Every season serves a purpose, perhaps especially the last one we walk with our best friends. A season with profound lessons – of accepting “there is nothing we can do” about the disease. But knowing “there is always something we can do” to help our best friends feel more comfortable and pain-free.
what is palliative care?
As our animal friends approach their golden years, they may develop terminal illnesses like kidney failure, heart disease or cancer. When we 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” – then we talk about palliative care.
Some animals are not good candidates for surgery or chemotherapy. Palliative care provides an alternative to premature euthanasia. Dr Cheryl Ho @ Mount Pleasant (Whitley)
The primary aim of palliative care is to provide comfort to the terminally ill. Relieve pain for the dying. Maximise quality of life in the final days. Until death occurs naturally or humane euthanasia becomes necessary.
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 walk leading up to that, we have a moral duty to not prolong suffering. To learn to manage chronic wounds and administer medications. To know when to drop ‘cure’ from our vocabulary and start palliative care. And most importantly, to realise when it is time to stop.
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).
Consider acupuncture to relieve pain from old-age conditions like osteoarthritis. Acupuncture may also relieve nausea which may then improve your pet’s appetite. Dr Audrey Loi @ Mount Pleasant (East)
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- unusually quiet or withdrawn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
* Read more about MANAGING PAIN.
A “preemptive” approach to pain – using analgesics before the onset of pain – is most effective. Animals who receive post-surgery pain control heal faster & eat sooner than those who don’t.
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 (especially for senior pets with dental problems)
- 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 or tuna or even small amounts of burgers and 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 & 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 force-feeding or tube-feeding will actually improve quality of life. Twinkle was treated by Dr Nathalee Prakash for FEGSF.
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, diarrhea or vomiting.
Some cats & dogs prefer to drink from automatic water fountains
Your vet can teach you how to administer subcutaneous fluids at home & depending on the medical condition, advise if fluid administration will make your pet feel better or worse. Dr Gloria Lee @ Mount Pleasant (Mandai)
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, increase circulation and prevent pressure/bed sores.
Engaging in day to day activities also keeps them mentally alert. So 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.
Some basic lifestyle changes can offer relief for pets suffering from chronic pain which affects mobility:
- Control weight and incorporate light exercises (e.g. hydrotherapy) to decrease joint stress and improve muscular support of the joints.
- Provide easy access to litter boxes or garden for elimination (e.g. gently-sloped ramp)
- Raise food and water 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. Use pee pads or diapers if they are incontinent. Brush their fur and clean their face and body daily with a warm damp cloth, especially for cats who have stopped grooming themselves.
Prepare comfortable sleeping spots in quiet areas & keep them clean & dry (especially if your pets are incontinent). Surround your pets with their favourite blankets & toys. Ming Ming @ Mount Pleasant (Mandai)
prevention is really better than cure
Very often, we only take our pets to the vet when signs of illness become obvious. Sometimes, that can be a little too late. As our pets approach their senior years, regular health screenings can help us detect age-related diseases at an early stage.
when to let go – choosing Euthanasia
There is 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.
We all know one day death will come. But perhaps, we are not prepared for how dying looks like.
We may say that based on medical tests and reports, your vet knows best when is the right time to euthanise. We may also say that based on years of living so closely with your animal friends, who knows better than you?
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 so we can be objective in deciding when it is time to end life.
When our animal friend is no longer responsive to his surroundings nor recognise us. When she refuses to drink or eat, even her most favourite food. When they are constantly crying in pain. When breathing becomes laboured. When he seems anxious and confused. When bad days outnumber good days.
You see, 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 death. Love them enough to give them that.
Dear Faye-Faye @ Mount Pleasant (Mandai)