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A collection of articles illuminating aspects of hospice care for animals in its application for small animals as well as horses. From differentiating between general end-of-life related animal care versus true hospice, understanding shortcomings of Quality-of-life scales, pondering Quality-of-death, how to recognize and soothe grief in remaining animal family members, to the spontaneous holding of a vigil, you will find topics and perspectives rarely to be found discussed elsewhere.

“The Stages of Dying from a 5-Element perspective” has proven to be crucial for users of our helpline or even only just our website who are looking to prepare themselves for the unhastened passing of their animal loved one.

To view an article in full, please click on the title you would like to read.

For publications on animal hospice translated into Spanish please click here.

For a number of these articles, a translation into Italian is available here.

For archived newsletters, click here.

Saying Goodbye to Our Pets 3 pages

In this article Ella shares her experience of being with the body of her dog Plouche (pronounced “Ploosh”), who died unexpectedly while Ella was on a short trip. Without being familiar with the concept of holding a wake, Ella found herself having a vigil for Plouche.

The actual incident preceded Ella’s engagement in hospice care for animals and has since become a natural and much appreciated part of her suggestions for aftercare. Whether an animal dies suddenly, under hospice care or has been euthanized, time spent with the body of a beloved animal family member can be very precious.

Written by Ella Bittel, Holistic Veterinarian, published in Natural Transitions Magazine, July 9, 2018, Volume 7, Issue 1, pages 13-15.

Down Horse – It must not (always) be the end 3 pages

Due to the much larger body size and weight, having a horse rather than a dog, cat or other small animal be the patient, takes giving hospice or even “just” special-needs or geriatric care to a completely new dimension of challenge. This has led to countless horse parents feeling as if they were left with no option other than to euthanize when their equine shows difficulty rising. By sharing how some incredibly dedicated horse lovers have managed to continue to care for their hoofed loved one instead we learn that at times the seemingly impossible becomes possible. If you have had an experience of your own along similar lines, whether you cared for a horse or other large animal when the situation deemed nearly hopeless, we would love to hear your story as well!

Written by Ella Bittel, Holistic Veterinarian, published in Natural Horse Magazine, April/May/June, 2013, Volume 15, Issue 2, pages 52-54.

Hospice 3 pages

This article is written for veterinarians with interest in integrative options, but can be informative also to other readers. Under the sub header “What to know about offering hospice”, it includes a list of 19 items covering various aspects to consider when aiming for such endeavor.

Written by Ella Bittel, Holistic Veterinarian, published in Integrative Veterinary Care, Winter Issue 2012, pages 46-50.

Is He Grieving? 4 pages

Grief is as real and impactful in horses as in people, though it may not always be readily observable. This article outlines three basic types of emotional responses that can be distinguished in animals, and shows ways how we can support the grieving individual with holistic means as to help it regain and maintain optimal overall health. Naturally, the tips given can be adapted for members of species other than the equine.

Written by Ella Bittel, Holistic Veterinarian, published in Equine Wellness Magazine, October/ November 2012, Volume 7, Issue 5, pages 42-45.

When is End-of-Life Care for Animals truly Hospice? 4 pages

“The (almost) invisible difference determining life and death” is the subtitle of this article. It shows how the terms Palliative Care, End-of-Life Care, and Hospice Care are distinct from another, and how the fact they get commonly used interchangeably can make it challenging to find who among veterinary providers indeed offers hospice services. It also contains a table illuminating the limitations of usefulness of currently publicized veterinary “Quality-of-Life Scales” in end-of-life care.

Written by Ella Bittel, Holistic Veterinarian, and James Armer, DVM, Emergency & Critical Care, published in Fall 2011, The Latham Letter, Vol. XXXII, Number 4, pg. 16-19.

The Stages of Dying from a Five Element Perspective 6 pages

This document describes some of the common symptoms one may encounter in a dying animal when providing hospice. The text was originally written by Ella Bittel to accompany her presentation at the 2nd International Symposium for Veterinary Hospice Care, which took place at UC Davis in fall 2009.

Hospice for Horses – Taking Time to say Farewell

This articles contains a brief description of goals of hospice care, changes one might notice in a horse close to the end of its life, and preventative steps on can take regarding the three most common conditions for which horses are being euthanized.

Written by Ella Bittel, Holistic Veterinarian, published in Equine Wellness, July/August 2009, Vol. 4, Issue 4, pg. 48-50.

SPIRITS in Transition – Spring 2009 Newsletter Update

Veterinary Hospice Care – Post Conference Reflections

Summarized in this article are considerations stimulated by the 1st International Symposium on Veterinary Hospice Care, which took place in California in March 2008 at the campus of UC Davis School of Veterinary Medicine.

Ella Bittel, Holistic Veterinarian, was a presenter at this event (proceedings text posted below), but wrote this article more from the perspective of an involved observer, contemplating possibilities and challenges the veterinary profession is facing when opening up to hospice care for animals.

Subjects covered include “Gap in Standard of Care”, “Sister Human Hospice”, “Re-evaluating the Plan of Care” and “Suffering and the Will to Live”.

Written by Ella Bittel, Holistic Veterinarian, published in theJournal of the American Holistic Veterinary Medical Association, July-September 2008, Vol. 27, Number 2, pg. 25-28.

Quality of Life – Quality of Death Article for the Latham Foundation, 1100 words

The Latham Foundation for the Promotion of Humane Education, celebrating 90 years of their excellent work in 2008, was represented also at the 1st International Symposium of Veterinary Hospice Care. Inspired by the presentations, it was decided the Foundation would dedicate an entire special issue of their quarterly magazine, The Latham Letter, to Veterinary Hospice Care. Several of the symposium speakers wrote articles on the topic they had presented on.

Click on the title for the article “Quality of Life – Quality of Death” by Ella Bittel. While still to the same topic, this a version distinct from the proceedings text. Published Fall 2008, The Latham Letter, Vol. XXIX, Number 4, pg. 12-14.

The Latham Letter – Special Issue Fall 2008: Veterinary Hospice Care The entire magazine!

Special Issue on Veterinary Hospice Care, The Latham Letter, Vol. XXIX, Number 4, Fall 2008. Includes “Veterinary Hospice Care- It’s History and Development” by Kathryn Marocchino, Ph.D., FT, Founder of The Nikki Hospice Foundation for Pets, and visionary who brought The International Symposium for Veterinary Hospice Care into existence.

Many thanks to The Latham Foundation, and specifically toJudy Johns, Managing Editor and Guest Editor Stacy Baar, for the creation of likely the first ever magazine entirely dedicated to Veterinary Hospice Care and sharing it with all so generously.

To visit The Latham Foundation web site, go to:http://www.latham.org/

Quality of Life – Quality of Death Proceedings text, 9 pages

This was the topic of Ella Bittel‘s speech at the 1st International Symposium on Veterinary Hospice Care which took place in California in March, 2008 at the campus of UC Davis School of Veterinary Medicine. Her presentation focused on distinguishing how different the needs of a dying individual are from those in the middle of life, and how we can support an animal throughout the end of its life.

This nine page document is the text as printed in the proceedings of the Symposium. It also looks at how our personal and societal notions about quality of life and suffering influence our decisions, which have triggered us to treat our animal family members very differently from our human loved ones when a terminal diagnosis has been made.

Focusing On The End

This article takes a look how in the veterinary profession the term “hospice” currently is being interpreted in various ways. While all focus on comfort or palliative care, there are great differences in how soon or often euthanasia gets implemented.

The article also talks about the First Symposium on Veterinary Hospice Care, shows what is in the making and already available in terms of education and pet hospice services and in addition touches on ways to memorialize a beloved pet.

We are grateful to Jessica Tremayne for taking on this topic. Her article was published inVeterinary Practice News, July 2008, Vol. 20/ Number 7/55, pg. 24-25.

A Natural Transition

Help your dog die peacefully in her own home is the subtitle of this article which briefly summarizes some of the key points of how to provide quality of dying.

Written by Denise Flaim, published in DogFancy, August 2008, Vol. 39, Number 8, pg.21

Leaving this Life, in Rhythm with Nature

Common misunderstandings present in our society lead people to euthanize their animals in reaction to normal signs that mark specific phases during the natural dying process. His mom choosing to provide palliative care over calling the vet for the final shot allowed senior gelding Sunny to overcome a serious health crisis in the winter of 2006.

Written by Ella Bittel, Holistic Veterinarian. First published in Holistic Horse, Integrative Therapies for Horse and Rider, Fall 2007, Issue 51, pg.28

The original article can be read HERE.

Sunny went forth to “host” the SPIRITS in Transition seminar in December 2007, enjoying another golden year including one more beautiful birthday party with his human and animal friends.

Embracing Death’s Journey with Our Animals

The death of her own dog, Momo, was the initial incidence that had Ella realize the extent to which in our society euthanasia has replaced knowledge about how to support an animal through its natural dying process.

Written by Ella Bittel, Holistic Veterinarian. First published in Alternatives Magazine, Resources for Cultural Creativity, Summer ’07, Issue 42, pg.35

The original article can be read HERE.

In 2017 the article got re-published in the Pets edition of Natural Transitions magazine