Our goal for our animal companions is to keep them feeling as good as they can for as long as they can. It is not always desirable to extend life, not if that is at the cost of Quality of Life.
We want the pet to still enjoy the things that make life worth living: some pet-and-cuddle time, a favourite food, a loved toy, a walk on a nice day.
Not all conditions can be cured. What we can do is mitigate the effects of a condition, such that that condition is not what defines the life of that pet.
Palliative care aims to restore the pet to a level of comfort and contentment.
This is the foundation of palliative care. If pain can not be controlled, then Quality of Life can not be maintained. This usually involves Multi-Modal Pain Therapy: targeting pain at different sites along the pain pathway.
The Cause of the Pain
If the illness is caused by a localized lesion or lesions (such as a tumour or tumours that can not be removed), we may be able to target treatment right at the site. Injections of long-acting, slow release corticosteroids can be used to counteract the inflammation provoked by a lesion.
The first step in pain transmission is the triggering of pain receptors right at a lesion. We can down-regulate the sensitivity of pain receptors with treatments such as Laser Therapy and anti-inflammatory medications. Diminishing inflammation also removes the stimulus for the pain receptors to fire.
After the pain receptors fire, the signal is transmitted up certain tracts in the spinal cord. Pain control medications such as Tramadol and Gabapentin target these pathways.
Pain ultimately exists in the brain. It is when these signal are perceived by centres in the brain that pain actually happens. There are medications that target this sort of pain, by “dialling back” the sensitivity of these pain centres.
The engine of the body needs fuel to function. Tissue maintenance and repair may be aided by extra nutrients. And none of these do any good unless they get into your pet!
The ultimate hope is that by diminishing pain, we bring back appetite. When we do need a boost to intake, options include medications that stimulate appetite, and special high-nutrient foods that can be syringe-fed. These food are concentrated, so a little goes a long way!
There is no one-size-fits-all in critical care nutrition! Each pet, in each circumstance, needs to be evaluated for the best nutritional balance that will provide for optimal maintenance of body condition and of quality of life. The protein balance, fat content, carbohydrate content and fibre content all have to be taken into consideration in different ways for different conditions.
There are a lot of options for supplemental support of the body’s function! For example, omega-3 fatty acids help to decrease inflammation, glucosamine supports cartilage health and repair, and arginine can short-circuit the division of cancer cells. We will work together to come up with a plan to help support your pet’s health.
Dehydration is the enemy! And in some conditions, such as kidney failure, maintaining hydration is a challenge – the kidneys lose water faster than it can be replaced by drinking.
Voluntary water intake can be encouraged by flavour agents in the water, and by aeration of water (for example with a recirculating water fountain).
When drinking is not enough, extra fluids can be given by this route. Cats and dogs have a potential space between their skin and their body, where we can deposit IV solutions to be absorbed gradually into the system. This is something that any Pet Parent can be taught to do; or, I can come in every 2-3 days to do it for you.
Sometimes, just the basics of going for a bathroom break become a challenge to an ailing pet. Strategies for a dog may include lift-harnesses, or even wheelchair-type carts. Cats may need accessibility options for litter boxes, such as ramps or cutting down the sides. If mobility is impaired by a problem with one particular joint, support braces may offer some relief.