Paul Rozin has seen lots of dogs come and go during his 79 years. Suki, you get the sense, wouldn't make his Hall of Fame.

"She's not, I would say, among the dogs I've had, I'd say she's less than average in intelligence," Rozin said. 

Ah, but what she lacks in brains, the white Cairn Terrier with shaggy hair more than makes up for in loyalty.

"She's been a good companion and she's surprisingly young. I mean, if you look at her, you wouldn't think she was 15 years old," says Rozin, a recently retired psychologist.

Suki is starting to show her advanced age in other ways, though. Her back legs are arthritic, she's developed a heart murmur, and Suki has started leaving unwanted puddles around the house.

That has, in part, prompted a call to the family's veterinarian, Dr. Tam Mengine of White Whiskers Vet, one of a fast growing number of providers in the past decade who specialize in in-home hospice and palliative care for geriatric pets, as well as those with terminal conditions. When the time comes, Mengine also performs in-home euthanasia.

Suki is not there yet.

"So in her case, we are managing the chronic conditions as they come up, making sure her quality of life is good, trying to keep her from driving her owners insane with urinating in the house, and that sort of thing," says Mengine, who averages about 10 house calls per week to homes in the Philadelphia area, along with her in-clinic practice.

Whenever possible, Mengine avoids aggressive treatments that may not prove effective, focusing instead on reducing pain or anxiety for pets as they enter their final stage of life.

"I got struck over and over again by this concept of, just because we can do something doesn't mean we should," she says.

This holistic approach to dying well — to making sure an animal is comfortable and that its owners feel part of the process — takes its cues from the philosophy at the heart of human hospice.

Though, of course, there's one big difference.

"Veterinarians and pet owners both are a little quick to go to the needle," says Dr. Jessica Pierce, vice president of the International Association For Animal Hospice and Palliative Care, an advocacy group with more than 385 members.

"Families are given, what seems to them, two very stark choices. You can do these expensive and aggressive treatments, curative treatments. Or you can euthanize. And hospice tries to fill in the realm of possibilities between those two extremes."

But along with extending an animal's life in a pain-free way, pet hospice is also seen as a comfort to the owners. It gives them the chance to have the last days or moments take place at home, rather than in a clinic.

"We literally take the most difficult thing that families have to go through, when it come to their animals, and make it as good as it can possibly be," says Dr. Dani McVety, who in 2009 co-founded Lap Of Love, a national network of in-home hospice providers.

"There is a huge potential to have that pet be as comfortable as possible for as long as possible. And then for the family to grieve in a way that allows them the privacy of displaying their grief, and having their grief, without having to hide that from anybody."

Lap of Love now operates a network of 80 doctors around the country who did more than 15,000 home visits last year. Their clients pay a modest premium over traditional care: in-home euthanasia runs about $250.

Suki's visit with Tam Mengine, though, winds up being just a $70 checkup. They're going to monitor her heart murmur and bladder problems for now, and get her started on a joint supplement.

"Those extra six months can mean a lot to people," says Mengine. "It can allow them time to adjust to the loss, and for the pets, if we can keep them comfortable, even if their day-to-day routine is different...maybe they are sniffing the smells on the porch and watching the birds instead of chasing them through the woods, they are still happy. So why not let them have that joy?"

Paul Rozin is on board with that attitude. Suki, he says, will be his last dog.

"I give her more treats than I used to....I used to give her one or two, but now I really spoil her. I mean, what the hell? That's one of the things she really loves."

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Paul Rozin and his dog, Suki. (Todd Bookman/WHYY)