the beauty and gift that is our own lives and the lives of those we love, and a peace within.

     There are times when it is not possible to care for your loved ones at home, and some occasions where there is a need to be in a hospital, but there are many times when there is a choice whether to care for our own at home, allow others to care for them somewhere else, or hide from death altogether by ignoring the situation. In the animal world, we are also often faced with the choice of euthanasia.

    Not every situation allows for hospice-assisted natural death at home, but if the opportunity were there, would you have the courage to try? Would you be able to overcome your fear of death and isolation from the dying process to take that leap of faith? Could you trust yourself, your knowledge, your skills, your instincts, and most of all your compassion enough to be that loving family caretaker?

     We think you can. We believe in you. And we know, no matter what comes, you will never regret trying.

     Death is not a dirty word. Take that leap of faith.

Quote for the Day

noreply@blogger.com (New England Pet Hospice) — Sat, 18 Feb 2012 02:13:00 +0000

FreePhotos.net

When a person is born, we rejoice

and when they're getting married, we jubilate,

but when they die, we try to pretend nothing has happened.

~ Margaret Mead

Quote for the Day

noreply@blogger.com (New England Pet Hospice) — Fri, 10 Feb 2012 04:45:00 +0000

Photo Courtesy of Shawn Dovey

Listen to your heart.

It knows everything.

~ Paulo Coelho