The front door of the Golden Valley house could be opened only a crack before it struck the limp, tired form inside.
"I was hoping for more from you today," Dr. Karen Randall said to Regis, the 80-pound Newfoundland-springer mix sprawled on the floor beneath her.
"He fell in the garage right before you got here," Donna Applebaum, Regis' owner, told Randall. "It was a low point for both of us. His body is starting to say, 'I can't do it.'"
Regis is one of Randall's patients in a small but growing "pet hospice" practice, in which she works with pets and their owners to make old and ailing animals comfortable in their homes during their final weeks and days -- and often provides in-home euthanasia when the time comes.
Like many of her patients, Regis has a combination of an incurable disease, lymphoma, and pain relating to age and spinal arthritis. Randall's animal-care practice mirrors the techniques and goals of human hospice programs: to help beloved dogs and cats finish their lives with minimum pain and maximum dignity.
"Well, let's figure this out," Randall said as she opened her briefcase to begin Regis' exam.
Randall started her business, Solace Veterinary Hospice, when she moved to Edina from Wyoming in December. At her previous veterinary clinic, she said, many pet owners requested in-home euthanasia and health care for their pets. Randall sensed that pet hospice care was what her clients were looking for.
"I started to really see people wanting something like this," she said. "They just didn't know what to call it."
During the first visit of a new patient -- the pets are always called patients in her practice -- Randall does an evaluation and physical exam and talks with family members about their expectations. Then she makes a care plan that could include writing prescriptions, administering physical therapy, fitting the animal for a leg brace, or other interventions. After the first meeting, the family can set up regular appointments or follow up at their pet's need.
To develop a client base in the Twin Cities, Randall contacted veterinary medical centers and other businesses with connections to animals that were sick or in pain. One of these centers was the University of Minnesota Veterinary Medical Center.
Jeannine Moga, the social work program director at the hospital, works with families whose pets are at an end-of-life point. If the family is not ready for euthanasia, they are referred to Randall to evaluate the benefits of additional treatment.
"Animals are members of families," Moga said. "providing end-of-life support for sick animals is resource- and labor-intensive and is difficult for families."
Randall is the only known provider of home hospice care for pets in the Twin Cities, and is among a small percentage of veterinarians nationwide who offer it.
"We are a little slower to catch on right now in Minnesota so that's why it's exciting to see that Dr. Randall is going to be offering some much-needed services to fill the gap here," Moga said.
Dr. Alice Villalobos, a California veterinarian and a founder of structured pet hospice care, said this West Coast trend will spread quickly because pet owners are starting to realize their roles as advocates for their animals.
"There is nothing natural about a sick and failing pet dying in a home anymore," Villalobos said. "Hospice creates a very protected environment for the pet so they don't waste away to a raisin."
Recently, Randall euthanized Kristen Kvanbeck's 13-year-old golden retriever, Charles.
"Quality of life was everything for me," said Kvanbeck, of St. Louis Park. "He's been such a good dog to me and I promised him I would not let him suffer."
When Charles stopped responding to chemotherapy treatments for his lymphoma, Kvanbeck found Randall through a desperate Google search. Randall worked with Charles for five days to manage his pain, but on the fifth day, Kvanbeck decided it was time to put him down.
"He was most comfortable here surrounded by family people in a familiar environment," Kvanbeck said.
With some pets, pain management lasts only a few days, Randall said, but others have gotten months of good-quality life back.
"Some people feel so obligated to cure and sometimes that's just not possible," said Applebaum, Regis' owner. "Dr. Randall is making Regis comfortable so that when he leaves this life, he can leave peacefully."
Andrea Schug is a U of M student on assignment for Star Tribune.