By Cherie T. Buisson, DVM, CHPV
Certified Hospice and Palliative Care Veterinarian
Originally published on DrAndyRoark.com June 3, 2018

Veterinary hospice and palliative care is my calling. That isn’t something I ever thought I would say, but there it is. I’ve devoted a large portion of my practice to helping pets at the end of their lives.

Along with pets, I also support their people through the worst part of pet ownership. As I’ve spent more and more time with pets at the end of their lives, I keep hearing the same myths and misconceptions. Let’s bust those myths and help our pets stay as happy as possible for as long as possible!

  1. They’re not in pain because they’re not crying

This bothers me so much that I started using #DontHaveToCryToHurt on @HelpingHandsPetHospice to try to get the word out. I’ve seen pets walking on broken limbs and not crying. The majority of pets with chronic pain don’t cry.  They change their behavior far more often than they complain. They don’t want to jump, they don’t climb stairs, they don’t want to get up, they have accidents. THEY LIMP. Limping is pain until proven otherwise. If I’m limping, it’s because I hurt. If my foot falls asleep, I do the crazy limping limb-shaking dance because it hurts, even for a short time. If you see your pet limping, please assume they are in pain and take them to the veterinarian for an examination. When in doubt, treat for pain and see if the problem goes away.

  1. If pets are eating, they have a good quality of life

Yes, appetite is one of the ways that we assess the quality of life. Pets in quite a bit of pain will often still eat. Pets with nausea may try to eat and walk away or only want to eat certain things (like treats!). Many of my patients go to the Rainbow Bridge eating delicious food. It’s not necessary or advisable to wait until they stop eating to say goodbye. If your pet has a decreased or nonexistent appetite, ask your veterinarian to try some medication for nausea. Just like us, pets will refuse to eat rather than eat and vomit.

  1. There is a perfect time for euthanasia

I feel so badly for people trying to hit this impossible target. There is no such thing as the “perfect” time. There is a zone between “too early” and “too late” – we try to land somewhere in there. As human beings, that’s the best we can do with patients who can’t tell us for sure when they are ready. With veterinary-guided hospice care, that zone is a far more comfortable place to be. If your pet passes naturally, you have the added benefit of having everything you need to ease any distress they may have. There are veterinarians (like me!) with special training in not only keeping your pet comfortable at the end, but also supporting you and your family during this difficult time. You can find them at www.IAAHPC.org

  1. Once a large dog is “down”, it’s time for euthanasia

Well, yes and no. It really depends on a lot of factors. Large dogs are commonly euthanized for end-stage arthritis – when they are too weak and too painful to get up on their own. Sometimes owners help them up or even carry them for a long time before they decide to let go. So many patients I see have never been on pain management, and that’s really a shame. A good pain protocol with several different therapies can be a literal life-saver for these dogs. It’s best to start these treatments early, but some “down” dogs can be given a second chance with the right treatment.

  1. Pain medicine is dangerous

We need to stop being afraid to treat patients for pain. I’ve had so many clients tell me they’d rather their pet be in pain than be groggy. I don’t know about you, but I’ll take sleepy over painful any day. Since your pet doesn’t have to drive or go to work, what’s wrong with a temporary increase in sleep? Obviously, if they are staggering around the house or falling face first into their water dish, we need to make a change. It’s hard to see your pet lethargic or “acting like a zombie”, but letting them suffer in silence is far worse.  In many cases, this lethargy is temporary and well worth the reward of having your pet happy and comfortable.

NSAIDs (non steroidal anti inflammatory) are a mainstay for treatment of arthritis. Like any drug, they can have side effects. Damage to the kidneys, liver, or gut are possible. These aren’t inevitable complications nor are they always irreversible.  The latest form of this type of drug actually has a reduced incidence of these types of side effects.  Working closely with your veterinarian and paying attention to changes in your pet can allow you to use these drugs safely for the benefit of your beloved companion.

The field of veterinary hospice and palliative care is growing, and with that growth comes the opportunity to give our pets a longer, happier life. Pet owners and veterinary teams need to jump on the bandwagon of providing excellent end-of-life care. Our pets are worth it!

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