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Q&A with Dr. Mary Gardner, Grey Muzzle Advisory Board Member

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We're pleased to share this interview between our Advisory Board member, Dr. Mary Gardner and our Board Member, Denise Fleck regarding Lap of Love Veterinary Hospice.

The Grey Muzzle Organization is delighted to introduce you to our newest Advisory Board Member, Dr. Mary Gardner.  Along with Dani McVety, DVM, Dr. Gardner founded Lap of Love Veterinary Hospice, the largest network of veterinarians dedicated solely to end of life veterinary care whose goal is to empower every owner to care for their geriatric pets. The philosophy centers around the human-animal bond and the need for that bond to be as undisturbed as possible during this most difficult time. The desire to bring this important service to families across the United States is slowly being realized as additional veterinarians begin working under the same philosophy. 

GMO:  Was there one senior dog or cat that you shared your life with, or whom was loved by a client, that propelled you in the direction of hospice care?

DR. GARDNER:  Well, not hospice care exactly, but becoming a vet in the first place.  You see, I was in software for almost a decade before vet school. I never intended to be a veterinarian when I was young. I loved animals like most kids – but to be a doctor – that was not in my mindset at all!

My Samoyed, who was with me through high school and college, died after a dog fight (she held on for about 2 weeks but finally became an angel after the infection was too much for her to fight).  Snow White was 12 at the time of her death. I can’t say she had a grey muzzle, because she was all white to begin with, but she was definitely a geriatric dog. What bothered me the most was when people would tell me that she was ‘old anyway’ – like the fact that she was 12 made her passing 'better.'  I was in a massive state of grief, and that experience led me to look into vet school.  At the age of 31, I entered vet school at the University of Florida.  I knew I wanted to help families who loved their animals as much as I loved Snow White.   I was in general practice for about 2 years before dedicating my career to end of life, but I knew that was the path for me.  The loss of my dog changed my life forever, and if I can help families with the loss of their furry loved ones, then I have come full circle.

GMO:  Software design and veterinary care – two career paths that don’t usually intersect in the same person, right?  I hear a lot of veterinarians struggling to get up-to-speed with the techie stuff.  With you though Dr. Gardner, it sounds like it was a perfect match.  Explain.

DR. GARDNER: Ha – you're right! Now that many clinics run on cloud-based software for managing patient records, all veterinarians need to learn to be a little techie, and it is a struggle for some.  What I love about what I do is that we built our own software management system which I lead the development of.  I really enjoy finding ways to help our vets manage their cases more easily, for our Support Center to answer the phones and client questions efficiently and for our website to function seamlessly.  It isn’t always the case, but I do enjoy that challenge.

GMO:  Euthanasia, Hospice Care, End of Life…Terms as pet parents we cringe at saying out loud.  How do you describe them and what can you share to help us feel better about making these decisions for our best friend?

DR. GARDNER:   We never want the day to come when we have to say goodbye. You make a promise to your pets the day you get them to take care of until the very end, but that also includes making the end just as good as all the years before.  Many people don’t fully understand what Veterinary Hospice is. Some even think it is prolonging the inevitable or allowing pets to suffer, or that it is a way to avoid euthanasia. In fact, it is the opposite! Hospice is about making the remaining time we have with our pets as pain-free and anxiety-free as possible and to enjoy that time. We can’t always extend the time we have with our pets, but we can make it better.

Many pet owners wish for their pets to pass in their sleep, and I don’t disagree as that is how I personally want to go (in my sleep).  The reality is however, that sometimes pets struggle and suffer before they pass, they may pass in the middle of the day, they may be alone, and finding your pet after they have passed can be traumatic and bring a lot of grief.  Providing a peaceful passing with euthanasia allows a family to be present, to ensure their pet is calm and comfortable before saying goodbye, and it is the only way that I can guarantee a family that their pet will pass peacefully.  The one thing families want (a peacefully passing in their sleep) is exactly what euthanasia is.  End of Life does not equal end of love.  So, loving on your pet until the very end and even beyond that is what I encourage all families to do. 

GMO:  Wow that makes so much sense Dr. Gardner.  It is so difficult to have to make that decision for another being, and I do think many of us do hope that it will happen 'naturally,' but you brought up a great point.  'Natural' doesn't mean peaceful or pain-free whereas euthanasia permits that.  However, how you answer that tough soul-searching question, “Will I know when it is time to say goodbye to my best friend?”

DR. GARDNER: This happens to be my favorite question to answer, and I get it on a daily basis.  Most of my hospice appointments focus on this question.  There is no ‘right’ time, there is no exact time, but there is a phase in time where euthanasia is appropriate.  That phase is different for every pet and family. Depending on what ailment(s) the pet is challenged with may change that phase. A pet in respiratory distress will need assistance faster than a pet that has chronic mobility issues.  Also, the pet’s personality comes into play as well as what they can tolerate.  Lastly, the family's ability to care for the pet financially, time wise, physically and emotionally.

I currently have a 13-year-old Doberman who has mobility issues and a heart condition. He takes medications 5 times a day and needs to be let out to the bathroom every 4 hours. This is very difficult to manage, and it takes a team approach. If I didn’t have help, I could not properly care for him and it would be best that I let him go. 

Every pet, family and situation needs to be considered individually.  There is no one black and white answer, but it is my duty as a veterinarian to help guide families appropriately and support their decision.

GMO:  What are your thoughts as far as ALL family members – regardless of age – being present during those final moments?

DR. GARDNER: I think that any member who wants to be present should be allowed to be present.  Children ages 4 or above should be asked if they want to be there. Often times youngsters say the most amazing things during the euthanasia.  With that said, I know that being present is not easy for everyone and some may elect not to be there.  I like to explain the process to everyone, so that all know how peaceful it is, and then each can decide how involved they want to be.

GMO:  Compassion fatigue, I would imagine, is a reality in your line of love (I purposely didn’t choose “line of work”).  I listened to a Steve Dale interview with you and you mentioned that what you do isn’t sad because you deal with families who REALLY love their pets.  Can you elaborate on what you experience and how you deal with your own personal feelings?

DR. GARDNER: (I love ‘line of love’!) Compassion fatigue is a statement that is often used in veterinary medicine and it is true that many of my colleagues are frustrated, depressed and even suicidal which is very sad to me. Most think vets have this ‘compassion fatigue’ because of euthanasia, which is not the case at all.  I think most veterinarians have an amazing amount of compassion, and euthanasia due to economics is hard for everyone, but euthanasia due to terminal illness or age-related changes – that is easier for us to wrap our heads around.  I believe many cases of ‘Compassion Fatigue’ are more likely “Ethical Fatigue” that plagues my colleagues, but that is a whole other discussion.

What many wonder is how we deal with death and crying families every day – multiple times a day.  This question can be posed to human hospice and funeral home workers, and I would assume we have similar outlooks.  You see, I cannot stop biology, I cannot stop ‘mother nature,’ I cannot stop the fact that we will all have to say goodbye to our pets one day, but...what I have control over is making the passing a good one. One that celebrates the love the family had for that pet, one that is full of dignity, one that is surrounded by love.  When I see a family crying over their pet, my compassion ‘tank’ is refilled.  That pet had a family who loved him. That pet was considered a family member.  That pet had a wonderful life.  I’m happy for that pet as not all animals are that lucky. So many are homeless or not treated well.

Not one of our vets suffer from compassion fatigue. Do we all have some life fatigue every now and then – yes, but what we do does not damage us. It actually is quite fulfilling, and it provides me so much happiness. When I leave a home, and I get the biggest hug and a pet parent says, “That was so hard, but you made it better!”  Well, then I’ve done my job well.

GMO:  Any special patients/stories you’d like to share?

DR. GARDNER:  Oh gosh – there are just so many stories, patients and families. One day I need to write a book because picking just one is an injustice! 

GMO:  How do you find the veterinarians in your network and what qualifies them to provide services via the Lap of Love network?

DR. GARDNER:   We have found the best veterinarians to work with Lap of Love. Many of them will hear me or Dr. Dani speak and then come up to us asking about working with us. Or they read an article that we have published, but this line of work is not for everyone. It's those vets who share our passion for end of life care that look into this niche of veterinary medicine.  Once they show interest, we first make sure they live in an area that can support our service. If they do, then we have a multitude of conversations with them about what we do, our standards of care, our beliefs/way of work, etc. We also want to make sure that they share our beliefs, care about end of life and can handle the difficult conversations we have.    If we align on everything, we offer them a position with us.   It’s not really a ‘network.’  We are a huge family that spans the U.S. but we are all connected on a daily basis.

GMO:  Please tell us about “The Pet Hospice Journal” and where we can learn more.

DR. GARDNER:  The Pet Hospice Journal is one of many tools pet owners can use to track the progress of their pet during end of life. It is more of a diseased-based program which will place more ‘weight’ on symptoms based on the pet’s condition.  It also allows owners to keep notes and pictures tied to each day or week they make an entry.  Some families like simple methods of tracking progress while others like more details – this Journal is great for the later families. 

GMO:  Would you mind sharing Bodhi’s story? And thank you so much for making a very generous donation to our hospice fundraising campaign in Bodhi’s memory.

DR. GARDNER:  I adopted Bodhi 3 years ago from a cat rescue. He was already a geriatric cat at that time, but he also had kidney failure. He was a smooshy lovey lap cat which I was in need of at that time. I didn’t know how much longer he would have, but I took it month by month. 3 years later he was still with us. He recently passed and I’m blessed to have had his presence in my life.  He was proof that even the old and wobbly can get adopted!

GMO:  Is there anything coming up or something else you’d like us to know about?

DR. GARDNER:  I’m continuing to speak around the country to veterinarians and technicians on end of life care – that part of my job is amazing! To share ideas and techniques with colleagues and see different places on this planet.  I’ve been very blessed!

GMO:  Where can we learn more?

DR. GARDNER: Our website www.LapofLove.com is filled with information for the pet owner! 

About the Contributor: 

Dr. Mary Gardner has a special place in her heart for the skinny, wobbly, grey-muzzled pets. Passionate about geriatric care, she is a veterinarian and co-founder of Lap of Love Veterinary Hospice, a nationwide practice whose 120+ veterinarians provide in-home hospice, euthanasia and end-of-life care.

She is a published author and co-editor of the textbook “Treatment and Care for the Geriatric Veterinary Patient”.  She travels the world speaking about geriatric medicine, assessing quality of life, veterinary hospice, euthanasia and caregiver burden.

A 2008 University of Florida College of Veterinary Medicine graduate, she was awarded the Angel award for the recognition of the human animal bond. She also received the Alumni Achievement Award from the University of Florida in 2016.