If your cat has a life-limiting illness and has reached the end of their treatment journey, palliative care may improve their comfort prior to the end of their life. The goal of palliative care should not be the extension of life at all costs. Instead, the focus should be to preserve quality of life until the time comes to say goodbye. We’ve previously covered palliative care for cats here. This post will discuss how palliative care can be applied to cats as a species and will take a look at the latest advances for cats in some of the key areas of end-of-life treatment.
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Palliative care plans for cats
Cats are a very different species to humans; they perceive the world in a very different way to us. They do not have a sense of the future or hope as we do. So it is imperative that when planning for palliative care, we try to empathise with what the cat is likely to be feeling, rather than let our own emotions cloud our judgement.
As a species, cats show pain in subtle ways that can often be missed by their caregivers. They depend on a consistent routine in a familiar environment to feel secure and at ease. These species-specific quirks can make it tricky to strike the right balance for cats when planning for their end-of-life care.
Your cat’s individual preferences must also be considered
Are they a well-socialised lap cat, or are they highly independent, rarely venturing indoors? If your cat doesn’t particularly enjoy handling, repeated vet visits and physical therapies like massage might be ruled out of their palliative care plan.
The first step in creating a palliative care plan is to meet with your vet to discuss the expected course of your cat’s illness and how it will impact them over time. At the appointment, you’ll also want to discuss your cat’s daily activities, their likes and dislikes, and how you will recognise whether their overall quality of life has become a negative one.
It’s helpful to keep a diary of their daily habits. And to take videos of their behaviour to share with your vet. The vet will be able to give you tips on how to adapt your cat’s living space so that they can retain easy access to their essential resources (litter tray, food, water, bed, scratching post, toys). It’s also important to talk through the end-of-life plan with other members of the household, so that their needs can also be taken into account.
New advances in pain assessment in cats
Pain assessment and management is an essential part of end-of-life care. It’s tricky to spot acute pain in cats, and chronic pain presents even more subtly.
Acute pain
Sudden onset, “sharp”, or “acute” pain can be identified by observing your cat’s facial expressions. To help, the University of Glasgow have developed a Feline Grimace Scale. And it’s recently become available to download as an App for your phone. The reliability of the scale was put to the test in 2021, when over 1,500 caregivers from 66 countries were asked to score ten images of cats in varying degrees of pain using the Feline Grimace Scale. The study showed that cat caregivers were able to use the tool reliably to assess acute pain.
It’s harder to assess chronic pain in cats
Identifying it relies on observing how their behaviour changes over time, while the cat is in the comfort of their own home. Recently, feline-specific ‘health-related quality of life’ questionnaires have been developed and partially validated. And in time these look likely to become more readily available for owners to use. VetMetrica is a web-based questionnaire looking at three areas of quality of life (vitality, comfort and emotional wellbeing). It’s currently only available on paid subscription but many veterinary practices are registered; ask your vet for more information.
Pain relief
Cats are notoriously sensitive to drugs. Historically this has made it difficult to properly manage their pain without unacceptable side effects. Cats also tend to dislike oral medication; especially when it is given forcefully, or when they can taste it in their food.
Opioids are a group of strong painkillers commonly used to treat acute pain and they may also play a role in managing chronic pain too. Previously these drugs were short acting and could only be given by injection by a vet. A new longer acting formulation of the opioid drug, buprenorphine, is now available, and in 2022 a transdermal skin patch was approved in the USA which will hopefully arrive in the UK soon.
Also in 2022, a new type of long-acting painkiller was approved for use in cats in the UK. This drug removes the need for daily oral medication and is given as a long-acting injection that can last for a month. Its primary use is for arthritic pain, but vets have reported that it can be useful in treating other types of pain too.
Physical therapy for cats
Integrating physical rehabilitation techniques can add great benefit to patient comfort at the end of their life, when used appropriately and on recommendation by your vet. The most common therapies used for cats are massage, acupuncture, and therapeutic laser.
Acupuncture is a complementary therapy that may benefit cats experiencing pain, particularly those with joint pain. Electroacupuncture involves attaching a small electric current to the acupuncture needles and is sometimes used when a longer lasting effect is required. Laser therapies provide pain relief, reduce swelling and promote tissue healing.
Recently, there has been a growth in the number of mobile veterinary services offering these treatments as part of a home visit. So it’s worth finding out from your vet whether they may be a good option for your cat.
Conclusion
Palliative care for cats has been difficult to get right in the past. However, an increased understanding of cat’s needs and recognition of their pain has made it a viable option for many cats. With new developments in pain control, it is becoming easier to preserve their comfort and quality of life while they remain at home.
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