Palliative Care

The primary aim of palliative care is to provide comfort to the terminally ill, relieve pain, and maximise quality of life until death occurs, whether naturally or through humane euthanasia.

Managing pain

Pain can be debilitating. Chronic pain can create a “stress response” associated with elevations of cortisol, weakening your pet’s immune system. This can lead to infections and slower healing. In palliative care, we manage pain with various drugs (e.g. steroids, NDMA antagonist, 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?

Animals have a higher pain tolerance as a survival advantage, and as such, tend to hide their pain well. As they’re unable to directly communicate their pain, it’s up to their owner to monitor signs. Look out for changes in behaviour. They may be undergoing pain if they’re: 

• Unusually quiet or withdrawn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?

Sometimes, the immediate instinct is to force feed them so they do not go hungry or lose weight. However, this might make them even more averse to eating. Most of the time, our pets are withdrawing from food due to pain or nausea. It takes a combination of appetite stimulants, medications to relieve pain and nausea, and novel ideas to tempt them to eat. Here are some tips to help tempt your pet into eating:

• If you are feeding dry kibble, soften it in water or broth, or mix in canned food to make it easier and more appealing 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 diets for your pet’s condition before doing this).

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 improve quality of life.

My pet is not drinking enough water

Dehydration can be life-threatening for an animal. They’ll quickly appear listless, with sunken eyes, and lose elasticity in their skin. Their gums may turn pale and dry, and their saliva may become thick and sticky. It’s crucial to correct this as soon as possible. If a pet isn’t drinking, you can try:

• Flavouring the water with some broth to tempt your pets to drink more.
• Syringe-feeding fluids at regular intervals throughout the day.
• Hydrating your pet subcutaneously, if they’re losing water from frequent urination, diarrhoea or vomiting. 
• Discussing the best way to maintain your pet’s hydration with your vet.

Stay as active as possible

When our pets are ill, they tend to rest a lot more. However, it’s important to keep them mobile with light regular activity, to 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 car rides with them.

Some helpful lifestyle changes for our senior friends:

• Control their weight to decrease joint stress and incorporate light exercises (e.g., hydrotherapy) to 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, wheelchairs or carts for animals who have trouble getting around.
• Speak to your vet for the best options for your pet.

Keep them clean and comfortable

Maintain your pet’s 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 an owner first considering euthanasia, and actually choosing to pursue it. We may be unsure if it is the right thing to do (for moral or religious reasons), or we may wonder if we should wait awhile longer because our pet looks a bit brighter and healthier today. Sometimes, we simply need time for closure with our beloved friends, who we’ve shared our lives with for the past 15 years. Nonetheless, it’s important to sincerely examine their condition, and ask yourself if it’s necessary to let go.

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 beloved companions to have a good life, it is just as important for them to have a good and kind death. Because we are so emotionally bonded with our pets, and afraid of losing them for good, it can be difficult to stay objective about their condition. It helps to maintain a daily record of their activities, and have an honest dialogue with family, friends, and our trusted vets, so you can remain objective when deciding whether euthanasia is truly necessary.