“Lily has a tumor that has attached itself to every blood vessel near her hind legs. I don’t know what else we can do for her…” I sat there in shock as I heard my veterinarian tell me this at the other end of the phone. Lily was our 8-year old basset hound who was otherwise healthy. We found a lump near one of her back legs, which the vet thought was something that could be easily removed. We were confident it wasn’t anything major. After all, she was only 8. And she was healthy. But in reality, she wasn’t. And that was a hard pill to swallow. Lily’s tumor couldn’t be easily removed, so it wasn’t. She came home to us that same day, tumor still inside her, and as happy as she was that morning (albeit a little more drugged). My husband and I had dealt with another terminal diagnosis of another one of our beloved dogs two years before this. We’d been here before. We knew what to do. We just didn’t want to do it again. If you’re a pet owner and you’re still reading this, chances are you’ve dealt with watching one of your pets succumb to a terminal illness or are in the throes of it now. My heart is with you. I’ve done it more times than I care to remember. I know how awful it can feel, and I also know how difficult it is, so I want to share some tips with you to help normalize what you’re experiencing, and maybe provide some suggestions on what to do next. First, feel the emotions that inevitably come when you find out your beloved pet is terminally ill. I remember throwing my pen across the kitchen into the wall as I listened to my vet tell me Lily’s diagnosis. Then I hung up the phone and ranted to my husband. I was angry. And I let myself be angry. Then I cried a lot. After you’ve allowed yourself to feel all the emotions, you’re going to need to make some decisions. What’s best for your pet? What treatment options are available? What will the impacts be on your pet’s quality of life? What will the impacts be on your quality of life? Don’t forget your quality of life directly impacts your pet’s life, so you have to consider what you’re willing and able to do as part of your path forward. Talk to your vet, get advice from other people, and do your own research. Get as much information as you can and then take it one step at a time. There weren’t many options for Lily. Her cancer had spread, and because it was such aggressive cancer, chemotherapy likely wouldn’t have given her much more time. It would have made her feel bad and required a long weekly car ride to the oncologist. Lily hated the car. It wasn’t an option for her. Depending on your decision to manage your pet’s illness, take the next necessary step. If you’re going to be seeing specialists or getting further treatment, make those appointments. Try not to plan beyond that because you don’t know what each specialist visit will reveal. With one of our other dogs, we had to see numerous specialists to deal with her end of life care, and each specialist visit presented another round of decisions to be made. That’s why I suggest taking it one step at a time because it’s all you really can do. With Lily, we knew we weren’t going to proceed with any additional treatment, so our next steps were making her as comfortable as possible and doing what we could to prolong her life, giving her the best quality of life. This included a new diet with all homemade healthy foods and having her on several supplements. Eventually, when those things didn’t seem to be maintaining her quality of life, we gave her prednisone until the end. We only had Lily with us for six weeks beyond her diagnosis, but we made the most of those six weeks with her. Every day was a gift. Next, consider the end of life decision that will need to be made if you plan on euthanasia. We spoke with our vet about our options for Lily, so we had a plan which included where we would euthanize her and who would be present. We also knew we didn’t want her to suffer, so continually assessed (sometimes daily), whether it was the right time. There are many quality-of-life assessments to evaluate whether your pet is living his or her best life, but we use the “five things” rule that our vet suggested to us many years ago. Think about five things your pet loves to do (and, if they’re older, it may only be three things). Ask yourself how many of those things they can still do. If it’s not at least half, they’re not living their best life, and it may be time to say goodbye. Trust your gut about when it’s time. You’ll know. You know them best. And they usually let you know. For me, it’s usually a look I get from them. Trust them, trust yourself. You’re doing the right thing. Finally, grieve. Grief knows no time and no process. It differs for everyone. Allow yourself space and time you need to grieve the loss. Get support if you need it. All you’re feeling is real, and it needs to be processed, even if it feels awful. That’s why support groups and understanding family members and friends can be helpful. Give yourself the care you need during this time and all during the end of your pet’s life. Even though we know that we’re going to outlive our pets in most cases, it doesn’t make watching them fail or age or be sick any easier. My biggest takeaway from dealing with end-of-life care for several of my pets the last few years has been to cherish every moment; cherish every walk, every tail wag, every meow, bark, lick, and hug. Those are the things that remain in your heart forever.  

The first time I lost an animal, I was 39 years old. It was my first pet, Lynx, who I adopted as a kitten when I graduated college at age 22. He was 17 when he passed and meant the world to me. I spent my childhood begging my parents for a pet. Other than a hamster, they never consented. So, as soon as I was able, I got Lynx. Losing him was heart-wrenching. I put him down on a Sunday and, at the time, was in a high-level job at a large corporation. I didn’t even think about taking Monday off. I remember thinking to myself, “no one will understand how heartbroken I am.” I also remember feeling slightly embarrassed about how devastated I was about losing a cat. After all, it wasn’t a human. But as I learned that day and am reminded each time I put down one of my beloved pets, it feels as bad as losing a beloved human. Sometimes it feels worse because, let’s be real, sometimes we’re closer to our pets than we are to humans.   Disenfranchised grief is common in pet owners and animal lovers. It is known as silent grief and occurs when we don’t feel validated for the grief and loss we feel and when we aren’t able to openly express our feelings because we assume that others will judge us, or our feelings will be misunderstood. In other words, it is grief that may not be accepted by societal norms. People often don’t know how to react to someone who is grieving. When it’s a loss that is not typically mourned in public (such as the loss of a pet), it creates even more discomfort for both the griever and others exposed to the grief. This discomfort can cause pet owners to hide their feelings. However, research shows that the grief of pet loss is sometimes the most heartbreaking loss one can experience (Marton et al., 2019).   As pet owners and animal lovers, we have a right to experience that loss and express our emotions, so we can fully process our grief and heal. I think it’s incumbent upon us not to add to the disenfranchisement of our grief by doing what I did many years ago when my cat passed away. Instead of assuming no one would understand and hiding the heartbreak, be open and honest about it with the people in your life – your friends, family, and colleagues. Sure, many of them may not understand, but I’ve found over the years that many of them will.   The day after my cat Lynx died, I went into work. My boss was aware that something was “off” with me and asked me if I was okay. When I told her that my cat died the day before, she was shocked that I came into the office. She was upset with me for not letting her know about it and not taking time away from work to grieve. She confirmed for me that first, many people do understand what it feels like to lose a pet. And second, what we’re feeling is real and valid.   The first step in acknowledging the validity of our feelings is recognizing and accepting them ourselves. When we do that and have compassion for ourselves, others’ responses have less impact on us. In fact, another person’s response to your feelings is almost always about them and not you.   What else can you do to not contribute to the disenfranchisement of grief related to pet loss? First, grieve in a safe space. At first, this may be alone, in your home, or with your family members who are also grieving the loss of your pet. Of course, family members may grieve differently than you do, so it’s important to remember that everyone will experience and express the loss differently. There is no right or wrong way to do it. Second, grieve with others who have also lost a pet. Pet loss support groups are a great way to connect with others who are experiencing a similar loss and who will understand and normalize how you feel. Other pet owners and animal lovers may also be supportive because they understand what it is like to lose a pet and how difficult it is. Finally, as I said earlier (it’s worth repeating), acknowledge your feelings, and be compassionate with yourself. When we recognize and accept our feelings, it makes it easier to share them honestly with others. I think the reason I felt uncomfortable sharing my heartbreak when I lost Lynx was because I was shocked by it. Now, after having lost several other beloved pets since Lynx, I am much more likely to express my grief openly. My feelings of loss are as real as it gets, as are yours. Whether or not someone else understands this grief isn’t our responsibility. Our responsibility is to not contribute to the disenfranchisement of grief over pet loss. Our pets are our family, and I believe that by accepting and acknowledging how hard it is to lose them, we are fully honoring the joy they bring to our lives. Reference:Marton, B., Kilbane, T., & Nelson-Becker, H. (2019). Exploring the loss and disenfranchised grief of animal care workers. Death Studies, 0(0), 1–11. https://doi.org/10.1080/07481187.2018.1519610  

“I feel like we just brought one-year-old Hokie home from the shelter, and now he’s suddenly a senior dog with a terminal illness. I can’t imagine my life without him” ~ Debra G. If you’re a pet owner, chances are you’ve experienced a thought or feeling similar to the above statement. How do our young pets suddenly become gray-faced seniors with limited days left on earth? If all goes according to plan, most pet owners will outlive their pets; yet, we don’t like to think about their end-of-life, and we usually don’t think about it until we have no choice. Anticipatory grief is grief that begins before the actual loss of a loved one (Allen & Gore, 2020). This grief is common in pet owners dealing with an aging pet or who receive a diagnosis of a beloved pet's terminal illness. Anticipatory grief is frequently defined in research as: “The phenomenon encompassing the processes of mourning, coping, interaction, planning, and psychosocial reorganization that are stimulated and begun in part in response to the awareness of the impending loss of a loved one (death) and the recognition of associated losses in the past present and future.” (Rando, 1986, p. 20) This is real grief that produces real feelings in pet owners. It is important for pet owners to know how to cope with these feelings. The remainder of this article will outline the triggers of anticipatory grief in pet owners, how it feels, and strategies for coping with these feelings. When does it start and how long does it last? Anticipatory grief can set in when you begin noticing signs of aging in your pet such as moving slower than they used to and becoming grayer in the face. Their aging process may trigger your awareness that their end of life is getting closer to becoming a reality. The diagnosis of a pet's terminal illness may also trigger anticipatory grief - regardless of the pet's age - and may propel you into feelings of grief about the expected loss of your pet.Anticipatory grief can be long-lasting and can go on for as long as someone is awaiting the loss of their pet whether due to old age or illness. For example, a pet owner - whose cat is diagnosed with terminal cancer and then passes away a month after diagnosis - may experience anticipatory grief throughout that last month of time that they spent together with their pet. For another owner whose dog is in a slow decline for the last two years of her life, the anticipatory grief may be prolonged over that two-year period of time. The timeframe depends on the anticipatory grief trigger point and when the pet passes.   How does it feel? Anticipatory grief impacts pet owners emotionally, cognitively, and physically (Cox, 2017). Guilt is a common feeling of pet owners as they question whether they are doing enough to help their pets, whether their pet is suffering, and when it will be time to say goodbye (Hewson, 2014). The pending euthanasia decision is one that causes many pet owners to feel deep sadness and despair. Having to make the decision to end their pet’s life is one decision that many pet owners struggle with, and that struggle is exacerbated during anticipatory grief (Laing & Maylea, 2018). Anticipatory grief also has physical impacts - stress impacts a pet owner’s physiological state, sleep patterns, and the way they live. Many pet owners change the way they live daily life to accommodate their sick or aging pet. For example, they limit time away from home because they need to administer medication to their aging or sick pets and forego vacations to properly care for their pets. Pet owners acclimate their lives to take care of their pets and are often unaware of how these life changes decrease their own quality of life over time. Although pet owners may not recognize or feel the effects of these life limitations while immersed in their caregiving, the realization becomes apparent when they look back or reflect on what their life was like as they dealt with their aging or sick pet. Anticipatory grief often strengthens the human-animal bond, and feelings of closeness to one's pet grow and deepen. Pet owners dedicate more time and energy to caring for their pets, tending to them physically, as well as spending more time with them in anticipation of their death. This can deepen their bond with their pet. For example, when Matt’s basset hound became too frail to walk up and down a flight of stairs, he began carrying her up and down the stairs a few times a day, every day for over a year. Those daily walks up and down stairs with a 50-lb basset hound in his arms deepened his love for her and made it even more difficult to anticipate the end of her life. How can you cope? If you’re experiencing anticipatory grief, know that your feelings are normal and justified. Even if others don’t understand what you’re experiencing, you are a pet-parent, and your feelings related to the expected loss of your pet are real and valid.  There are a few things you can do to help cope with your anticipatory grief. First, take care of yourself so that you can best care for your pet. It may be easy to sacrifice your own well-being and do everything to ensure your pet is comfortable and well-cared-for; however, if you are not well, you can’t provide the best care for your pet. Practice self-care by getting good sleep, eating well, and spending time in nature. Or, if you enjoy yoga, a massage, or meditation, take time for those things. You must be fully healthy to best tend to your pet’s needs. Second, feel your feelings. Whatever you’re feeling - whether sadness, anger, guilt, or frustration - feel it without any judgment. Emotions are energy and need to move through your body, so that they don’t get stuck and create additional stress. By acknowledging your sadness or anger and giving yourself space to express it, either through talking to someone about it, writing about it, going for a walk, or a run to release it, you give those feelings space to move. That’s part of coping with negative emotions – feel them so that they can move through your body. Third, spend quality time with your pet. You best know your pet and know what they love to do. You also know what they can do comfortably during this time. What can they do that they love to do? Spend time doing those things with your pet. Fourth, plan ahead, if possible. If you’re planning to euthanize your pet, discuss this with your veterinarian so you know where it will happen and who will be there. Also, talk to your vet about how to know when it’s time.  There are several quality of life scales that you can use to assess your pet’s quality of life and to determine when it might be the right time to say goodbye. Remember, you may always question whether it’s the “right time,” but having a plan about where it will happen and what to look for when making the decision may help with your anticipatory grief. Finally, seek support. Many pet owners have experienced and are experiencing the same anticipatory grief as you. Attending a pet loss support group with others in a similar situation can help you cope with your anticipatory grief. The process of sharing your feelings with others who understand - because they’ve been there - can be extremely helpful and healing. You can also seek individual support from a professional grief counselor if you prefer a one-on-one setting. Our pets bring so much joy to our lives, and most pet owners always wish they had more time with their fur-babies. Unfortunately, saying goodbye to them is part of the cycle of life. Anticipating that goodbye is also a difficult reality of being a pet owner. Remember - all that you feel as you await the end of your pet’s life is real. It's a reflection of how much you love them and how much they love you. Be kind to yourself and trust that the love you have for your pet will guide you through and help you make the best decisions at the end of their life. References: Allen, E., & Gore, M. (2020). Helping clients prepare for pet loss. In. L. Kogan & P. Erdman (Eds.), Pet loss, grief, and therapeutic interventions: Practitioners navigating the human-animal bond (pp. 281-292). New York, NY: Routledge. Cox, S. (2017). Anticipatory grief and preparation for loss. In M. Gardner & D. McVety (Eds.), Treatment and care of the geriatric veterinary patient (pp. 311-315). Hoboken, NJ: John Wiley & Sons, Inc. Hewson, C. (2014). Grief for pets – Part 1: Overview and some false assumptions, Veterinary Nursing Journal, 29(9), 302-305. DOI: 10.1111/vnj.12175 Laing, M., & Maylea, C. (2018). “They burn brightly, but only for a short time”: The role of social workers in companion animal grief and loss, Anthrozoös, 31(2), 221-232. DOI: 10.1080/08927936.2018.1434062 Rando, T. A. (1986). A comprehensive analysis of anticipatory grief: Perspectives, processes, promises, and problems. In T. Rando (Ed.), Loss and anticipatory grief (pp. 1-37). New York, NY: Lexington Books.