Senior dog sleeping

After several years in general practice, Dr. Mary Craig, DVM, found herself drawn to an area of veterinary work that requires an especially sensitive touch: at-home pet hospice care and euthanasia.

While most vets usually focus on cures, Dr. Craig saw a need for end-of-life care, when a pet can’t recover but still needs help in the comfort of their home — and the family needs some support too.

In 2011, she founded Gentle Goodbye Veterinary Hospice & At-Home Euthanasia. Through her Connecticut-based practice, Dr. Craig pays house calls to evaluate each pet as well as helps owners recognize the signs of discomfort or distress. If a pet needs to be put down, she works with the family to plan a familiar, loving environment for the procedure.

It’s an issue that many pet owners struggle to face. However, Dr. Craig explains, treating a pet at home can be the most compassionate choice. “Euthanizing a pet is one of the hardest decisions we make, but I also feel it is the kindest gift we can give them,” she says. “In fact, as their caretakers, their well-being is our moral obligation. I’ve come to feel that at-home euthanasia is a better option for nearly every pet and their people.”

Vetstreet talked to Dr. Craig about how her practice helps pets, vets and, most important, families.

Q. What inspired you to found Gentle Goodbye?

A. Dr. Mary Craig: “When I was in general practice, I always felt [putting a pet down in a veterinary office] was a difficult way to lose a pet. The last activity a pet lover did with their pet was a stressful, anxious drive to the vet. Saying goodbye at home, in a familiar place, at the right time, with the right people around, allows everybody to be less traumatized. My hope is that a gentle goodbye allows people to heal faster and get another pet sooner!”

Q. Did you have any personal experiences that prompted you to devote your practice to end-of-life care?

A. “A number of realizations helped me to this calling. I had many pets in my life that died — some in the vet’s office, some naturally. I know I waited too long in some cases because I dreaded that trip, and my pets suffered for it. I recognized a need for veterinary care in that end-of-life stage. Providing nonjudgmental care, and reinforcing education around signs of pain, can make a huge difference in quality of life for the pet and the relationship between pet and person.”

Q. What’s involved in pet hospice care?

A. “Veterinary hospice care, like human hospice, is as much about those left behind as it is for the patient. [For the pet, it includes] pain management, sometime appetite and hydration support, and environmental changes to help mobility and hygiene.

Hospice also [involves] conversations with the family about what the pet is going through, what the signs of pain look like and what I believe it feels like for pets to experience dehydration, nausea, immobility and chronic or acute pain. [We also discuss] the emotional impact on pets when they can’t participate in family activities or exercise longstanding housetraining habits. All of this can help people get to a point where they are OK with the decision to let go.”

Q. What are the benefits for keeping end-of-life care at home?

A. “The major benefit is less stress for the pets and the people. I always begin [with sedating the pets]: a small injection, like a vaccine, and over five to 10 minutes they drift off to sleep in the arms of their people. The last thing [the pet is] aware of is love, surrounded by familiar smells, sights and sounds. I let the family set the pace, so if they want to embrace, cry or tell stories, it’s the perfect time.”


Q. How do you and the owners know when “it’s time”?

A. “The human–animal bond is an amazing conduit for understanding. Clearly, there is a point when it is too soon, and at the other end, there is a point when it’s cruel not to provide relief. But there is a period of time in between where it is subjective, and the people who know that pet best know when that time arrives, especially if they’ve been educated about what quality-of-life indicators look like. In many cases, after I evaluate the animal, I can tell the client, ‘He’s ready, but he loves you so much that he wants to wait until you are.’ The bottom line is that the right time is different for everyone.”

Q. What have you learned about the grieving process when it comes to pets?

A. “Many people tell me that they feel guilt and grief that is more profound than they felt with the loss of a human friend. It is a loss of unconditional love that doesn’t have much of the baggage and complexities of other relationships. The other difficulty [to acknowledge] is that society is less understanding of our mourning over a pet. We don’t get to take a week off when our pet dies; we have to straighten up and act normal, and that makes healing through the normal grieving process that much harder.”

Q. Do you sometimes find the work emotionally difficult too?

A. “Although the situations I enter are invariably very sad, I find my work incredibly gratifying. I am providing compassionate support and important professional services at a delicate time, and people are so grateful for the services I provide. While I am very much emotionally available for clients, I am careful not to let it eat me up. It was actually more difficult when I was in general practice because I knew the client well, I had watched the pet grow, and, in some cases, we were euthanizing because I wasn’t able to be successful. That was emotionally difficult for me and the staff.”

Q. Have you seen a growing acceptance of at-home euthanasia, both amid the public and the veterinary community?

A. “As Dr. Marty Becker says, ‘Pets have gone from the barnyard to the bedroom.’ As they become more a part of our lives, we expect the same level of care we would want. If hospice and dying at home is the compassionate choice for our family members, why not our pets? Veterinarians with a focus on end-of-life care have helped move the discussion forward. We are taking steps as a profession to develop a standard of care for the end of life, and part of that is supporting pet owners in making difficult decisions.”

Q. What are your future goals for Gentle Goodbye?

A. “I’d like to be able to add other veterinarians and offer more services. There’s also the evolution of getting the word out. There’s a huge barrier in getting people to think about it, but they should think ahead. The gentleness is about the goodbye — and the journey up to it.”