Dr. Kim Freeman, DACVIM Oncology
I came across a quote once that began, “In our dogs, we see ourselves…” I believe that it’s true and often most true, when they grow old and become ill. Their accelerated lives are frightful reminders that one day, you and I will grow old. Maybe we will die of old age. Or, maybe we will be diagnosed with cancer or some other life threatening illness. What I hear most is people’s projections of their own fears of disease and aging on their dogs or cats. There is genuine concern that their pet does not feel pain or misery and that their quality of life remains good. Isn’t that what we all want for them and ourselves?
Many people think of hospice care in pets as the “do nothing” approach to end-of-life care. In reality, hospice, for both people and our pets, means that a patient is facing end of life and the goal is to make the patient comfortable and provide quality of life. To me, there is no such thing as “do nothing”. It’s not an option. We can always do something. We can provide love, a caring touch, we can move the food bowl closer or hold up the water bowl. We can provide pain medications or things that help soothe the stomach. We can treat infections and manage wounds. We can provide soft beds and warm homes. All of these things are doing something.
Most importantly we can have a plan. I like to explain how a patient’s disease is likely to progress. It is important and helpful to know the signs or symptoms that may be seen with time and what we can do about them.
GOALS: It is important to establish goals. A goal might be to keep your dog comfortable until your children can come home and visit one last time. A goal might be that you can spend one good week with your cat. My job is to make sure those goals are feasible with the tools I have for supportive care and your dog or cat’s medical condition. Once we establish realistic goals, then we move forward comfortably knowing that things change with time and we can tailor our care along with those changes.
MONITOR: In order to make sure we are achieving our goals, it is important to monitor your dog’s or cat’s progress. Each of you might have a different way that works for you. Sometimes I suggest keeping a journal or a calendar to mark down good days and bad days. It can be as simple as making a happy or sad face, or more detailed.
It is also important to have a final, end-of-life plan. I encourage you to discuss this up front, even though this is one of the hardest things to think about. However, if you know what that last day is going to look like, I think it significantly lowers stress and anxiety about that day. These are some things to consider:
- Who do you want to perform the euthanasia?
- Your primary care veterinarian? Your oncologist?
- Are you comfortable going to an emergency clinic?
- Do you want to be at home?
- Do you want to be present? Who else would want to be there or do you want there with you?
- Do you need someone to drive you home afterwards?
- Do you want your pet cremated remains or do you plan to bury them somewhere special?
You can discuss all of these issues with your veterinarian. We are here to help with all these end of life decisions, as well as the medical ones.