When my 14-year-old Sheltie, Drew, was diagnosed with kidney failure, my veterinarian offered me something that wasn't really an option when I started writing about pets a couple decades ago: hospice.
He encouraged me to manage Drew's terminal disease with daily IV fluids given at home and with a diet geared toward reducing strain on my dog's failing organs. That was a few weeks ago, and now Drew's kidneys are functioning well and he looks and acts years younger than he is. No one who meets him would guess he may have only weeks to live.
That quality of life is what hospice is all about, and the trend is catching on, according to advocates.
"The path to death is detoured a bit," says Dr. Robin Downing of the Windsor Veterinary Clinic and The Downing Center for Animal Pain Management. An internationally known expert in pain management, Downing is one of a handful of strong advocates for palliative care for pets, the practice of keeping animals happy and comfortable in their final days, weeks and months.
"We needed to find a way to help these animals live until they died," Downing says. "That's what hospice is about: living fully."
Since the 1990s, the introduction of a series of effective nonsteroidal inflamatory drugs (NSAIDs such as Rimadyl, Metacam and Deramaxx), along with the increased acceptance and use of complementary pain medications, has changed veterinary practice.
Previously, many veterinarians had avoided pain control for animals after surgery. The consensus view was that if moving hurt, a pet would be more likely to be still while healing. That thinking was changed by research showing that animals heal more quickly when pain is controlled.
For veterinarians such as Downing, these improvements in pain management made it clear that in some cases, they could also ease the suffering for animals for whom they could do little else.
Veterinary oncologist and hospice advocate Dr. Alice Villalobos of the Animal Oncology Consultation Service in Woodland Hills, Calif., notes that this idea ran counter to what veterinarians had been taught for decades.
"We were taught to offer euthanasia when a pet started faltering, and we have all been educated to focus on care for the pet's life stages," she says. "But end-of-life care was not included, and it is a life stage."
Villalobos says that only a small percentage of the nation's veterinarians offer end-of-life care, but there are signs that this is beginning to change. Indications of the increased interest include the first-ever pet hospice symposium at the University of California, Davis, School of Veterinary Medicine in 2008, followed by the founding of the International Association for Animal Hospice and Palliative Care the following year. The American Veterinary Medical Association recently revised its guidelines to emphasize that "veterinarians who do not offer hospice services should be prepared to refer clients to a veterinarian who does."
Although advances in veterinary pain management have helped propel the idea of hospice, that's not all there is to palliative care. Other means of easing an animal's suffering may include regular subcutaneous fluids to improve hydration -- such as I provide to my dog -- oxygen therapy and assistance devices such as slings to support weakened hind ends.
Hospice help may also include physical and massage therapy as well as advice: urging the covering of slippery floors with rugs for better traction, or finding or developing diets that support a patient who may not want to eat. Complementary and alternative veterinary medicine, such as acupuncture, can be part of the package as well -- as it is for Drew.
The final aspect of veterinary hospice is recognizing when it's time to say goodbye. And while I'm certainly not looking forward to it, I know I'll be better prepared for the end after the extra time together my dog and I have both enjoyed.
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Q: Can you remind people about the danger of antifreeze? I lost my cat to it last winter. I think she got into it after my neighbor spilled it on his driveway. -- via email
A: Pet lovers have two ways to protect their animal companions from lapping away at deadly antifreeze -- one relatively foolproof; the other not.
Not foolproof: Use a safer antifreeze made from a different formulation than the more popular variety, store chemicals properly, and wipe up spills promptly. While this should eliminate most of the risk for dogs, these strategies are not foolproof for free-roaming cats because you cannot control what your neighbors will do when it comes to using or storing deadly chemicals.
Foolproof: Keep cats inside. Free-roaming cats have relatively short life spans because the outside world is full of deadly hazards. To antifreeze, add cars, coyotes (even in cities!) and even cat-hating neighbors to the list of things that can kill a free-roaming cat.
If you even suspect that your pet has gotten into some antifreeze, get him to the veterinary clinic immediately. There's no "wait-and-see" period with this stuff. -- Dr. Marty Becker
Pickup bed is no place
for an unrestrained dog
Q: We saw a dog fall out of a pickup truck on the highway. We couldn't stop, but I cannot imagine that the animal survived. Could you please tell people to put their dogs inside the truck's cab? Having the dog in the back is all-around dangerous. -- via e-mail
A: Allowing a dog to ride without restraints in the back of a truck is never safe, which is why it's illegal in some states. Dogs who must ride in the back of a truck are best transported in airline shipping crates, properly secured to the truck bed.
A crate will keep the animal from jumping or being thrown from the truck and will provide some protection from the elements. While I'd personally rather see a dog secured inside a vehicle, a strapped-down crate in a truck bed isn't a bad alternative. -- Gina Spadafori
(Do you have a pet question? Send it to email@example.com.)
Puppies should stay
with siblings longer
-- Puppies removed from their siblings too soon are more likely to display problem behaviors as adults, according to a study in the journal Veterinary Record. Researchers compared puppies adopted between 30 and 40 days with those adopted after 60 days. Puppies kept with their littermates for 60 days were less likely to mature into dogs with chronic behavior issues. The authors believe some dogs may have a genetic predisposition to problem behaviors, and when puppies don't stay with their siblings long enough it may increase the likelihood of those behavior problems not being corrected. Behaviorists have long argued that puppies should not be sent to new homes until two months of age.
-- When told one of three doors reveals a prize, most people are reluctant to switch once they've made a decision, even though choosing a different door has a better outcome statistically. Not so with pigeons, according to the Journal of Comparative Psychology. The birds seem to understand the concept of probability after training, and will switch to another choice 96 percent of the time after making an initial decision.
-- The phrase "Beware of Dog" is so old that its Latin equivalent -- cave canem -- has been found on signs in Roman ruins. The word "watchdog" isn't quite so old; the first mention of it is by Shakespeare, in "The Tempest." -- Dr. Marty Becker and Mikkel Becker
ABOUT PET CONNECTION
Pet Connection is produced by a team of pet-care experts headed by "Good Morning America" and "The Dr. Oz Show" veterinarian Dr. Marty Becker and award-winning journalist Gina Spadafori. The two are affiliated with Vetsteet.com and also the authors of many best-selling pet-care books. Dr. Becker can also be found at Facebook.com/DrMartyBecker or on Twitter at DrMartyBecker.