Finnegan and Duffy sit on a chair. Photo by Laura Cadmus Laura Cadmus’ cat, Duffy, used to sit on the edge of her table and a CD rack with his front legs dangling off the side.  Now, the same spots are decorated with photos of him in those odd positions, her way to hold onto his memory aft er he died of cancer earlier this year at age 8.  “(It) was absolutely so devastating to me,” said the Barre native. “I mean, it’s probably just in the last couple months that I’ve stopped crying every day.” Duffy the cat leans an arm over the side of an end table, showing off a shaved patch of fur. Photo by Laura Cadmus There’s one thing that has brought Cadmus comfort through her grief. Duffy was able to avoid the veterinarian’s office, which was always a “nightmare” to get him to, and pass away in the comfort of his own home thanks to the work of Dr. Erika Bruner, a Washington County vet who specializes in at-home euthanasia.  A small but growing contingent of Vermont veterinarians is offering at-home end-of-life care to pet owners, including hospice and palliative care along with euthanasia. In the process, they’re rethinking the way we shepherd our beloved animals through their last days.  Dr. Caroline Horn, another veterinarian who offers end-of-life care from her practice in Chittenden County, said the field has grown during her time in it. When Horn attended her first conference of the International Animal Hospice and Palliative Care Society in 2018, she estimated fewer than 100 people were there. At the latest one she went to, hundreds of people from around the world attended. “I’ve had to say goodbye to many of my own animals. It is just brutal,” Horn said. “But I want it to be so peaceful that owners can more quickly heal from this tremendous loss, and that’s the space that most mobile vets try to fill.” “It was just peace and calm” Tippy the cat had traveled around the country in a trailer with her owner, but she was terrified of strangers.  “She wasn’t a huge fan of the vet for sure,” said her owner, Patrick White, of Williamstown. “For me, she was super snuggly, super close.” White lost his other cat, Tippy’s travel mate Mary J, several years ago. He and his partner had opted to put down Mary J in the more traditional way at the vet’s office. He said the staff worked hard to make the process gentle and unhurried, but ultimately it still felt rushed and stressful.  Tippy the cat with her owner Patrick White, left, and his partner. Courtesy of Patrick White. So when Tippy began to show signs of kidney failure a few months ago at 16 years old, White thought back to a friend in Chicago who had put down their dog at home. White called Bruner, head of Heart of Vermont Vet in Washington County, and started to make arrangements for when it was time for Tippy to go.  Bruner said her work usually starts with a conversation about the animal’s health, behavior and day-to-day life to help guide owners to their decision about when to put down their pet.  “You’re not telling them what to do. They’re telling you what they’re seeing and what they’re feeling,” she said. “And most of them already know what the best thing for them is going to be. But they just need some reinforcement that their decision is a good one.” When that time came for Tippy, White said, Bruner talked the couple through every stage in the process, giving them the option to go at their own pace.  “As soon as she walked into the room, it was just peace and calm,” White said.  Bruner’s service also allowed Tippy to pass away in a comfortable spot on her owners’ bed. Horn’s work also starts with a conversation or a visit, but she has a slightly different emphasis as a vet who offers hospice and palliative care. When a pet is declining but not yet ready to die, she provides owners with comfort kits, pain and nausea medications, and a plan for worsening symptoms.  Tippy the cat. Courtesy of Patrick White. She also advises owners to take advantage of the time to fill out the pet’s bucket list.  “I don’t think any dog in Vermont should pass away without a creemee — or two or three,” she said. “We want them to go through the McDonald’s drive-in if that’s what their pet likes.” Horn’s staff at her practice, Paws at Home, checks in with owners regularly as they care for their pets at home. Sometimes she has had to guide owners to recognize the reality in front of them.  “We can say, ‘Look, do you remember when we first came out, and your pet was doing this and this and this, and they’re not doing any of that anymore?’” she said.  Bruner said she didn’t think there was such a thing as a perfect time to say goodbye.  “There’s a time when it’s clearly too early, and a time where it’s obvious what the decision should be,” Bruner said. “And then in between, there is a gray area where it seems to me that as long as the person feels like the bad is outweighing the good, like it doesn’t have to be the right day or the right moment.” “The most valuable job I’ve ever done”  Horn came to end-of-life pet care through an indirect route. She spent years as a conventional veterinarian then switched to human medicine and worked in anesthesia for two decades.  Seeing the growing prominence of hospice and palliative care for people opened her eyes to the “huge need” to bring that to the veterinary world.  “When I got out of school, I never thought I’d be doing this,” she said. “But I do think it’s probably the most valuable job I’ve ever done.” The rise of at-home end-of-life care might provide an unexpected benefit to veterinarians’ mental health, too. Vets report high rates of burnout and depression, and one factor is the emotional toll of difficult procedures like euthanasia, according to an analysis of research studies by Nature.  Horn said some vet clinics have begun referring euthanasias to her practice to avoid the stress on their staff.  “There’s an emotional toll on everybody in the building, and this just brings it out and makes it a very safe thing,” she said.  The clearest downside of these services is their cost. Amid rising vet bills and other cost-of-living expenses, some pet owners struggle to afford euthanasia at all. The Central Vermont Humane Society provides low-cost in-office euthanasia to some low-income pet owners on a case-by-case basis. Erika Holm, the shelter’s co-executive director of programs and operations, said one Vermonter who reached out for help had been quoted $600 by a veterinarian to put down their very large dog because the cost of the drugs rises by weight.  “We completely understand when people truly can’t afford it, and we do not want animals to suffer and pass away at home,” she said.  Duffy the cat and owner Laura Cadmus. Photo by Laura Cadmus She advised Vermonters to call their local shelters to get a list of low-cost clinics and other resources in their area.  Holm said she’s seen a growing understanding of the impact that losing a pet can have on a person.  “There’s the people that go, ‘It’s just a dog, you know, or it was just a cat. Why are you so upset?’’’ she said. But “think about what happened during the pandemic. Shelters emptied because people were home, and they wanted a companion there with them. People recognized how meaningful it would be.” Holm believes that losing a pet can be as difficult, or more difficult, than losing a person in your life.  “I don’t think unconditional love exists for people toward people, but … animals don’t hold us to the standards that we hold people to, and we also pour our hearts and souls into them in ways we are often more guarded toward people,” she said. Read the story on VTDigger here: A rising cohort of vets is giving Vermonters new ways to say goodbye to beloved pets. ...read more read less