In veterinary medicine, we pride ourselves on our ability to end suffering.
We are fortunate to be able to offer humane euthanasia as a common and widely accepted practice for those canine patients with terminal illnesses or poor quality of life.
But is euthanasia always the answer? And does it need to happen immediately?
Pets are part of the family, so it is not surprising that pet owners are looking for ways to keep their furry companions with them as long as possible.
Veterinary hospice care and in-home euthanasia services are in increasingly high demand, yet this growing field is often undervalued among veterinary professionals.
Meanwhile, our human medicine colleagues have offered hospice care for decades.
Their experiences can provide us with a useful framework for implementing this type of care for veterinary patients.
In human medicine, the value of home care for the terminally ill patient has been well-recognised ever since the publication of Dr Elizabeth Kubler-Ross's famous work, On Death and Dying, in 1969.
Patients receiving dedicated home hospice care are reported to have a better overall appearance, as well as an improved quality of life.
While we cannot ask our furry friends about their end-of-life wishes, we do know that the majority of dogs experience fear in the veterinary clinic.
Problems with pain, loss of mobility, and increased anxiety are also likely to complicate the issue further.
Thus, it seems safe to assume that canine patients would prefer to receive hospice care at home.
As Dr Racine, veterinarian advisor at Gentle Dog Trainers, says: "As so much of dog hospice care relies on the pet owner's observations of their dog, this is a prime area to incorporate telemedicine into your vet appointments."
If it comes down to it, dogs and owners can also benefit from in-home euthanasia services.
However, not all veterinarian practices can provide this service, so make sure you ask around.
Remember that, in most cases, long-term or terminal illnesses in dogs are not a painless process.
No matter what the condition - worsening osteoarthritis, osteosarcoma, kidney failure, or any other chronic disease - there's a good chance that your dog will experience some level of discomfort as their body declines.
Pain control should be implemented early and frequently reassessed in order to maintain a good quality of life.
Dog owners should also be trained to evaluate the signs of pain in dogs and their assessment should be discussed with the veterinary team at regular intervals.
Palliative and hospice care scenarios also provide a unique opportunity to introduce alternative therapies.
Treatments such as medical massage and acupuncture may provide some benefit to the patient with little risk for adverse effects.
Pet owners should also remember that caring for a sick dog is physically and emotionally challenging.
They should ask their vet what to expect as their dog's condition progresses and how to identify end of life symptoms.
Training can be provided to assess pain and overall quality of life, with these assessments determining when euthanasia should be considered.
Discussions about end-of-life care and when and where they would like the euthanasia to be performed should be discussed well in advance.
These conversations can be extremely difficult for pet owners.
However, making such decisions in advance can both prevent miscommunications and minimise stress during a time of real grief.
Palliative and hospice care are rapidly growing areas of veterinary medicine, and the demand for these services will likely continue to increase.
Speaking to your vet about options for care at the end of your pet's life is not just good planning.
It will also mean that you're doing everything in your power to ensure your dog is comfortable in their final days.
Dr Elizabeth Racine is a writer and veterinarian.