Palliative & End of life Care
(Hospice)
What does palliative care and hospice mean?
Palliative care aims to improve a cat's quality of life by relieving the pain and distressing symptoms of a serious illness. It is what you would think of as "comfort care". It provides you and your cat with the support that is needed regardless of whether the illness is curable, chronic, or life-threatening. Importantly, palliative care does not treat the underlying cause of the illness. Palliative care can be used alongside specific treatments aimed at curing a disease or on its own when nothing more can be done. This sort of palliative care at the end of life is also called hospice. End of life palliative care does not serve to speed up or delay death, it simply provides you and your cat with the support that is needed to achieve the best quality of life possible.
When might palliative care or hospice be needed?
Here are some scenarios where palliative care or hospice may be needed:
Common examples of palliative care
Anti-inflammatory medications for arthritis
Appetite stimulants and anti-acid medications for cats with kidney failure
Insulin injections for complicated, long term diabetics
Decongestants, anti-inflammatories, appetite stimulants, warmed smelly meals for nasal cancers
- After diagnosis of a chronic illness (eg arthritis, heart disease, kidney disease, diabetes)
- When symptoms of a chronic illness interfere with your cat's normal daily routine (eg arthritis is a very common one)
- Disease processes in which curative treatment was possible but failed (eg relapses of previously treated cancer)
- When a decision has been made not to pursue curative treatments
- (eg inoperable tumours, multiple/severe illnesses, elderly cats with multiple diseases)
- After diagnosis of a terminal illness (eg cancer)
- Health problems that require long-term intensive care (eg fractures)
- Illnesses that are progressive (eg cancer, heart and kidney diseases)
Common examples of palliative care
Anti-inflammatory medications for arthritis
Appetite stimulants and anti-acid medications for cats with kidney failure
Insulin injections for complicated, long term diabetics
Decongestants, anti-inflammatories, appetite stimulants, warmed smelly meals for nasal cancers
Palliative Care Myth Busting
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The overwhelming difference between hospice care for people and animals is that we have the option of peaceful euthanasia for our animals, once we are unable to continue to control debilitating symptoms like pain, nausea, breathing difficulties and mobility. As much as it is about keeping cats comfy and happy, end of life care is about educating you on how to monitor quality of life and also preparing you for the eventual loss of your beloved cat.
Helping your cat drift into a final sleep at home with dignity, surrounded by their family, is the final act of love you can offer your cat. It is unlike any experience of euthanasia you may have had with pets in the past and prevents them from experiencing the long and drawn out period of suffering that often accompanies natural death. |
There are plenty of negative misconceptions surrounding the use of the terminology "hospice" amongst pet owners and the veterinary profession. For this reason, I prefer to use the phrase "palliative end of life care".
MYTH #1: Palliative care is just about treating pain & other physical symptoms
Palliative care aims to provide a multifaceted approach to give your cat the best quality of life possible so this does not just mean giving medication. I have plenty of resources to help you to understand not only your cat's illness, but also provide you with a greater understanding of your cat's behavioural, social, environmental and emotional needs. Think of me as a feline doctor, nurse, psychologist and occupational therapist rolled into one. For instance, if your cat suffers from arthritis, there is far more to palliative care than taking a dose of meloxicam liquid once a day! I have loads of advice tips that can help you look at your cat's environment from their perspective. It's amazing what a difference a few subtle changes can make to improve your cat's quality of life... arthritis-friendly scratching pads, toileting arrangements, creating easy access steps as an alternative to jumping and bedding suggestions to accommodate those stiff and aching joints. How are your cat's claws looking - did you know ill-health can cause nail growth changes and reduce essential maintenance like grooming and claw sharpening behaviours. There are lots of ways we can help them to stay comfy and well-groomed!
MYTH # 2: If my cat needs palliative and/or "end of life" care it means they’ll have to go into a hospice
Hospice does not refer solely to a place of care as many people mistakenly believe. It actually reflects a philosophy for "end of life" care which is pretty much what you think it is... the act of providing comfort care for cats nearing the end of their life. Humans receive "end of life" care in a range of settings (at home, in hospital, in a care home or in an actual hospice). In veterinary medicine however, the welfare interests of each animal needs to be considered which means that in my opinion cats are best cared for by a mobile vet in the comfort of their own home. At-home hospice care is by far the least stressful way of minimising pain, discomfort and distress to keep your cat happy and comfy for as long as their individual illness will allow before euthanasia is necessary.
MYTH #3: Hospice care means your cat can't be euthanased
Many US vets allow sedation-assisted natural death or admission of animals into a hospice facility. I do not feel that this is something that sits comfortably with me. All end of life palliative care recommendations I make are based on maintaining good quality of life, through preventing avoidable pain and emotional distress. My end goal is always allowing a peaceful death through euthanasia.
MYTH #4: Only your cat benefits from end of life palliative care
Palliative care at life's end not only helps your cat, it also provides emotional support for anyone who loves them! This pathway offers your cat the opportunity to continue happily with good quality of life, precious time together which only strengthens the bond between you both. It provides a feeling of reassurance that a beloved family member is being treated with the dignity and respect they deserve in their time of need. Veterinary hospice is by no means an alternative to euthanasia, but having been through hospice with your cat, you know that from the moment they came into your life until the end that you have done your very best to ease pain and suffering. This really can help you process your grief when the sad time comes for us to send your cat gently to sleep for the last time. It can provide great comfort knowing that you could have done no more to provide optimal quality of life for your animal right to the very end, even if this was a shorter time than you hoped for.
MYTH #1: Palliative care is just about treating pain & other physical symptoms
Palliative care aims to provide a multifaceted approach to give your cat the best quality of life possible so this does not just mean giving medication. I have plenty of resources to help you to understand not only your cat's illness, but also provide you with a greater understanding of your cat's behavioural, social, environmental and emotional needs. Think of me as a feline doctor, nurse, psychologist and occupational therapist rolled into one. For instance, if your cat suffers from arthritis, there is far more to palliative care than taking a dose of meloxicam liquid once a day! I have loads of advice tips that can help you look at your cat's environment from their perspective. It's amazing what a difference a few subtle changes can make to improve your cat's quality of life... arthritis-friendly scratching pads, toileting arrangements, creating easy access steps as an alternative to jumping and bedding suggestions to accommodate those stiff and aching joints. How are your cat's claws looking - did you know ill-health can cause nail growth changes and reduce essential maintenance like grooming and claw sharpening behaviours. There are lots of ways we can help them to stay comfy and well-groomed!
MYTH # 2: If my cat needs palliative and/or "end of life" care it means they’ll have to go into a hospice
Hospice does not refer solely to a place of care as many people mistakenly believe. It actually reflects a philosophy for "end of life" care which is pretty much what you think it is... the act of providing comfort care for cats nearing the end of their life. Humans receive "end of life" care in a range of settings (at home, in hospital, in a care home or in an actual hospice). In veterinary medicine however, the welfare interests of each animal needs to be considered which means that in my opinion cats are best cared for by a mobile vet in the comfort of their own home. At-home hospice care is by far the least stressful way of minimising pain, discomfort and distress to keep your cat happy and comfy for as long as their individual illness will allow before euthanasia is necessary.
MYTH #3: Hospice care means your cat can't be euthanased
Many US vets allow sedation-assisted natural death or admission of animals into a hospice facility. I do not feel that this is something that sits comfortably with me. All end of life palliative care recommendations I make are based on maintaining good quality of life, through preventing avoidable pain and emotional distress. My end goal is always allowing a peaceful death through euthanasia.
MYTH #4: Only your cat benefits from end of life palliative care
Palliative care at life's end not only helps your cat, it also provides emotional support for anyone who loves them! This pathway offers your cat the opportunity to continue happily with good quality of life, precious time together which only strengthens the bond between you both. It provides a feeling of reassurance that a beloved family member is being treated with the dignity and respect they deserve in their time of need. Veterinary hospice is by no means an alternative to euthanasia, but having been through hospice with your cat, you know that from the moment they came into your life until the end that you have done your very best to ease pain and suffering. This really can help you process your grief when the sad time comes for us to send your cat gently to sleep for the last time. It can provide great comfort knowing that you could have done no more to provide optimal quality of life for your animal right to the very end, even if this was a shorter time than you hoped for.
The Quality of Life Assessment
The most important factor that I consider when making a decision about euthanasia or formulate a palliative care plan is the Quality of Life Assessment. This is basically a checklist that helps vets and owners ensure that they are providing proper care for unwell and terminally ill pets.
Animals, particularly cats, do not show pain in the same way that humans do. So many animals suffer in silence because their owners do not appreciate that the subtle signs cats display could be due to pain. By using a factual list of criteria alongside a veterinary examination and consultation we can get as close as possible to understanding the needs of your cat.
Animals, particularly cats, do not show pain in the same way that humans do. So many animals suffer in silence because their owners do not appreciate that the subtle signs cats display could be due to pain. By using a factual list of criteria alongside a veterinary examination and consultation we can get as close as possible to understanding the needs of your cat.
I can offer palliative care assessments with appropriate management plans to suit you and your cat's needs without leaving your home. Contact me for more information.
