24 HOURS EMERGENCY I PHONE: 6251 7666
FaceBook    Instagram    WordPress


Palliative Or End Of Life Care

Education > Dog Health & Behaviour 4th January 2019
 


As our animal friends approach their golden years, they may develop terminal illnesses such as kidney failure, heart disease or cancer.

The last chapter with our best friends often come with profound lessons. Of accepting “there is nothing we can do” about the disease and dropping "cure" from our vocabulary. But knowing “there is always something we can do” to help them feel more comfortable and pain-free.

WHAT IS PALLIATIVE CARE?

From the moment we decide to share life with our animal friends, the day will come when we have to watch, with breaking hearts, as they grow old and die.

In the last days, we have a moral duty to not prolong suffering. To learn to manage chronic wounds and administer medications. To understand that the condition is not treatable or the decision is made not to treat it – yet our pet still has “that light in her eyes” – and start palliative care.

The primary aim of palliative care is to provide comfort to the terminally ill. Relieve pain. Maximise quality of life. Until death occurs naturally or humane euthanasia becomes necessary.

MANAGING PAIN

Pain is debilitating. Chronic pain can create a “stress response” associated with elevations of cortisol, reducing your pet’s immune response, leading to infections and slower healing. In palliative care, we manage pain with various drugs (e.g. steroids, opioids, non-steroidal anti-inflammatory drugs) and holistic therapies (e.g. acupuncture, massage, physiotherapy, hydrotherapy).



HOW DO I KNOW IF MY PET IS IN PAIN?

Firstly, animals tend to hide their pain – an instinctive survival advantage. Secondly, they cannot verbally communicate their pain. Watch your pets closely to detect any changes in behaviour:

  • unusually quiet or withdrawn
  • hiding and avoiding human interaction
  • restless, pacing, trembling
  • whining or whimpering
  • biting or snapping when touched
  • licking or biting a body part excessively
  • limping or exhibiting stiff body movements
  • having difficulty lying down or sleeping
  • refusing food

MY PET IS NOT EATING, WHAT CAN I DO?

We tend to get upset when our pets will not eat. The immediate urge is to force feed them so they do not go hungry or lose weight. But this might make them even more averse to eating. Most of the time, our pets are feeling pain or nausea which makes them withdraw from food. It takes a combination of appetite stimulants, medications to relieve pain and nausea, and novel ideas to tempt them to eat.

  • If you are feeding dry kibbles, soften them in water or broth or mix in canned food to make it more appealing and easier to eat
  • Warm up the food to make it smell tastier
  • Feed small amounts throughout the day instead of one big meal
  • Offer strong-smelling foods like cheese, tuna or bacon if your main aim is to have your pet eat something (always consult your vet about appropriate diet for your pet’s condition)

Feeding tubes are useful for animals who are ill and have lost their appetite, or are keen to eat but have difficulties swallowing or keeping food down. For chronically ill animals, discuss with your vet if tube-feeding will actually improve quality of life.

MY PET IS NOT DRINKING ENOUGH WATER

Dehydrated animals lose elasticity in their skin. Their gums become pale and dry, the saliva is thick and sticky. They are listless and their eyes may appear sunken. If not corrected quickly, the condition becomes life-threatening.

  • Flavour the water with some broth to tempt your pets to drink more
  • Syringe-feed fluids at regular intervals throughout the day
  • Hydrate your pet subcutaneously, especially for animals who are losing water from frequent urination, diarrhoea or vomiting.



STAY AS ACTIVE AS POSSIBLE

When our pets are ill, they tend to rest a lot more. However, light regular activity is important to keep them mobile, improve circulation and prevent pressure/bed sores. Engaging in day to day activities also keeps them mentally alert. Continue short play sessions and go on leisurely walks if your pets are up to it. Drive them to the parks and beaches or simply enjoy the car rides.

Some helpful lifestyle changes for our senior friends:

  • Control weight and incorporate light exercises (e.g. hydrotherapy) to decrease joint stress and improve muscle strength
  • Provide easy access to litter boxes or garden for elimination (e.g. gently-sloped ramp)
  • Raise bowls to a comfortable level (e.g. place bowls on non-slip stools)
  • Provide non-slip floor surfaces to help arthritic pets get up and walk more easily (e.g. yoga mats)
  • Provide comfortable firm beds for arthritic pets
  • Use body harnesses, slings, wheel chairs or carts for animals who have trouble getting around



KEEP CLEAN AND COMFORTABLE

  • Maintain your pets’ grooming routine to keep them clean and happy
  • Brush their fur and clean their face and body daily with a damp cloth, especially for cats who have stopped grooming themselves.
  • Prepare comfortable sleeping spots in quiet areas and keep them clean and dry
  • Use pee pads or diapers if they are incontinent
  • Surround your pets with their favourite blankets and toys

WHEN TO LET GO – CHOOSING EUTHANASIA

There is often a period of time between the first thought of euthanasia and actually choosing it. When we are unsure if it is the right thing to do (for moral or religious reasons). When we wonder if we should wait awhile longer because he looks brighter today. When we simply need time for closure with our beloved friends who have shared our life for the past 15 years.

Because we are so emotionally bonded with our pets and fearful of the flood of grief that follows, it helps to have a daily record of their activities and an honest dialogue with our trusted vet, family members and friends so we can be objective in deciding when it is time to end life.

Is your animal friend no longer responsive to his surroundings? Does she still recognise you? Is he refusing to drink or eat, even his most favourite food? Are they constantly crying in pain? Is her breathing becoming more laboured? Does he seem anxious and confused? Are there more bad days than good days?

Living longer does not always mean living better. As much as we want our best friends to have a good life, it is just as important for them to have a good and kind death. Love them enough to give them that.