Jonathan Leshanski, DVM, offers housecall euthanasia because he knows from personal experience the importance of the service to ailing animals and their emotionally distraught owners. "Before I became a veterinarian, I owned a cat named Hobbs who had terrible panic attacks that almost qualified as seizures anytime we took him out of the house," said Dr. Leshanski, owner of At Home Veterinary in New York City and former president of the American Assn. of Housecall Veterinarians. "I took him to the veterinarian when the time finally came to have him euthanized, and I felt miserable over the fact that the last 40 minutes of his life were spent in abject terror. "It was a terrible ending for a beloved pet, and I decided then that when I became a veterinarian, one of the things I would do was offer home visits-including euthanasia." Today, Leshanski performs a minimum of five home euthanasia procedures a week-much to the appreciation of his grieving clients. "My clients are incredibly grateful," Leshanski said. "Many have been with me since I got my license. Others are strangers who call me asking for help because their own veterinarians won't leave their clinics to come do it." Housecall euthanasia remains relatively uncommon, especially among veterinarians with brick-and-mortar practices, but those who go that extra mile say the service brings great value to their practices. "We've found that there is a great need for this kind of service," said Angela Andrade, administrative consultant at Whole World Pet and Veterinary House Calls for Cats in Santa Monica, Calif. "Not only for our high-profile clientele, but also for the lady who is in a wheelchair, the person who has no means of getting out and the family that just can't handle having their pet euthanized [in a hospital setting]. Everyone is so appreciative." Jeff Werber, DVM, owner of the Century Veterinary Group in Los Angeles, fell into home euthanasia by accident seven years ago when an elderly couple asked him to euthanize their ailing great Dane. "I thought of sending a tech over with a stretcher to pick up the dog, but then I realized the coldness of that and decided that since they were such good clients I would go to their house," said Dr. Werber, who has offered home euthanasia ever since. "That experience all around-from the owners' perspective, my perspective and most importantly from the dog's perspective-was the seller for me," Werber said. "That was what clinched it." Most pet owners request home euthanasia because they want their pets' final moments to be comfortable and loving rather than cold and clinical. But performing the procedure at home also benefits the client, said Barbara Smith, VMD, owner of House Call Veterinary Services in Pittsburgh. "Performing euthanasia at home reduces the stress level for the pets," Dr. Smith said. "I find it's also easier for the owners because they feel freer to grieve and show their emotions. It's also safer in that they don't have to drive home while upset." Home euthanasia is a compassionate service, but it's also a smart business move-especially if few other practitioners in your area are willing to go out to clients' homes, say practitioners. Werber offers a home euthanasia package that ranges from $250 to $350, depending on the travel distance. The fee includes the housecall, the cost of the euthanasia and a memorial plaster mold of the pet's foot. Roger Valentine, DVM, owner of Whole World Pet and Veterinary House Calls for Cats, charges $85 for the housecall in addition to the cost of the procedure, Andrade said. She added that home euthanasia-which is offered 24 hours a day, seven days a week-is a special service for clients and was never meant to be a big profit center for the practice. "However, we get a very satisfied client, and they often refer other clients to us," Andrade said. Smith said that home euthanasia is not a lucrative profit center for her either, but she keeps the cost low because the service helps ingratiate clients to her practice and strengthens the doctor-client bond. "If you're there in a supportive manner, they are grateful," Smith said. "If you take the time to help them grieve, it produces a very strong bond and very strong loyalty." Follow-up is also important. Smith and Leshanski, for example, always send condolence cards to clients who have lost pets. Werber sends cards and flowers, and for longtime clients he will make a donation to the University of California, Davis, School of Veterinary Medicine in their pets' names. When considering adding housecall euthanasia to your practice, keep in mind that the service can be much different than in-clinic euthanasia. "Home euthanasia tends to be much more time consuming," Leshanski said. "In a clinic setting you bring the patient into the exam room, place the catheter and when the client is ready you give the injection. "When you're in someone's home, it's much more personal. You can't go see another patient while they are getting ready; you're sitting there waiting. The average euthanasia takes a minimum of 35 minutes and sometimes as long as an hour. You don't want the client to feel rushed." Because of his busy hospital schedule, Werber performs home euthanasia only after hours, which can make for a very long day. One time he arrived at a client's home around 11:30 p.m. and didn't leave until after 1 a.m. "But no matter how long it takes, it's always a very special experience," Werber said. Don Vaughan is a frequent contributor to Veterinary Practice News. This article first appeared in the October 2004 issue of Veterinary Practice News. A Pet Owner's Story Karen and Lew Berish of Frisco, Texas, are glad they had their cat, Houdini, euthanized at home. Doing so, they said, made the procedure far less traumatic for everyone. Houdini survived a variety of health problems throughout his 15 years, Karen said, but they finally decided to have him euthanized when he developed an inoperable tumor on one leg. Because Houdini became physically sick every time they drove him to the veterinarian, the Berishes asked their practitioner, Dawn Nolan, DVM, of VCA Preston Park Animal Hospital in Dallas, if she would come to their home to put Houdini down. "We didn't want his last hours to be miserable," Karen said. Having Houdini euthanized at home made the experience much easier to bear, Karen noted. Dr. Nolan was sympathetic, and even cried with them as she put Houdini to sleep. The practice also handled Houdini's cremation. "They only charged for the euthanasia and the cremation; there was no extra charge for the house call service," Karen said. "They didn't talk about charges at the time of the procedure-I was presented with the bill when I picked up Houdini's ashes a week or so later." The staff of VCA Preston Park Animal Hospital sent the Berishes a sympathy card and a house plant. The practice also sent a donation in Houdini's name to an animal charity. -D.V. Popular Disposal Choice Most veterinarians who perform home euthanasia assist, at least in part, with the disposal of an animal's body. Cremation is by far the most popular choice, they say-often because many municipal ordinances prohibit the burying of animal carcasses within city limits. "I would say 70 percent of my clients opt for private cremation, 25 to 28 percent will do what we call 'communal' cremation, and the rest will do 'other,' meaning they take the body and bury it themselves somewhere," said Jeff Werber, DVM, who works with a San Fernando Valley, Calif., veterinary cremation company called Guardian Aftercare. Whole World Pet & Veterinary House Calls for Cats in Santa Monica, Calif., also helps make arrangements for cremation, said administrative consultant Angela Andrade. The practice provides a free cedar box for the ashes and marble and brass urns are available for an additional fee. "Almost all of our clients want their pets cremated," Andrade said. "I'd say less than half of one percent take the body and bury it themselves." Jonathan Leshanski, DVM, will handle a pet's remains if asked, but he limits them to 35 pounds. "Anything larger is too difficult for me to manage," he said. "In New York, we have a crematorium that will pick up at the owner's home if necessary." Dr. Leshanski also gives mourning pet owners the phone number of a grief hotline. "That way they have someone to lean on, particularly in the case of an older person who, at 2 or 3 in the morning, may not be able to deal with the fact that their pet is no longer with them," he said. -D.V. <HOME>
