If your dog has been diagnosed with an incurable illness, then you may be wondering whether palliative care is an option. Maybe your pet is entering their senior years, and you’d like to know what options will be available, should the time come. So, let’s take a look at palliative care, what it entails and what your options are.
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What is palliative care?
Palliative care is management of an end-stage or incurable illness. Therefore, palliative treatment is aimed at keeping your dog comfortable for as long as possible. Palliative care can go on for months (or even years), so it is not necessarily just immediate end-of-life (or hospice) care. However, palliative care is still applicable in the last stages of a dog’s life.
In human medicine, NICE (National Institute for Health and Care Excellence) defines palliative care as “the active holistic care of patients with advanced, progressive illness. Management of pain and other symptoms and provision of psychological, social and spiritual support is paramount. The goal of palliative care is achievement of the best quality of life for patients and their families.” This definition is much the same for dogs. So, the aim of palliative care is to ensure the best possible quality of life for our pets with chronic or end-stage illness, as well as for their family.
What does palliative care involve?
This will vary, depending on the illness, the patient and the family’s wishes. The main aim of palliative care is to improve quality of life for as long as possible, rather than to extend life. This means managing pain, maintaining mobility and also ensuring adequate mental stimulation. In other words, making sure they are still enjoying life!
The most important part of palliative care is almost always pain management. While this has been the case for a long time, a ‘multi-modal’ approach has become common more recently. Pain management can involve a combination of:
- Pain medication (usually involving a combination of drugs)
- Adjunctive treatments (alternative treatments used alongside conventional medicines), such as physiotherapy, acupuncture, laser therapy or hydrotherapy.
- Home modifications, such as using ramps, special beds and non-slip floors.
Modern advances in palliative care mean there are more options for controlling distressing symptoms. Depending on your dog’s symptoms, other aspects of palliative care could involve:
- Anti-nausea medication
- Appetite stimulants
- Cough suppressants
- Fluid therapy
- Vitamins or dietary supplements
- A special diet
- Nursing care, such as extra bathing if they become incontinent.
Your vet can tailor the palliative care plan to your pet’s illness, their general health, and your wishes as the pet parent. Some treatments may need to be given at the vets, whereas others can be given at home.
Many owners like to keep their dog at home as much as possible towards the end, rather than taking them to the vets. There are an increasing number of vets offering home visits to facilitate this. However, there are times when it is more appropriate, and safer, for treatment to be given at the vets. If you aren’t sure, have a chat with your vet.
When can palliative care be considered?
Palliative care is usually offered when:
- there is no cure for a life-limiting illness
- an owner opts not to try for a cure (for example by deciding against major surgery or chemotherapy)
- the symptoms of a chronic disease progress, so that they are interfering with quality of life.
Palliative care is not always the best choice, and it is a very personal decision. Your vet will be able to guide you in your decision making.
Is palliative care the right choice for my pet?
Whether palliative care is right for you and your pet is a very personal decision. You may decide that euthanasia is kinder. You may not have the time or finances for palliative care. There is no right or wrong answer, and your vet will help you with your decision.
Palliative care requires regular vet check-ups, so they can continually assess pain and quality of life. There are now a number of ‘scoring systems’ that vets use for assessing these, so it’s much better that your vet monitors your dog, rather than relying on your own judgement.
Sadly, there will come a point where palliative care is no longer working to improve quality of life or alleviate suffering. The bad days will outweigh the good. As hard as the decision is, at this stage euthanasia is the kindest option.
At the end of the day, you know your dog better than anyone. However, palliative care decisions can still feel overwhelming. Whatever you decide, your vet can guide and support you through the decision making process. Remember, you are not alone!
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