Georgina Morrison named her dog Vegas after "the happiest place on Earth".
"He is very much like me — aloof with strangers. He's lazy. He likes to sleep all day long," she said.
In June, the 12-year-old Rhodesian ridgeback was diagnosed with a spinal tumour and a tumour in his hip, affecting the function of his back legs.
"It was brutal. It's like the worst news I've ever heard. But now, we could have him for another year," Ms Morrison said.
Rather than put him through surgery as recommended by that vet, Ms Morrison turned to a range of specialists and therapies to keep Vegas moving and content in his final months of life.
Vegas does hydrotherapy twice a week at Sutherland in Sydney's south, has a brace and a wheelchair to go on walks, and has medicinal mushrooms, medicinal cannabis product CBD, Chinese herbs and an anti-inflammatory every day.
"We don't have any children, so this is our child, so I don't see why he should get any less care than a human," Ms Morrison said.
Just a few years ago, there would have been far fewer options available for terminally ill animals.
Palliative care a growing speciality
Melbourne veterinary oncologist Claire Cannon sees a lot of animals with terminal illness and has noticed a big shift in palliative care in recent years.
"It's not like there are magical new drugs or procedures, it's more the approach that has become better defined and really a collaboration between vets and pet owners," Dr Cannon said.
While it remains a small proportion, an increasing number of vets are specialising in palliative care.
"It's only relatively recently that palliative care has been defined in veterinary medicine as a separate part of the work rather than just something that nearly every vet does," Dr Cannon said.
Courtney Prue opened Rest Your Paws, an in-home pet palliative-care service, five years ago in Sydney, inspired by the care offered in the United States and Canada.
"I wanted that service for so many of my pets and their families when I was working in a clinic, and there wasn't anyone offering that service [in New South Wales]," Dr Prue, who treats Vegas, said.
Initially, her business was met with confusion, but since the pandemic made travelling to the vet more difficult more people are taking up the in-home service.
"We now have a team of 15 veterinarians working in Sydney, and we just keep getting busier and busier," Dr Prue said.
From backyard to bedroom
Driving the demand also is the growing importance of dogs in the home. Dogs have gone from being in the backyard to in the bed, under the covers.
"The relationships that people have with their pets now is so different to how it was 20 years ago or even 10 years ago. So many people feel that their dog or their cat is a family member," Dr Prue said.
Another of Dr Prue's clients, Penny Snow, credits her dog Bonnie with getting her through the darkest period of her life.
Eight years ago, Ms Snow's husband died of cancer.
"Bonnie was truly just the most comforting presence in my life at that stage. She's just a creature that wants love, but gives it about tenfold back," she said.
At age 14, Bonnie developed bone cancer, which has most likely spread through her back right leg.
"We're so aware of the gravity of where this is at … but I think it's really important to still be positive and be optimistic in the sense of trying for a good day today," Ms Snow said.
How far is too far?
Dr Prue visits Bonnie at her Paddington home in inner Sydney regularly, helping to bandage her leg, assess her movement in a wheelchair, provide pain relief and advise on any modifications that can be made to make Bonnie more comfortable.
Bonnie barely stirs as some of her fur is shaved on the most recent house call.
Susan Hazel from the School of Animal and Veterinary Science at the University of Adelaide welcomes the increase in palliative care vets.
"They're specialists in pain medication, and in recognising the quality of life of the animals that they're working with, but also in having a little bit more time to spend developing a relationship with the owner," Dr Hazel said.
In other cases, treatment can involve intravenous drips or feeding tubes — something Dr Hazel said would likely be rare.
"If you're using a feeding tube to keep an animal alive that's about to die, then I think that would be going too far. But it's a case-by-case basis," she said.
Not an option financially for most
Both Ms Snow and Ms Morrison know they are fortunate to be able to afford such care for their beloved dogs.
Ms Morrison hasn't tallied up the cost of caring for Vegas since his diagnosis, but it is at least thousands of dollars a month.
"Even if we didn't have the resources to give him the care that we give him because it costs a lot — I would have a GoFundMe page up. I would have absolutely no shame in saying to people, 'I need help', because I need to give my dog the best life I can give him."
Ms Snow estimates she has spent between $8,000 and $10,000 on Bonnie's treatment and tests.
Dr Prue's palliative care fees make up a relatively small proportion at $200-$300 for an initial consultation and $150 for follow-up checks.
For others, end-of-life care remains out of reach financially.
Vets are increasingly using what is referred to as a "spectrum of care" to find an ethical balance.
"You tailor what options you give owners, because you don't want to make them feel guilty that they're not paying for something that might cost $10,000," Dr Hazel said.
The time and effort required from owners must also be taken into account.
Dr Hazel said palliative-care vets who had built a relationship with the owner were in a good position to judge when owners reached their limit.
Dr Prue said it was important to be upfront about the costs of keeping pets comfortable at the end stages.
"If they want to go down that route they need to be aware of financially what that's going to entail for them and then we can help decide if that is the right option for them," she said.
Bucket list for your dog
Dr Prue also advises her clients on the signs to look for to know when it's time to let go.
It's confronting for pet owners, but many take comfort from knowing there is in-home euthanasia available.
"I'll never be ready," Ms Morrison said.
"I don't understand what life is without my dog and I'll never get another dog, ever. Never. He's a once-in-a-lifetime dog.
"I don't have the room in my heart to love another dog like him."
In the meantime, she has a bucket list for Vegas — an idea suggested by Dr Prue.
"She said, 'This doesn't have to be like a traumatic experience waiting for the end,'" Ms Morrison said.
Already ticked off are visits to Coogee where they used to live, Bondi for ice-cream and a trip to Gundagai to sit on the tackle box.
Soon, they're embarking on a road trip to the Great Ocean Road in Victoria.
"I'm giving my dog the happiest time you can have," she said.
