Pain Management
Pain management is a key part of successful hospice practice. It is important to treat ALL pain that may be occurring in the hospice patient, not just the pain associated with the terminal condition. In the older pet concurrent conditions often include, chronic degenerative joint disease, chronic intervertebral disc disease, chronic periodontal disease and chronic otitis. Pain management takes many form and may include, injections, pills, oral liquids and transdermal patches. Often multiple drugs are used in the same patient to treat different types of pain. In hospice we often assume a disease, like cancer, is associated pain, especially if a similar condition is known to cause pain in humans. We also encourage and support the use of alternative treatments such as massage and acupuncture. It is important to note that our pets rarely show their pain in a way that is obvious to us.
Palliative Medical Care
The goal of palliative treatment is to make a pet as comfortable as possible and to enhance his or her quality of life. This may include medications to address nausea or constipation, drugs that stimulate appetite, drugs for seizure control or sedatives that help with nighttime sleep. Palliative care may also include offering heated beds and turning up the thermostat in the room where a pet spends most of their time.
Nutritional Counseling
This includes encouraging appetite through the use of highly palatable and high quality diets. It may also include also include the use of hand feeding or balanced homemade diets. Therapeutic diets may be enhanced to encourage adequate consumption. We can also help owners manage long term feeding tubes that have been placed at their regular veterinarian. There is also an evolving field of nutritional supplements that may enhance immune function and inhibit some cancer growth. This may be referred to as immunonutrition and chemoprevention. There is also good evidence that some cancers thrive in a high carbohydrate nutritional environment, so cancer patients may benefit from diets that are high in proteins and fats. Increasing levels of antioxidants and fatty acids may help geriatric pets deal more effectively with chronic inflammatory conditions.
Maintaining Hydration
This may include making fresh water easily accessible, offering homemade broths and the use of subcutaneous fluids at home.
Managing Issues of Mobility and Hygiene
Mobility issues play an important role in our pet’s quality of life. Mobility is to be encouraged, even if it is accomplished through the use of slings, harnesses or pet “wheelchairs”. Other examples might be the use of boots to prevent scuffing in neurologic conditions and splints to support and protect dogs with bone cancer. Many times a pet’s environment can be modified to allow more mobility through the use of ramps or non-slip surfaces. Assessing the pet’s environment through their eyes and limitations can often improve life for the pet and the owner. Hygiene issues may involve bandaging or treatment of external conditions, use of “potty pads” to wick urine away from the pets skin, intermittent urinary catheterization and general grooming and bathing.
Quality of Life Assessment (QOL)
Owners are taught to use a biweekly or weekly QOL scale to evaluate their pet’s condition. This is a scale developed by Alice Villalobos, a veterinary oncologist. An initial evaluation is gone through with the owner on the initial visit. If there are multiple caretakers, each should do their own and discuss any disagreements. Having an objective scale can help owners see changes that might not be apparent from day to day. It is also a good idea to discuss your “bottom line” or benchmarks in advance, something that defines, for you, when euthanasia is appropriate. It can help to think about behaviors define quality of life for your pet.
Assessment of Caretaker Needs and Expectations
It is very important to understand that veterinary hospice care can look very different, from one pet to the next, and from one family to the next. Not all pets have the same tolerance for medications or treatments. Not all owners have the same time and financial resources. Some families are just looking for an extra few days to say good bye and other families want to provide every possible support to give quality of life for as long as possible. Solace Veterinary Hospice is here to support you and honor your decisions. However, we must agree to remember, at all times, the comfort and quality of your pet’s life is our priority.
Home Euthanasia Services
There will often come a time when the bad days outweigh the good. In most cases pet hospice doesn’t replace the option of euthanasia, but it does give owners more time to plan for it. We can help facilitate a peaceful death, with family, in the comfort of your home.