Winston gazes intently at his doctor as his parents look on anxiously.
They remove his sweater and Dr. Lauren Cassady gently runs her hand along his distended abdomen. His bones still protrude along his hips and back.
Despite this, the news is good — for once.
Tweaking his medicine seems to be working.
Winston has a lot more energy and his appetite has picked up.
The 5-year-old dog hasn’t been given a second chance at life, but he has been given more time.
Winston has been diagnosed with inflammatory bowel disease and intestinal lymphangiectasia, a disorder that causes an abnormal loss of protein from the digestive tract. The condition is not always fatal, but doctors gave him only a few weeks to live.
“We’re not going to let him suffer,” said Cassady, who offers in-home hospice and palliative care for pets. “My goal is to never let them get to the point where they’re suffering.”
Palliative care for pets is very similar to that for their human counterparts. It provides relief from symptoms and pain and improved quality of life for pets with serious illnesses.
Cassady doesn’t want to be called a miracle worker.
Catherine Harris, Winston’s mom, shakes her head.
But she is.
Cassady communicates with the Harrises at least once a week to check on Winston, who shares their Decatur home. She’s always available by phone and email, and when the time comes, she plans to be by their side.
She’s part of a growing number of veterinarians and companies in the United States offering pet hospice and palliative care services for animals. It’s hard to determine how many vets, rescue groups or companies offer similar services.
Veterinarians have probably always provided such care, although it may not have carried the hospice or palliative care descriptions.
Whether illness, old age or accidents have weakened a pet, Cassady, 35, wants to be there.
“I just do what I feel I have been called to do — help pets and their families through what can be an extremely difficult time,” Cassady said.
Catherine Harris, who teaches high school literature, and Hunter Harris, who works in commercial finance, found Winston at Animal Action Rescue.
They had talked a long time about expanding their family. He was admittedly more gung-ho than his wife.
Any doubts his wife had, though, vanished the moment she saw Winston and those big brown eyes latched on to hers.
“He looked so cute,” she said. “He had this look on his face like, ‘I can’t believe I’m here.’ ”
“I could tell right away there was something special about him,” he said of Winston, who was then about 7 months old. “He’s made out of love.”
As best they can tell, Winston is an American bulldog and pointer mix.
He would chase and catch squirrels, but didn’t know what to do with them. So he would let them go and run as if to say, “Come and chase me now,” said Hunter Harris, who often refers to him as “son.”
Then earlier this year, Winston, now 5, became sick. He started having bouts of diarrhea. Weight fell from his 75-pound frame.
The diarrhea persisted and the Harrises took him to a vet. Several tests and biopsies showed Winston was severely ill. They stayed on the Internet researching the condition.
The disease can be found in adults and is common in certain breeds of dogs. It’s not clear what causes it in pets or how Winston got the disease. Many experts think it’s hereditary.
His abdomen filled with fluids, which had to be drained on a regular basis.
The trips to the vet, treatments and the medications added up. One medication costs $140 a box for 15 pills, two of which are taken daily. Catherine Harris estimated they were spending $1,500 a month on prescription food, medication and draining.
They tried specialists. They took Winston to the University of Georgia’s Veterinary Teaching Hospital in Athens.
The condition was manageable now. It was not curable and he had possibly a few weeks to live.
The stress was unbearable.
“We had accepted his death as imminent,” said Hunter Harris. “It’s going to happen and perhaps very soon. But we didn’t know how to handle that. We needed someone to help us through the process. What to expect? How soon it’s going to go down? What will it be like for him?”
Cassady, a native of Birmingham, Ala., was always interested in a career in medicine, but she didn’t realize her patients would be pets until her junior year at Furman University.
Then her cat, Lilly, was in an accident. She was rushed to the vet and survived. That summer, Cassady began working for the vet who saved Lilly’s life.
Over the years, she’s been a general practitioner, an emergency vet and a practice owner.
She felt her greatest impact in the lives of pets and their human families was during the final days of the animal’s life.
“I feel like that’s when families need the most help and support,” she said. “I’m able to help ease that transition as much as possible.”
The cost of Cassady’s initial appointment, which includes an examination, a review of the pet’s history and treatment recommendation, is $300, with additional costs for follow-up care. That care might range from administering fluids to routine checks to euthanasia.
Cassady is usually called in anywhere from a few days to several weeks before a patient’s expected death.
Christy R. Simpson, a grief therapist whose specialties include pet loss, said some people go through similar emotions when facing the loss of a pet as they would the loss of a relative.
There’s shock and disbelief, anger, depression and guilt, particularly because animal loss carries with it the possibility of euthanasia. “We see it a lot more often in folks that don’t have children and their primary attachment is to companion animals,” she said.
A week after the UGA visit, Catherine Harris contacted Cassady, who works through Lap of Love, a nationwide network of hospice and palliative care practices. She wanted to discuss euthanasia options when “the time came to make the most awful decision to keep Winston from suffering.”
Cassady explained what they might expect as the end neared but said she didn’t expect that time to come in the immediate future.
“After that meeting, I had such a sense of calm,” said Catherine Harris.
Cassady suggested changing the way Winston received one of his medications, giving him a steroid by injection instead of orally.
In a few weeks, Winston began showing marked improvement and stabilize.
It’s now been four months.
And while the Harrises know what’s ahead, they are more comfortable with knowing they did the best for Winston.
When that time does come, Cassady will guide them through the process “and help us deal with an unimaginable situation,” Catherine Harris said. “We trust her.”