Holly

Photo courtesy of Wendy Beckwith

It's difficult to live with the end in mind, but as you'll read from two local residents' stories, doing so and keeping the pets' best interests in the forefront can be invaluable.

The beginning of a journey's final leg

Wendy Beckwith speaks of her yellow Labrador, Holly, with a quiet fondness that you would expect of any person that has shared her life with a pet for as long as she and her husband, Paul Takessian had.

After arriving in their lives in 1999, it was evident that Holly loved people, and, as Beckwith illustrates, Holly loved attention more than food — unlike most Labradors. In hearing about her, Holly's exuberance and the bond that she shared her with owners is still resonant.

After presenting with a limp that led to a diagnosis of osteosarcoma — a type of bone cancer — in December 2010, her owners decided that, based on Holly's prognosis, the best path to follow would be to offer palliative care and to forgo surgery.

Beckwith notes that she felt strongly that her beloved dog should be able to go through that period of her life in a dignified way — including her final days. In fact, the mantra that she and her husband kept in mind was that Holly should be afforded a life that was joyful and dignified.

With that in mind, as normal of a schedule as possible was maintained, but it also contained lots of attention, plenty of time on the floor with Holly with toys and games, as well as physical contact — lots of touching was important.

Something else was in the forefront: The idea of Holly's last moments being spent in a clinical setting, if euthanasia was needed, was something that Beckwith and Takessian wanted to avoid. Not long after the diagnosis, Beckwith was on a walk with a friend and confided that she felt being at home would be ideal for Holly as she made her transition.

Her friend said, "I know just the person that you need to be in touch with."

Dr. Cathy Theisen, DVM was brought on early as a home vet and proved to be integral in helping the family navigate through the entire period, making everyone feel very comfortable.

Visiting vets are the preference of many pet owners today, as the premise provides for a more comfortable alternative for uneasy pets to get the care they need — especially when addressing end-of-life issues.

Despite the disease affecting a front limb, Holly did well for a time with radiation to help mitigate some of the pain, as well as great care from her family. Beckwith and Takissian felt that it was integral to have ongoing, daily dialogue regarding how Holly was feeling and getting along: Was the pain being managed adequately? How well was Holly able to physically get around? Her quality of life — was it still good?

Another important part of their dialogue meant checking in with each other about how they were managing as Holly's caregivers. Beckwith, a retired guidance counselor, noted how important it was for her and her husband to maintain an open dialogue with each other, asking, "How are we handling things? How is the experience affecting us today?"

After all, it wasn't just Holly's journey, but their journey as well.

Drawing from her experiences in caring for two friends during their terminal illnesses, Beckwith instinctively knew to apply the same mindfulness when it came to caring for Holly at that point in her life.

Zeppi

Photo courtesy of Kimberly Troiano

Kimberly Troiano and her husband, Chris, were on a similar journey this past winter.

Their cat, Zepplin — or Zeppi, as he was affectionately known —  was adopted in early 2005 and shared his owners with another feline, Tana.

Life was good for years, and then sadly, Tana fell ill, and eventually the illness was having a profound effect on his quality of life. Euthanasia became the most logical choice.

The Troianos did what many people do: They took Tana into the very clinical setting that is the veterinary exam room, lingered while they said their goodbyes, waited by the side of their four-legged family member through the process as they watched him slip away.

Because the couple wasn't sure how Zeppi would process the idea that Tana wasn't going to be around anymore, they made the decision after talking to their vet to bring him along and into the room during the process. In retrospect, Troiano says that not might have been the best decision, as trips to the vet after that were impossible to manage for the cat: The fear and anxiety was just too much.

Troiano, who took faith as a Nichiren Buddhist in July 2010, notes that chanting Daimoku daily was integral in helping to find a different solution to address her pets' health needs in a way that would help them be more comfortable — ideally at home. It was then that Dr. Theisen came into their lives.

Fast forward to September 2010, and Zeppi needed to have a dental cleaning performed by Dr. Linda Griebe, DVM at Ann Arbor Cat Clinic after Dr. Theisen's recommendation.

There was one glitch: Dr. Griebe saw a problem as she prepped Zeppi for the procedure, which requires anesthesia.

As it turns out, the news wasn't good. At age 7, Zeppi was diagnosed with Squamous Cell Carcinoma. Although the cat had some minor health issues, the diagnosis was a shock to the couple.

After looking at treatment options, it was decided that palliative care was the best choice. As a Nichiren Buddhist, it was important to Troiano that Zeppi be able to go through this process with dignity, as much joy as possible and a decent quality of life.

After all, this was not about his owners — it was about how they could help him navigate through this period of life, an all-encompassing process, just like Holly's family was doing.

Final transition

Holly lived fully with her family from the time she was diagnosed, with the help of radiation to help quell the pain of the disease for a time — and pain medication throughout. Takessian made a ramp to assist the pooch in getting in and out of the house, which proved to be helpful.

By early March, it was a different story: Over the course of a week or so, her pain medication wasn't being tolerated very well, and Holly was having difficulty getting in and out of the house to eliminate. Her owners had anticipated this time coming and made the decision to call Dr. Theisen to come by and help Holly transition.

That morning, because her husband was unable to help lift the struggling canine, Beckwith asked a neighbor to come by and help with getting Holly outside to relieve herself.

"The vet is coming today to take care of Holly; it's time."

Understanding the gravity of the situation, her friend asked, "Would you like me to stay?"

The offer was most welcome, and her friend graciously brought her guitar, and softly played "Amazing Grace" as a handful of other loved ones came by to shower Holly with attention and love, stroking her and talking, reminiscing, comforting her and each other.

Holly was aware of those around her and maintained a relaxed, peaceful state throughout that afternoon. Even after Dr. Theisen helped Holly ease through the final moments, the mutual support remained, as her loved ones lingered that day.

Beckwith said softly, "It was totally unexpected, the way that everything fell into place that day: The people who were important to the three of us were present, Holly's peaceful passing ... and it was very much like a wake afterwards."

Conversely, I noted that the process that day sounded a bit like awaiting a birth — everyone gathered, the anticipation, the support.

Beckwith, her voice brightening, said, "Yes, yes it was very much like that, ironically enough; you're right. It was."

Zeppi maintained a quality of life that was totally manageable for a few months after his diagnosis. Despite the cancer affecting his epiglottis, he ate wet food without issue and, to someone who didn't know him, he didn't look like he was batting a terminal illness.

Troiano's faith continued to be a sustaining factor throughout the process, and she and her husband kept in mind that this process was more than about Zeppi's dying. It was a transition — one that would assist him in attaining Buddhahood — and through chanting Daimoku, this would be facilitated.

Sadly, right after New Year's, Zeppi started to decline and, by mid-week, had stopped eating. At that point, the Troianos understood clearly that it was time but were glad that they didn't have to move their furry friend, who had since settled into the quiet sanctuary of the master bedroom.

Arrangements were made for Dr. Theisen to come by at about 2 p.m. on Jan. 11 to assist Zeppi. Fellow Nichiren Buddhists were notified by phone to chant at that time to help him through the transition.

As it turned out, the doctor arrived a bit early, and after chatting downstairs about what each party might see and hear during the process (the couple got some insight into how euthanasia is administered and what typically ensues, the doctor was clued in on the chanting that she'd hear throughout), all three headed up to where Zeppi had chosen to retreat.

In keeping with the Buddhist tradition so that a proper transition could be facilitated, Zeppi was positioned with his head pointing toward the north and his face to the west. His owners sat at his side talking to him, stroking him, all the while chanting as the doctor helped the animal along.

As he began to slip away comfortably, slowly, the doctor gave the family private time to comfort Zeppi, and each other — saying all of those things that pet owners want to convey to their four-legged loved ones in those final moments if they are able — and as it was evident that he was gone, the clock read 2 p.m. exactly.

The event still very fresh in her memory, Troiano is incredibly sad that her very loyal sidekick is gone, but she finds solace in knowing that the choices that were made on behalf of her pet were the right ones. Musing how Zeppi would sleep with her, his habits, the joy that he brought to the family, it's clear that he was very special.

"Zeppi was able to go through this process — especially dying — on his terms. We had an obligation to ensure that he lived and died with dignity." She adds, "We're very thankful to have had the option to allow him to stay home and transition where he was comfortable."

One piece of advice that both pet owners give: You are your pet's advocate. When they are facing death — regardless of the reason — keeping their best interests in mind is paramount. It's hard to let go, but it's harder to watch them suffer needlessly.

Read more about the topic of end-of-life care for companion animals by clicking here.

Lorrie Shaw is lead pets blogger for AnnArbor.com and has previously written about end-of-life, palliative and pawspice care. She welcomes your contact via email, and to follow her daily adventures as owner of Professional Pet Sitting on Twitter.