Palliative care can be a controversial topic, even in human health; however, in a survey conducted in 2019 by Public Opinion, on behalf of Centre to Advanced Palliative Care (CAPC), more than eight in ten consumers stated they would consider palliative care for themselves or a loved one if they had a serious illness. But what if the question referred to our four-legged, furry friends? Would public opinion change? Does palliative care even exist for dogs? If so, how does it differ from human palliative care?
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What is palliative care?
Palliative, or end of life care, is the medical care of patients with untreatable, life-threatening conditions, with the goal of providing as much quality of life, for as long as possible.
What does veterinary palliative care look like?
Dogs can’t give consent to medical treatment. Therefore, veterinary palliative care is aimed at controlling pain and other clinical signs caused by severe illnesses (such as nausea or opportunistic infections, for example), while limiting the discomfort that can be associated with these treatments. For instance, chemotherapy in dogs is performed in lower doses when compared to human chemotherapy (to prevent nausea and other side effects) and in dogs that tolerate treatment without distress; the primary goal is to increase the length of life with quality, rather than cure cancer.
In human medicine, “hospice and palliative care are considered to be the model for quality, compassionate care for those facing a life-limiting illness or injury.” Veterinary hospice care is defined as “giving clients time to make decisions regarding a terminal companion animal and to prepare for their pending death. The comfort of the animal must always be considered.”
My dog is old, is it fair to prolong their life?
Dogs live shorter lives than us. Sooner or later, every pet owner has to make decisions concerning their pets’ health and life, including its end. Ending a pet’s life is an enormous responsibility. However prolonging it by increasing the amount of medications to be taken daily, diagnostic tests and visits to the vets can feel just as overwhelming, because no one wants their dog to suffer and certainly not contribute to it.
Like us, dogs have bad days too. That does not necessarily mean they are suffering or that their lives must end! However, if bad days become the norm, this should be discussed with your vet. And, together, you can agree on what the next step should be.
It may be helpful to reflect on whether your dog meets the 5 welfare freedoms; originally defined by the UK’s Farm Animal Welfare Council to establish standards of farm animal care. The 5 welfare freedoms are freedom from: hunger and thirst; from discomfort; freedom from pain, injury and disease; freedom to express normal behaviour (by providing sufficient space, proper facilities and appropriate company of the animal’s own kind); and freedom from fear and distress. Although this is an overly simplistic way of considering animal wellbeing, it is certainly a good framework to start as a minimum.
I have decided to give my dog palliative care, where do I start?
The first step when starting palliative care is to discuss a therapeutic plan with your vet, including provision of pain relief when appropriate.
Pets on palliative care will spend a lot of time laying down, and therefore it is important to have a comfortable, supportive bed, of an adequate size for the dog.
If they are incontinent, make sure they stay clean and dry and their skin is well looked after. You can use nappies, lay incontinence pads where your pet lays down or help them toileting with a sling under their abdomen.
Overall, you know your dog better than anyone and, with the professional help from your vet with regards to your pet’s health, you will be well equipped to provide your furry friend the appropriate end of life care they deserve!
You might also be interested in:
AVMA Membership Directory and Resource Manual. Schaumburg IL, 2004:111.Epstein, M.; Kuehn, N..; Landsberg, G.; Lascelles, B. Duncan X.; Marks, S; Schaedler, J.; Tuzio, H (2005). ‘AAHA Senior Care Guidelines for Dogs and Cats’. Journal of the American Animal Hospital Association, 41, 2, 81–91.