On November 1, 2011, the phone rang at 8 a.m. It was the day Hampton Roads Veterinary Hospice opened, and the first family was calling for help.
Later that morning, founder Dr. Tyler Carmack drove to Chesapeake to meet a family whose 12-year-old Dalmatian was facing several diagnoses at once. They were trying to understand what it all meant and what came next.
“I remember leaving with the feeling that we were both really grateful we’d found each other,” Dr. Carmack recalls. “They needed this kind of support, and I needed to know it could work. It did.”
On November 1, 2026, Hampton Roads Veterinary Hospice marked 15 years of caring for pets and supporting the people who love them. As we celebrate this milestone, we’re looking back at the experiences, relationships, and belief in compassionate care that made it possible.
The Inspiration: More Time, More Support, and the Comfort of Home
The idea for Hampton Roads Veterinary Hospice grew out of Dr. Carmack’s years in emergency medicine.
Again and again, she found herself helping families make some of their hardest decisions in unfamiliar surroundings, often in the middle of the night. She was grateful to be there for them, but she kept thinking about what could happen before a family reached that moment.
“I kept wishing we could give them more time, more support, and a calmer place to have those conversations,” she says.
She envisioned a practice that could help families understand their pets’ changing needs, explore ways to support comfort, and feel less alone as they considered what lay ahead.
“I wanted to help families through that stretch before the crisis, and to do it somewhere that felt less clinical. Home was the obvious answer.”
That vision became Hampton Roads Veterinary Hospice: a way to bring veterinary care and thoughtful conversations into the places where pets and families already felt comfortable.
Dr. Carmack’s Grandparents, Jim and Kitty.
Dr. Carmack’s Mom, Carol.
From a Prius and a Closet to a Community of Care
The early days were simple. Dr. Carmack drove a Prius to appointments, and the practice’s headquarters was a dedicated closet in her mother’s house.
At the time, many families did not know that veterinary hospice care could come to them. Building the practice meant introducing people to a different kind of support while caring for the families already reaching out.
Her own family helped make those beginnings possible. Over the years, they continued to support her through the challenges and changes that come with running a veterinary practice.
Friends made room for the work, too. They understood when a tearful phone call interrupted dinner and she needed to leave for an appointment.
“None of this happens without the people who make room for it.”
This anniversary belongs to those people as well: the family members, friends, and supporters whose encouragement helped turn an idea into a lasting part of the Hampton Roads community.
Honoring the Pets and People Behind the Work
Fifteen years of care holds many memories. For Dr. Carmack, the working dogs of Hampton Roads have a special place among them.
These dogs have served, worked, and protected, sharing extraordinary bonds with the people beside them. Learning their stories and caring for them at the end of their lives has been especially meaningful.
“These dogs spent their lives taking care of the people around them,” she says. “Being able to care for them at the end of their lives, and to support the people who worked alongside them, has been one of the real honors of this job.”
Every pet we meet has a story. There are favorite routines, familiar places, and people whose days have been shaped by that companionship. Taking time to understand those relationships is part of understanding what comfort means for each family.
It is also why this work stays with us long after an appointment ends.
HRVH holds a lantern-lighting ceremony to honor our beloved pets.
Joining Caring Pathways Through a Shared Commitment
In 2021, Hampton Roads Veterinary Hospice joined the Caring Pathways family of practices.
Dr. Carmack’s family had been growing alongside HRVH, and Caring Pathways was looking to expand beyond Denver. As conversations began, a shared understanding of care became clear.
“We both believed in true hospice and palliative care, not just end-of-life appointments, and we both put families at the center of it.”
For Dr. Carmack, joining Caring Pathways offered a way to continue the work she believed in while helping that approach reach more communities.
Today, she serves as Caring Pathways’ Director of Hospice and Palliative Care and the Lead Veterinarian for Hampton Roads Veterinary Hospice. Her work continues to reflect the purpose that brought her to that first home visit in 2011.
Dr. Tyler Carmack represents Caring Pathways and Hampton Roads Veterinary Hospice at the SCIVAC Rimini 2024 in Italy.
Helping Families Discover What Is Possible
When Dr. Carmack reflects on what makes her proud, she thinks of the families HRVH has connected with across Hampton Roads. She also thinks about the growing awareness that high-quality veterinary care can happen at home.
“When we started, most people didn’t know this was an option,” she says.
Today, more home-care services are available in the area. Even when a family chooses another provider, she is glad they know they have options.
The veterinarian who once worked out of a closet in her mother’s house could hardly have imagined that shift: something families had never heard of becoming something they expect to be available.
Helping make that possibility more widely understood is a meaningful part of Hampton Roads Veterinary Hospice’s story.
Some of Hampton Roads Veterinary Hospice’s first community events, spreading the word about pet hospice.
Looking Ahead: Helping Families Find Support Earlier
Dr. Carmack’s hope for the next five to ten years is that more families recognize that a support system exists and find it earlier. She also hopes that more primary veterinarians are raising awareness for their clients of these types of services.
She hopes changes in senior and geriatric pets will prompt conversations about comfort and care, rather than being dismissed as simply getting older.
“We may not be able to cure, but there is almost always something we can do to help a pet feel better and enjoy their life more,” she says.
For families wondering what that support can involve, our article on what comfort care really looks like for pets shares a closer look at caring for comfort, connection, and meaningful moments together.
The belief Dr. Carmack hopes will always remain at HRVH’s heart is the same one that inspired its beginning:
“Comfort and quality of life are always worth working toward.”
HRCV Hospice Technician McKenzie LeSueur, helping a patient at a comfort care appointment.
Thank You for 15 Years of Trust
To every family who has welcomed Hampton Roads Veterinary Hospice into your home, thank you. Thank you for sharing your pets’ stories, trusting us with your questions, and allowing us to support you through deeply personal moments.
To our team members, veterinary colleagues, family, friends, and community, thank you for helping make this care possible.
From that first visit in Chesapeake to the families we serve today, our purpose continues: helping pets feel comfortable and helping their people feel supported.
As we begin our next chapter, we carry your stories with us.
If you are noticing changes in your pet or wondering what comes next, learn about our in-home Comfort Care services. We are here to listen, answer questions, and help you explore the next step.
Dr. Tyler’s beloved dog, Jersey, lived till she was 16. Rest in peace, Jersey. 💚