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How your pet’s illness could put your mental health at risk

It was a difficult season of loss for Sean Owens’ family.

Shortly after his father died of kidney cancer in 2010, his mother’s beloved black Labrador retriever mix — Mary Margaret, or Maggie — was diagnosed with hemangiosarcoma, a rapidly growing tumor of the blood vessels. Maggie had a history of health problems, and Owens’ mother was distraught.

“That’s not an uncommon scenario in veterinary medicine,” said Owens, veterinarian and professor of clinical pathology in the School of Veterinary Medicine at the University of California, Davis.

“If you ask most veterinarians the hardest thing they do, it’s telling the senior man or woman that comes in, having just lost a significant other or spouse or partner, that now their animal, their dog or cat or whatever their loved one is, now has a terrible disease as well,” he said. “Those conversations … they just tear the heart out of you.”

In the months leading up to his father’s death and Maggie’s diagnosis, Owens said, his mother was the primary caregiver for both her husband and her dog. Watching the emotional toll that caregiving took on her was difficult.

“My mother would often have to take my father to the hospital. They’d all load up in the car. There would be the dog in the car, my dad in the car. My mother would have to take my dad to the hospital down in Philadelphia, and then she’d take the dog to the veterinarian,” Owens said.

“Caregiver burden is a real thing. It’s not an embarrassing thing. … There should be no stigma attached to it. It’s a normal part of loss and grief,” he said, adding that such burden can affect the well-being of pet owners caring for an ailing animal.

Maggie, his mother’s four-legged friend with white spots on her black paws, died soon after she was diagnosed with cancer, Owens said.

A new paper published in the journal Veterinary Record on Monday ties caregiver burden in pet owners to elevated stress and general symptoms of depression and anxiety, as well as poorer quality of life — similar to the burdens of caring for a human loved one.

The findings are the first to show how providing daily care for a sick pet could affect a pet owner, said the paper’s lead author, Mary Beth Spitznagel, associate professor of psychological sciences at Kent State University in Ohio.

“It is important that we do not minimize what family caregivers are experiencing in human caregiving relationships. I would not say that pet caregiving is the same, for example, as providing care for a parent with dementia or a spouse who has had a stroke,” Spitznagel said.

“But pet caregiving in the context of a chronic or terminal disease is clearly stressful for the pet owner, and we can probably learn a lot about how to help people in this situation by looking at what helps reduce stress in human caregiving,” she said.

Owens’ mother died unexpectedly last year, he said. As he reflects on her experiences as Maggie’s caregiver, he hopes that her story — and the new paper — shed light not only on caregiver burden but on ways to help pet owners better manage caregiver challenges.

“My mother would be tickled pink to know that one of her stories could help anybody else,” said Owens, who was not involved in the new paper.

The burden of caring for a sick pet

The paper involved 238 pet owners and their dogs or cats. The researchers separated the owners, who were recruited through social media, into two groups: 119 with pets who were diagnosed with a chronic or terminal disease and 119 with healthy pets.

Then, through questionnaires and testing scales, the researchers measured each pet owner’s level of caregiver burden, stress, depressive symptoms, anxiety and quality of life.

All of the questionnaires and measurement scales were borrowed from studies on human caregiving relationships, Spitznagel said.

The researchers also used a questionnaire to measure how well each pet owner adhered to his or her veterinarian’s recommended regimen for caregiving. The owners of healthy pets could respond with “not applicable” to some questions.

The researchers found that, overall, higher levels of caregiver burden and stress, greater symptoms of depression and anxiety, and lower quality of life were present in owners of sick animals than in those with healthy animals.

“I think down the road, this paper is going to turn out to be a landmark paper addressing the issue of caregiver burden in veterinarian medicine,” Owens said.

However, the paper has some limitations, including that the participants were recruited online, that they were not tracked over a long period of time and that they were primarily white women of relatively high socioeconomic status, with an average age of 48.

More research is needed to measure caregiver burden among a more diverse group of pet owners, and “we need to do more research to determine how to best help pet caregivers,” Spitznagel said.

Tips for pet caregivers

For pet owners who might be in a caregiving role and experiencing a burden, some of the same strategies often recommended to human caregivers could be helpful, said Richard Schulz, distinguished service professor of psychiatry at the University of Pittsburgh, who was not involved in the new paper.

Strategies include “having a good understanding of the disease and its trajectory so that appropriate interventions and decisions can be made. … Their vet could play a big role in this,” said Schulz, who has studied human caregiving burden.

Also, “making sure that they have the knowledge and skills to provide the needed care for their pet, including minimizing the suffering of their pet — again, their vet would be key in providing this knowledge,” he said. “Getting emotional support from friends and relatives, and perhaps respite, if that is needed, (and) dealing with their depression, which might include getting professional help.”

Schulz added, “The elephant in the room in comparing pet with human caregiving is that euthanasia is an accepted option with pets but not humans. It would be fascinating to learn from pet owners how the euthanasia option affects them and how it impacts their caregiving experience.”

Owens, whose mother was a caregiver for her husband and her dog, said it is important for caregivers to ask for help early on and to make time for things they enjoy while occasionally finding a sitter for their pet.

On the other hand, “many people are afraid that if ‘I’m not there and something happens, then I wasn’t there.’ I think in many ways, that’s the greatest fear,” he said.

As Owens reflected on the lives of his father, his mother and their black lab, Maggie, he said his family found peace at his mother’s memorial last year.

Before her death, Owens’ mother said she wanted her ashes mixed with those of her husband and Maggie and then spread into the ocean.

At her memorial, family and friends “each took a handful of sand and put them in with the ashes, and my sister and I took them out and cast them in the surf,” Owens said. He watched as the ashes sprinkled across the Atlantic Ocean, off the shore of Pawleys Island in South Carolina.

“In many ways, it was the perfect sort of closure for my sister and I, in terms of bringing everybody back together,” he said.

All in all, as a society, humans have developed stronger bonds with their animal companions over time, said Bernard Rollin, distinguished professor of philosophy, biomedical sciences and animal sciences at Colorado State University.

For that reason, he wasn’t surprised by the findings in the new paper.

‘People need closeness. … They seek it in their pets’

Rollin, who was not involved in the new paper, remembers an incident when he was a young boy growing up in Brooklyn and saw one of his neighbors crying uncontrollably.

It was in the middle of the afternoon. The woman ran out of her home in her bathrobe, holding her small Chihuahua in her arms, Rollin said. The dog was dead.

“She was hysterical, yelling, ‘First my mother and then you.’ I could see she was upset,” Rollin said. “But the interesting reaction was the neighbors. If they said anything at all, they sort of tapped their heads in the sign of insanity, and the ones who did talk to her, they would say, ‘It’s just a dog.’ ”

Nowadays, however, a grieving pet owner wouldn’t receive that reaction, he said.

“What’s fascinating to me, in the time since I was a kid, how much people’s relationships with companion animals has changed,” said Rollin, an animal-welfare expert who was awarded last year’s Lifetime Achievement Award for Excellence in Research Ethics from the Public Responsibility in Medicine & Research.

“I have my own views as to why pets have become so important to people. I think part of it is … people are more distanced from other people,” he said.

“It’s the electronic fixes — Facebook, email, text messages — and so the result is inevitably a loss of intimacy,” he said. “People need closeness with other human beings, and failing that, they seek it in their pets.”