Dr. Sally Foote estimates that she's put down hundreds of pets during her 26 years as a veterinarian. It's a part of her job that she believes only gets more difficult with experience.

“Euthanasia really brings me down. The older I get the harder it is, particularly with a client whose pet I’ve treated for 10 or 15 years,” said Foote, a practice owner in Tuscola, Ill.

Foote got the idea to host a memorial service for clients of deceased pets while reading through a veterinary journal’s practice tips. In one tip, a veterinarian noted that a memorial service for clients was touching and beneficial.

Incorporating the idea into her own practice, Foote viewed the memorial as another service for grieving clients. To her surprise, she found the ceremony just as beneficial to her and her staff.

"If you don’t know how to help yourself cope with the sadness, you’ll get stuck in grief if you don’t do something,” she said. “There’s been an internal fear that I won’t be able to do the next appointment if I get into grief. It benefits us to have an outlet for our emotions, especially the difficult emotions like sadness and grief. When we don’t have an outlet, that’s when some of us get too hardened and not emotional, and then we burn out and leave practice.

“Nobody ever wants to delve into ‘how much emotion can I allow (myself) to show to my clients or staff?’ and it creates more problems for the vets and staff than we recognize,” she added.

In Canada, Dr. Kim Ward of Martensville, Saskatchewan, has for the past decade held memorial tea services for clients that involve readings, refreshments and a chance for people to share stories about their pets. Like Foote, Ward has found at least some of his staff benefit from having an outlet for their grief.

“Some say the memorial service doesn’t affect them at all and they just come and do the job. They come for the clients, but they don’t really bond,” said Ward, who has been in practice for 30 years. “Some staff members are as teary as clients, especially when they’ve taken care of the animal over the long term and they are emotionally attached to the owner and animal.”

Ward has found that he, too, uses the ceremony as an emotional outlet. That’s because some of his patients have really worked their way close to his heart.

“About 15 years ago we started doing new things,” he said. “The best example was our Puppy Club, a free set of socialization classes for the pets of clients who had paid for their puppy’s vaccinations upfront. Last month, I euthanized my first two Puppy Club puppies, and that was hard. I never thought it would be that hard.”

“It’s not just emotional ties,” Ward continued. Unless the need to euthanize is obvious, he doesn’t recommend it to clients because euthanasia is not a decision based solely on science. He is well aware that a pet’s poor health can improve, due to medical intervention or happenstance.

“Medicine is better now, and we keep them going longer," he said. "I used to have very few ‘gray’ euthanasias; it used to be black and white. Now I’m finding my gray zone (for recommending euthanasia) is getting wider and wider because of better technology. That was a real surprise for me.”

Ward holds memorial teas every eight weeks on Monday nights. The interval was something he worked out with experience. 

"There is a magic period of time in which the grief hits home. Before it, they’re too confused. After it, they think ‘I’ve made peace, I don’t need to go to a memorial tea.’ The best period of time to get an invitation is three to four weeks (after the death),” he said.

However, he found that wasn’t practical for his staff, and every eight weeks worked better. 

The gatherings always begin with Ward trying to ease the guilt some people experience over having chosen euthanasia.

“People who elect euthanasia often have more guilt or grief because they had a hand in it,” he said. “I tell them they should be happy to have had a hand in it and saved their animal from more pain. You have to divorce them from guilt over choosing euthanasia. Clients give very genuine thanks as they leave. They’ll say ‘I didn’t want to come but I’m so glad I came.’ I think a lot of people don’t want another pet until they can close off the last one, and the memorial tea helps them close off.”

The refreshments serve to relax participants. “We give tea and dainties,” said Ward, meaning sweets such as cookies and muffins. “People talk better when they have something in their hand. They don’t talk unless they’re circulating, and tea and dainties get them up, then you move the groups around rather than sitting down. We circulate and talk. Pictures are a really positive thing; it really opens the door, so we encourage them.”

Ward has struggled with how to address the spiritual dimensions of pets’ deaths, given the spectrum of his clients’ beliefs. “Religion here runs the gamut from (people) being very religious to not at all. We live in an area with many fundamentalist people, (many of whom) have trouble with the concept of pets having souls. Then there are those who don’t believe in heaven at all. They just want to talk to others who experienced it. It’s hard to cater to them all.”

At one point, Ward felt the memorial teas were becoming too religious, almost like a service, and he could see that some clients were uncomfortable. Now his readings are only poems such as “Rainbow Bridge.”

Like Ward’s, Foote’s memorial consisted of readings, refreshments and remembrances of departed pets.

She was a little nervous about it. As a solo practitioner in a small rural town where new ideas are not always well received, she wondered if it would go well. She need not have worried.

Foote readied for the event in December by placing in the waiting room a Christmas tree that doubled as a memorial tree. The clinic had up-to-date photos of every animal in its records, so staff members printed a photo of every pet that died during the year. Into flat foam pre-cut ornaments, they inserted the photos and wrote each pet’s name on his ornament. When they finished, there were 40 to 50 photo ornaments on the tree. Invitations to the memorial went to the pets’ owners for Jan. 1.

“We said come if you like, refreshments will be served, and we’ll give you your pet’s ornament,” said Foote. “It was nasty cold weather, yet we got eight or nine clients. That’s great for my little practice.”

Foote read from “Animal Blessings: Prayers and Poems Celebrating Our Pets” by June Cotner. The young daughter of one client lit a candle.

“I said that part of our purpose is to remember what our pets brought to our life, and if anyone would like to share something about their pet, now is the time,” Foote said. “One client said she was glad we did this because she appreciated having the time, ornament and recognition. She said it shows you know that pets matter.”

Among the ornaments on the tree was one for Sissel, the veterinarian’s beloved mixed-breed dog. “My 14-year-old dog died of a heart problem within 36 hours,” Foote told the group. “She was stealing toys the night before. She still wanted affection while her heart was going into failure. If there is anything I ever learned from animals it’s how they get it.”

That helped get other pet owners talking. The event ended with quiet conversation among the pet owners and refreshments.

The experience was so gratifying that Foote shared her feelings in a Veterinary Information Network online discussion and encouraged her colleagues to offer memorials.

"This idea cuts across urban, rural, rich, poor and could work in any kind of practice,” she said.

At the time of a pet’s death, Ward's clients are sent a grief packet. Foote's version includes a sympathy card and donation to her clinic's charitable fund, which she uses to help strays and clients who cannot afford medical care. It also includes a clipping of the pet's fur attached to a 4x6 card with the pet's photo and seeds for forget-me-not flowers. Some of Foote’s clients who could not attend the memorial service donated to her charitable fund in honor of their pet.

Foote sees the memorial service as positive for all involved and plans to host one annually.

"It was hugely helpful to me to get closure for these lost pets and the grief that gets stifled in the workings of a practice,” she said. “I highly recommend practices do this as they see fit. It is a good way for you and your staff to let go and feel the joy of what these patients were to the staff as well as their owners. We — vet and staff — have our mental health to consider, and a memorial service can really help us help ourselves.”