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Veterinary Talk by Dr. Jim Humphries

More veterinarians filling a void with end-of-life care

If you feel your pets are practically part of the family, youíve cared for them from their early days through their senior years. Our pets are living longer because of better nutrition and outstanding advancements in medicine and surgery. This means both dogs and cats face a longer life. Near the end of their life, they also face special needs, including pain control, cancer care, special nursing and therapies. In fact, end-of-life care could include hospice. If we have not experienced a hospice program with a close family member, we humans have a hard time understanding how hospice works.If you have experienced hospice, you know the extraordinary level of compassion and care that can be delivered by the right caregiver at the end of a personís life. It is often a comforting and rewarding experience because you see the dedication of caregivers delivering whatever the patient needs in the final few months of life so he or she can pass with dignity and respect.For years in veterinary medicine, pet owners and veterinarians alike might wait until the pet is very ill and then make a hard decision to ìput them to sleep.î In todayís world of modern veterinary practice, it is no longer necessary to wait too long to deliver comfort care at the end of a beloved petís life. Symptoms of old age and other debilitating diseases like cancer vary widely so the science of delivering hospice, a special form of palliative care, varies as widely as the symptoms.Hospice is done at home and part of the reason I focus on hospice care is because of the nature of my house call practice. However a veterinarian in a fixed hospital can certainly direct home hospice care by giving you an understanding of what to do in delivering certain therapies and medications and re-checks, if the pet is mobile enough.The ideal situation is to have hospice performed at home, as it is done in human medicine. In that case, a veterinarian makes an initial admission into hospice care, and then visits as needed whether it is every few weeks, weekly or even every few days.Care includes comfort, good nutrition, life enrichment, affection, supplements and a heavy dose of compassion and love knowing youíll have your friend only a short time longer. Medical care includes primarily pain control, physiological supports with good nutrition and directed supplements; and then some symptomatic care like controlling vomiting and diarrhea, mobility; even some simple physical therapy that can be done at home by the pet owner. Other advancements like laser therapy can ease pain without sedating drugs. But the primary goal is not to cure disease but to comfort and ease the pets last months.A common mistake made in the delivery of hospice care is an assumption the animal is in pain when, in fact, they simply lack the ability to move appropriately because of neurological problems. Then, if sedating drugs are given to control ìpainî it makes the situation worse. I see this far too commonly. An astute diagnosis must be made in order to know what therapies and comfort care should be given, without making the situation worse.Hydration and nutrition, physical therapy and drugs where needed plus a heavy dose of love and compassion allow our pets to face the end of their life with the dignity and respect they deserve. Much of the cost of hospice care is covered by pet insurance, but overall no heroic measures are typically done so the cost of care is not expensive.If your cat or dog is nearing the end of its life, the critical question is it too early for euthanasia, or have we waited too long? Hospice, with the guidance of a veterinarian and perhaps a skilled technician, can help you make these critical decisions. Hospice care should keep your beloved family member as comfortable as possible; and, when it is the right time, your pet has dignity and respect and the entire family gets closure and positive memories to hold on to.If you are interested in professionally delivered end of life care for your pets, call your veterinarian and find out if they understand these important concepts and are willing to deliver proper medical and compassionate hospice care for your pet family members. Dr. Jim Humphries is a house call veterinarian in the Falcon area. Heís passions are dentistry, pain management and home hospice. He also serves as a visiting Professor at the College of Veterinary Medicine at Texas A&M University and lectures nationally. He lives in Falcon with his wife, horses and Great Danes. www.MobilePetDocs.com

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