What we do, in honest detail.

The two things we do — hospice care and in-home euthanasia — sit very close to each other but they are different work. The hospice work is the long conversation. The euthanasia visit is the last conversation. Most of our families do both with us, in that order. Some only come to us for the last day.

Hospice

Hospice and palliative care.

The first hospice consultation is a ninety-minute visit. We come to your home, sit down right away (often on the floor or wherever the animal is), and start with what you already know: the diagnosis history, the current medications, what your general-practice vet has said about prognosis, what you are hoping for, what you are scared of. We listen more than we talk. The first conversation is for the family, not for the chart.

We do a full physical exam, calibrated to the animal's mobility. If your dog cannot stand comfortably, we examine on the floor or on their bed. We palpate gently. We look at gums, listen to the heart and lungs, check hydration and pain response. We adjust medications if needed — sometimes a hospice consult is the first time a family hears that there are still meaningful options for comfort that were not yet on the table.

Ongoing visits run weekly to biweekly, depending on the animal. We come to your home, do a comfort check, adjust medications, talk through what you've been seeing. We are also reachable by phone between visits, eight to eight, seven days a week. The phone line goes to one of us, or to Sage at the desk who knows every active hospice family by name.

Hospice care cannot reverse the underlying disease. It can dramatically extend the period of comfortable, meaningful days. For many families, the hospice work is what gives them weeks or months of time they did not know was still possible — a last birthday at the beach, a last quiet morning on the porch, a slow goodbye instead of a sudden one.

The first hospice consultation is $295. Follow-up palliative visits are $185 each. Most families do two to six follow-up visits over the course of a hospice. Medications are dispensed in-home when we have them, or written as a prescription to a pharmacy of your choice; the medication cost itself typically runs $40 to $180 per month depending on the protocol.

For some families, hospice care leads — at the right time — to a planned in-home euthanasia visit with the same doctor. The continuity matters. The animal already knows our voice; the family already knows what to expect.

The Decision

The decision to let go.

The decision to euthanize a beloved animal is, for most families, the hardest decision they will ever make. We do not make this decision for you. We can help you read what you are seeing. We can help you think about what your animal would want if they could tell you. We can help you understand what waiting longer looks like, and what it does not. The decision is yours. We will support whatever you decide, including not yet.

The framework we use is the Quality of Life Scale — the HHHHHMM Scale, developed by Dr. Alice Villalobos. Hurt, Hunger, Hydration, Hygiene, Happiness, Mobility, and More Good Days Than Bad. We walk through each of the seven categories with you during a hospice consultation, give honest scores, and look at the total together. The total is not a verdict. The total is a way of taking the question out of your gut and onto a piece of paper.

The signs we tend to weight most heavily are the ones that the animal cannot hide and the family cannot misread: persistent pain that current medication is no longer controlling; loss of appetite that holds for more than a day or two; loss of interest in the family (the dog who used to greet you at the door no longer doing so, the cat who used to come to bed no longer coming); difficulty rising; falling; loss of dignity that the animal seems aware of.

Most families know before they think they know. Most families wait a little longer than they should because they're still hoping — and we want to be clear: hope is not a thing to apologize for. We are not in the business of rushing you. We are in the business of helping you see clearly, and then standing with whatever you decide.

If your family is in active conflict about the decision, we can help with that, too. Often the disagreement is not about the animal but about how each family member processes grief. A hospice visit, with everyone in the room, can sometimes resolve in an afternoon what has been a week of strain at the kitchen table.

The Visit

The euthanasia visit itself.

When the family has decided, we schedule the visit. Usually within 24 to 48 hours. If the morning is too far away, we will come sooner whenever we can. The visit takes ninety minutes, sometimes more — we never rush.

1. When we arrive. We knock gently. We let the animal come to us if they are able. We sit down right away — on the floor, on a chair, wherever you are. We do not stand over you. The first few minutes are quiet. We meet the animal where they are.
2. The first conversation. We ask if there's anything we should know that the family hasn't said yet. Sometimes there is. We listen. We confirm the plan. We answer any questions you have, no matter how small.
3. Sedation. A single injection of a sedative cocktail, usually in the muscle of the back leg. It takes five to fifteen minutes to work. The animal becomes deeply relaxed — eyes soften, breathing slows. This is the most important part of the visit for many families: it is the moment the suffering ends. We allow time here. Often it is when families say goodbye in the way they meant to.
4. The IV catheter. Placed in a hind leg if possible, usually the saphenous vein, while the animal is already sedated and feels nothing. This step is fast.
5. The second injection. A high-dose anesthetic, delivered through the catheter. It stops the heart within seconds. The animal feels nothing. Death is quick and quiet.
6. The time after. We stay. We listen to the chest with a stethoscope. We confirm. We give the family as much time as they want. Some families want fifteen minutes. Some want an hour. Some want us to leave very quickly. Whatever the family wants.
7. The keepsakes and the transport. A clay paw print, pressed carefully, and a clipping of fur in a small velvet pouch. If the family is doing cremation, we coordinate the pickup with our partner Dignified Pet Services — usually they arrive within one to three hours, or the family can hold the body at home overnight and arrange transport in the morning. If the family is doing home burial, we leave you with everything you need, including a simple cotton shroud if you'd like one.

The hardest part of the visit is the decision before the visit. We can help with that.

After

After the visit.

A few days after every visit, we send a card. We write them by hand at our kitchen table. Sometimes we cry while we write them. The card is not a service item; it is a thing we do because we cannot do this work without doing it.

About three weeks later, we make a follow-up call. We ask how you are. We do not push; if you don't want to talk, we let you know we are still here when you do. Grief for a beloved animal is real grief — not a smaller grief — and many families find that the first few weeks are harder than they expected, especially around the small daily moments (the empty spot on the bed, the leash still on the hook). We carry resources for local pet-loss support groups and for the WSU Pet Loss Support Hotline, which offers free phone support from trained counselors.

If the family chose cremation, the ashes return in seven to ten days. We will let you know when they arrive at our partner facility and how you'd like to receive them — pickup, or a small box delivered. Most families want to receive them quietly, with no ceremony attached to the moment of receipt.