Marilyn Stewart walks between the cages in the far corner of her Alpha Canine Sanctuary, north of Bakersfield. She calls out greetings, naming each dog as she passes by. They wag their tails and stick their noses through the fence, hoping to get a pet and a snack.
"There's something spiritual about them," Stewart says, calling the animals "old people."
Among the 100 dogs at Stewart's "no-kill" kennel for strays and unwanted animals are about 30 "very old people." They are living out their lives in clean, orderly cages. They are too old to be candidates for Stewart's adoption program. But they are all beneficiaries of Stewart's obvious love.
It is fairly quiet in this quadrant of the sanctuary. While a dog may occasionally bark, absent is the loud yapping in the areas where younger animals are housed. The "old people" seem to sense they are on their last legs and they aren't about to squander their time or energy on senseless noise.
Stewart believes the dogs are at peace. And she aims to keep them as happy and comfortable as she can until they pass away naturally.
"As long as they are comfortable and have a good quality of life, they will be here," she said. But when a dog goes down, when he is too sick to stand to eat, he will be euthanized.
Knowing when a dog's quality of life has diminished terminally and when the animal should be euthanized is a dilemma, said Stewart, who has to make that call with her sanctuary dogs and has been called upon to counsel other pet owners when it is "time to let go."
Advances in veterinary science and Americans' willingness to pay the escalating cost of caring for their pets have made the end-of-life decision even more difficult.
The American Pet Products Association estimates Americans will spend $45.4 billion this year on their pets: $17.4 billion on food; $10.2 billion on supplies and over-the-counter medicines; $12.2 billion on veterinarian care; $2.2 billion on live animal purchases; and $3.4 billion on grooming and boarding.
Just as they have with humans, advances in treatment procedures and medicines, as well as research into lifestyles and diets, have prolonged the lives of our pets. It is not uncommon for a dog diagnosed with cancer, for example, to undergo expensive diagnostic and treatment procedures, including MRIs, surgery, chemotherapy and radiation. The price tag for such procedures climbs to several thousands of dollars.
Dr. Kathryn Marcchino has what she believes is a better alternative. Marcchino is a sociology professor at the California Maritime Academy in Vallejo. She teaches a "death and dying" course to cadet merchant mariners.
When her old cat Nikki experienced kidney failure a few years ago, she encountered veterinarians who either prescribed costly advanced procedures or who pressed for immediate euthanasia. Instead, Marcchino wanted Nikki simply to be kept out of pain and allowed to enjoy a quality end of life at home with her family.
"They looked at us as if we were from Mars," Marcchino recalled.
The experience prompted Marcchino to establish the Nikki Hospice Foundation for Pets (www.pethospice.org) and to help organize the International Association for Animal Hospice and Palliative Care (www.IAAHPC.org). This fall, the association held its second annual international symposium on animal hospice care at UC Davis.
"I can't tell you how many people call us," she said, recalling stories pet owners have related about veterinarians insisting animals be immediately put down and threatening owners with animal abuse accusations if they do not comply. At the other extreme, Marcchino recalled cases in which costly and painful procedures were prescribed, despite little likelihood they would benefit the animal.
"It's an education process for vets and for people," Marcchino said. "But hospice for pets is not for everyone. It can be emotionally draining."
Marcchino said she is seeing more veterinarians willing to recommend and support palliative care for terminally ill animals, rather than insist on quick euthanasia or advanced procedures.
Stewart said many Bakersfield veterinarians are receptive to administering palliative care, which basically involves the use of pain-relief and comfort medications.
As an example of when "hospice" might be appropriate, Bakersfield veterinarian Jennifer McDougle pointed to kidney failure, a common ailment in cats. McDougle noted the gold standard for treating kidney failure is a kidney transplant. But few owners can or will pay for such an advanced procedure. A successful alternative is treatment at home with medicine and monitoring by a veterinarian, which will extend the cat's life and preserve quality of life.
Often pets with terminal diseases such as cancer can have their pain controlled at home while they live out their lives. McDougle said owners may opt to have their dogs and cats at home, "wagging their tails and eating for the remainder of their lives," rather than undergoing expensive, painful procedures.
The best course to take depends on the age and condition of the animal and the likelihood of a successful outcome, she said.
Stewart closely monitors the animals, particularly the "old people," at her sanctuary. "I won't let them suffer. We have a gift and we should use it. (Euthanizing) an animal to spare it pain is the one unselfish thing we can do for a dog that we love," she said.
This story written by DIANNE HARDISTY appeared first in The Bakersfield Californian on Nov. 22, 2009.