Pet loss and support

Grief is not only experienced with the death of a loved one, but is also experienced in the events that lead up to the death, including the actual illness itself.  The Animal Cancer & Imaging Center is a bond-centered practice that focuses on the strength and importance of the human-animal bond.  When that bond becomes fragile or broken through illness or death, a whole host of manifestations of loss and grief can be overwhelming.  

As my mentor Dr. Steve Withrow (Colorado State University) wrote, veterinarians are not and should not consider themselves qualified psychologists, psychiatrists, social workers or grief counselors.  My hope is to provide general information and give references for resources that can help you through the illness or death of a beloved pet.  This website should not be used as a sole resource for grief recovery.   Our doctors and staff care about what you are going through and are always here to help in any way we can.

I was very fortunate to have done my oncology residency training at Colorado State University where a major focus of the oncology practice was with the human-animal bond.   My training at CSU gave me the foundation upon which I have practiced oncology and much of the information referenced in this section of our website is from Colorado State University’s Argus Institute for Families and Veterinary Medicine and the Changes program.   I was extremely lucky to have worked with the founding members of this program at it’s inception.  Always remember, you’re not in this alone.
                                                                                                                                -Dr. Joyce Obradovich

“Those who do not know how to weep with their whole heart don’t know how to laugh either” …Golda Meir

When it's time to say good-bye

From the Colorado State University Animal Cancer Center website.

There is no time more difficult than the last days of a pet’s life.  Regardless of how much time you’ve had to prepare, the decision to euthanize your friend will not be easy.  Throughout the life of your pet, you have been concerned about his/her quality of life.  But at this moment, quality and dignity of life become immediate.  It is important that your concerns are honored at this time and that you are allowed ample information to make all of the decisions that are ahead.  Your entire veterinary health care team will assist you during this time by providing information as well as a concerned, understanding ear.  It is important to remember that you have options available to you.  Options may include hospice care, assisted by your veterinary health care team, to reduce pain and suffering until natural death occurs.  

Euthanasia is the medical procedure of alleviating pain and suffering by administering drugs in the vein to stop the heart permanently, and allow a quiet, painless death.  Every veterinary health care team performs euthanasia a little differently.  However, it is important to remember that you are the ultimate decision maker.  Even at this critical time, you have control.  You have the right to select options for these final steps in the care of your pet.

Perhaps the most often asked question is, “How will I know it is time?.”  Deciding the actual time is very personal. It is important to remember that there is no incorrect decision, there is only a decision that is right for you.  There are many issues to take into consideration.  They include your pet’s quality of life, the kind of continued care necessary, the time you must invest for continued care, and the kind of life you want your pet to live.  Quality of life is a subjective assessment, but it can be judged in part by accounting for things such as appetite, activity and energy level, grooming habits, and attention to daily rituals.  One such daily ritual might include not sleeping in a favorite place.  It may be helpful to keep some sort of written record of your pet’s “lifestyle”.  In that record, you may ask yourself questions like:“Do the bad days and times out-number the good?”“Is my pet able to do the things that make him/her happy?”“How does my pet’s day differ now, compared to days before he/she was sick?”

In preparation for your pet’s death, you may want to consider the following:You may wish to spend some special time, doing some of those special things that have held meaning to you during the lifetime of your pet.  This may be as simple as allowing your pet to bask in the sun in a favorite place, or on your lap as you read the paper. Many studies have shown that excluding children or making up stories (e.g. “Fluffy ran away”) may be destructive in the long run.  It is important that children not be “sheltered” from this decision-making process. It is also important for parents to appreciate a child’s ability to comprehend the concept of death. (See section on Children and Pet Loss).You may wish to take pictures, clip a small piece of hair, or make paw imprints on paper or in clay as a lasting memorial.

EUthanasia

by Sally Walshaw and Joyce Obradovich

Once the decision is made to euthanize a pet, it is important that you know what is involved in the procedure so that you can be prepared for what is about to happen and feel confident that all of your wishes are being fulfilled.

At Animal Cancer & Imaging Center, we try to make the procedure as comfortable as possible for you and your pet under the circumstances.   Taking away the unknown through knowledge of the procedure helps you fully focus your attention on your pet.  If your pet is euthanized at another hospital, our hope is that this information will help you know what questions to ask and know about things that you have a right to ask for.    

It is vitally important that your concerns and wishes are honored at this time.  Dr. Sally Walshaw was the founding member of the grief support program at Michigan State University and has helped us put together a list of things to remember or consider when faced with euthanasia. Bring another member of the family or a friend so that you don’t have to drive home alone. The veterinarian performing the euthanasia should inform you of the exact procedure and what steps they take to insure the comfort of your pet.  It is customary for veterinarians to request your signature on a document giving them permission to perform the procedure. 

Make any decisions regarding arrangements such as burial or cremation before the procedure is done.  At times, it may be desirable to perform necropsies on pets that have died.  Necropsies (post-mortem examinations) are never performed or considered without your permission.  In patients euthanized without a definitive diagnosis, learning what happened through a necropsy can give comfort in knowing that the euthanasia decision was the correct one and helps make it easier to accept.  The knowledge that information gained may ultimately help another pet or human with the same disease gives great comfort for many pet owners. 

The euthanasia should be performed in a quiet room separate from the hospital activity.  In nicer weather, the euthanasia can even be performed outdoors if you request. You should be allowed to spend as much time as you need in order to say good-bye before the procedure is performed.  Euthanasia, unless under a dire acute emergency, should be performed in a way that you do not feel rushed. You have the right to be with your pet when the euthanasia injection is given.  Most pet owners prefer to be with their pets at this time, but some are not able.  This is a personal decision, but we do encourage you to remain with your pet.  

Pet owners will often have guilt associated with feelings of abandonment that can last for years(Lagoni, et al. The Human-Animal Bond and Grief). It is OK to talk to your animal during the procedure.  Don’t be embarrassed or think that others will think it strange.  These are the last few moments of your pet’s life and he/she deserves to hear your voice for comfort and knowing that your voice was the last heard will give you comfort as well.

Understand the medication protocol that your veterinarian uses and ask questions.  It is usually easier on the pet to receive some form of sedation prior to the actual injection.   Most people don’t realize that the euthanasia injection, typically an over dosage of a barbiturate like drug, works very quickly, in a matter of seconds. Humane death by euthanasia is painless and peaceful.  However, your pet may urinate, defecate, twitch, or even sigh a bit.  These are natural occurrences and your pet will not be aware of any of this and will not feel any kind of pain. 

You should be allowed to spend as much time as you need with your pet following his/her death.   Without viewing a body, it is often difficult to accept the reality of the loss or allow the grieving process to begin. Remember that you do not get over grief, you integrate it.  You are changed forever.  You do not return to an old normal, but to a new normal.  Grief is painful.  However, experiencing grief after a significant loss is essential to the ultimate quality of one’s life.

Helping children understand death in pets
...special relationships begin very early in life. 

“Myths about loss and grief exist in our culture, and we, as a society, abide by these myths.  Some of the most damaging myths involve children.  For example, many people believe that children are resilient during times of crisis and loss and that they do not grieve with the same intensity as adults.  Because of this myth, people also believe that pets’ deaths are fairly trivial losses for children.” (Lagoni, et al).  

Because of these ill-conceived notions, many children do not get the attention and support needed during the loss of a pet.  In an attempt to make children quickly recover, parents will often provide quick replacement of pets, not allowing them to appropriately understand or grieve.  With each stage of growth and development comes a different level of understanding and coping with death and grief.   The following are age-related recommendations from “The Human-Animal Bond and Grief” (see reference below).

Infants (Birth through 1 Year of Age):
Babies feel the escalated levels of stress that arise in families, but they are not aware of the cause of tension.  They respond to high stress levels through crying, whining, clinging, withdrawing or regressing.  Talking to babies about pet loss is obviously not comprehended at this age.  Babies are best reassured by hugs, cuddling, and special time devoted to them.  Family routines should be kept as normal as possible.

Toddlers and Preschoolers (2 through 4 Years of Age).
At this age, children still do not understand that death is permanent and universal.  Toddlers and preschoolers are ready and willing to talk about death and are more relaxed and curious about it then any other age group.  Young children may or may not cry about their losses initially and their symptoms of grief will come and go with varying degrees of intensity.  They may express their confusion, fear, and sadness about death through play, open displays of emotion or through their developing lingual skills.  They may also express them by “acting out”.  Acting out is a way that children release feelings of pain, distress, and anxiety when they lack other, more positive vehicles for expression.  Toddlers and preschoolers may also display symptoms of separation anxiety, developing clinging behaviors or withdrawing from normal friends and activities.  Psychosomatic complaints like stomach aches, sore throats, and chronic fatigue can also signal the presence of grief that has been suppressed.  Changes in children's personalities, daily habits, social lives, and behaviors can be signs of grief that need more positive vehicles for expression.  Young children may explore death through play.  They might draw pictures, bury stuffed animals in their sandboxes, or plan funerals for their dolls.  Although these activities may seem alarming and morbid to adults, they are normal, healthy responses and should be encouraged.  Children deal with new information and current issues through experimentation.  Their activities do not, in most cases, require adult intervention.

Early School-Aged Children (5 through 8 Years of Age) 
This age group is less willing to talk about death.  They often personify death and think of it as The Grim Reaper, The Dark Angel, or as a monster-like form.  Because they imagine death in concrete ways, they also think that they can hide from it or avoid it.  This belief can cause them to feel angry at someone who dies.  They do not understand why their loved one did not just run away or hide when death came to get them.   Early school-aged children are in the “magical thinking” phase of cognitive development.  They perceive that the world is under their control.  With viewing TV and movie characters “killed” only to reappear next week in a different program or movie, death to them appears reversible.  Grief is often delayed due to peer pressure, emotional inhibitions, or even due to busy schedules.  It may surface weeks and even months after a loss.  Children may need to have the facts honestly restated and may need to be reassured that they are not responsible for what happed to their pets.  Generally, around the age of 8 years, children realize that death is permanent and universal.  This time can be troubling for them as they begin to ponder the mortality of those they love.  It is important for these children to have opportunities to talk about their losses and to ask questions about death.

Late School-Aged Children (9 through 12 Years of Age).
Most older school-aged children know that death is irreversible and that it eventually happens to everyone.  They are capable of sustaining intense periods of grief and can become preoccupied with a loss, particularly if they have had feelings of abandonment or rejection previously.  For older school-age children, grief for a pet may be connected to another, equally disturbing death and can trigger memories of that loss.  Like younger children, older school aged children may ask some shocking questions about death.  It is most helpful to given them honest answers and suggestions for active resolutions.  Suggestions may include viewing their pet’s bodies or participating in goodbye or memorial ceremonies.  As with younger children, opportunities for heart-to-heart talks or questions-and-answer times are usually helpful.

Adolescents (13 through 17 Years of Age)
Adolescents are self-conscious and hyperemotional.  Their feelings and thought processes are confusing and often contradictory.  They may wish to be treated like adults one day and like younger children on the next.  They will be devastated by their pets’ deaths one day and will say it’s “no big deal” the next.  Parents and veterinarians must be cautious not to overburden teenagers during the experience of pet loss.   Adults must also be careful not to engage teenagers’ rebelliousness by insisting they grieve in certain ways or within certain time frames.  They need to be offered time to talk and ask questions about their losses.
 

Young Adults (18 through 21 Years of Age)
When a young adult experiences pet loss, it is often due to the death of a childhood pet.  When a childhood pet dies, an important part of a young adult’s childhood also dies.  Thus, the deaths of childhood pets often represent a rite of passage from childhood to adulthood because they sever the last link to a simpler, more innocent time.  For young adults who had strong bonds with their pets, their pets’ deaths truly represent the “end of an era”. Another common issue for young adults is the guild that they may feel for “abandoning” their pets when they home for college, work, or to get married.  Guilt is not easily erased, but young adults benefit from and appreciate words of comfort from sincere adults.  Adults should verbally acknowledge the symbolic connections that exist between pets and young adults’ childhoods.  Like younger children, young adults should be reassured and provided with opportunities to discuss and resolve their feelings of grief and guilt.

FOR CHILDREN OF ALL AGES:
Talk honestly to children about their pet’s illnesses, injuries, treatments and death.   Children of all ages can be included in decisions, euthanasias, and goodbye rituals and ceremonies.   With adequate preparation, most children who are old enough to think and speak for themselves can choose whether to be present at euthanasia.  Children, like adults, respond well to straightforward explanations and concrete words.  Using words and phrases like “died,” “dead,” and “helped to die” may seem harsh, but they help children clearly understand and accept the reality of their pets’ deaths.  Using euphemisms like “put to sleep” or “went away” should be avoided.  Because children are “put to sleep” every night, these words could cause them to fear that they may also die in their sleep. From Lagoni, Butler, and Hetts: The Human-Animal Bond and Grief, 1994 W.B. Saunders Company, pp. 345-370.
 

manifestations of grief

Manifestations of grief can differ from one person to another.  These manifestations occur on physical, intellectual, emotional, social, and spiritual levels:

Physical: Crying, sobbing, wailing, shock and numbness, dry mouth, a lump in the throat, fatigue, exhaustion, sleep disturbance, appetite disturbance, body aches, stiffness of joint or muscles, dizziness or fainting.

Intellectual: Denial, sense of unreality, confusion,  inability to concentrate, feeling preoccupied by the loss, experiencing hallucinations concerning the loss (visual, auditory, and olfactory), a need to reminisce about the loved one and to talk about the circumstances of the loss, a sense that time is passing very slowly, a desire to rationalize or intellectualize feelings about the loss.

Emotional: Sadness, anger, depression, guilt, anxiety, relief, loneliness, irritability, a desire to blame others for the loss, resentment, embarrassment, self-doubt, lowered self-esteem.Social:  Feelings of withdrawal, isolation and alienation, a greater dependency on others or a reluctance to ask for help.

Spiritual:  Bargaining with God in an attempt to prevent loss, feeling angry at God when loss occurs, renewed or shaken religious beliefs.

Growth from grief:  Many people are familiar with the Kübler-Ross model for the stages of grief: 

Shock stage: Initial paralysis at hearing the bad news. 

Denial stage: Trying to avoid the inevitable. 

Anger stage: Frustrated outpouring of bottled-up emotion. 

Bargaining stage: Seeking in vain for a way out. 

Depression stage: Final realization of the inevitable. 

Testing stage: Seeking realistic solutions. 

Acceptance stage: Finally finding the way forward.

(Elisabeth Kübler-Ross, On Death and Dying, Macmillan, NY, 1969)

Below is a similar outline developed to describe more specifically the phases of grief for pet loss.   

Initial Awareness of Loss: In this early phase of grief, pet owners may acknowledge that pets’ deaths are imminent.   Pet owners dealing with the initial awareness of loss often show signs of shock or denial.

Coping with Loss:  During this phase of grief, clients experience their pets’ dying processes or deaths.  Veterinarians can help in coping with the loss through answering questions, assisting with important decisions, preparing clients for their pets’ deaths or euthanasias. 

Saying Goodbye:  Many pet owners want to say goodbye to their pets before, during, and after their pets die. Veterinarians should support clients’ methods of saying goodbye by encouraging their open expressions of grief.

Painful Awareness of Loss:  In this phase, many pet owners realize that no way exists to avoid grief and thus, allow themselves to experience the full extent of their painful emotions. The numbness that accompanies shock and denial seems to lift and can leave deep feelings of sadness, depression, loneliness, and guilt. The changes and adjustments that pet owners make in t heir day-to-day, companion animal-centered routines are common catalysts for the onset of painful feelings. Support from veterinary professionals and staff and friends and relatives are needed during this phase.

Recovery from Loss:  Pet owners that reach the recovery phase of grief focus their energy back into normal life activities. For some, feelings of sadness still surface, but happier memories again gain prominence.

Personal Growth through Grief: Many pet owners who progress through normal, healthy processes of grief find meaning in their pets’ deaths.  They realize that the death taught them important lessons or helped them change old, outdated habits and attitudes. Nonjudgmental listening often helps to finally reconcile pets’ deaths.

This phases of grief described above are not discrete – most grievers move back and forth among them.
Schneider, J. Stress, Loss, and Grief. Aspen Publications, Gaithersburg, MD, 1984 and Lagoni, et al).

 how to help yourself

This information is provided courtesy of Gail Bishop: Grief counselor, Fort Collins, Colorado.

Give yourself permission to grieve.  Only you know how much this relationship meant to you and only you know how much you hurt because of the loss.  Allow yourself the time and space to grieve.

Rest-relax-exercise: Grief is an exhausting experience emotionally.  Allow time to replenish yourself.

Surround yourself with people who understand. Now, more than ever, you need to have supportive, loving people around you.  Allow others to care for you. It’s their way of helping and it can be healing for you.

Educate yourself about the grief process.  Knowing what you are experiencing helps normalize an experience that feels anything but normal.

Acknowledge your feelings. Talk or write about your feelings as this can help sort them out.

Allow yourself small pleasures.  Sometimes it’s the everyday little pleasures that serve as small steps in your healing process.  Sunsets, a favorite food, an accomplishment or helping someone else are all ways in which you can begin to enjoy life again.

Be patient with yourself.  Grieving the loss of a significant relationship takes time, much more time than society sanctions, so go easy on yourself!

Give yourself permission to backslide. The nature of grief can be compared to riding a roller coaster.  One day you may be feeling good only to wake up the next day in the depths of despair. This is normal. Certain memories, sights or smells can trigger tears, sadness, and other feelings of grief.  Again, be patient with yourself.

Seek professional assistance if necessary.  If you feel suicidal, “stuck” in your grief process, or uncomfortable with how you are handling your loss, seek assistance. Please do not feel like you have to work through this alone.

Get in touch with your higher power.  Many people derive an enormous amount of support from their religious or spiritual beliefs. This belief alone can often sustain you when other support systems cannot.

Identify what has helped you in the past.  You already have a wealth of coping mechanisms that you have been using all of your life. Try to identify and implement them.

reading lists:

For adults                                                                              http://csu-cvmbs.colostate.edu/documents/argus-resources-books-adults.pdf

For children                                                                            http://csu-cvmbs.colostate.edu/Documents/argus-2011-01-books-children.pdf

For parents                                                                             http://csu-cvmbs.colostate.edu/Documents/argus-2011-01-books-parents.pdf

the rainbow bridge

Just this side of heaven is a place called Rainbow Bridge.
When an animal dies that has been especially close to someone here, that pet
goes to Rainbow Bridge.

There are meadows and hills for all of our special friends so they can run and
play together.There is plenty of food, water and sunshine, and our friends are warm and comfortable

All the animals who had been ill and old are restored to health and vigor; those who werehurt or maimed are made whole and strong again, just as we
remember them in our dreams of days and times gone by.

The animals are happy and content, except for one small thing; they each miss someone very special to them, who had to be left behind.

They all run and play together, but the day comes when one suddenly stops and looks into the distance.  His bright eyes are intent; his eager body quivers.  Suddenly he begins to run from the group, flying over the green grass, his legs carrying him faster and faster.

You have been spotted, and when you and your special friend finally meet, you cling together in joyous reunion, never to be parted again.. The happy kisses rain upon your face; your hands again caress the beloved head, and you look once more into the trusting eyes of your pet, so long gone from your life but never absent from your heart.

Then you cross Rainbow Bridge together....-Paul Dahm

words of comfort

DON’T GRIEVE TOO LONG
Don’t grieve too long for now I’m free.  I’m following the path God set for me.
I ran to Him when I heard His call, I wagged my tail and left it all.
I could not stay another day, to bark, to love, to romp or play.
Games left unplayed must stay that way.  I found such peace it made my day.
My parting has left you with a void, so fill it with your remembered joy.
A friendship shared, your laugh, a kiss; Oh, yes, these things I too shall miss.
Be not burdened with times of sorrow, I wish you the sunshine of tomorrow.
My life’s been full, you’ve given so much – Your time, your love and gentle touch.
Perhaps my time seemed all too brief, don’t lengthen it now with undue grief.
Lift up your heart and share with me.  God wanted me now, He set me free.
~Author unknown.

A DOG’S PRAYER
Treat me kindly, my beloved master, for no heart in all the world is more grateful for kindness than the loving heart of me.

Do not break my spirit with a stick, for though I should lick your hand between the blows, your patience and understanding will more quickly teach me the things you would have me do.

Speak to me often, for your voice is the world’s sweetest music, as you must know by the fierce wagging of my tail when your footstep falls upon my waiting ear.

When it is cold and wet, please take me inside…for I am now a domesticated animal, no longer use to bitter elements…and I ask no greater glory than the privilege of sitting at your feet beside the hearth…though had you no home, I would rather follow you through ice and snow than rest upon the softest pillow in the warmest home in all the land…for you are my god…and I am your devoted worshiper.

Keep my pan filled with fresh water, for although I should not reproach you were it dry, I cannot tell you when I suffer thirst.  Feed me clean food, that I may stay well, to romp and play and do your bidding, to walk by your side, and stand ready, willing and able to protect you with my life, should your life be in danger.

And, beloved master, should the Great Master see fit to deprive me of my health or sight, do not turn me away from you.  Rather hold me gently in your arms as skilled hands grant me the merciful boon of eternal rest…and I will leave you knowing the last breath I drew, my fate was ever safest in your hands.
~Beth Norman Harris

A FAITHFUL DOG
A faithful dog will play with you and laugh with you or cry.
He'll gladly starve to stay with you,
nor ever reason why.
And when your feeling out of sorts,
somehow he'll understand
He'll watch you with his shining eyes
and try to lick your hand.
His blind, implicit faith in you
is matched by his great love.
The kind that all of us should have
in the Master up above.
When everything is said and done
I guess this isn't odd
For when you spell "dog" backwards
you get the name of GOD 

Grief Counseling Hotline Argus Institute for Families and Veterinary Medicine (970)297-4143 at Colorado State University.  Staffed by professional grief
therapists. http://www.argusinstitute.colostate.edu
 

Other Sources of Support

(530) 752-4200 staffed by University of California-Davis veterinary students

(352)392-4700 staffed by University of Florida veterinary studetns

(517)432-2696 staffed by Michigan State University veterinary students

(508)839-7966 staffed by Tuft's School of Veterinary medicine students www.vet.tufts.edu/petloss/

(607)253-3932 staffed by Cornell University veterinary Students http://web.vet.cornell.edu/public/petloss

(217)244-2273 staffed by University of Illinois veterinary students  http://www.cvm.uiuc.edu/CARE/