It was painful to watch our dog, Ezzy, deteriorate during the long confining months of 2020. We had nursed the 9-year-old blue merle Shetland sheepdog through various illnesses during her lifetime, including one that required a trip to the emergency room in the middle of the night. Her joints were giving out, so we had invested in a stroller to allow her to continue to enjoy walks. But now, we could see that just lifting herself to get to her food bowl or crouching to go to the bathroom had grown obviously uncomfortable.

This prompted a hard family conversation about quality of life. It was time, we thought, and made the heart-wrenching decision to euthanize her. But there was one bright side: We were able to do so in a way that was best for Ezzy and for us: in the privacy, comfort and, given the ongoing coronavirus pandemic, safety, of our home.

 Here are some things to consider about at-home euthanasia, if you are faced with this difficult decision.

Home offers pets a humane, respectful setting 

My husband and I had covid-19 work-from-home orders, allowing us to bond even more with Ezzy, and she with us. Being home with us, in her favorite place and with her favorite people, was when she was happiest, making it the compassionate choice for her final moments.

As Maryland veterinarian Karen Randall puts it, “Where do you want to be when you don’t feel well? You want to be home. And for dogs and cats, home is their sanctuary; it’s their safe place. These are the people they trust. These are the things that smell like them. This is where their happy place is.”

Those were among the reasons Randall, who came to our house in November to put Ezzy peacefully to sleep, founded Solace Veterinary Services a decade ago.

At the time, Randall, a now 30-year veteran in the field, could have opened her third bricks-and-mortar practice. Instead, she felt called to focus solely on at-home euthanasia services after occasionally offering home visits to some longtime clinic patients. “It was really kind of mind-blowing how much easier it was for the patient and also for the family,” she says.

Like Solace, practices such as Peaceful Passage and Tranquility Vets are small and regional, while Lap of Love is one provider offering a national network of veterinarians. If you’re unsure where to start, the In-Home Pet Hospice and Euthanasia Directory  can connect you with local providers.

Psychotherapist and thanatologist Andrea Warnick has experienced both clinic and at-home euthanasia when her cats were terminally ill. “I think [at-home euthanasia] is a wonderful option because at this point a pet is pretty sick, and actually transporting them to a vet’s office can be anxiety provoking and uncomfortable,” says Warnick, whose practice in Canada, Andrea Warnick Consulting, focuses on supporting grieving children, youth and adults.  

It eases stress for families and provides privacy for grief 

Pet loss is often underappreciated as a traumatic life event, says grief therapist, author and speaker Claire Bidwell Smith. Your stress will be eased if you can stay home. “Especially with pets — because they are so dependent on us since we are their caregivers — we feel the added responsibility to take care of them to the end. If it’s this chaotic stressful thing that we fear is causing more pain, then that just causes us more pain,” says Bidwell Smith, who is based in San Francisco. 

In a veterinary clinic, we’re likely to self-consciously suppress our grief, something Warnick says can be harmful. “The essence is that, as humans, we are designed to do grief — there’s no pathology. It’s rooted in our love and actually withholding it and not allowing ourselves to express it is far more harmful.” Home provides a haven conducive to facilitating a “healthy grief process.” 

Being home also provides an unhurried environment that Randall believes is valuable. Saying goodbye can take time. She won’t rush it, often remaining with clients for a couple of hours. Logically, you can know death has occurred, but the body remains and there’s a connection, she explains: “The head and heart are not the same beings.” 

It allows you to prepare and include kids

The home environment can also give children the time and space to process their pet’s death. Warnick suggests that you let your kids decide whether they want to be there, after you explain in detail what will happen. Be straightforward and leave nothing to the imagination, avoiding euphemisms such as “put down,” she said; whitewashing what’s happening will undermine your children’s trust. As Bidwell Smith points out, losing a pet often is a child’s first experience with death, and perhaps their first exposure to the concept of mortality. The importance of honesty cannot be overstated. 

 You can tell them that the procedure is generally quick and, barring a pinch when the sedative is given, is pain-free. First, the heavy sedative is administered, which causes the pet to fall into a deep sleep. Then a final injection — a concentrated barbiturate — is delivered directly into the vein, which halts all brain activity. Randall says it’s a peaceful process. Two potentially upsetting effects to warn children about are that the pet’s eyes might stay open, and that sometimes the muscle relaxation leads to urination or defecation.  

Parents also can use this opportunity to teach kids that it’s natural to struggle after someone we love is gone, Warnick says. Modeling healthy grieving means crying with your kids and letting them know that when people are sad, it’s not their job to fix it but simply to be supportive. Conversely, she says, “it might be that a child is devastated for five minutes and then is off running to play video games, and that’s completely healthy as well.” 

 It allows you to incorporate meaning

 Randall, who has completed multiple grief education courses, worked with hospice palliative care and hosted several pet-loss support groups, says that euthanizing a pet may be one of the most difficult decisions we face.

Once you decide it’s time, book an appointment several days in advance, because last-minute slots are more difficult to secure. During the lead-up to the appointment, you may experience what Bidwell Smith calls “anticipatory grief.” Randall explains that grief doesn’t begin with a pet’s death, it begins when we know death is drawing near. 

But this gives you time to prepare. Randall underscores the importance of “the where,” encouraging families to consider one of the pet’s favorite places in the home as the spot for their last moments. 

Conducting a ceremony or ritual can be therapeutic, Warnick says. Poetry readings, candles and a photo display with favorite toys are a few ways Randall has witnessed pets being memorialized. “We really need ritual to move through these kinds of transitions in life,” Bidwell Smith says. 

It is especially helpful during the pandemic

During the pandemic, demand for at-home euthanasia has increased, Randall says. Covid-19 restrictions have made clinics “much more forthcoming about referrals for the service that we offer,” she adds. At-home visits follow covid protocols, including requiring masks and practicing social distancing.

 It can be expensive  

One drawback is that at-home euthanasia costs more. Liz Bales, a Philadelphia veterinarian with more than 20 years of experience, says that though it’s difficult to compare prices, owners should generally expect costs to run 30 to 50 percent higher than in-office euthanasias. Randall charges $350 for the visit, and cremation is an additional cost, ranging from $175-$350 (we paid $650 total). 

 It is not for everyone

Some owners find this approach too personal and the thought of having their pet die at home distressing. We’re all different, Randall notes.  And for those more comfortable with their pet dying at their local veterinary clinic, Randall is reassuring, explaining there’s not a clinic that doesn’t do its best to make the end of life as easy as possible for animals and families. “We don’t want pets to suffer,” she says.

It does not guarantee closure 

Our decision to have Ezzy die at home didn’t ease the ache nor necessarily hasten healing. “Closure is a bit of a myth,” says Bidwell Smith, whose parents died when she was a young adult. She doesn’t think we ever “get over” those we lose and that although grief doesn’t last forever, the loss is something we hold. 

Randall believes that while it can be helpful when the environment is peaceful and gentle, it doesn’t take any time off the grieving process. “We know that grief is proportional to the relationship you’ve had with a pet,” Randall says. 

Still, Randall sees at-home euthanasia as so valuable that she considers her work with Solace Veterinary the most consistently rewarding period of her career. “There are a lot of cases where people don’t have a choice about how their pet dies, but when you do, I think this is such a gift. I really do.” 

Kathryn Streeter is a D.C.-based freelance travel and lifestyle writer. Learn more at kathrynstreeter.com.