End of life doesn’t mean life must end

The second time I met her, she greeted me at the door, hackles raised, barking, charging me a bit, a wild Storm! She was a completely different dog from the first time I met her.

She was in animal hospice and we were controlling her pain and gave her a great quality of life until her cancer had metastasized to her brain and her bone and we helped her with a gentle euthanasia. She lived nine months past the initial diagnosis, far past when she was “supposed” to die.

People who have been given a terminal diagnosis do not stop living at the moment of diagnosis. They have several choices to deal with their disease to fulfill their life for as long as they are able. This can include life prolonging care, limited care and comfort care, more commonly known as hospice care.

People often spend this last part of life — termed the end-of-life stage — doing things they wanted to do; a bucket list, for example. Some may be past the point in their disease process where they are able to go out and do a bucket list but they’re still engaged in life activities around their home and with their family.

As a hospice and palliative medicine veterinarian, I most often encounter animals who have been given a terminal diagnosis. I help those animals live as full and happy a life as they can with their terminal disease. This can mean there is a cessation in curative medicine, no more tests, no more trips to the veterinarian’s office, often bringing in a house-call veterinarian to help the family through comfort care.

It also can mean for some, the same as for people, life-prolonging care, such as palliative radiation, or limited care, such as giving fluids, or treating an abscess. It does not necessarily mean that the animal has to be euthanized at that time; there is often more a hospice veterinarian can do to help keep the animal comfortable.

Euthanasia is still an option, and most hospice veterinarians will perform euthanasia when it is time and is deemed appropriate by the team taking care of the pet.

The concerns that I often see or hear about are that the animal is in pain, or that the owners or the veterinarian have not perceived pain in the animal but think they are suffering in some other way. Most often it is pain, and because chronic pain is much more difficult to assess in animals, no one has seen it.

However, if you ask human beings in the same condition — cancer, for example — as they get farther into their disease process, they will report pain. Humans can tell you about the chronic pain they’re feeling. Animals can’t tell you directly, but they show you in other ways.

So many animals I see have gotten off their nice, cushioned beds and are now lying on the hard floor. They do this because pressure can help relieve pain. Think of a person with back pain: They get the firmest mattress they can find because it helps relieve pain.

Animals who pace at night, who stop eating, who get grumpy or have change in their behavior — all could have chronic pain. (If you are reading this and notice any of these things, bring them to the attention of your veterinarian.)

There are many things a hospice and palliative medicine doctor can do for your animal at the end-of-life stage. End of life does not mean life has to end. If we can make them comfortable, they can go on living, and be engaged in life. If not, we can always help them have a gentle death.

Consider hospice before you make the next step as your elderly animal approaches the end.

— Dr. Lynn Hendrix operates Beloved Pet Mobile Vet in Davis. For more information, visit www.belovedpetmobilevet.com