Even the most meticulously laid plans can play out differently than expected. Seeking to carve a niche and fulfill an unmet need in my community, I launched a veterinary practice focused on animal hospice, pain management, and end-of-life care in August of 2015. Back then, I expected that confronting grief on a regular basis would be emotionally demanding; that I would need to learn how to set and keep boundaries between personal and work life; and that I’d need to actively reach out not just to pet owners, but also my colleagues to get out the word about this new option.

I also encountered some other challenges – and rewards –  that I hadn’t seen coming. Here are some things which surprised me in my first year as a hospice veterinarian.

End-of-Life care isn’t depressing.

Don’t feel sorry for me. I genuinely respect my colleagues who cheerfully continue to do daily battle with parvovirus, deal with emergencies disrupting the most carefully planned day, and give the flea talk or the heartworm talk for the bazillionth time. Leaving behind the chaos of general practice for my clients’ living room floors lets me focus on the needs of one family at a time, with no distractions and responsibilities lurking just outside the exam room door. Being invited into someone’s home to help at such a vulnerable time is an honor and a privilege, and the ability to help make it easier is truly uplifting.


In hospice, service matters more than price.

A terrible salesperson, I’ve always been pretty upfront  if a client can get something elsewhere cheaper.   “Hey,” I thought I was saying, “I’m not selling anything, so you can trust me!” I would , for example, carefully write down dosing instructions for a popular over-the-counter antihistamine, emphasizing the correct version to get. After all, the local box store carried a huge bottle for a few bucks, and our minimum medication fee was nine dollars! I wonder what percentage of my clients would have preferred to pay a little extra to save going to the pharmacy, if they even bothered.

One sunny morning, I was granted a moment of clarity as I sat on the front stoop with a hospice client, an intelligent woman with a career and  busy family life. After listing several recommendations for her dog, I asked what she thought. She took a few moments to consider before sighing, “I’m overwhelmed.”

Families who are coping with grief and loss often need us to make things easy. Instead of providing links to online retailers, I learned it’s better to do the ordering myself and arrange for home delivery, assembly, and training.  Yes, it costs more, but sometimes you just need to sell them the darn antihistamine.

Animal hospice is still far from the mainstream.

Build it and they will come, I thought. If I just dropped by my local clinics with doughnuts and brochures, the phone would ring. Not so fast! Relationships and trust, not mere awareness, are needed to earn referrals.

Much like acupuncture a mere decade ago, animal hospice is still an emerging field, considered on the fringe by many veterinarians.  It’s well on its way to becoming a recognized specialty, but until then it will take impeccable integrity and professionalism  to gain acceptance by my peers.

My patients are all dying.

“Wait,” you say, “this is a surprise?” Well, no, but I had hadn’t anticipated that after 15 years of a career dedicated to curing disease and fixing problems, I’m still reflexively disappointed in myself when my patients inevitably take a turn for the worse. Truly accepting that the point of hospice is not to “fix” what’s wrong, but rather to make this final journey as comfortable and fulfilling as we can, takes an incredible level of Zen.

Starting a new business from scratch wasn’t so hard.

I never thought I’d identify as an entrepreneur, of all things. For years I swore I’d never own a practice- who wanted those hassles?  Running a business just sounded so…complicated.

And yet here I am, amazed at what I accomplished one task at a time. Some ideas didn’t work out as planned, but were still valuable learning experiences.  My advice is, if you’re considering venturing out of your own comfort zone, do your research, plan like crazy, then jump in and just plug away at the to-do list. Sometimes the list grows faster than it gets completed, but it will be worth it.

The bottom line after almost twelve months of doing animal hospice? Giving the gift of a peaceful end-of-life experience, the creative challenges, a sense of empowerment, and the pride of practice ownership have made this the best year of my career so far. I can’t wait to see what new lessons the next one brings.

The views and opinions expressed in this article are those of the author and do not necessarily reflect the position of the DrAndyRoark.com editorial team.


Carolyn Naun, DVM is the owner of Arms of Aloha, the first hospice-only veterinary practice in Hawaii. She regularly writes about quality of life for pets, pain management, and the human-animal bond on her website:www.armsofaloha.com/category/education. You can also follow @armsofaloha on Facebook, Instagram and Twitter.