In-Home Vet Care

Senior dogs benefit from in-home vet care.
By Melissa Shapiro DVM, October 2015

When I was in veterinary school, a house-call practice was far from the career I imagined. Yet years later, I found myself at a crossroads. I knew I wanted to work for myself, but the thought of opening my own vet hospital was daunting. So, I compromised, taking part-time jobs while building my in-home practice. Word spread, and within six months, I was able to focus entirely on veterinary house calls.

Though my practice was designed to offer full-service veterinary care to dogs and cats in all stages of life, it soon became clear that senior pets benefited the most. Elderly arthritic dogs with mobility issues are difficult to get into a car, and diabetic dogs with cataracts can become disoriented and anxious in a waiting area filled with young, active and noisy pets. Even routine vet-clinic check-ups can be distressing for old dogs.

In-home care guarantees a relaxed, familiar setting conducive to in-depth examination. And when dogs are at the very end of their lives, quality-of-life assessments, palliative and hospice care, and euthanasia are all most comfortably done at home. Two years ago, when I introduced Your Senior Pet’s Vet, a subdivision of my general house call practice, the response was overwhelmingly positive.

House calls for seniors don’t have to wait until dogs are in the last stages of a terminal illness. Most of the issues that arise with older animals can be addressed in the home, and when radiographs or surgery are necessary, the dog can be transported to a base animal hospital for tests and treatment. My senior house-call patients tend to tolerate less-frequent hospital care with ease, possibly because they have been conditioned to consider me a friend from home.

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My clients are also much happier with this type of personalized service. Like their elderly dogs and cats, people also experience increased stress associated with vet-clinic visits. Taking the car ride, waiting-room delays and steel exam tables out of the equation is a great relief. Additionally, home visits make it possible for owners to evaluate my caregiving style on a more intimate basis than is possible with a quick hospital visit, resulting in a higher degree of trust and comfort when it comes to my treatment of their special pets.

Katie and Poppet, 13-year-old Jack Russells, lived with Patsy, who was in her early 80s at the time. She and her two terriers walked a couple of miles to the beach and around the golf course every day. I made my first visit in response to a handwritten letter Patsy left in my mailbox requesting a house-call appointment for Katie and Poppet’s routine check-ups. This was also the start of a wonderful friendship; Patsy gave me parenting advice and told me stories of her years as a nurse and a law student, and of past dogs in her life.

Eventually, Katie developed congestive heart failure that required medication and regular rechecks. Poppet survived a serious case of leptospirosis, but ultimately slid into canine cognitive disorder. After Patsy had lost both dogs, I helped her adopt a new senior Pomeranian from the local shelter. Billy moved in, and I continued to be Patsy’s on-call vet.

I share this story as an example of the benefits of in-home vet care for senior dogs such as Katie and Poppet. Whether the issue is simple old age or a chronic, debilitating problem, an objective professional evaluation and consult can make it possible for a dog to continue to live comfortably at home. Sometimes, people are sure it’s time to let their dog go, but in many cases, I am able to alleviate their worries and help them find ways to keep their dogs with them longer than they thought was possible. As dogs and cats transition into the final phase of their lives, in-home visits coupled with pain-management therapies, changes in treatment protocols and environmental accommodations (ramps, carpeting on slippery floors, support harnesses and slings) can make all the difference.

When I met Rocky, a 13-year-old, 75-pound Pit Bull mix, his family was very upset. Not only was he incapacitated by severe arthritis, he also had a large mass at the base of his tail and had been diagnosed with Cushing’s disease. Because his family couldn’t get him into the car, Rocky had not been to his regular vet in over a year. When I first saw him, he was lying on a piece of carpet surrounded by small sample-sized carpet squares, panting and wagging his tail as three adorable small children doted on him, petting him and offering him water. The children were interested in the equipment in my house-call box and asked questions about what I was doing with Rocky. The parents and grandparents waited anxiously to hear what I had to say about their amazing old boy.

The mass was large and open, and Rocky’s nails were very long. After reviewing all aspects of Rocky’s situation, we made a plan to treat the infected mass with antibiotics, cut his toenails so he would have an easier time with foot placement, and cover the slippery wood floor with larger carpeting and runners. We also started conservative but effective pain-management medications. We discussed harnesses and slings that would make it easier and more ergonomic to get Rocky from place to place within the house and yard.

He was a cooperative, friendly patient, and I was able to draw blood for the necessary full senior dog panel before putting him on anti-inflammatory medications. Rocky’s response to these interventions was remarkable. His family was delighted at his increased comfort and improved ability to get up and down, and they had a much easier time caring for him.

Eventually, his arthritis worsened, the mass grew and his overall quality of life deteriorated. We met a number of times after our initial visit, and had many email and phone conversations. Over a period of about eight months, I was able to guide them smoothly through their transition to saying good-bye to their sweet Rocky. When the decision was made to let him go peacefully, Rocky left this life on his bed, in his own home, surrounded by his loving family,

In-home euthanasia is a gift to beloved old animals and to their families as well; it makes the final goodbye comfortable and natural. Take Petey, for instance. To a man and his three daughters, the 16-year-old Bichon was not only a cherished companion, he was also a living link to the wife and mother they had lost to cancer nine years earlier. However, Petey’s quality of life had diminished to the point that he couldn’t eat and was vomiting and in pain. It was clear to the family that it was time to let him go, but they were distraught and having a very hard time with the process.

We discussed keeping the focus on what was best for Petey; what an important, special friend he was; and that they would always have pictures and beautiful memories to keep him with them. We set a time for in-home euthanasia, and when the day came, the weather was perfect. We were able to go outside to a beautiful grassy area in their back yard. After a very long goodbye, I euthanized Petey. The family agreed that I should make ink paw prints and clip some hair for them to keep. For this family, being together in the privacy of their back yard was the only way this could have been done.

Whether for routine, palliative or end-of-life care, senior dogs and cats benefit from in-home veterinary visits—compassionate support in the most comfortable environment they know. When I was searching for my niche within the veterinary profession at the beginning of my career, I never would have guessed how rewarding house calls and senior pet care could be. It has been profoundly gratifying to see the difference it makes in the lives of so many animals and their owners.

Article first appeared in The Bark, Issue 83: Fall 2015

Photo of dog by lculig
Photo of vet by Dimitri Maruta

Melissa Shapiro, DVM worked in several small-animal practices before opening Visiting Vet Service in Fairfield County, Conn., in 1991. visitingvetservice.com