Quality of Life & End-of-Life guides
Practical, veterinary-led guidance on Quality of Life & End-of-Life, following the journey stage by stage. Read in order, or jump to where you are. View all guides
1Facing what's ahead
5 guides
Anticipatory Grief: Mourning a Pet Who Is Still Here
Crying over a pet who is still here, still eating their dinner, still pleased to see you when you walk through the door, is not a sign you have done anything wrong. You have not given up on them. You are not wishing them away, or being morbid, or loving them any less for letting...
Alastair Greenway, BVM&S MRCVS · 18 min read
Preparing the Family When a Pet Is Dying
For most children, the death of a pet is their first real encounter with death, which makes it formative whether we plan it or not (Blue Cross, n.d.; VCA Hospitals, n.d.). That is the fact worth holding on to before any of the words come. There is no easy way to tell a child that...
Alastair Greenway, BVM&S MRCVS · 15 min read
When Age Becomes Illness: Understanding Decline in a Senior Pet
Some worries never get a diagnosis attached to them. No one has said anything frightening at the vet's. There is no scan, no result, no word like "terminal". There is just a creeping sense, building over weeks or months, that the dog who used to meet you at the door now lifts his head from...
Alastair Greenway, BVM&S MRCVS · 16 min read
The Questions to Ask Your Vet About a Poor Prognosis
A scene plays out in the consult room more often than you would think. I say the word, the grave one, the one that changes the shape of the next few weeks, and something behind the owner's eyes simply closes. They nod. They say "right," or "okay." And every question they meant to ask, the...
Alastair Greenway, BVM&S MRCVS · 19 min read
Your Pet Has a Terminal Diagnosis: What Happens Now
Certain words change the air in a consulting room. "I'm so sorry." "There's nothing more we can do." "It's terminal." "The outlook is poor." Most owners walk out having held on to only half of what came after, having nodded at a plan they can no longer recall, the whole conversation gone quiet around a...
Alastair Greenway, BVM&S MRCVS · 17 min read
2Is it time?
6 guides
Measuring Quality of Life: The HHHHHMM Scale, and How to Use It
The feeling moves too much to look at, and that is the cruellest part of watching a pet you love decline. Some mornings you are almost sure. By the afternoon, when they lift their head for you or finish their dinner, you are sure of the opposite. The question of whether their life is still...
Alastair Greenway, BVM&S MRCVS · 17 min read
How Will I Know When It Is Time?
Owners carry this question to me more than any other, usually in a near-whisper, often with a hand resting on a greying head. "How will I know when it is time?" Underneath it sit two fears at once: that I will leave it too late and let them suffer, and that I will act too...
Alastair Greenway, BVM&S MRCVS · 18 min read
When the Family or the Vet Sees It Differently
Most of these pages are written for one frightened owner standing over a beloved animal. This one is different. Here you are that owner, but you are standing inside a frightened, grieving, divided family, and very often feeling alone in there too. Your husband thinks it is time and you are not ready. Your wife...
Alastair Greenway, BVM&S MRCVS · 19 min read
The Guilt Is Normal: Making Peace With the Decision
Guilt is one of the most common companions of this decision there is. If you are lying awake landing, every time, on the certainty that you failed them, two things are worth knowing before we go any further. You are not the first owner to lie there like this. And you have not failed them....
Alastair Greenway, BVM&S MRCVS · 17 min read
Too Soon, or Too Late? Living With the Timing
Two fears tend to keep owners awake at this stage, and they pull in opposite directions. One says: I cannot possibly do this yet, he still wags his tail when I come in, who am I to take that away. An hour later the other arrives: have I already left it too long, is he...
Alastair Greenway, BVM&S MRCVS · 16 min read
More Good Days Than Bad: Tracking the Trend, Not the Day
Reading your pet one day at a time wears you down in a way few people warn you about. This morning he ate his breakfast, lifted his head when you came in, managed the garden, and the relief floods you, along with a guilty little voice asking how you could ever have doubted him. Then...
Alastair Greenway, BVM&S MRCVS · 19 min read
3Comfort and time together
6 guides
Pet Hospice: Comfort Care at Home in the Final Chapter
A decision has been made, by you or by the disease, and the aim is no longer to fix this. The aim now is to give your pet the best of whatever time is left, at home, where they are loved. A quieter worry usually arrives once the house has gone still: can I actually...
Alastair Greenway, BVM&S MRCVS · 18 min read
Giving Medication and Managing Comfort at Home
Seven in the morning, no proper sleep in days, a tablet in one hand and in the other a cat who has already worked out what you are up to. Or a dog who used to inhale anything you offered and now turns his head from the cheese with the pill tucked inside. The vet's...
Alastair Greenway, BVM&S MRCVS · 17 min read
Making Memories: A Good Last Week
A particular pressure tends to arrive once the first shock of a hard prognosis has settled. The appointments thin out, and your pet is still here, still reasonably comfortable, dozing in their usual spot. And then a thought creeps in that can feel almost worse than the diagnosis itself: I should be doing something. There's...
Alastair Greenway, BVM&S MRCVS · 15 min read
Keeping a Frail Pet Clean, Comfortable and Mobile
Most of what you are doing for your pet right now will not happen in a consult room. It happens on the kitchen floor at six in the morning, with a towel and a damp cloth and a dog who can no longer stand to be cleaned. It happens lifting a cat onto the windowsill...
Alastair Greenway, BVM&S MRCVS · 19 min read
Appetite, Hydration and the Final Weeks: What to Expect
"He won't eat." Of all the sentences I hear in hospice care, that one comes up more than almost any other, and it is rarely said calmly. It is said over an untouched bowl, sometimes at two in the morning, sometimes with a syringe in one hand and a favourite food going cold in the...
Alastair Greenway, BVM&S MRCVS · 20 min read
Spotting Pain in a Pet Who Hides It
One question tends to surface in the quiet of the final chapter, often at night, once the diagnosis has settled and the busy part is over. You watch your pet asleep in their usual spot, and you wonder: is he in pain, and I just can't see it? It is one of the hardest questions...
Alastair Greenway, BVM&S MRCVS · 17 min read
4Saying goodbye
7 guides
After They Have Gone: Cremation, Burial and the Options (UK)
One question tends to arrive at the worst possible moment, and it catches almost everyone off guard. You have just held your pet through the end, the room is still, and someone, gently and through no fault of their own, asks: "And had you thought about whether you'd like a burial or a cremation?" Often...
Alastair Greenway, BVM&S MRCVS · 15 min read
What Actually Happens When a Pet Is Put to Sleep
Once the deciding is done, or very nearly done, a different fear tends to move in to take its place: not knowing what the day itself will be like. Owners ask me about it in a lowered voice, almost apologetically, as though wanting to know is somehow ghoulish. It is the opposite. The single thing...
Alastair Greenway, BVM&S MRCVS · 17 min read
When There Was No Time to Prepare: The Emergency Decision
Some goodbyes give you weeks. This one gave you minutes. One moment a normal evening, the next a crisis you did not see coming, and a vet you had perhaps never met asking you to make the largest decision of your life in the time most of us take to choose what to have for...
Alastair Greenway, BVM&S MRCVS · 18 min read
Paw Prints, Fur and Keepsakes: Deciding in the Moment
A lot of owners turn the same small thought over in the days before they say goodbye, and almost none of them say it out loud. It runs something like: I think I might want to keep something. A print of her paw. A little of his fur. And then, often in the very same...
Alastair Greenway, BVM&S MRCVS · 14 min read
Should Children Be There When a Pet Is Put to Sleep?
It is one of the hardest small decisions inside a very large one. You are at, or close to, the point of letting a much loved pet go, and now a second question sits just behind the first: should your child be in the room when it happens? Perhaps your eight-year-old has asked to be...
Alastair Greenway, BVM&S MRCVS · 17 min read
Should I Be There at the End?
The hardest decision a pet owner ever faces is one you have made, or very nearly made. You thought that was the whole of it. And then, somewhere in the quiet of the night before, a second question crept in that you did not expect and cannot now put down: do I have to be...
Alastair Greenway, BVM&S MRCVS · 15 min read
At Home or at the Clinic? Choosing Where to Say Goodbye
The hardest decision an owner ever faces is made, or very nearly made, and just when you thought the deciding was done, one more choice is waiting. Where. At home, in their own bed or a sunny patch of the garden, or at the practice where you have taken them all their life. The most...
Alastair Greenway, BVM&S MRCVS · 16 min read
5The first days
4 guides
Is It Normal to Grieve This Much? Pet Loss Is Real Grief
People come to me weeks after a pet has died and half-apologise before they have finished the sentence, asking some version of the same question: is it normal to feel this much, this hard, for an animal? They expected sadness. They did not expect to be ambushed in the supermarket, or unable to sleep, or...
Alastair Greenway, BVM&S MRCVS · 17 min read
Helping Children After Losing a Pet
For many children, a pet is the first death they ever meet, and you are now the person who has to walk them through it while your own heart is in pieces. It shows up in all sorts of ways. A seven-year-old keeps asking when the cat is coming home. A toddler starts wetting the...
Alastair Greenway, BVM&S MRCVS · 17 min read
Do Other Pets Grieve? Helping the Companion Left Behind
There is a second animal in the house, and they have gone quiet. Maybe they are off their food, sleeping in odd places, or padding from room to room and pausing at a door as if waiting for someone. Maybe they have curled up small and will not be coaxed out, or have turned into...
Alastair Greenway, BVM&S MRCVS · 18 min read
The First Days: The Empty Bowl and the Quiet House
The first morning is usually the one that undoes people. Not the appointment, not the long drive home with an empty collar in your pocket, but the ordinary morning after, when your body wakes into a routine that no longer has anything to do. Your hand reaches for the lead before your mind catches up....
Alastair Greenway, BVM&S MRCVS · 17 min read
6Living with loss
5 guides
Pet Loss Support: Where to Turn When Grief Is Overwhelming
One thing comes first on this page, on purpose. If you are reading this in the small hours and a thought has crept in that you cannot go on, or that you might harm yourself, please stop here and ring the Samaritans on 116 123. It is free, from any phone, at any time, day...
Alastair Greenway, BVM&S MRCVS · 16 min read
Ways to Honour and Remember Your Pet
Once the first shock has eased and the house has gone quiet, many owners feel a small, insistent pull to do something. To mark that this animal was here. That they mattered. And then, almost in the same breath, a doubt arrives: is it silly to make a fuss over a dog, a cat, a...
Alastair Greenway, BVM&S MRCVS · 15 min read
Are We Ready for Another Pet?
This question usually arrives carrying two opposite weights at once. Some owners catch themselves, weeks or months after losing a dog or cat, glancing at a rescue page, and the wanting is followed straight away by a hot wave of shame, as though they had been caught betraying someone. Others sit on the far side...
Alastair Greenway, BVM&S MRCVS · 21 min read
Grief Has No Timetable: Waves, Triggers and Anniversaries
It is rarely the funeral that undoes people. It is the supermarket. You are halfway down an aisle you have walked a hundred times, thinking about nothing in particular, and there is the food you used to buy, or a lead on a clearance shelf, or just a dog the same colour as yours rounding...
Alastair Greenway, BVM&S MRCVS · 21 min read
"It Was Just a Pet": Grief That Others Do Not Understand
Someone has said it to you. Maybe out loud, maybe with a look, maybe in the cheerful way a colleague asked whether you would be getting another one. "It was just a dog." "It was only a cat." And it has done something quietly cruel: it has made you doubt your own grief. You came...
Alastair Greenway, BVM&S MRCVS · 19 min read