The Death of Pets — with Dr. Lianna Titcombe

Written By Jeffrey Weill

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EPISODE DESCRIPTION

Dr. Lianna Titcombe, founder of Claire Place Veterinary Hospice, is an author, speaker, educator, and mentor in the field of animal hospice and palliative care. She is past president of the International Association for Animal Hospice and Palliative Care. Dr. Lianna participates in volunteer missions to provide veterinary care to underserved communities worldwide. She has also been director of the Pet Loss Support Group of Ottawa, Canada.

In 2021, Dr. Lianna joined the Companion Animal Euthanasia Training Academy as an instructor. In her spare time, she runs Li Li's Lounge and Patio Bar, a Caribbean-inspired community hub in Ottawa

ABOUT THE GUEST: DR. LIANNA TITCOMBE

EPISODE TIMESTAMPS

00:00 — Introduction & Guest Background

02:30 — Why We Bond So Deeply with PetS

06:15 — Disenfranchised Grief and Why Pet Loss Hurts So Much

09:45 — How Animals Experience Death Differently Than Humans

13:30 — Home Euthanasia and Creating a Peaceful Final Experience

18:10 — Quality‑of‑Life Scales: Helpful but Incomplete

21:45 — “You’ll Know When It’s Time” — Why That’s Not Enough

26:30 — The “Personal Bottom Line” Concept for Pets

31:10 — Comparing End‑of‑Life Decisions for Humans and Animals

35:05 — Loving All Creatures: From Dogs to Rats to Tarantulas

39:15 — The Rainbow Bridge: Comfort, Skepticism, and Healing

44:10 — Music at the End of a Pet’s Life

48:20 — How This Work Changed Dr. Titcombe’s View of Her Own Mortality

52:10 — Final Question: What Music Would You Want at Your Own Death?

54:45 — Closing Reflections & Credits

RESOURCES & LINKS MENTIONED

Professional Organizations & Services

Concepts & Tools

  • Quality‑of‑Life Scales

  • Pet Acoustics calming music

  • The Rainbow Bridge poem

FULL TRANSCRIPT

Rabbi Weill: The Death of Pets with Hospice Veterinarian, Dr. Lianna Titcombe. Dr. Lianna Titcombe, founder of Claire Place Veterinarian Hospice is the past president of the International Association for Animal Hospice and Palliative Care. Dr. Lianna participates in volunteer missions to provide veterinary care to underserved communities throughout the world.

She has also been director of the PET Loss Support Group in Ottawa, Canada. In 2021, she joined the Companion Animal Euthanasia Training Academy as an international instructor. She's an author, speaker, educator, and mentor in her field and in her spare time, she runs Lili's Lounge and Patio Bar, a Caribbean-inspired community hub in Ottawa.

 Rabbi Weill: Dr. Lianna Titcombe. Welcome to Unveiling Death. Thank you so much for being on this podcast. 

Dr. Titcombe: Thank you for having me. 

 Rabbi Weill: So you have seen people in the depths of sadness as they are preparing for and preparing the last days, you know, weeks, days hours, minutes of their pet's lives. And I just went through this with our dog, lucky about a month ago.

 Rabbi Weill: But my question about animals is like, why in your experience, just personally, why do we experience such a deep attachment to members of another species? 

Dr. Titcombe: Such a good question. I, I do hear it a lot from my clients. Uh, a lot of them will say that they have a stronger bond with their pets than some human companions, and they feel the loss even greater.

Dr. Titcombe: And I think there's a lot of reasons for that. I think with pets, one of the biggest things is they provide us with this unconditional positive regard that we don't necessarily get from our human counterparts. That they're there with us through thick and thin. They love us no matter what. Doesn't matter what we do for a living, how we look sometimes, even how we treat them.

Dr. Titcombe: They still continue to love us, uh, exactly as we are. They have a wonderful way of communicating with you without words that most of the time is just pure love, and that's hard to get from people. So when an animal dies. It's tricky because we call it a disenfranchised grief in a, in a way because it's not as well recognized or supported in society compared to human loss.

Dr. Titcombe: So the grief can be more difficult to navigate because you don't have the supports that you would for human loss. It's, it just becomes a lot more complicated. 

 Rabbi Weill: I first heard you talking about this on the What Now Podcast, which is a really interesting podcast. When animals die, I, I think about this a lot.

 Rabbi Weill: Like when an animal is dying, obviously every individual animal resists or struggles against its own demise individually, I think. But you know, sometimes I wonder if they, like we conceptualize our deaths is like the end of us, of ourselves, and that's one reason that we are so, you know, so frightened of it or.

Rabbi Weill: In awe of it or whatever, but animals not having the same sense of self, I don't think. Right. I mean, I So sometimes wonder like what they are they like melting like the wicked witch and the witch of Oz saying like, oh, what a world. What a world. Or are they struggling just by some instinctual thing, not having a sense of the end of their person could.

Dr. Titcombe: Yes, for animals. What I find in my experience, because sadly, like I, I've been present for the deaths of thousands of animals and they don't have the forethought to fear death the way we do. They don't think about it all the time the way we do. You know, so this is how I find with animals that unnecessary suffering.

Dr. Titcombe: I'm not okay with that. I'm okay with death. I've come to become very comfortable with death of animals and, and even with humans, but I'm not okay with suffering because I don't think that it is necessary in my belief with animals. It, it is kind of a beautiful thing at the end. I've had some of my animal patients that their, people plan a living funeral.

Dr. Titcombe: And so the dog is there, but he doesn't know that, that, you know, he's going to die soon. So he's having a great time at his party 'cause all these people are coming over and he is having all his favorite treats and he's getting all his attention and it's like the best day ever. For us, a living funeral for that person could be a very different experience.

Dr. Titcombe: So the animals, what I find is when I come to the home, we, our service, a clear place in Ottawa, provides a home euthanasia service. 'cause we find it's a lot nicer for the pets and their people to be in the comfort of home and familiar surrounding. And when we come, um, to the door, the pets are very often happy to see us.

Dr. Titcombe: You know, they don't know that why we're there. And this was difficult for me to come to grips with that, you know, because I would come into the home and I know that I'm there to end that animal's life, but they're so trusting of me. And that is a hard place sometimes for a veterinary professional to live with that day in and day out.

Dr. Titcombe: But it's a beautiful thing for the animal and for the animal's people. That you remove a lot of that anxiety and fear when you're at home and you have a trusted professional come to help you. And so much so that there were people that were, I mean, and it sounds like a joke, but they, they were half serious saying, can you come back when it's my time?
Dr. Titcombe: Because they didn't know that it could be this beautiful, peaceful experience and they could be in the backyard with the sun shining the birds chirping and having their favorite snack and just lying down in a blanket and falling asleep, comfortably surrounded by loved ones. That they've experienced a loss of, uh, human companions that didn't go that like that.

Dr. Titcombe: And I would say the same for myself, that a big part of the reason I got into this field of end of life care for pets is that some of my family members and friends dying didn't have a peaceful, comfortable death. It was quite agonizing actually, and I just wish and hope it could be better for everyone.

 Rabbi Weill: You mentioned that it's unnecessary for animals to suffer like it shouldn't be, and there are ways to avoid that. And, you know, there's a, I dunno, I think it's like 10 criteria or questions that offices often give to pet owners about like how the pet's animal, uh, quality of life. 

Dr. Titcombe: Quality of life scale 

Rabbi Weill: yes, and quality of life scale.

Rabbi Weill: Right. And um, we as lucky was, you know, the last year of his life, we kept on scrutinizing that scale and trying to understand like, well, you know, he seems to still enjoy his food and sometimes he see wags his tail and like he can get, get around it. It's very, very difficult to really evaluate it, especially when you're dealing with something that you love and we love lucky.

Rabbi Weill: So I'm wondering if you endorse that scale, I mean you who are a veterinarian, who specifically works in that stage of life for pets, you know, with their owners. Is that, is it helpful? 

Dr. Titcombe: Quality of life Scale is a great tool and there's tons of them, right? There's not just one. There's many different people and organizations have written quality of life scale.

Dr. Titcombe:  I think they definitely have a place, I think they provide a structure, they provide a conversation, a opener for families. What's good about them is you can do the scale one day, do it again the next date, like and compare. You can have different family members comparing their results. I think it is a really good tool.

Dr. Titcombe: I don't think it's a be all and the end all. I think the problem sometimes comes with these scales is that, you know, family will go into a clinic and speak to the vet and they, and they say, you know, Lucky's time is coming soon. Here's this scale. Take it home. Call me. You'll know when it's time. And I think that is such an, an empty statement for families because I think they really need a lot more guidance than that It for so many people, when they call my service, they'll say.

Dr. Titcombe: This is the hardest phone call I've ever had to make in my life. This is the hardest decision I've ever had to make in my life. So having to do that can be an almost impossible thing for people to navigate, and I think they need more than a scale. So I even have a whole lecture that I give to veterinary professionals that's called When Quality of Life Scales aren't Enough.

Dr. Titcombe: Counseling clients who can't let go because most people call us when it's already too late. You know, because nobody wants to take away hope from their pet. You know, they're always buying the big bag of dog food, the big bottle of pain control medication, because nobody wants to give up hope on, on their beloved pet.

Dr. Titcombe: That I just think that they need someone to talk to who's objective, who's professional, who can be very real with them. And I think when you get to the point of talking to a palliative doctor or palliative veterinarian, I just don't think you really wanted sugarcoat it anymore. I remember when my sister, Leslie was in palliative care and once she finally made that decision.

Dr. Titcombe: It was, I don't know, it was like the skies opened in terms of, we just moved to a better room that had a window and she's like, oh my God. Like, so she was out of this ICU hallway and it was just a better space. And when the palliative doctor talked to me, she was so real with me, you know? She said, you can't take her home.

Dr. Titcombe: She's not gonna make it. She's not gonna make the trip. I'm like, oh my God, I wish someone had said that to us like days ago. So I, I just, I feel that quality of life skills have a place. I think they have a lot of value. I just don't think we should depend on them. I don't think we should leave families out there in the wilderness struggling on their own.

Dr. Titcombe: I think that we should really say to them that you're not necessarily gonna know when it's time. I think luck Lucky will give you some, some cues, but we'll G, we're gonna work together and I'm gonna guide you through that and I'm gonna be right there helping you make that decision. I think that would be a better way to, to look at it.

Rabbi Weill: Right. That's good. Actually, our vet, um, Dr. Jones did have that help. Helpful approach, but I did hear a lot from other pet owners primarily, like, you'll know when it's time and that made us struggle even more. 

Dr. Titcombe: Yeah. I, I think that's a lot to put on a pet owner. Mm-hmm. I, I don't Did you find you knew when it was time?

Rabbi Weill: You know, I think with the encroaching winter here in Chicago, it became clear, like we were like, he doesn't wanna go out when it's Clement weather and to have to take him out, he's gonna really not want it to do it when it's, you know, 12 degrees or one degree. So that really helped, I think, to bring him past Thanksgiving, you know, late November year.We thought that would've been unkind to him. 

Dr. Titcombe: Yeah. Have you heard of the idea of a personal bottom line for your pet? 

Rabbi Weill: No, what is the personal bottom line for your pet?

Dr. Titcombe: That was an, an idea I gave to pet owners. So I had my dog George, who had a spinal disease and couldn't move his spinal legs very well.

Dr. Titcombe: And I came, but much before, uh, the end of his life, I came up with a personal bottom line for George of when would his life no longer be worth living for him? And that would, to me, what made it a little simpler than, you know, all the intricacies of having to look after him and things like that. Just what would it mean for himDr. Titcombe: At the time we lived on a property that had about a half kilometer trail at the back through the woods, and he would go on that every day all the time. Loved it. He would chase deer and never catch him, of course, but he, it was his life, you know? He loved it and I felt if he could no longer independently walk that trail.

Dr. Titcombe: I would need to make a really tough decision for him. So that to me was George's personal bottom line where he would tick that box that said, you know, I've made a decision now that I feel that, you know, against medical advice or whatever, uh, I don't wanna have any more treatments. And I've decided that I would prefer to end my life comfortably and peacefully now.

Rabbi Weill: So we really do have to then, or at least one approach is, especially that personal bottom line on behalf of a pet, is to determine when the narrowed life has become too narrow. 

Rabbi Weill: Yes. Like I work with humans who are nearing the end of their lives, uh, through my rabbi work. Some of them are very accepting of like, my life has gotten narrower and narrower and narrower in all sorts of ways in their interactions with family that might be far away in the mobility issues, dietary issues, I mean so much what their bodies can do, what their senses can do.

Rabbi Weill: And some of them are very accepting, like, okay, this is my life now, but I wanna continue living. And others, you know, have that personal bottom line pretty clear. Like at a certain point, if I'm not vigorous, then that's what, however they define that, then that, that would be it. That would be my whatever, inability to walk the trail in the back.

Dr. Titcombe: I like what you said about narrowing of the life because that happens for pets very much. I'd say, you know, the life she wants new is just closing in on her and, and when it gets to the point where like, she only has like one thing left, well she's deleting. This is what people say. She's deleting. Wait, is that enough?

Dr. Titcombe: You know, I don't think it is like, I think she needs a much richer life. She needs to be able to be social and be able to move from A to B independently, like so many other things that it encompasses. So that's part of the discussion with people to say she only has this one tiny aspect of her former life left.

Dr. Titcombe: Is that enough for her? Is that what we call quality for her? I don't think it is, but I have those very real discussions with people and it's, it's hard. It's a very hard discussion, but in the end, I feel like they're grateful that they had that guidance because it's such a massive responsibility for pet owners to try to make that decision on their own.

Rabbi Weill: So part of the conversation in that, what now podcast episode was how people bond with all sorts of different animals, mammal, feathered, reptilian, and that they can mean as much, you know, like a tarantula. I think that might've been the example. Yes, but a tarantula can be as meaningful. It's hard for me to imagine it, and it's even hard for me to articulate it, that one can bond and feel love for tarantula as well as one can with a puppy or a kitty cat. What do you think about that? 

Dr. Titcombe: Well, that's such a good question. It's, it's all, you know, they say fondness is in the eye of the beholder, is phrase something like that? I think it's so true. It wouldn't hold true for me that I would love a reptile the same way I would love a cat, for example. But that's not for me to choose or think about it aside.

Dr. Titcombe: It's what that person bonds with and gives and receives love from in their own way. I think the example I gave on that other podcast was that little rat named Starlight and they wanted an ash return cremation with a little urn. And the the dad in the family said, well, she's just happens to be the smallest member of our family, but she's no less important.

Dr. Titcombe: And that was early in my career and that was a real eyeopener for me. That it's not for us to judge at all or anything like that. If that particular creature brings that family joy, that's amazing. 

Rabbi Weill: Right? So I think at some level it's like the extent at which or to which we are able to anthropomorphize these beings.

Rabbi Weill: So a dog has puppy dog eyes because it's a dog and a cat, you know, has two eyes, a nose and a mouth. It gives off a certain vibe that you can relate to a human being, which could enhance the, the relationship, the personal relationship with a snake. I think it's harder, a tarantula, even harder a rat may be easier because, you know, it's a mammal like whatever, and it has warmth, you know, like you hold it and you feel it's a little bit of warmth.
Rabbi Weill: I, by the way, had a friend who had pet rats and those rats were crawling all over me with their little claws on my neck and everything. So I kinda like them. 

Dr. Titcombe: I love rats. 

Rabbi Weill: What's that? You love rats? 

Dr. Titcombe:Yeah. Yeah. I grew up with rats as well. We had a, that was a, a family pet of ours for years. They're very friendly little creatures.

Dr. Titcombe: I know people see them in movies as you know, sewer rats. But the pet rats are lovely. 

Rabbi Weill: Right. Wow. I think that if we had called rats something different, the connotation we have with rats, movie rat is ratty. Um. So if we talk about the death of pets, we must address Rainbow Bridge. The Rainbow Bridge. And that is something that it doesn't bring me comfort.

Rabbi Weill: It's not something that I even like to think about because I just find it to be, it's wrong. It's not, it doesn't work for me. But many people find a lot of comfort, and I'm not just talking about how they're explaining the death of their pets to their children, but for themselves, like adults find a lot of solace from this notion of Rainbow Bridge, which surprises me. You wanna share some thoughts about that? 
Dr. Titcombe: So the Rainbow Bridge is a poem written by a person. It's sort of the idea of pet heaven, I guess, if you will. It talks about a place where animals are returned to their, you know, former glory and all the pain and everything is gone and they're running free and you meet up with them.

Dr. Titcombe: I don't know. I'm not a religious person. I don't believe in heaven. I don't believe in the rainbow bridge either, but I think it really, really works for people. If it works for you, fantastic. I was talking about the idea of a creative visualization where you walk someone through meeting up with their pet in something like the Rainbow Bridge, and you walk up this steep torturous mountain path and it's really difficult.

Dr. Titcombe: And finally, when you get to the top. You exchange a message with your pet. And my example was a gentleman who had lost his dog because, uh, they were out for a walk and the dog wasn't on a leash. And I think a lot of people are quite proud when their dog is not on a leash. They feel, oh, he listens to me, he's smart, he'll stay with me.

Dr. Titcombe: I'm a good pet owner. That dog ran out in the street and got hit by a car. And so the pet owner had massive amounts of guilt and I can fully understand that. And he himself was a therapist, a psychologist, and when he got to the top of the mountain and exchanged words with his dog, the dog just said to him, you're a really good guy.

Dr. Titcombe: And uh, and he was telling that story and crying and it was really emotional for him, and he just didn't think he was a really good guy. He didn't think the dog would think that because he felt he'd made this deadly mistake in letting his dog be off leash. So that I think works for me in the sense of a rainbow bridge where you can, you can exchange a message with your pet. Because honestly, like, I think another reason why I think we love animals so much is there's so forgiving. Like if we could forgive ourselves the way our animals, our pets, would, wouldn't life be so much better? 

Rabbi Weill: Yeah. And in that very powerful visualization for that, for that man, forgiveness was bestowed. Whether it was somehow by the animal soul, the dog soul, or from himself, there was some measure of forgiveness. 

Rabbi Weill: So I'd like to talk about music. I assume that when you are, maybe I shouldn't assume it, but I Do you, when you are going through the process of euthanizing an animal, do you use music and, and if so, it benefits whom?

Dr. Titcombe: Yes, I have, and I will. What I found over the years, we used to have this little box called Pet Acoustics. It was a really cute little music box, and it wasn't too loud, but it had really nice soothing music on it. We would take that to appointments. We also connected with a musician named, uh, Susan Raymond, who did harp music, which again was clinically proven to calm animals.

Dr. Titcombe: So we used that for a while, and then I came to realize that it is such a personal choice. For people what music they like or don't like. And I think it even could be a personal choice for animals because there have been studies done to show that classical music is more calming for animals. Like in a shelter environment, for example, is more calming than rock music.

Dr. Titcombe: And for people the same holds true. So in a final service, you know, a, a home euthanasia. I would suggest it the families that they would choose, the music they would like instead of me imposing what I would like on the, I think it's really nice. I think it's, it's very calming. I think it can elevate the experience and make it more special sometimes.

Dr. Titcombe: People will have like a certain song that reminds 'em of their pet, or let's say that they listened to when they went out for walks with the dog or things like that. So they have a certain very meaningful song that they would like to play, you know, as the pet's leaving this world. And I think, uh, I think that's a nice touch. I would definitely encourage it. 

Rabbi Weill: So before the last question, which will be about music again. But your work with animals, euthanasia and so forth, how has that affected your understanding of your own mortality? 
Dr. Titcombe: I like to think over the years I've become more comfortable with the death of humans as well as animals, including my own.

In having gone through the loss of human companions, and particularly my sister who died at like the age I am now, which is kind of hard to think about, and I remember she wrote me a letter, um, a little card, and part of that card said that she wasn't afraid of death. She was just afraid of being separated from her loved ones.
Dr. Titcombe: And I think that would kind of be the biggest thing for me, but I think, I hope that I will be much more at peace with it, that I found in my experience that it tends to be the people around the loved ones, the, the person dying, the people around seem to be struggling more than the actual person who's dying.
Dr. Titcombe: I mean, that's not gonna be the case for everyone, but I, I hope I'm that person where. I can be as comfortable enough with my own death that the people around me will have a smoother path through grief and loss. 

Rabbi Weill: Lianna, I'll conclude with this question. You give pet owners the option of choosing some music for when their pet approaches Rainbow Bridge.

Rabbi Weill: So when you are on your breathing, your last, when you're on your deathbed, what song or music or sounds would you want to be hearing? 

Dr. Titcombe: I'll bring my sister Leslie up again, just 'cause her death is so profound for me. But, um, she died when finally when we all left the room and just her daughter was with her and her daughter was singing quietly to her and that's how she left the earth.
Dr. Titcombe: And I thought that was such a beautiful way to go. I think she just needed that peace and quiet and, and music. For me, I think I would like music. I often thought that, you know what? I love movies and TV and everything, and I always wish I had a soundtrack to my life. I think it would make my life so much more interesting.
Dr. Titcombe: So in the end, I would imagine the song, Imagine by John Lennon. I love that song. I never get tired of listening to it, and I love the message of it, and I think that our world right now is full of a lot of hate and anger and war and terrible things happening that that song to me is hope. You know, and peace and hope and humanity.
Dr. Titcombe: And I would hope for my children and my children's children, and well everybody, you know, my friends and family, that they would have that, that the world would become a peaceful, beautiful, welcoming place that, you know, everyone lives as one. So I, that's how I would like to go out. I would like to leave the earth with hope.

Rabbi Weill: Excellent. And by the way, we're recording on December 8th, which I'm pretty sure is the anniversary of the, of John Men's last day she was murdered on December 8th. So, uh, I really appreciate that and I appreciate this conversation Dr. Lianna Titcombe. Thank you so much. 

Dr. Titcombe: Best do I. Thank you so much.

Rabbi Weill: I hope you are enjoying this music by Brian Jalo. Thank you podcast editor, Bethany Subang Milano. Follow Unveiling Death and share this and other episodes with friend and foes alike. Thanks for listening to Unveiling Death Eternity in about 24 minutes.


Jeffrey Weill
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