A Gentle Guide Through Goodbye: An Interview with Pet Hospice Veterinarian Dr Stephanie Freed
In this deeply compassionate interview, we sit down with Dr Stephanie Freed, a veterinarian who specialises in hospice and end-of-life care for pets. Through her work, Dr Freed walks alongside families during some of the most tender, confronting, and love-filled moments of their lives, helping them navigate not just medical decisions, but emotional, spiritual, and relational ones too.
With warmth, honesty, and extraordinary insight, Dr Freed speaks about planning a peaceful farewell, the role of ritual and ceremony, the depth of pet grief, and why saying goodbye to an animal companion deserves time, care, and intention. This conversation is not about rushing toward an ending - it’s about honouring the bond, centreing the pet, and supporting families through a transition that matters.
Whether you are facing decisions now, or simply want to better understand what compassionate end-of-life care can look like, we hope this interview offers reassurance, clarity, and a sense that you are not alone.
Tell me about your work at the hospice and end of life veterinarian?
Dr Freed: So I started my in-home hospice and end of life company in 2021. I spend my days driving to and from clients' homes and most of my appointments are either hospice consultations where I am guiding them through end of life decision-making, treatment plan, options to manage symptoms and then also obviously the end of life in home euthanasia appointments.
What led you to specialise in this area of veterinary care?
Dr Freed: I think there were clues all along the way, but I first heard about it while I was actually still in school and I graduated in 2016 and through school I thought I was going to be a large animal vet to start and I just realised all my interests came together in this area such as pain management, which is a huge passion of mine, integrative care and alternative therapies as well as client communication. And it all just kind of converged in this niche of end of life care that I decided to explore it more once I graduated.
Was there a specific moment or a time or something that happened that made it all converge?
Dr Freed: There were instances all along the way that led me to this specific niche. Definitely once I got out into practice, I started doing hospice on the side early on in my career as a part-time job and I really noticed the need for it when I was in a clinic. But one of my earliest memories I think of realising this is my calling, is when I was in vet school and it was the semester before we started clinical practice and we were doing role playing sessions with actors in front of our classmates and our professors and I had the euthanasia scenario and the response I got from my administrative faculty as well as the students and the actor was really positive and shocking almost. They were so impressed with my skills that I was like, oh, this comes really naturally to me. So that was an early on indicator that I was going this direction.
How does hospice care for pets differ from traditional veterinary care?
Dr Freed: In traditional practice, our goals are to treat and cure disease with an end goal of remission ideally. And in hospice care you're shifting from that treat and cure to more comfort care and taking what I call a whole patient approach where you're looking at the patient's not only physical status but their social and emotional status, the things that make them happy, their interaction with their environment and their family, and it's that more comprehensive zoomed out view of the wellness of that patient.
What does end of life planning actually look like perhaps for the pet parents then?
Dr Freed: So traditionally end of life planning for pet parents is unfortunately pretty non-existent. I think a lot of our families are told after a diagnosis, here's some pain medicine and go home and let us know when it's time and then when they decide it's time they come in, they schedule that appointment. And then beyond that, after the euthanasia, their choices are private cremation where they get ashes back or communal where they're spread at the crematory. A lot of my initiative and my hopes is to expand what end of life planning looks like for pet families because it's such a pivotal experience for that family and obviously for the pet and it has long lasting implications where we can bring in more of our traditions from our human loss that I think it would really support these families at their time of loss. And expanding it to look like just maybe who you want there on that day, where you want it to occur and what things you want to do that final day with your pet would all help kind of expand that end of life planning.
What should families start thinking about when it comes to hospice care or that final farewell?
Dr Freed: I think families should seek out a hospice or end of life veterinarian as soon as they think that they may have to start planning it. There's really never a too soon point because some of the ideas and concepts we can bring in at any point along the journey towards end of life and the more we try to open our minds to think about it and plan for it, the more peaceful that end of life experience can be. I think a lot of folks still don't even know it's an option. So realising that there are hospice veterinarians out there that can really partner with you and have that longer conversation can be really helpful as a companion on this journey for your final chapter with your pet.
Is this something that's new in the United States? Have you seen it in other countries?
Dr Freed: The hospice movement in the veterinary community started relatively recently as far as veterinary specialties go, I think early 2010 some of the first clinics were focusing on it. The governing body for veterinary hospice is the I-A-A-H-P-C, the International Association of Animal Hospice and Palliative Care. And so they're international and they started with their certificate program to train vets in veterinary hospice in 2016. And we do have a few international veterinarians from the UK as well as from Australia and Canada that partake in our conferences and join in on those groups. But it is still relatively new as far as a niche, it's not even a specialty. We are, the IAAHPC, is working to make it a boarded specialty in the next few five to 10 years. We're starting that committee process, but in-home euthanasia has really taken off across the country and there are plenty of many veterinarians providing it in most suburbs and larger towns, even in some rural locations. So the hospice part is still much smaller, but it's growing.
One of the things that you do is the farewell ceremony or ritual - why does that matter when it comes to end of pet life?
Dr Freed: I think ceremonies and rituals are really important. Humans have been doing it with the loss of their human companions for millennia. We bring all sorts of things into that moment. And I think sometimes folks can be kind of deterred by the word ceremony or ritual, associating with religion and other practices when it can be really something quite simple like lighting a candle or saying a poem, reading a letter. And the idea for me is that I think death and end of life is that moment where medicine and spirituality kind of come together again. Over the last few decades and hundreds of years, we've kind of separated the two, making death something so foreign to us that we ignore the more mystical part of it where the soul is transitioning and there's some significance to that that can really, I think profoundly help our grieving process if we were to bring those two back together again where it's not just a sterile procedure that happens in and out and you're done. It's that moment of transition where this being that we've loved is no longer in its body form, but transitioning to whatever we believe is beyond.
Some of the more accessible rituals that folks are familiar with would be writing a letter to go with the pet to the crematory, tucking that in with them, bringing in their favorite toys to tuck into the blankets with them at the time of death. Those little things are, to me, the rituals. Something that we do to signify the importance of this moment and the being that's passing. Other things would be lighting incense, lighting candles, playing a favourite song is a common one. I love that. I like to know what kind of music the dog or cat liked with their pet owner over there, life together, other, and often I'll have clients have a specific playlist and we'll turn a certain song on at the time of death or they'll kind of hum a song.
Has there been any particular ceremony that you've attended or taken part in that reiterated the importance of what you've done or was a highlight?
Dr Freed: I think one of my most treasured moments was when I had the opportunity to help one of my good friends through the loss of her own pet. And this is a friend that I had known a while back, we lost touch, but we came back together around this time she had had some really traumatic losses in her history losing her father at a young age and other family members. And so this loss was really weighing heavy on her and we had the opportunity to spend that afternoon together and really make it a special moment for this patient - Lily was her name. And we took Lily out to the farmer's market where she got to get pets from strangers and get fed some treats. And then we went to one of her favorite swimming holes. She couldn't really swim anymore, but we went and then we came back home and we prepared the space, cleaning off my friend's patio, lighting some candles, laying out blankets and Lily's toys. And then at the time of death we played a special song to my friend that was significant to my friend and it was just the most beautiful transition I'd been able to witness in a long time and just so peaceful. It felt like everyone was at ease with that moment because doing these little small rituals kind of bring us all to the moment of culmination together where we are accepting it as much as we can and letting go with grace. So it was really beautiful.
Is it predominantly dogs you assist with? And what has been the most unusual pet that you've had the privilege of helping to farewell?
Dr Freed: I would say being in home it's almost 50 50 cats and dogs. One of the most unusual was probably a pet rat that I had gone out to help. This poor rat had some respiratory issues, they had oxygen in the home and we helped it pass peacefully at home. It was so beautiful and it's just a testament to the human animal bond that the depth of which we can be bonded with these animals that are in our lives.
How do you personally help families who feel uncomfortable or guilty grieving a pet?
Dr Freed: When families are struggling with pet loss, my first step is always to normalise the experience. Guilt especially is such a common feeling afterwards. It almost feels to some degree required, especially when we're choosing euthanasia because it's always that piece of choice. And then the grief itself is what we call in the grief study is a disenfranchised grief, a grief that's not universally accepted. So it's diminished by the society to begin with. So it's again normal to really feel like you're doing it wrong and there's never any way right or wrong to grieve. And I try to remind clients of the disenfranchised aspect of it because it's so important. The people that we may go to for any other life-changing event may not be the right people to go to in this instance because of that unique experience of pet loss, you really want to surround yourself with the people that understand what you're going through and are also pet lovers because those people will get it. You don't have to even explain yourself, they'll get it in a heartbeat. And it's not a universal experience like the loss of a parent or the loss of a friend, but it's no different than that just because not everyone experiences it.
Why do you think society struggles with giving pet grief the same importance as human grief or the loss of a human?
Dr Freed: I think society as a whole struggles to appreciate pet loss. I mean, from the academic point of view, I see it as pets have come a long way into our homes over the last couple hundred years from beings that were a tool for use on a farm or for protection to now be in true intimate family members where, and again, since that's only a limited population that are experiencing this deep bond, the society as a whole hasn't caught up to the depth of these relationships. It's just been such a quick change, which is beautiful and I love it and I'm here for what the human animal bond can bring in for people. But it's just been such a rapid transition. I don't think that we have been able to really appreciate the depth of it universally. And with that said, though, historically in many cultures and societies, animals have been revered and worshiped in varying degrees. But I like to think that in another 50 to a hundred years we won't be having this conversation and it'll be more understood and appreciated by the society as a whole.
Have you seen many different cultural or spiritual beliefs in any of the ceremonies you have done? And how do people show that's important or indicate that's important to them, to you and bring that out in their ceremony?
Dr Freed: So as far as different cultures and religious beliefs, I've seen a few different folks with different religious backgrounds. When I was out practicing in Colorado, I had a few Buddhist clients that don't necessarily support euthanasia. So in-home hospice was really important for them to guide them through that journey towards natural death. And there are certain prayers and rituals that they bring into the moment of death in passing as well as afterwards sitting with the body for some time. I think for the most part though, a lot of folks are really hesitant to bring in their personal religion because some religions question if pets still have souls, which is I think hard for a lot of families who have this deep love and bond with their pets. Sometimes I can see that a family has religious objects around their home and I'll ask if there's any sort of prayer or words they'd like to say over their pet before they pass.
There's a really wonderful book that was written by a veterinarian about animal spirits and she goes through all the different religions and talks about the evidence in each one that they do have souls and spirits and that they are acknowledged by the religious base. And I find it really comforting because I do think it's an undeniable, when you have a bond with an animal too, know that there's a spirit there.
What are the first steps a pet parent should do when they begin preparing for their pet's goodbye?
Dr Freed: As a veterinarian and a hospice veterinarian, I think my first step would be finding which vets in your area provide in-home services if that is important to you. And then I think the next step after that would be a practice where I call planning the best last day. And it's really sitting down having a quiet moment with your family or whoever else really loves your pet and thinking about what would make their last day the best last day possible. Because I think we all deserve to end on a high note and there's so many wonderful things that we could bring into those moments. And thinking about what is important to that pet can really help us to centre the pet in our decision making at the end with how we want their last moments to go. And it can be similar to, like I said earlier, who you want to be present, who do they want to see on their last day? What do they want to eat? Is there anything that they haven't had to eat that they might want to try? Or are there places that you want to go visit with them one last time? And it's hard to think about these things, but thinking about it in making them happy, kind of frames it in a more helpful way as we go through this journey with them.
Is it important to include children? Is that a healthy thing in the process?
Dr Freed: I always welcome children to be present at my appointments. The psychologists and therapists all say that around that seven to ten years of age is when children start to really understand the permanence of death and loss. But I still welcome children of all ages to be present. The important things are to make sure we're using corrective wording for these appointments. It's hard as adults, we like to kind of soften all of our language around death and dying saying people have passed or they're going to sleep. But those words can be really confusing to young children. So I prioritise using words like death and dying. They're very sick and we're going to help them die because it's less confusing. The children I think always amaze myself and the families with how well they handle it. They're very curious. They have questions and each child's different and can have different bandwidths for the experience. But one piece of advice I usually have is if you do have a younger child or even an adolescent child that wants to be present, having a family friend come to be in the home. So if that child does need to step away, they can be with the child. So the parents don't have to step away from their pet at that time. It could be really helpful.
What do you wish people knew more about when it comes to end of life care for pets? If there was one thing that you thought, I just wish people knew this, what would that be?
Dr Freed: I think I wish people knew that there are veterinarians out here that specialise in end of life care. And even if they aren't available in your town, a lot of us do virtual consultations where we can sit with you. You can have that longer conversation where we can go through all your concerns, talk about quality of life and what may be important to your pet and what may lie ahead and what that final journey may look like. Because traditionally I think pet parents are so lost when they're faced with that decision making. Their veterinarian made the diagnosis, gave them the treatment plan and sent them on their way to let us know when it's time. And there's so much gray there that I'm nothing against my colleagues in clinical practice. It's just not how that practice is structured. My hospice consultations are usually one to two hours where I really sit with these families and walk through everything, which is just not feasible in practice. So I wish people knew that there are vets like us out there. Sometimes it's just that conversation with a professional that you need to really come to peace with the decision you're making.
Do you help them decide when it is actually the right time?
Dr Freed: Part of my process is helping them decide what it will look like when it is time. The tough part is in my consultations. I'll talk about that crisis moment where things have gotten so bad where they're in a crisis, they're really in pain, suffering or whatnot, and there is no other option except euthanasia. And our goal is to try to get as close to that moment as possible without experiencing it. But inherently doing that leaves us questioning our decision just a little bit because the only time it feels 100% right is when you're in that moment. Most of the time towards end of life, there's a large period of time where helping them pass humanely with euthanasia is not the wrong decision and can be the right decision. And it's a gray zone for weeks, sometimes months, depending on what's going on with the pet. And at no point are you often taking away good days, you're more likely saving them from more bad days because you're on that journey where things are going to continue to decline. So I think I wish I could come in and say, yes, today's the day, or 100% yes or no. But it's much more complex than that, which is why I love having the time to have these conversations with my clients. But I try to assure them that what they're seeing and their decision-making, they know themselves and they know their pet. And I don't think I have yet come into a home where the family thinks it's time and I'm like, wait, wait, wait.
Working in this space, how has it changed your view on life and death?
Dr Freed: I think it has to have changed my view on life and death being this close to death on a daily basis. I think on one hand it's definitely given me this deep sense of the fragility of life and how fleeting our time together is and how lucky we are to share this time and space with those we love. And at the same time, when the time of death comes, I think it's given me this really beautiful sense that it's not goodbye, we're losing their physical body, but it doesn't feel like they're ever really far away, that it's truly a transition to another realm where we just can't see them anymore. And I think they carry on with us either in our hearts, our memories and those that also love them. But being in this line of work, it feels much less like an ending and more of a transition than anything.
If there's someone who's avoiding thinking about the pet's passing, what could you gently say to them to maybe start the conversation?
Dr Freed: That's a really hard question, and I think all of us want to avoid it. We are human animals that are wired to avoid pain and suffering. And so it's normal, first off, you're not alone in wanting to not think about it, not plan it. But I think the tricky part of love and loss is that grief is an inherent part of any loving relationship. We can't live forever and there's so much, there's a large potential for deepening your relationship with your pet if you are willing to open that door to grief just a little bit in anticipation of their passing. I think there's so much richness in those final moments where we can continue to pour love into the relationship. The more we consciously process that the end is coming and it's as hard as it is, it is equally beautiful and so rich in love that it's worth trying. And I don't think you will regret it as hard as it is because it makes a journey to be able to love on them that much more.
Does everything you speak of have to be done at home?
Dr Freed: A lot of these things I talk about that we can do at home can also be brought into the clinic. I don't think there's a veterinarian in the world that would be like, no, you aren't allowed to bring those extra elements to that final appointment. We all understand the pain these appointments are and the significance of them in that family's life. You should never feel rushed during these appointments. And while the doctor may unfortunately be being rushed because of their schedule, I know you're allowed to sit in that room as long as you'd like and take the time you need with your pet. So bringing in their toys with them, bringing in their favorite bed and blanket if you choose to be at a clinic for this passing and even bringing in their housemates, their other dogs that may have a bond with them can be important. And it is not limited by being in the practice and to not feel ashamed to ask to do these things in a clinical setting as well.
How do you prepare people for their pets passing ?
Dr Freed: I think it's a unique challenge. I'm in rural Pennsylvania. Pennsylvania is a very purple state we call it. So there's a lot of conservative folks here that are from very traditional religious backgrounds. And I want trying to open that door in a respectful way to bring in these elements into their pet's passing. It has been a delicate line to balance, but it's in my confirmation email for my euthanasia appointments, I added a little blurb about, because everyone's always like, what do I need to do to prepare? And I'm like, I will bring everything medically necessary. All you need to do is prepare the space, and I just write some things in there about, set the lighting, put music on, light a candle, maybe open a window if it's nice out. And seeing the change in folks that I can tell intentionally read that email and did that afterwards, it just warms my heart. I'm like, oh, they're hungry for this. But they don't realise it and they don't know how to ask for it. So it's a lot more of demonstrating it for families in those, I'm not coming in being like, we're going to create a ritual, but just setting the tone and it's actually really well accepted. I really love the work I do.
Why do some people grieve more on the loss of a pet than a person?
Dr Freed: It sounds awful, but then there's actually been studies about this - why it is so much harder to lose a pet than to use a human companion. And there's a lot of pieces to it, but I mean, I always joke, I'm like, my dog will follow me into the bathroom, my boyfriend. So that intimacy of that relationship, they're your shadow. They're on your shoulder at all times, and they're like a permanent toddler that always needs you. So it's a bond like nothing else. With society, the way it is, where our elders are often isolated, animals are this lifeline for them. And I have an appointment scheduled tomorrow where this dog was, is the last remaining link this man has to his wife and the dog's gotten him through losing her five years ago and has been his daily companion. And he has never done any of this. He would never go to the vet with the pets for euthanasia. That was always his wife's job. But he's bringing me into the home this time because he knows how hard it's going to be for him himself. And it's just these bonds are so big and so deep and so important that it's things that I didn't expect to contend with. I never thought that I would be having to navigate that as a veterinarian. The other big one is when pets belong to a child that passed, and that's their last remaining link to their child, it's another heavy, deep relationship. And all the more reason to put significance into that animal's passing because it is significant. So yeah, it's heavy stuff.
A final work from Dr Freed…
I feel really lucky to be in this niche of medicine at this time because I think the medical side of my profession has really done leaps and bounds over the last few decades to catch up to human medicine. The quality of care you can get is extraordinary. And this is kind of that last piece of the puzzle. And I think at the same time, human medicine is going through the same transition where we're putting more of this focus back on end of life planning and the ceremony ritual and significance of it and trying to humanize it a little bit more. So to be going through these together, I think it's a neat time to be pushing or encouraging families to think about these things.
It is a very hard job. But I do love it. I wish no one needed me, but obviously that's not reality. And I tell people I have the gift of seeing the most beautiful act of love. I think there is in this world where you break your heart for someone else you love, and it's just, I get to see it every day. It's like, what a gift. It's hard. I'll cry every day, but it's a loving act to choose to help someone pass in this way. So I do love it. I'm blessed.
We are deeply grateful to Dr Stephanie Freed for sharing her time, wisdom, and heart with our community.
Her work is a powerful reminder that end-of-life care is not just about death — it is about love, presence, and the courage it takes to break your own heart for someone who has given you everything. Through her words, we are invited to see goodbye not as a failure or a moment to fear, but as a meaningful transition that deserves gentleness and respect.
To Dr Freed, thank you for the compassion you bring into homes, the dignity you offer animals, and the steady guidance you give families when they need it most. Your work matters more than words can say.
