Cat in Lap
Anyone who has taken more than a passing glance at the pet food section of a supermarket can tell you the three distinct pet life stages traditionally recognized: puppy/kitten, adult and senior. These three stages influence all aspects of a pet’s care, including nutrition, exercise and veterinary care.

These stages are informal designations with somewhat fluid gateways rather than hard-and-fast age requirements, because there is so much variability from breed to breed, For example, 6 years old might represent senior age in a giant breed such as a Great Dane, but a small dog like a Chihuahua might not be considered senior until closer to 10 or 11 years old. Nonetheless, veterinarians have had a good deal of success in using these three stages as a starting point in assessing individual needs.

Why Three Stages Is Not Enough

No matter the age of the pet, treating a pet in any of the three life stages has the same goal: keeping the pet healthy and happy for as long as possible. But, as we all know, despite our best hopes and efforts, life spans are finite, and the last weeks or months of a pet’s life are often spent in declining health. There is a distinct difference between a dying pet and a senior pet who, despite his or her advanced age, can still be in excellent health.

Does this matter? You bet. It matters so much, in fact, that many veterinarians are beginning to add a fourth life stage designation to our arsenal of terms: end of life.

End of Life: the Fourth Stage

Unlike the other three life stages, end of life has less to do with age and more to do with a pet’s condition. Though we hope a pet reaches senior age before facing the end of her life, terminal illnesses can also strike younger pets.

Traditional veterinary medicine focuses on extending life through treatment of disease, which often continues right up until the pet either dies naturally or is euthanized. But if owners decide during the course of an illness that they no longer wish to pursue curative treatment, many feel very confused as to what to do next.

What can veterinarians offer when we know a pet’s passing is imminent and that the owners are no longer pursuing a cure, but they aren’t yet ready to euthanize? While some veterinarians are starting to offer forms of palliative care for dying pets, a comprehensive end-of-life strategy is much more encompassing.

Palliative and Other End-of-Life Care

The International Association of Animal Hospice and Palliative Care (IAAHPC) is leading the charge in that regard. Palliative care, which refers to treatment aimed at relieving the symptoms associated with disease (as opposed to curing the disease itself), can be applied at many moments in life, such as surgical rehabilitation and recovery from illness. When it comes to treating a pet suffering from terminal disease, palliative care has many forms: pain management, relief of nausea or management of dehydration, just to name a few. Palliative care is an important component of end-of-life care, but it is not the only part. 

As a pet’s terminal disease progresses, mobility needs can also change, necessitating such items as carts or slings for some patients. It’s important for pet owners to watch for signs of incontinence to keep the pet clean and comfortable. Nutritional needs can also change dramatically as a pet’s appetite decreases, so making sure a pet gets optimal nutrition during this time can be a challenge and often requires regular counseling as the situation changes.

Keeping the Pet’s Owner in Mind

Learning about the pet’s special needs during this stage is every bit as important as it is during the formative puppy and kitten years. Veterinarians can play a key role in helping pet owners understand the processes a body undergoes as it shuts down, from restlessness and agitation to rattling breathing and gasping. Being prepared ahead of time can help pet owners navigate this stressful process.

The IAAHPC also calls for a mental health counselor to be a part of the veterinary hospice team. Pet owners may find themselves struggling with the decision to euthanize a pet or unsure of how to talk about an impending death with their children. Often they’re taken by surprise by the depth of their grief. Though some veterinarians are not trained to help clients in these situations, having a mental health professional available can be an invaluable service.

When I speak to clients and colleagues, I regularly hear that the hospice care available consists of pain medications, fluids and not much else. It’s time we evolve and recognize that, as much as we are saddened by a pet’s end-of-life process, there is so much more we can do to make it better for both the pet and the family who loves her.

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