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The Art of Being Kind to Your Vet with Lianna Titcombe

Show Notes

Dr. Lianna Titcombe is the founder and owner of Claire Place Veterinary Hospice in Ottawa, Ontario, one of the first practices in Canada devoted to end-of-life care for companion animals.

You may remember her from The Art of Checking Your Phone. Lianna is one of the veterinarians who have contributed to the pet loss grief content in Help Texts, an SMS-based service to help people cope through loss and grief.

On the subject of animal hospice and palliative care, she is an author, speaker, educator and mentor. She is the past president of the International Association for Animal Hospice and Palliative Care and is still active with their international committee.

She participates in volunteer missions to provide veterinary care to underserviced communities both locally and in developing countries.

And she has been the director of the Pet Loss Support Group of Ottawa for over 20 years.

In getting to know each other, Lianna and I learned we were both in the 2022 cohort for David Kessler’s grief educator program.

Her true passion is the art of gentle euthanasia and in 2021, became the international director and instructor for Companion Animal Euthanasia Training Academy.

After 20 years in veterinary medicine, she has retired from clinical practice to focus on education. She’s also a certified yoga instructor and compassion fatigue professional, who is offering grief retreats to people living with loss.

Today, we have an in-depth conversation about the veterinary field, euthanasia and the vet-pet guardian relationship.

What to listen for

3:29 How Lianna’s mom and dog George drive her to improve the death experience
7:12 Why planning the end can make it more peaceful
17:47 Veterinary burnout versus client expectations
26:44 The financial challenges of pet health care
38:04 The emotional impact of euthanizing pets as a veterinarian

Where to find Dr. Lianna Titcombe

Claire Place Veterinary Hospice in Ottawa, Ontario
Instagram
Facebook
Grief Retreats

Resources mentioned

Not One More Vet tips for pet guardians
Companion Animal Euthanasia Training Academy

Your discount codes

Dr. Buzby’s Tip-to-Tail Health Scan: Use code ONELAST
Get $10 off your first 12 months of Help Texts

Transcript

Angela  

Welcome to One Last Network and the Art of Being Kind to Your Vet.

Dr. Lianna Titcombe is the founder and owner of Claire Place Veterinary Hospice in Ottawa, Ontario, one of the first practices in Canada devoted to end-of-life care for companion animals.

You may remember her from The Art of Checking Your Phone. Lianna is one of the veterinarians who have contributed to the pet loss grief content in Help Texts, an SMS-based service to help people cope through loss and grief.

On the subject of animal hospice and palliative care, she is an author, speaker, educator and mentor. She is the past president of the International Association for Animal Hospice and Palliative Care and is still active with their international committee.

She participates in volunteer missions to provide veterinary care to underserviced communities both locally and in developing countries.

And she has been the director of the Pet Loss Support Group of Ottawa for over 20 years.

In getting to know each other, Lianna and I learned we were both in the 2022 cohort for David Kessler’s grief educator program.

Her true passion is the art of gentle euthanasia and in 2021, became the international director and instructor for Companion Animal Euthanasia Training Academy.

After 20 years in veterinary medicine, she has retired from clinical practice to focus on education. She’s also a certified yoga instructor and compassion fatigue professional, who is offering grief retreats to people living with loss.

Today, we have an in-depth conversation about the veterinary field, euthanasia and the vet-pet guardian relationship.

Good morning, Lianna Titcombe. How are you today?

Lianna 

I am well and good morning and good afternoon in Ottawa.

Angela  

Yeah, Ottawa. How are things in Ottawa these days?

Lianna 

A little chilly, can’t lie.

Angela  

My brother lives in your area, I get updates on the weather all the time. I remember the big ice storm.

Lianna 

Oh, me too. I’m still getting work done here in my house after that flood.

Angela  

So you were one of the first end of life veterinarians in Canada? What prompted you to move into that niche of the medical profession?

Lianna 

That is such a good question. People talk about your elevator speech, you know, you have 30 seconds go. Yeah, yeah. So at that point, I’d been a vet already for 15 years, hadn’t really found my niche. I did emergency general practice, shelter, medicine, lots of different things. And I would say it was the death of some humans in my world. So my mom and later my sister, and just seeing what kind of death they had. And it really wasn’t what I would have hoped for either one of them or for, you know, us, the family to live through. And then also the death of my own pets and how that looked and how I just wanted it to be different and better. And I knew that I wasn’t in the human health profession although my mom was a human doctor and my dad as well. It’s funny, we call them that right human doctors. And I just thought, you know, for my mom not to die the death she would have wished for it. Although she had given like her whole life, her whole profession to human health care. And even she didn’t get to die the death she wanted to so that’s kind of what started it. And I and sort of, you know, you have those aha moments.

So I had my dog George, who was a big Rottie-shepherd mix, and he had lost function of his hind legs, not completely, but he was very weak in the hind. And when we decided to let him go, it was in the backyard, and the sun was shining. And my two little boys are jumping on the trampoline. And it was super sad, of course. But I look back at the time, and I remember thinking, well, this is what we do as veterinarians, like, we don’t take our dog into a clinic, we have other vet friends, you know, come over and help us and say goodbye at home. And shouldn’t it be like that for everybody? And all pets and our clients? And how can we make this different and make it better? Because I don’t think that, like I know death is sad, but it can also really be beautiful. And I’ve always said that death is okay, it’s a part of life, it is going to happen to everyone. And can we not just make that a better experience with as little suffering as possible? Because to me, like suffering is not okay.

And even when my sister died, she lived with leukemia for 20 years. And at the end, this is 10 years ago. So I don’t know really how well, you know, medical assistance and death was … how available it was at the time. But she did choose at the end like hospice palliative care, like, you know, no further, aggressive treatments or anything like that. And at the time, she said, it’s just too much suffering. And that was like when once we all together, especially Leslie, but everyone had decided that it was time to let her go. Everything just got so much better and more peaceful and kinder and gentler, and everybody came together. And that part was, I mean, I’m not gonna say good, but it was just a different experience compared to leading up to that was really, really tough and cold and dark and in a basement and painful and everything. So I think it’s, it’s, we all … we’re all like a product of our experiences, right? And my experiences were very negative in the end of life for at least the humans in my life, and I wanted to make it better for the animals I cared for.

Angela  

You and I are both fans of and friends with Coleen Ellis …

Lianna

Yes!

Angela

She says we should be planning the end so that it is beautiful and peaceful. Is that an underpinning to how you approach your end of life veterinary care?

Lianna 

Absolutely. Because I think one of the hardest things for us as hospice veterinarians, you know, people always think it’s the death that’s the hardest and the sadness. And it’s really the people that wait way too long. And I know it’s hard but Leave me like I have a whole lecture on how to help clients how to guide them when they’re having such a hard time letting go. So I get it, I’ve been there, I’ve done the same with my own pets. But I think that if we can make that decision, you know, maybe a week sooner than we would have wanted rather than a day too late when that poor animal has suffered and been in pain and anxiety and stress and all those things, if we can plan ahead, and we have it so that the final moments are actually in control and calm and peaceful and gentle and beautiful. That’s so much better. That I think one of the biggest stresses for me is people that wait too long and becomes a rush and emergency. And everyone, everyone, including the family is kind of suffering through this somewhat traumatic goodbye. So the pre planning, although it’s so hard to, to recognize and to know that it’s time to say goodbye, once you do that, that being able to plan it so that it’s somewhat controlled and calm. It’s just the alternative is so much worse, you know,

Angela  

As a vet, then, you often have to deliver some very bad news to your clients. And sometimes you might have to deliver very bad news that gives them time to plan but other times not, how do you approach each scenario?

Lianna 

That is true, sometimes you don’t have the gift of time to work with at least not a lot of time. I would say for me as a palliative vet one of the most important things that I can provide to my clients is honesty. I think that a lot of us have been kind of wishy washy in the past and just said, well, you know, we could do this or we could do that, this test, this, this treatment when really in our hearts and with all our medical knowledge and everything. We know that really the best choice would be to say goodbye that I think that I’m just honest, I don’t mean brutally honest, I mean, kind, kindly honest to say, I wish someone would have said that to me, you know, that it’s hard, you’re so emotionally connected to that pet that you can’t see outside of it, outside of that of the emotion to recognize what’s really happening with them, that I would want someone to be honest with me in a gentle, compassionate way.

So I think that that’s what I provide. You don’t want to like hit someone over the head with terrible news right away, but just explain to them. Yes, there, there may be options, and by all means let’s talk through them. And I want to hear how you feel, and you know what you think is best. And then I’ll give you my honest opinion at the end and professionally. And people always say, you know, what would you do if it was your pet? And, and I answer them honestly, I answer them honestly, with if I were in their shoes, right? Because what I can do as a vet with, you know, where I live and what, you know, financial backing I have or you know what beliefs I have might be different. So I answer how I how I would handle that situation if I were in their shoes. So I think that you can deliver bad news gently but honestly, and I think that that’s a real kindness.

Angela  

I imagine that possibly more often than not, you receive less than ideal reactions to the news that you’re delivering. What’s that like from your perspective?

Lianna 

That people are really sad that I’ve told them they really should say goodbye. By the time we have that conversation, I believe I’ve approached it in a way that at that stage people aren’t, aren’t angry with me. Obviously they’re upset with the situation. But I think to be honest, what I get is more relief. Because it’s like there’s been so much uncertainty and questioning and just you know, not knowing what to do that when you have somebody who has years of experience in end of life care says it’s okay. You’ve tried everything. You’ve done your absolute best for your beloved pet. And now it’s okay to let go. I don’t really, I don’t really, a sadness for sure. But I don’t get the anger that you might expect at that time.

Angela  

You think vets who are not in the hospice or palliative care niche of veterinary medicine receive more severe reactions sometimes?

Lianna 

Definitely. I ran a pet loss support group for 20 years and I always would start the meetings by saying I’m not here as a vet. I’m here as a friend, a fellow pet lover, someone who’s lost her own pets in the past, I’m here to share your story and, you know, feel with you and everything. But what would happen quite a bit is the clients would want to go over all the medical details of everything that had happened and all the mistakes the vet made, and they, they would be really angry for a really long time. And oftentimes at the vet, and I don’t know, I guess they … I told them, I wasn’t there as a vet. So they would kind of forget about that, that I heard a lot of very, very negative remarks about how they thought they were, their pet was misdiagnosed or mistreated, or, I mean, I don’t mean, mistreated, I mean, just the treatment plan wasn’t appropriate with the disease process, you know, that that sort of thing. So I’m quite certain a lot of vets do receive a fair bit of the brunt of the anger of clients that I don’t think they’re really angry at the vet, I think they’re angry at the situation. And they’re angry that medicine’s not perfect, and we do make mistakes, and we are human. And, you know, cancer and, and life-limiting disease, it really sucks. And you need an outlet for that anger. And I think it just gets redirected to that medical professional. And I think a lot of clients just think, well, we can take it. And that’s tough. It’s tough on us.

Angela  

Well, it’s your job to take it, is it not?

Lianna 

I don’t think so. I, I think that yeah, I think that clients can come through the other side of that, with a lot more understanding. And I, you know, we’ve often talked about stages of grief and anger being one of them, but to live in, in that stage for in some clients live it if for years. It’s so not healthy for you or for anyone around you, that I really do my best to to guide them through that stage to get to the other side of that, which is, you know, yes, you will need to, to live through depression and mourning and grieving and all of that, to get some hopeful, peaceful resolution that yes, it happened. It was terribly sad. But it wasn’t really anyone’s fault. And where are we now? I’m hoping we’re at the point where we can look back with warmth in our heart and loving memories and then just living a more peaceful existence for yourself. Even if your pet died some time ago, they’re at peace, but you’re not. And how can we get you there?

Angela  

Do you feel that trust in the veterinary care industry has been affected by the onset of Dr. Google?

Lianna 

Yeah, that’s so interesting you say that, because I, I have been creating videos for students and, you know, supportive messages, things that I wish people had told me years ago, and how different life was for us as veterinarians 25 years ago. And part of that is, I would say, you know, we didn’t have the internet to look things up. And if  we had a question about something, it would take a lot of research and a lot of, we look to our colleagues, and you’d have to look in books and go to the library and all these things and how hard that was, because you couldn’t just really quickly look up something on the internet. Then I said the alternative to that, though, the negative to that is the Dr. Google, that we didn’t have people who thought they knew more than we did. So that has layered in a lot of challenges, that a lot of clients will read something on the internet that is not peer reviewed. It’s not from a veterinary source, like anybody could have written that, you know, some teenager in their basement, like who knows, and then they’ll believe that over someone with 25 years experience plus 10 years of education in the veterinary profession, you know.

So it’s a huge challenge for us, it really is that we have to do our best to kind of backpedal through, how to wade through all the waters of what people have read on the internet to get to the truth. And the problem with things on the internet is it tends to be sensational, the you know, whereas vets were, were much more scientific about it and we’ll compare things and we’ll talk about the possibilities. We won’t say you must feed your dog this food or you will die. You know, we’ll say well, these are the, you know, the different products that are in it. And these are the different studies that have shown that this new tuition is good. So I think that we’re less dramatic in that, in that way. And that’s not always what people want to hear or want to believe.

Angela  

How has the relationship between pet owners and veterinarians shifted because of this phenomenon?

Lianna 

I think that we are still some, like a pretty respected profession, I believe, I hope anyway, that I, I want to believe that the general public sees us as, as animal lovers that are in a helping profession, and that want to do our best for that pet and for the client, I hope that it’s still the case. I just think recently, in the last few years, we’ve had some struggles just in the in the sense that we the demand for veterinary services, the number of pets out there, everything is on the increase. Whereas in the profession, we’re on the decrease, like people are retiring early, just leaving the profession, wanting to do something completely different. You know, so that, that you that’s the that’s I think the definition of burnout really, is that the demand has exceeded the resources and the clients, and they still want and need more, and we’re becoming less able to provide that.

So then I think that the trust in us goes down, because we’re just burning out, and we’re not able to give them what they want and need and certainly not as fast as they need it. And then they say, well, then my pet is suffering and you’re not doing and you’re not helping and it’s a really tough time. And, and I see a lot of my colleagues, just not even wanting to be a vet anymore. And that’s heartbreaking. You know, I ran a retreat for veterinary professionals, and we got together for a support and share meeting. And we all talked very openly because it was a really safe space. And so many of them said, I don’t even want to be in this profession anymore. I know people that are, you know, just completely shifting and becoming a yoga instructor. I know a vet who’s making soap, has her own soap making company like I’m taking bartending lessons like we are kind of wanting to get out. And it’s tough because, like, I love this profession, I love what I do. I think it’s really valuable. It’s just become so challenging for us. And I hope that clients can understand that, you know, the person behind the profession?

Angela  

Between facing the challenges and vet’s leaving the industry and your industry having one of if not the highest suicide rates of any profession, what are we going to do if we have no vets?

Lianna 

You know, I have listened to a lot of podcasts and read a lot, a lot of articles about this very problem, because it is so prevalent right now. And we have sadly lost so many of our own to suicide, or just to, you know, leaving the profession altogether, what do we do? So I’m starting, I’m listening to, you know, potential solutions, and they’re saying let’s graduate more vets. And so some of the colleges are actually working on having satellite vet schools in northern areas to get more people educated in, in vet medicine, you know, like that, that’s a solution. But, you know, for the future. And it’s not even, like, how many more bodies do you need to really solve the problem that I think what I’d really like to see out there in the community is, is a support, I guess from the client side.

I would say like 99% of my clients are amazing, kind, beautiful, wonderful people. And then you just have that 1% that just really says the wrong thing at the wrong time. And I’ve had, I think I’m not going to say a lot, but they’re kind of the ones that stick with you, you know, people that will say you people take advantage of our pain, and you’re just in it for the money. And I just wish the clients knew how soul crushing that is to somebody who is just doing everything they possibly can to try to stay in the profession and help as many pets and their families as we can. That if you really think that’s are in it for the money. I mean, typically when you’re saying that to event, I mean nine times out of the 10 that’s not somebody who has any control over the fees anyway. So it’s saying something that’s very hurtful to someone who really isn’t able to make that change for you. So I guess I would just like clients to recognize that, that that’s very hurtful for us as a profession and there is some level of responsibility for clients to maybe just ease back a little bit on the demand and recognize that we’re all doing our best, and that we can’t work 24 hours a day, and we do have to charge for our services sadly. I mean, I wish we could always give everything away for free. But it doesn’t mean that we lack compassion and we don’t care, when we’re just still trying to make a living and still, you know, trying to protect our own mental health at the same time.

Angela  

When I was a sports writer in Canada, and I would go to hockey games, and I would see parents in the stands, I would think, man, if I had a kid, and it played hockey, I would not want to be that hockey parent. And now — bear with me, I’m going somewhere — and now seven years into being a dog photographer, and trying to understand the animal care industry, I don’t want to be that client.

Lianna 

Thank you.

Angela  

How do we not be that client?

Lianna 

Right. This is my suggestion. I think we all have complaints about the cost of everything in the world, you know, and I would just suggest to find the right audience for that remark. And have it not be that poor vet who has worked through her lunch break, hasn’t had a chance to go to the bathroom, his or her relationship is failing, because she’s never home. Like, maybe just say that comment for a trusted friend, who also struggles to afford the vet bills and just say, man, you know, these vets charge a whole lot. That’s just one little thing I think that the population in general could do is choose your audience, when you, when you have something to see about the cost of something, and maybe redirect it to somebody who’s not going … it’s not going to crush their soul of, of why they’re in the profession in the first place. I don’t know, that’s just one little thing I … that I think would help if everybody out there did that. Because you know, we have complaints about everything. Not just vet care, but also …

Angela  

Wait, are you suggesting Americans filter themselves?

Lianna

Yeah, yes that’s right.

Angela

Canadians, too.

Lianna 

Just talk, talk to your sister, or your mom, or your best friend or something and say, you know, this is really hard, they charge a whole lot. And they’ll say, yeah, they sure do. But when you actually get there, and you need help for your pet, maybe just keep that to yourself, because it’s just not helpful.

Angela  

Oh, we discussed off camera and you’ve alluded to the financial challenges a lot of clients face in pet care, do you think there needs to be some kind of education or informational system out there, even before we bring a pet home, about the costs that we are going to get into, like, puppy to three years old t,raining, this is how much training is going to cost. And it can range from here to here, depending on what kind of, you know, how certified your trainer is, and then, you know, the kind of pet care, what pet care costs in your area. And certainly what it’s going to cost when medical issues severe medical issues start coming into play. And, and, you know, the changes that I’ve made to my home since Bella became a quote senior dog. I’m fortunate, I don’t have to worry about cost. But yeah, some of this stuff that has come up can be a bit of a sucker punch. How do we, how do we know? How do we prepare? Is insurance the right way? Is having a savings account the right way? What works?

Lianna 

Very, very good question. And, I mean, I’ve seen the stats, you know, they publish them in in our veterinary journals and say what is the real cost of owning a pet? And I mean, it’s a billion dollar industry. And it’s and that’s not vet care. Let’s be honest, like a small portion of that is vet care. We’re spending a lot of money on food and toys and clothes for dogs and bedding and all kinds of stuff that we’ll happily spend money on the vet care is definitely a big part of it. I don’t want to sound like I’m uncaring. Like honestly like even for my business. I have a Goodbye My Friend fund that helps less fortunate families that can’t afford it because yes, it is hard. It is expensive and I don’t want people to have to worry about money in the end that, you know, most vets are out there volunteering their time, and, and helping with community about outreach and all these different ways to be. I think the thing is that everybody deserves to be loved. You know, that’s the bottom line.

And when people want to say, oh, well, if someone doesn’t have a home, and they shouldn’t have a pet, and it’s like, you know, is that really fair? Because maybe that’s the only living being that loves that person, and you want to take that away. And so then we’re out there and we’re doing free clinics for marginally housed people and trying to help as well, because I’m not trying to say that if you don’t have money, you don’t deserve to have a pet like we’re trying, we’re really trying. But I guess for the general public to know like the high cost of having a pet and even having a human child, like the costs are pretty astronomical in the beginning that you, you don’t really think about, it’s something you want, and you desire it. So you go and get it and then the costs come in later.

Oh, my gosh, I wish people were reading more about even the breeds, you know, like someone says, I want to get a bulldog. They’re so cute or different, or, and then they just don’t really look into my gosh, the vet fees, the health challenges that that poor breed has that people just don’t think about. I don’t I don’t know what the, what the answer is. So that I wish I did. I think pet health insurance is a big part of that. And if there’s some people that say, I’m not going to do that, but I’m going to put a certain amount of money aside in a bank account, you know, as you mentioned, I don’t … I wish I knew the … it’s such a tough question. I wish I had an answer to that. I wish people educated themselves more about the high cost of owning a pet, instead of just you know, how much how exciting it is to get a new kitten or a new puppy and, and don’t have the forethought to think about what happens when they’re 12, 13 years old and all these health issues come up.

Because like as you as you said, earlier, I think off camera was we were talking about the commitment that you make to this creature that you’ve brought into your life, that it’s a responsibility, and it might last 20 years, and it shouldn’t be the kind of thing that well, you know, it’s not working out, I’ll just have to, you know, ship that dog off to somebody else. Like I really, I understand it’s a huge commitment and responsibility and money comes into that. Sometimes it is a kinder choice too, instead of euthanizing a pet, because you can’t afford the cost of care. It could be like a heart wrenching decision that you surrender that pet to someone who can afford it. I mean, honestly, Angele I wish I had the answer. Yeah, that’s a tough question.

Angela  

Wouldn’t we be millionaires if we knew the answer?

Lianna

Yeah.

Angela

You’re an instructor as well. You’ve mentioned that a couple of times that your students, you’re teaching about hospice and palliative care, I assume?

Lianna 

Euthanasia mostly, yeah.

Angela  

How has that evolved over the last 10 years? And how is that reflective in the communication process with clients?

Lianna 

Oh, I think it’s evolved in amazing ways. And all of them good, I want to say. The only thing I think is really missing is that education and euthanasia, I think should be in the core curriculum of all veterinary and veteran technician school programs. And it isn’t. So that’s what we’re, you know, as a community really pushing hard for is that to, you know, to recognize that all of our patients are going to die at some point and most of them with our assistance. So that’s, and it’s also like one of the most highly emotional and difficult appointments of the entire life of that pet in the family, that it’s something that we really should and need to learn well. So I would love to see that in core curriculum and in all schools, sadly, just talking to current veterinary students, they receive very, very little education and euthanasia.

So what we’re trying to do with it, so I’m part of the Companion Animal Euthanasia Training Academy, that’s called CAETA. And so we’re out there trying to change that and bring this education to the schools and I have been lecturing at many most of the vet schools in Canada and starting with in some technician, schools, as well, and I conferences and all kinds of stuff. Because I think how people used to think of euthanasia and companion animals was, you know, give them the needle. Like that was kind of the idea that, you know, you had a very short procedure, which the animal came in, and the vet gave a needle into the arm and they died. And that has evolved now. So that was what was happening 25 plus years ago, and now it’s orchestrated into an experience, not just for the pet, but for the family as well, that we’re doing pre planning. We’re talking them through how everything’s gonna go, narrating the process, developing rapport with them. All of that, we even had a time talk about their aftercare wishes, if they want to have the ashes back or a paw print or all those things.

And then for the actual appointment, we’re doing pre-euthanasia sedation or anesthesia, so they actually are asleep by the time we go to give the final injections. There’s lots of technical aspects to it, that we’ve developed a lot further than that, we want it to be this gentle, smooth, peaceful transition and not a sudden death that we’re easing them through. So that it’s, it is a much gentler approach, that everything that goes into that, so by the time you’re through, that’s more like an hour appointment, and not this five-minute thing that people might have remembered from the past. So we’re using indwelling IV catheters, we’re using absorbent padding and like, it just becomes a much more I think I use the word orchestrated, but because it’s like an experience, and it can be a beautiful experience. But there’s so many things that go into that.

And with CAETA, we have like the 14 essential components of what we call modern euthanasia. And for my team, when the, in the home euthanasia service, I have like a 30-step process that I want and you know, it starts right from when you get there don’t ring the doorbell that scares a lot of cats and gets a lot of dogs really amped up. And that’s not the right thing to do. So it starts from the don’t ring the doorbell and it ends with when we have a stretcher to bring the larger dogs to the vehicle. And then you sort of roll them in. And when you do that, make sure the head is that the last thing that goes in instead of the first thing. And the reason is because the families all come with you to the car, because they want to say goodbye. So they want to say goodbye to the head of the dog, right. And that’s a very meaningful time for them. So we have the blanket is still like pulled back so they can go down and you know, give a last kiss and pet them and say goodbye. And then when we actually close the trunk down it, it’s kind of ceremonial, you know that it’s a big deal. And we sort of step aside and we let them have their time. And then we say okay, we’re going to close the hatch now and say our final goodbyes, and then we drive away. But that you know, from one to 30, there’s a lot of steps in there to make it make it the experience that it should be instead of the needle in the arm.

Angela  

I’m getting emotional, because I’m remembering my experience. And it doesn’t sound … it was not anywhere near as beautiful as that sounds.

Lianna 

Well, I’m sorry for that, Angela. That, you know, that is so hard. What I, what I say when people tell me stories, and believe me, I’ve heard, sadly, so many difficult stories, is I take those stories, and I bring them into the education. And I say this is what we don’t want. We don’t want clients to remember experiences with the death of their pet as a trauma that they’ve got to survive that too, you know, and so that that’s what I’ve done, I’ve taken pictures of the pets that have passed, and I say I’m going to honor their memory. And I’m going to take that and I’m going to build that into a lecture. And I’m going to teach new veterinary professionals how we’re going to do this better. So that we don’t have people that are sad when we talk to them about how euthanasia should be because they didn’t get that for their pet, you know. So I think that we can turn that around and make it better. And I also think that we can learn from the human side like I recently met with human physician that does ME (medical euthanasia). And so she and I had an amazing discussion. And I said, you know, it’s really remarkably similar what we do, it’s just that we’ve been doing it for so many more Are yours. But, but there’s so many things we can learn from the human side as well. And I see that as the path forward, that you know how much better it could have been for my sister and my mom, if if I had this lovely doctor who helps with medical assistance and death, if my mum could have had that, how much better it would be. So I see that as mistakes from the past sadness from the past and hope for the future. That’s, that’s how I like to look at it.

Angela  

Interesting that there are so many parallels between animal medicine and people medicine.

Lianna 

There, there really are. And I know my, my mom wanted me to be a human doctor because she was. So it’s funny to think, you know, she was maybe a little disappointed, maybe a lot disappointed that I went to vet school and not med school. But there are so many parallels. And I just think it’s amazing. And I think that the path forward is collaboration, honestly, that I’m excited about that I’m excited to meet people in the human hospice world and I and I’m, I’m proud to be one of the pioneers on the animal side.

Angela  

And yet, you’re moving away from it.

Lianna 

Yeah, I am, I’m attempting to retire from clinical practice. And I think, you know, we all have our stories. And when you and I talked about doing this podcast, and I was talking about the effect of the impact of euthanasia on veterinarians, because, you know, we’re not made of stone. And for me, I did home euthanasia for 10 years. So, you know, every day, every working day, I was responsible for ending the life of so many pets. And it adds up, you know, I, I would say that I don’t mind death in the sense that I think it’s a normal part of life, and I prefer death to unnecessary suffering. But, but it definitely, it’s like a grief pileup that happens. And I think for me, I never really took the time to even consider it. And when I first started my home hospice business, I had two young kids and I was really busy trying to launch this unknown entity of animal hospice. And so I was very focused on the business and helping clients and helping pets and, and growing this field of veterinary medicine, I never really thought too much about the effect on me. And then, in 2020, so February 2020, I took a step back, and I went away to Bali, and I did a yoga teacher training. And it was the first time that like, I mean, I, I’m not saying I never had a holiday, like I went away for a week here and there, and, you know, had fun, but I never really took like three weeks like that, to just focus on me. And, and what, you know, what I, what was going on inside of me, and, and, you know, that sort of thing.

But anyway, so that, so in Bali, part of the experience was, we had the silent mornings, and we did, we weren’t able to talk at all. And then we did a meditation. And so there were about 23 of us, and nobody’s talking. And so you see already, it’s a lot of introspection, and then you’re doing this meditation. And so for the first six days, I just cried my eyes, like I was just bawling through the whole thing. And I didn’t really know why. And at day six, I just stopped. And again, I didn’t really know why. But on day six, the meditation, they sort of explained what it meant. It was kind of like this chant. And I didn’t really understand the words, but they explained it. And they said, that was the idea of how we’re all connected, you know, the world, the earth, humans, animals, plants, like everyone is all interconnected. And they were sort of explaining that. And as that, as they were explaining that, I was thinking that when, over the years, I helped to say goodbye to so many of these animals in the home setting, and we would get there and a lot of times, I mean, they were very sick, but they would struggle to get up and come and say hello and wag their tails, and we would give them treats and they would be so loving. And I remember thinking I just hope on some level that those animals know that I’m here to help them. And that was kind of my moment, I think my aha moment where I stopped crying. After six days of just like, I think this release, you know, and at the time, I remember when I come out of that after it was like a three week course and at the end, I decided that I wanted to do more, do less in terms of less euthanasia appointments. I want to do less than I wanted to teach more. That was my goal that I was, you know, getting older, I’d been a vet for 25 years. I felt like I could maybe I could be more impactful if I if I taught instead of just continuing to do to do the work myself.

So I came back to my practice with this great idea. And then the pandemic hit. So there was no chance for me to do less it was do more. Right. And so there I was, you know, continuing to do home euthanasia, after home euthanasia at a point where, I mean, it sounds like such a little thing, but we’re, we couldn’t even use the bathroom anywhere. So it was mean, a pregnant technician out on the road all day, with nowhere to go the bathroom. I was like, I think that broke me. I don’t know if I can keep doing this. You know, it was a really, really tough time. And, and I had this one moment that I recall where I was so busy, and I didn’t even have time to, to get anything to eat. And so I’d stopped at the grocery store on the way home. And do you remember when there were lineups around the corner to get into the grocery store? And then they would have like a security guard. Because, you know, it was just a crazy time and nobody knew what was going to happen. But I was still out there working because pets still needed us, you know, and I and I went to go to the back of the line and the security guard saw me and he said excuse me, excuse me. He said, come to the front of the line. And I’m like what? And I was wearing my scrubs. And I think he thought it was a human health care practitioner. Yeah. And he said, frontline workers skip the line. And I said, okay, and I went in, because I just truly believed I was a frontline worker.

Angela

You were. You are.

Lianna

I was I was out there when a lot of, of clinics were turning patients away and turning clients away and saying you can’t you can’t come into the clinic with your pet. You have to drop them off for euthanasia. And I’m like, that’s unacceptable. We have to continue helping these people. I remember I was helping a nurse that no one would help her because she had been exposed to COVID. And she had this little schnauzer and she said, no one’s going to help me but he, it’s his timing needs to go, he’s suffering. And I said, we’re going to help you, but we’re gonna figure out a way. And so we sedated the … and this is a nurse right? So she knows medicine, which was really helpful. So we sedated her little dog on her front porch. And then and she and her husband came in and brought him into the house to get sleepy in the house while we were right there in the car, like just in case. And then when he was asleep, they brought him back out all snuggled and blankets and we did the euthanasia on the porch. So we were still separate. But I thought my God, you know, we’re out there like banging on pots and saying thank you to frontline workers, and then nobody’s helping this woman with her dog. I’m like, we need to go.

But anyway, that’s a long answer. But I think it just really added up for me that I got to the point where at the end of that, I’m like, I really do need to do less and teach more, and be part of the solution for a larger number of veterinarians and up and coming, you know, new graduates and, and make a real difference. And, and so that’s my idea of sort of trying to, to get out of clinical practice in and then I used to be a bartender, back in the day. That’s how I got myself through 10 years of post secondary education. So I was a bartender for more than a decade. And now here I am going, I would just love to go back to that where people are happy and getting a drink and not complaining about the cost. And if nobody dies, and you know, that’s kind of a …

Angela

Have you been to a bar lately? Do you know what the price of beer is? Geez.

Lianna 

But I guess people think of it more as a luxury. And so I’m learning how to make fancy cocktails. And maybe that’s just a hobby right now. But it is fun.

Angela  

What is Grief Retreats?

Lianna 

Oh, so brief retreats is an idea I came up with when I was at this yoga teacher training because I had to have a theme for my yoga practice that I was going to teach the group. And my theme was the idea of of a retreat where you were you’re going to work through your grief and loss. And so I had music about that and different poses. And I had, you know, different quotes and things I was talking about through this. It was a 45 minute yoga class that I taught. And then I had this idea that my gosh, if we could all just press pause on our busy lives. And just take a moment to sit with it and think about it and talk with other people that have had the similar collective experience and share our stories of loss and sadness. And you know, maybe there’s yoga or there’s self care. There’s Miss Suraj there’s support and sharing meetings, there’s nature, there’s all these things that we could bring together with just even a short amount of time. Not everybody has three weeks, but even a couple of days that we could actually acknowledge, recognize and try to work through some of our grief and loss. So that was my idea of creating a supportive space to restore hope, after loss that was, I guess, kind of my tagline for it. So that’s my new passion project, what which I, I’m really excited to, to develop and explore is how to bring people together that need help in coping with loss and sadness that, that we’re there to face it, it’s tough, it’s so hard, people want to kind of bury it away and not talk about it. But you know, the way through grief is through, it’s not, you don’t get over it, or, you know, you can’t really bypass it, you have to go through it. And so, I guess I would say grief is my side hustle. And this one, what, what I really what I’m passionate about is helping people not just with pet loss, but loss of all different kinds, right? There’s human loss, there’s loss of a job of a house have a relationship of loss of your own personal safety, there’s the loss that comes in retirement even in aging. And I mean, there’s so many things that happen that that we just try to brush under the carpet and don’t face and I just want to sit down with people and share and support and work through that and try to come to some coping mechanisms and way forward that we can feel that we are sustainable that we are we’re going to be okay that we have people that love and care about us and will support us through it.

Angela  

And what is it that our mentor David Kessler says all the time? You gotta feel it to heal it?

Lianna 

Yeah, yes. Yes. I love his teachings. I’m, I’m a fan girl for sure. I’ve learned a lot. And I still have so much more to learn, right? So Oh, yeah. I’m not a full time bartender.

Angela  

Yes, but as a full time bartender, one of the things that you have to know how to do is listen.

Lianna 

Yeah, actually, I think that’s a big part of it. I really do, that people will come in, and I would love to talk to them about the deeper things that people don’t want to talk about. That, you know, so many people are afraid of people in grief and loss and sadness, they don’t know what to say. So I’m like, Well, I feel like I know what to say. Or at least I know what not to say. Maybe you just need to listen. And I think bartenders are great at that. So I would love I would love to kind of put it all together. You know? Wouldn’t that be amazing that that all these different aspects of my life could come together to help people

Angela  

How fun. What is one last piece of advice you can give pet owners and working with their vet at the end of their pets’ lives?

Lianna 

I think open honest communication is really key from both sides. And I think that the idea of euthanasia should be brought up sooner rather than later. That if you’re, if you’re thinking about it being time to let go if you’re a veterinarian, that tech, anyone in the profession, if you’re thinking that, say it out loud, and same goes for the client. Instead of that, you know, that’s a taboo subject that no one wants to talk about. Let’s open up that conversation and that dialogue. And even if it’s a couple months in the future, if you start to talk about it, it takes away some of that fear and anxiety of the unknown. Because you’ve brought it to the table. And now we can work together as in partnership in making the right decision together.

Angela  

Beautiful. Thank you so much for joining us today.

Lianna 

Thank you.

Angela

“I feel like pets don’t get the best medical care.”

“I will never leave my animal with a vet.”

“Vets don’t really know what they’re doing.”

These are comments I read on a recent thread in a Facebook group dedicated to pet loss grief.

I was appalled.

Yes, I have questioned a diagnosis or two. Whether Bella needed this ultrasound or that drug, and I have sought a second opinion on one determination.

I would never, however, say these things about her veterinarians. I absolutely trust that they have my dog’s best interests in mind.

Is that my bad?

Maybe. My husband has questioned the need for that test or that medication. I said, “Oh, from which school did you receive your degree for veterinary medicine?”

It’s important to have questions about your pet’s health care.

It’s important to give a shit about the drugs your vet is prescribing your dog or cat.

BUT …

It’s also important to understand that most of us don’t have the education our veterinarians do.

They spend hundreds of thousands of dollars attaining first a bachelor’s degree – which only 38% of Americans have and a medical school degree. They have to pass an admission test to get into veterinary medical school to get their doctorate and then they need to pass licensure to practice veterinary medicine.

They have to have practical experience to graduate.

And may the goddesses help them if they choose to specialize in an area of veterinary medicine, like rehabilitation therapy or hospice and palliative care.

The journey to become a veterinarian is demanding.

And the people who choose to take on this journey do it because they care about animals. Not just animals in general, but the animals who make our lives complete.

As rewarding as that can be, our vets face emotionally charged situations, delivering sometimes shitty news to pet guardians. Witnessing animal suffering. Ending lives.

It takes a toll on their emotional well-being. They experience burnout, angry pet guardians who are shocked by the news they may have just received, student loan debt, pet guardians who may not be able to afford the treatments their animals need to survive.

According to the Not One More Vet website, 1 in 6 veterinarians consider suicide at some point in their career. Female vets are 2.4 times more likely to have suicide ideations, male 1.6. Female vet techs, 2.3 times. Male vet techs, FIVE TIMES.

We can all do better.

Whether it’s the way our vets communicate with us or the way we react to the news we receive our beloved fur friends.

The Not One More Vet website has a list of ways we as pet guardians and veterinarian clients can do better and I’ll post the link to that in the show notes.

Our veterinarians are in short supply and high demand. While it may not be possible to put all of our trust in one individual, we must recognize and appreciate the dedication, education, and emotional resilience our care teams bring to their profession.

By fostering open communication, seeking understanding, and acknowledging the challenges they face, we can collectively contribute to a more supportive and compassionate veterinary care environment for both our beloved pets and the caring professionals who serve them.

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