What Pet Hospice Means
Karen Scott, Ph.D.
Hospice is preparing for the end of a life. It is such a simple word, yet it is connected to so many emotions. The biggest one for me is death. Losing a friend and family member is difficult, whether they have been around for days or months or years, and preparing for future loss is difficult. For me, a part of hospice is being there at the very end if possible.
I’ve learned much about feline medicine and general veterinary care ever since I got my first cat when I was in fifth grade. I’m not a veterinarian or veterinary technician/nurse, but I have spent 30 years working with veterinarians in a research setting. Before then, I took my animals to the animal clinic and learned from those office visits. I learned to give fluids subcutaneously to cats with advanced kidney disease. I gave medication orally, topically, and by injection. Even before Fear Free practice had a name, I always used gentle methods for handling animals. Now the technique has a name. More veterinary students are taught these approaches, so more are aware of these gentle methods when handling pets. All the things I’ve mentioned are good when working with a cat receiving hospice care.
Basically, hospice means keeping them happy and comfortable as long as possible. Giving treats, finding foods they want to eat, even occasionally feeding using a syringe can help if the cat is willing to accept this. It’s important to have clean blankets, beds, and towels available – and to change them as needed. Giving meds as gently as possible and giving lots of attention are key. Do whatever the cat will allow such as petting, holding, lap sitting, or just sitting beside them. Talking to them, listening to them, and sharing quiet time with them are all part of hospice care.
Palliative care is like hospice care, but the support comes while the individual undergoes curative treatment. During my schooling, I had a silver tabby American Shorthair who had traveled the country with me. He ended up with lymphoma. While it was caught early, the oncology team explained what they would do to achieve the goal of a cure. My cat was willing to come in for treatments and didn’t need sedation for the injections. He also loved people. He continued chemotherapy for over a year before he started not wanting to go for treatments. He was telling me that enough was enough ... so, we stopped. He was fine for about six months, then we transitioned to hospice care so that I could provide care and comfort for him at the end of his life. I tempted him with food treats and gave him medications for comfort. We had veterinary monitoring visits, which he didn’t mind. He lost weight and his condition went downhill quickly. When he let me know that he was ready for the end, his veterinarian agreed, and I held him for his final injections.
Many things need to be considered when you are told of treatment options. Is the treatment likely to extend the cat’s lifespan enough to be worth the pain or discomfort of the treatment? Is the cat healthy enough to undergo the treatment? For example, an 18-year-old cat with advanced intestinal cancer will usually undergo surgery to remove the mass. It might extend the lifespan a few years before recurring. At 18, the cat might not live much longer even if it is otherwise healthy. Can the cat live through the anesthesia and surgical treatment? If the cancer has spread to the lungs or liver, maybe not. Or perhaps there is hidden heart disease not yet detected. There are many possible considerations, so discuss this with your veterinarian and the technicians. They are experienced, and can provide helpful information for making your decision regarding treatment options. Include yourself in those decisions: Can you handle taking the cat for treatment? Can your budget and your emotions handle the treatment options?
Hospice can be short, or it can last for months and might occur at home with little or no warning. It all depends on the individual cat, its health conditions, and the treatment options. In some ways it is different for animals than for humans. The goal for humans may be an ultimate cure, while it is providing quality of life for animals. For me, part of hospice is being there at the end, if at all possible. The point is providing care and comfort at the end of life.
Over the years, I’ve debated with myself and with others about whether it’s better letting an animal die in their own timeline or opting for euthanasia. The few times I’ve let an animal die on their own schedule, it was usually something unexpected. I find it extremely difficult to let an animal lie there and die without trying to help in some way. So, I choose veterinary visits if possible and will use palliative care at the beginning, which usually ends with euthanasia. The animal will let me know when it is ready, and I’m not anthropomorphizing here. The signs are there: watch the cat’s body language, look into its eyes, watch how it eats and drinks. Are its eyes dull? Is it hesitant to move? Is it less responsive?
Find a veterinarian you like and trust, one your cat accepts. Have conversations about your cat’s health. Be informed. Hospice care is much easier with the help of a good doctor, as is ending hospice. See your veterinarian enough so that they know your abilities and comfort level with doing home hospice. Ask for help learning procedures so that you are able to administer injections, syringe feeding, medications, gentle massage, and heat treatments for arthritis. There are many things that can be done at home with a little help from willing and knowledgeable veterinary professionals. Sometimes alternative methods such as acupuncture, heat treatment, and massage might help. If interested, seek out people with these skills and talk with them.
As one who likes to adopt senior cats, I have a lot of experience doing hospice care. It starts with veterinary visits, diagnoses, and treatment options. If a condition is treatable, the cat allows the treatment, and it is affordable (even if it hurts on the credit card sometimes), then go with the treatment. Try to find other ways to give medications to keep the animal as comfortable as possible for as long as possible. Flavored liquid meds, cut up or crushed pills in a favorite or smelly food, or transdermal (on the skin) applications are options. Sometimes a cat won’t like a treatment because it tastes bad, it hurts, or it is too stressful to give. Any number of other reasons for treatment not working may occur, and if no other options remain, then it’s time for hospice care.
Sometimes there is no cure for a condition, such aselderly cats with kidney disease. Subcutaneous fluids can help the cat feel better if the cat is willing to accept the needle sticks, but dialysis and kidney transplants are not practical options for cats. Dialys Heart disease can often be treated in the early stages, but when it progresses to end stage heart failure, then it’s time for hospice care. Advanced arthritis can also be a reason for hospice care. It might be in the cat’s hips, making it difficult for the cat to walk, get in/out of a litter box, and walk to food and water bowls. There are several drugs that can help with the pain, but eventually the medications and other treatments are not enough to control the discomfort. It’s important to ease the pain as much as possible and try to keep things handy for the cat’s convenience. Bribe the cat with treats. Watch and listen to the cat – The cat will let you know how things are going.
Keep in mind that other cats in the household will know what is happening. They are watching and waiting, and they know the end for the ill cat is near; the cat in question also knows. Because cats are good at hiding their pain until it is severe, hospice care helps them feel better. And that is the goal – comfort care. As a side note, it also helps prepare humans for the upcoming loss of a family member. While not the primary goal, it is a useful side effect.
Hospice is watching your cat during their end-of-life stages and helping as you can and as they allow. I find that talking to the cat about what is going on helps me deal with events. Others might journal their thoughts and feelings or write poetry or short stories or novels. There are innumerable ways for people to cope. Remember to keep yourself as comfortable as possible through this process: Hospice care for any family member includes caring for yourself.