Sammie and Dr. Toby Goldman haven’t known each other long, and Sammie tends to be wary of strangers even on a good day. But when Goldman stopped by for a visit recently, the pair got along famously.
“Who’s the sweetest boy ever? Who? You are,” Goldman gushes, eliciting friendly tail wags from Sammie, a 13-year-old Jack Russell terrier.
“He is such a character,” Goldman says. “I love it.”
Sammie is looking good, and that’s fine because he suffers from a heart murmur, a leaky valve and mobility issues. All of that, in concert with his geriatric-for-a-dog status, means that Sammie’s owner, Cheryl Mitts, probably will be facing a tough decision, and sooner rather than later.
And that’s where Goldman enters the picture. He’s a veterinarian who specializes in hospice care and in-home euthanization for pets. For several weeks, he’s been monitoring Sammie regularly to ensure that the dog is leading a high-quality life for as long as he can.
And when that is no longer the case, it will be Goldman who arranges for Sammie’s passing, which will take place in the home Sammie knows, with the people who love him surrounding him.
Goldman is affiliated with Lap of Love, a nationwide network of hospice veterinarians. He used to work in general veterinary practice but several years ago decided to devote himself exclusively to pet hospice.
Although in-home euthanizations make up most of his practice, Goldman also does in-home consultations for pets such as Sammie who suffer from incurable health problems but who aren’t ready for euthanasia.
Goldman estimates that he does 10 to 12 in-home euthanizations for every one or two consultations. Then the goal is not to cure but to comfort, helping pets live out their final days comfortably and without pain, he says.
Goldman says he’s neither a grief counselor nor a psychologist. But his practice encompasses both in a general way because in helping pets, he helps to prepare owners to make end-of-life-decisions for their pets.
“When you get a new puppy or kitten, it doesn’t cross your mind that there’s a good chance you’re going to outlive them,” Goldman says. “You don’t want to think about it. But the reality is that … it’s never long enough.”
Mitts adopted Sammie when he was about 5 years old. Even then, “he had some serious injuries,” she says, including a permanent leg injury caused, perhaps, by a car accident.
About three months ago, Mitts noticed that Sammie wasn’t acting like himself. A friend told her about Goldman’s hospice practice. As a former hospice nurse, she was comfortable with the concept, and the notion having Sammie in hospice appealed to her.
During Goldman’s first consultation, he reviewed Sammie’s condition, his medical history and his medications. Altering some of the medications — increasing Sammie’s pain meds, for instance — helped Sammie to get “back up and running again,” Mitts says.
Not that Sammie moves quickly or displays boundless energy, and his heart problems — for which Sammie takes different medications — remain. “I kind of watch what’s going on,” Goldman says of his periodic visits, with an eye toward noticing when Sammie’s quality of life begins to irreversibly decline.
“It’s always too early until it’s too late when it comes to saying goodbye,” Goldman says. “Over the years, I’ve had many people tell me they would have much preferred to say goodbye even if it was a week or two early than wait a day too long.”
“When we schedule to say goodbye, we want to be able to do it at home, where the love is, where there’s no anxiety or fear (of) going in the car or getting on a table at the veterinarian’s, where it’s strange, Goldman says. “And we do it in a very loving, peaceful way.
“And it’s a gift to the dogs, because we take away the possibility of them dying alone, we take away the possibility of them having a stressful experience, where we have to run in the middle of the night to an emergency center. So it’s a gift to be able to do this.”
In the meantime, Goldman says in-home exams offer a more precise picture of how a pet is doing.
“Dogs show their pain in their behavior,” he says. So Mitts is tracking Sammie’s behavior daily using such indices as whether he eats, how he sleeps, whether he seems to be in pain and how easily he moves. Over a period of days and weeks, those measures can signal a decline in the quality of Sammie’s life.
“When the down days are adding up, it’s probably time to say goodbye, or at least we can change something,” Goldman says. “So this way we have a strong, tangible way that we can know what’s going on.”
Mitts says that when Goldman visited her home for Sammie’s initial consultation, “he did an exam and said, ‘You know, right now, if (you) wanted to euthanize him, you wouldn’t have to feel guilty because he’s in pretty bad shape.”
But Goldman also taught Mitts how to chart Sammie’s health each day. He told Mitts that “you’ll see there’s going to be peaks and valleys,” Mitts says, and that “overall, you’ll probably see a gradual decline in him, so you’ll know.”
Deciding to end a pet’s life can be difficult. In one sense, by offering owners a pathway toward the point where a decision must be made, “I give them permission, as a veterinary professional, to say goodbye,” Goldman says.
General veterinarians aren’t necessarily “well-trained in how to deal with end-of-life issues,” he adds. “So where I get most of my referrals is through regular veterinarians, and I’m connected to this wonderful group called Lap of Love.”
When the time to say goodbye to a pet does come, Goldman says his goal is to make the process comfortable for both pet and owner. He uses a cocktail of drugs that will first make the pet woozy but aware of what’s going on around him, allowing pets and owners to say goodbye in their own time. At the end, he’ll leave a paw print and a lock of hair as a memento, and he offers such after-care services as transporting the pet to a cemetery or crematory and even writes a Facebook tribute to the pet and the family.
Goldman says in-home euthanizations start at $300, and after-care options begin at $85. (A price list and additional information can be found at www.lapoflove.com/Locations-Nevada-Las-Vegas.)
For some pet owners who have large animals or infirm pets that can’t easily be transported to a vet’s office — in-home euthanasia can be a practical option. But, for most it’s simply a quieter, more gentle option to an office-based procedure.
Mitts says she’s comforted to know that, when the time comes, Goldman will come to her home and Sammie’s goodbye will be conducted lovingly and peacefully.
Goldman says he’s not the only mobile veterinarian in town. But, he says, “I don’t do anything else. I don’t do vaccinations. I’m happy to leave that to other people.”
“I’m full of gratitude that I can do it,” Goldman adds. “I meet some great families and I meet some wonderful pets.
“Whenever I leave the home, I have the feeling that the karma of the world is just a little more right.”
Read more from John Przybys at reviewjournal.com. Contact him at firstname.lastname@example.org and follow @JJPrzybys on Twitter.