The "how will I know it is time?" question is one of the most common and most difficult questions asked of veterinarians. We can offer benchmarks to help gauge the pet's quality of life. For pets known to us (as patients), we can offer guidelines more specific to the situation and pet's overall health.

One of the most difficult times is that time between a pet's terminal diagnosis (or failing health due to age) to the time when the actual decision is made.

This may be weeks, months, or sometimes even a year or two, depending on the medical condition we are dealing with. As a disease or old age progresses, it becomes it even more confusing to "know" and be objective. 

One of the people navigating this limbo time is Edie Jarolim, writer and blogger at Will My Dog Hate Me. Her dog Frankie is a senior diabetic dog who has Canine Cognitive Dysfunction (CCD). Confused by Frankie's growing confusion, Jarolim contacted a veterinarian who specializes in doing in-home visits to help assess a pet's quality of life.

Here is our interview to learn more about this valuable service for others in this situation.

1) How did you learn about the quality of life evaluation/service?

Jarolim: A friend of mine had used the service when she wasn’t sure whether her beloved German shepherd, Ellie, was enjoying life any more. It was a while ago, but my friend was so pleased with the experience that I remembered when I was in my own quandary.

2) What did you expect from this visit? 

Jarolim: Objectivity and honesty – and maybe confirmation of my gut instincts. I had recently visited my usual veterinary practice and had been told that my dog needed to have his two bottom teeth pulled, which would require a veterinary specialty dentist because it would be a difficult procedure. Frankie is 14 and has had Canine Cognitive Dysfunction for a while. This suggestion seemed nutty under the circumstances – not only expensive but needlessly stressful.

Once I decided that I wasn’t going to do anything like this, I wanted to know what it was I should do. Try different antioxidants for his CCD? Continue to exercise him in spite of his reluctance to go out because it was good for him? I had no clue.

3) Did the evaluation meet your expectations?

Jarolim: It exceeded them. I think it takes a special personality to have this kind of practice – kind and sympathetic but also direct -- and Dr. Sheila Kirt definitely has it. She answered all my questions, then observed Frankie and examined him (in a very gentle fashion) and made an evaluation.

She said what I suspected – that Frankie wasn’t really very aware of his surroundings – and clinched my suspicions that it was to let him go when she said he might be frightened as well as confused much of the time.

4) Would you recommend this service to others?

Jarolim: Without reservations. It’s the best thing I could have done for myself and for Frankie. People always say your pet will tell you when they want to go. Well, my pet didn’t and I didn’t know. I needed a human to help. A hospice vet can’t eliminate sadness and grief, but she can eliminate guilt and uncertainty.

5) Do you have any other advice for people during this "in limbo" time, knowing that their pet's time or quality of life is winding down?

Jarolim: Spoil them silly without making them sick or pushing them beyond their physical capabilities. You know best what it is your dog loves; try to provide it in reasonable doses. And don’t forget that this is going to be tough on you, too. Spoil yourself silly without making yourself sick when you next look at the scale or pushing your budget beyond your credit card’s capabilities. 

Thank you, Edie Jarolim, for taking the time to help others facing these difficult caregiving decisions.

Connect with Edie Jarolim:Twitter | Will My Dog Hate Me | Facebook

This is Part 1 of a series on Hospice Help. 
Don't Miss Part 2: Hospice Help: A Veterinarian's Perspective with Dr. Jessica Vogelsang.