Palliative Care

Providing a Good Life to the End

When Big Jeff, a large, jet-black kitty, was in the middle of his 16th year, his kidneys began to fail. A transplant wasnt an option for him. We can manage the disease for a few months with diet and medication, his veterinarian said. Well make sure hes comfortable.

Youll know when he no longer has the quality of life you want for him.

For the next five months Big Jeff seemed to be doing fine; he played with the other felines in his household, ate well, and except for a little slowness in his gait, he hid whatever discomfort he may have been feeling. But at the beginning of his sixth month after diagnosis, Big Jeff began rapidly losing weight, his coat lacked its usual luster, and his breath had a strong ammonia smell. It was obvious the medication and diet were no longer effective.

Quality of life
When your veterinarian says your kitty is terminal and his disease is not responsive to curative treatment, youll be faced with a number of decisions. One possible option may be escalating medical treatment, says Rodney Page, DVM, director of the Comparative Cancer Program at the Cornell University Hospital for Animals. In other instances, he adds, palliative care or euthanasia may be the best decision.

According to the World Health Organization, palliative care is: The active total care of patients whose disease is not responsive to curative treatment. For humans, hospice (end-of-life care) has provided compassionate care to patients at the end of their lives and has helped families in the bereavement process. While veterinarians have always been concerned with their patients quality of life, it is only recently that palliative care has become more broadly available for companion animals.

Length of life is secondary to quality of life, says Page. The goal of palliative care is to reduce pain and fatigue, relieve signs, minimize hospitalization time, and reduce treatment-related toxicity.

Disease control
Page, who is currently developing guidelines for caregivers who would provide palliative care to companion animals with cancer, says, Palliative care is indicated when curative treatment is not appropriate or working and when the cat is too frail for curative treatment or has had a relapse following curative treatment.

Depending on the type of disease, palliative care can include antibiotics, anti-inflammatory medication, pain medication, nutritional support, fluid therapy, radiation therapy, chemotherapy, and even surgery. To help you make the best choices, youll want to know how long and how well your cat will live as the disease progresses – can he take an active part in the daily routine and whether be kept comfortable.

Currently there are few facilities that provide on-site hospice care. In many instances, a felines human companion is taught how to care for her cat at home or veterinary technicians provide hospice-nursing care in the cats own home. Some veterinary practices help prepare clients for their cats passing while others offer bereavement counseling.

It is important that providers have sufficient training to work with the cat and its owner, and be skilled in the use of pain medications and other palliative therapies, says Page.

The final decision
For Big Jeffs owners, the decision to euthanize him was made with the help of their veterinarian. It was apparent to all that Big Jeff was hopelessly sick and that the quality of his life had diminished; the most humane thing was to allow him to die in a relatively painless way.

At some point it will become apparent to you and your veterinarian that the quality of your cats life has diminished. Knowing that you have done everything you can to provide a good life to the end will make the decision to euthanize your cat one of pure compassion and love.