Speaker 1: Way you were listening to Petlife Radio dot com.
Speaker 2: Well, good morning, We're good afternoon, whatever the case may be,
here on this glorious Sunday morning. You're here with doctor
Jeff Werber, your host for the next thirty minutes on
Asktabet's with Doctor Jeff. You're on pet Life Radio once again,
here at the North American veter Night Conference here Orlando,
Florida live and sitting with me is a guest we
had on just a couple of weeks ago, Doctor Dan
and mcbattie also here attending the conference. And once again
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petlife radio dot com. So last week we started talking
about eyes. Having finished a lot of the indocrint issues,
we wanted to start to get into some different organ
systems that seem to present problems. But about a few
weeks before that, we were talking about Lap of Love
and doctor Danny mcbetdie's company, which is home euth in
Asia Touch talking about the process eth and asia. And interestingly,
this week mine had a very interesting case and I
actually got a call from an officer of the Department
of Animal Regulation in Los Angeles because he received a complaint,
interestingly from another veterinarian, which I thought surprised me a lot.
The complaint was that they had this woman doctor, this
veterinarian had seen a dog that she had been treating
with rehab rehabilitation, and they noticed a sore, an open
wound on the dog. Who's interesting is this dog was
fifteen year old, a Dalmatian that was truly wasting away,
no doubt about it. It was a dying dog. And
this particular client just really refused to have their pet euthanized.
And we're going to talk about that with Danny in
a minute, but they literally talk about hospice, and that's
another thing that we need to talk about because this
is an up and coming field in veteran medicine and
we want you to know about it. They were doing
hospice to the best degree. They had hired a nurse
to be with the dog all day. They were hand feeding,
they were getting a dog up and walking it outside,
was eating like crazy, normal stool. It was just wasting
way because of age. I'm sure cancer somewhere, maybe severe
heart disease somewhere. But we're doing everything and their power
as a veterinarian would want to. And by the way,
the owner, one of the owners was a physician to
alleviate suffering and pain, which with the medications it was on.
They were doing a great job. So the dog finally passed. Interestingly,
two days later, after I got the call, I spoke
to the officer for the Department of Animal Regulation, told
them what was going on, my involvement, what they were doing,
what we were doing. He was cool. He just wanted
me to check in with them every two weeks. So
with that intro, first of all, any of you who
want to know more, when do people elect for hospice?
Why do pet parents elect for hospice? And to talk
more about it, Danny, let's talk about hospice versus we
talked a lot about euthanasia. What about hospice.
Speaker 3: It is not about extending suffering, that's not the point
of it. But the point is to actually provide palliative care.
And palliative is our medical word for comfort oriented, not curative. Right,
So we're not trying to cure the condition anymore. We're
not trying to cure old age.
Speaker 2: I no way.
Speaker 3: One of our tox is the seminar is old age
is not a disease, but as sure as a killer, right,
so our pets don't die, you know, the old age
isn't a disease, but yeah, it is going to eventually
kind of take their life, just like you know for
a lot of us it'll be the same too. So
veterinary hospice is much different from human hospice, as is
venteringoncology and everything else. But it's cured towards managing the
symptoms such that the symptoms don't cause a decrease in
quality of life. We want to maintain quality of life
for as long as possible and as great as detail
as possible, such that the humanimal bond is also maintained,
and that pet gets to stay with the family. Family
is loving up on them, they have that time with them,
and they can come to the decision if they come
to the decision, right if euthan asia is elected or
natural death occurs.
Speaker 2: Now, you know, given the fact that most of us
who practice know when it's time, why from your experience,
why the main reasons for people to elect for hospice
instead of euthanasia.
Speaker 3: It's fine, And Jeff, you've obviously been practicing for much
longer than I have, and you've been doing hospice. Well,
you've been doing hospice for years. You know, we veterinarians,
we have been doing hot We just haven't called it
hospice care, right, And that's the neat thing about it
about it coming because us humans have more and more
experience with human hospice. Now we're asking for that for
our pet animals and our pet family members also. So
now we're going to call it a hospice and what
that does. When I did emergency medicine, when I would
say the word hospice to the families, you saw the
relief on their face. They got it, you know, they
got that. We're not curing anymore. I'm not the doctor
saying there's nothing more I can do, go home, call
me when you're ready to euthanize. No. I mean, that's
like I've just completely left them on their own at
the most important and stressful moments of their life with
their pets. So instead of saying go home, call me
when you're ready, there's nothing more I can do, there's
one more thing we can do. It's called hospice care.
And we're going to manage the symptoms. You know, I'm
not going to manage the disease per se, but the
actual symptoms that are causing the quality of life to
be decreased. And taking those symptoms and making sure that
human animal bonds stayed there.
Speaker 2: One of the probably the most common, and made a
really good point that many practicing veterinarians have been doing
this for years, just not calling it that. But here's
here's the classic scenario. Dog is diagnosed with something really terminal.
There's no doubt in the owner's mind that it's time.
But they have a child, for example, who might be
a way at college, who grew up with this pet,
and it was extremely bonded, extremely attached. So they answered, doctor,
we definitely we agree that it's time that our son
or our daughter is coming home to say goodbye to
the pet. Is there anything we can do over the
next couple of days, and there are a lot of
things that we can do. Yeah, absolutely, So let's talk
about some of those.
Speaker 3: So we do I mean almost anything you could almost
anything you can do in the clinic, we can do
in the home. You know, it's particularly under the hospice realm.
So again, we're not trying to cure this pet. Well,
let's say we even have fluid on the lungs I've done.
You know, thrastocentisis in the home. You can stick a
needle in there and you can pull up the fluid.
Now all of a sudden, that pet can breathe better
oxygen in the home, pulling fluid off the abdomen, if
that's causing pain and discomfort in the abdomen. Obviously, was
the number one thing that someone is going to ask
you towards end of life? What do they want to say?
Speaker 2: Why do they want to pain? And is comfort? Yeah? Exactly?
Speaker 3: The number one thing they're going to say is I
just don't want them to suffer? Right, So we talk
about what the definition of suffering is and my definition
and inability to think or do anything other than address
it being here in so say, let's okay, suffering is
not a sustained time and it can they can ebb
and flow with the suffering. Obviously, that can happen. But
pain management is number one, the number one thing we do.
And I use pain management at a much higher level
than we do under normal circumstances.
Speaker 2: Sure, because I mean typically a lot of the pain
medications we used to cause a lot of sedation and
who cares, you know, our goal here is provide comfort,
minimize any kind of suffering. When we take that their names, oh,
it is to minimize to prevent animal.
Speaker 3: Suffering to relieve, right, animal suffering suffering.
Speaker 2: That's a difference. When you're you'ally with a young veterinarian,
they remember the results by word for word by heart.
For the old guys, we just concept, you know, exactly
what we're supposed to do, but they not remember all
the names for the words. Yeah.
Speaker 3: So pain management is the number one thing that we do.
That's the number one symptom, right, you know, And there's pain, hunger, hydration, happiness,
you know, and mobility. This are the five most common
symptoms that we want to address. I go and I
talk to families about pain medicine, and every pain medicine
is different. You have to talk to your veterinarian about
what exactly your pet's on. But there are certain class
of them that I tell families is like a glass
of line. Sometimes you need one glass of line, sometimes
you need two or three or four glasses of wine.
So whatever we need to give them so we help
them get through the night. Now, if we're doing five
glasses of wine for three nights in a row, we
have a quality of life issue, right, So that's completely different.
But we're managing pain. It is not a one size
fits all correct, not absolutely not. There are some medications
that is you give this, don't stop giving this, but
this other medication we can use when and house needed. Right.
Speaker 2: But also what I find very instinct is my mom
passed three years ago and for her last several weeks
she was on hospice, and it was so interesting how
little her physicians knew about the differences in hospice care
versus medical care.
Speaker 3: It's totally different, absolutely, it really is.
Speaker 2: And and talking to the hospit this doctor, an MD
who specializes in this, there were so many things that
were different in the case. For example, perfect example, you
have a person who is a little dehydrated and has
certain organ dysfunctions and breakdowns. Well in clinical practice general
typical clinical practice, one of the most important things we
can do for this patient is hydration via ivy fluids.
But the rate as systems are breaking down, sometimes the
worst thing you can do for them is overhydrate them.
So what was good when they were healthy and healing,
or it was just an organ disease or an organized function,
now can become deadly. Those kidneys are starting to fail,
the lungs are starting to fail. The lungs are going
to be filling up with all that excess fluid. And
it's a much different rate when you're dealing with a
hospice patient than with a.
Speaker 3: Normal Well, you're not treating a normal body anymore that body.
And I tell people all the time with this and
we're providing hospice euthanasia like this is not a normal
is a situation or else you wouldn't be doing this
in the first place. Yeah, and anything that you can
do can cause more harm to know exactly what you're doing,
why are you doing it, what you're using it for?
And yeah, it's completely different.
Speaker 2: And I think that also a lot. For example, I
think that the mindset has to change within our industry,
within veterinarians, within your veterinarians, if you're out there listening
that it's okay. And I was not so much shocked
that I got the call from the Department of out
of Regulation. What did shock me is the veterinarian who
called on this dog to complain without first researching a
little bit, finding out what they're doing, why they're doing it,
what are your reasons? Who can can a veterinarian make
a decision for their client about what the client needs
or should do with their pet. It's ultimately the best
we can do as providers of care is to equip
our clients with as much information as we can, but
ultimately the decision is theirs.
Speaker 3: We advocate for the pet right and we partner with
the family right.
Speaker 2: That's right.
Speaker 3: Advocate for the pet and partner with the family because
in the end that pet really does, in the eyes
of the law, belong to the family.
Speaker 2: Absolutely.
Speaker 3: All we can do is be there to say this
is what's best via our knowledge, our experience, all this
stuff is best. And it's funny, you know, we're talking
about hospice care. There's also on the other end, you know,
treating there's a lot of medications that I take patients
off them. We don't need antibiotics anymore, right because you're
completely killing their normal gut flora. Take them off antibiotics,
redo their heart or lung medications or I mean, there's
a lot of medications that I can take them off,
even human medicine, human hospice. When they go into hospice care,
they will actually say would you like us to take
you off these medications? And a lot of times, especially
some heart medications, not all of them, but some heart
medications cardiac admits, they take them off and the patients
get better. They get better for a certain period of time,
but then what happens at the end of that period
they crash very heart, which again is if you ask me,
that's kind of how I would like to go, right,
I want to get better, better, better, and then when
I go down, I want it to go fast and
good and you know, and it's fine. So we forget that.
There are a lot of side effects on these medications
that we use, and a lot of them are procurative
reasons that are not for comfort reasons at that moment
like comfort.
Speaker 2: Now right, we are at that halfway plan. I want
to hear from you, want to hear any of you
and iasa I mentioned if you've been listening last couple
of weeks. I've had a miserable last month and a
half with two of my cats, and unfortunately, sadly, I
have a third one coming up. The good news of
having all these animals is, boy, I had a full
house of fun. And for the bad news is when
there a lot of them are old at the same time,
they seem to go a lot, you know, pretty close
to each other and it's really tough. I want to
hear from you about any questions you might have for
me or doctor Danny about youth in Asia. When's the
right time, what's science to look for? When we will
come back from our break, we're going to share our
own feelings about that, but would love to hear from
you once again. Eight seven seven three eight five eight
eight eight to two. Just pick up the phone or
log onto Petlife Radio dot com and join us live
here on the show. Don't go away, We'll be right back.
Speaker 4: We'll be right back right after these messages. Stay tuned.
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Speaker 2: And welcome back, right you're live with doctor Jeff Werber,
your host here on Askabets with doctor Jeff here on
pet Life Radio, and along with me is my guest,
Doctor Danny mcbeide. Has been on a few weeks ago,
and we are here live from the North American Veterinary
Conference in Orlando, Florida. That's good conference, isn't it It is.
Speaker 3: It's actually the largest conference in the world.
Speaker 2: And that crazy. I mean, there are so many people here,
it's unreal. And I hear that they're actually going to
be moving this conference in a couple of years. Very sad, Yeah,
because I kind of like it here. But yeah, we
used to be here at the Marriotte World Center for
years and I've been coming to this conference for almost
thirty and then because it grew so much, there was
another hotel called the Gaylord, and they've kind of split
it and their buses shuttle buses going back and forth,
and so we have a lot of the scientific sessions
to the Gay Lord, a lot of the business and
technician sessions here at the Marriott and it's just a
packed house. Well, it's gotten so big, and they've had
to have two exhibit halls, which is really difficult for
a lot of the exhibitors because people that are going
to more of one session than another may not make
it over to an exhibit hall. So we're moving to
the Orlando Convention Center. Oh my, oh my, which you know,
I get it, Yeah, because from a exhibitor standpoint session
standpoint rooms, it's going to be great. However, the hotel
situated there are not two hotels that can fit all
of us. The hotel situations have a different world would
be spread out all over the place, so it's gonna
make a difference. One thing about this conference, despite its size,
it's always very homey, and we went, right, yeah it is.
So anyway we're here. Before the break, we were talking
about obviously hospice, some of the differences in care, some
of the reasons why. And as I said, one of
the number one reasons that I was providing hospice care
over the years was not that the client did not
want to or know they needed to ultimately say goodbye.
It was a matter of timing. They needed just a
little more time. They want an extra day or two,
they wanted an extra week, whatever it was. That's from
a GPAT general practitioners standpoint. What else, what are some
of the other reasons why people want hospice instead of
you know.
Speaker 3: And sometimes they're just not ready, right, I mean, we
hear that all the time, and they whether or not
they're saying that they're not ready, if they're able to
actually do a self introspection to say they're not ready,
or they say it as my dog's not ready yet.
As an I don't see that from them yet. And
so for whatever reason, gosh, there's more even it's kind
of that is going to be extended or even shortened. Also,
people are going out of town. I think we talked
about this last time. If you're going out of town,
your pet's going to be in a lot of stress
when you're leaving. And it's okay to say, how are
we going to make this decision before or after, or
how's that going to affect the choice. But we do
a lot of hospice for waiting for people to get
home A lot of times, you know, mom, dad, brother, sister, son, daughter,
they're getting in from out of town, and can we
just get an oxygen mask on them for twelve to
twenty four or forty eight hours, just until we can
get them them through so that you know, this gonna
member can say goodbye. And I think that that's a
completely heroic reason to do that. There's absolutely nothing wrong
with that. I'm a doctor, right, I can manage the medicine.
I got the medicine. So let's manage this as good
as we can and tell the family's ready.
Speaker 2: You know. I often also well, I can tell a
lot of clients, and we tend to do this, and
it's not always bad, by the way. In fact, because
of this particular trait we called anthropomorphizing, where we put
our own values in the animal. We often tell people
don't anthromorphize. Don't just because you feel that we don't
project out onto your pet. I think your pet's going
to feel that way too. But now that we're learning
so much about pets emotions and interesting, a brand new
field that is sort of going to be hitting the internet.
You'll be hearing more about it. We're going to be
talking about it in the future on our show. Here
is fear and anxiety and how it affects pets, and
we are looking now more towards their emotional well being,
not physical well being, but actually emotional well being because
of our anthemomorphizing and realizing. Wait a second, there's something there.
We don't understand them because they can't communicate with us.
They can't use their words. So now we're learning to
read their cues. And it's so interesting.
Speaker 3: They don't communicate with us in English, communicate with us
in nine exactly. And I tell people, I'm like, you
can't expect your pet to grieve like a human grieves
your pet. You know dog is going to grieve a
dog greeve, right, You know dog is going to feel sad.
A dog sad. It's not a human sad. It's a
dog sad and still sad.
Speaker 2: Right.
Speaker 3: But yeah, and you are literally a pediatrician, right, we
are a petatrician, and your kids do not. I hated
going to the nutritian stop. I hated it, even though
I hate taking my kids. You know, it's more stressful
for me, right, well, I mean I interpreted it is.
But of course I'm so scared for them because I
know what that feels like.
Speaker 2: Right. So yeah, But oftentimes I find myself staying to
a client that we get to a point in care,
especially towards the end of life, and I'll stay to
the client understand, and I understand that I'm treating you,
not the pet. That a lot of times clients aren't ready.
They know it's inevitable, they know it's coming soon, but
they're just not ready.
Speaker 3: That was literally my very first hospice case I ever had,
very very very first, when I had just started laugh
of love and I went and we did it as
a cat in renal failure. Her name was Ali. It
was a male cat. It was Ali cat, which is
where she got Ali from. And at the end, I
did a couple of past disappointments. And then I went
to the Euthenasian. She's funny, she actually she stood there.
She goes, Okay, I'm not saying this for real, but
I'm just going to say, just a practice, Okay, I'm ready.
She would practice saying that, Okay, I'm ready. And then
after the Euthenasians said, Danny, you know you not only
treated my pet, you treated me too. But it is
there's so much of that that goes on, right.
Speaker 2: You know, there are a number of states now I
think five or six that actually allow for what we
call assistant suicide, and in animals, we have had this luxury,
this gift to be able to provide euthanasia, which is
a pain free way to say goodbye. And so we're
learning as well from a lot of our states are learning.
And it would have been so great to have had
more choices for people. But one of the things that
we are able to do is to provide that care, okay,
And yet there are still people that don't want it,
and I think it's for their own philosophical reasons. I think, interestingly,
the case that I just had.
Speaker 3: For human reasons, for humans.
Speaker 2: No for animals too. They just don't believe. And that
was another reason. They just don't believe it that it's
up to us to play god and to make that decision.
For the same reason that many cultures, we will not
allow it the people because it's the natural way. What
this family wanted was their dog to pass the natural way. Right?
Speaker 3: But what does that mean?
Speaker 2: Right?
Speaker 3: But do you want to say, like your york isn't natural,
your bulldog isn't natural? Nature is a lion coming and
get in when they're not contributing to the pack anymore.
I love people like I want them to guide to
die naturally. I want them go to sleep and not
wake back up. Okay, go to sleep and not wake
back up.
Speaker 2: That's what I do.
Speaker 3: I guarantee that with euthanasia, right, But if you want
your pet to die naturally, that's not what we're doing.
Food and water, they're every whim bring up through the nose,
you know, the wounds cared for and everything that's unnatural.
Speaker 2: But they feel so they wanted to. When that heart
finally stopped, when they finally took that last breath, it
was not them, right, There's a certain guilt that people have.
Speaker 3: I know, what do they say all the time, like
when we're in euthanasia, I'm so sorry, I'm so sorry.
I'm like, no, I don't say you're sorry. It's okay,
but as veterinarians, you know that's what we have to
get over. Also, right, we are the ones pushing that plunger.
I say, I'm not going to do this unless I
also believe in what we are doing. Not what you're doing. Family,
You're not doing it. We are doing it together. You
know the pet from that, I know the pet from
the medical works to get the other. We're making that choice,
and then we're going to we're going forward.
Speaker 2: That was an interesting point that I made with the
officer that called me. I said, you know, I had
a case early on in my career. It haunts me
to this day. It's been over thirty years, and it
was a situation where a lady came in with a dog.
It was a seven year old, pretty healthy mine a
problem problems, but a pretty healthy Cocker Spaniel, and she
wanted to put it to sleep, and I was not ready.
I didn't think this dog mus could put to sleep.
I tried everything I could to not let her to
do it, and I did it anyway because she wanted
to be there, and she insisted on being there. Now
I am much more bold and comfortable in my own skin.
I said, no, no, no, if you want this dog just
to be able to go someplace else, So I said
to the officer, I said, do I as a veterinarian,
can I dictate? Can the owner who owns that pet?
That owner dictated to me she wanted to have that
pet put to sleep. Whatever her reasons were, I disagreed
with them. She had reasoning, but I disagreed. But whatever
I said, I can't, they can't. It's their choice, so
reverse it now.
Speaker 3: But it's her choice to ask for it.
Speaker 2: But you don't have to, right, absolutely absolutely so with
this family, I said, we on the other side couldn't
recommend it till we're blue in the face. But it's
ultimately their choice as long as they were taking the
necessary attempts and practices to relieve that suffering, which they
clearly were. So you know, when I talked to this offshot,
I even said, you understand, I'm on your side. I
would bet ninety nine percent, ninety nine point nine percent
of veteran care professionals on the planet would be telling
them it's time, would be recommending it's time, but not
our choice. It's their choice. So the best we can
do and then the best they're doing. And they know it.
As they said, he was a physician, he knew it
is everything he could do to run the suffering. But
it was, you know, it was almost like God's way.
That literally two days after that conversation and two days
after the visit with the animal control and so other
veterinarian who made the complain, she finally passed. Yeah, so
you know, amazing, it is amazing.
Speaker 3: So there was a lot of me telling of the story.
So I was doing emergency medicine, is working, and the
woman came in with the fourteen year old cat had diabetes,
and she came in and she said, I need to
have my cat euthanized, and this is emergency. So we
have no relationship with them, right because is the first
time we've ever met them. And it was so incredible.
The other veterinarian that was on with being refused to youthanize.
The woman walked out. She ended up letting her cat
out of the carrier and the cat ran across the street.
You know, something probably happened after that, But that's the
ramifications of us not going and understanding what's going on.
Speaker 2: In the right and I think we do. That's our
job is to work is best we can with these clients.
Best we can do is educate them. It's like anything
with a disease, treating a disease. The more they know,
the better decisions they can make.
Speaker 3: That's what we're here for.
Speaker 2: So anyway, it is that time. Boy goes fast. So
I want to thank once again doctor Danny mcgetdie, our
guest from Lap of Love Veteranic Care Ventery Hospice, and
we will be here well, I'll be here next week
same that time here on pet Life Radio at noon
Eastern at nine Pacific and anything in between. And have
a great week. Once again, thanks for our sponsors and
protens and too calm And if you have any questions
or comments about this, please go ahead send me an
email to doctor Jeff at tetlife radio dot com and
we will read your email on our next show and
once again we will send you out some cool gifts
just for joining us here on the show or sending
me the email. Have a great week. Be here next week.
Speaker 4: Let's talk Pets every week on demand only on Petlight
radio dot com.