Conscious Cat

May 14, 2012 19 Comments

Palliative Care for the Feline Cancer Patient

Posted by Ingrid

Buckley_November_2008

While cancer in cats is not as common as it in dogs, it is still one of the leading causes of death in older cats. According to the Animal Cancer Foundation, 6 million cats will be diagnosed with cancer in the United States along. And because cats are masters at masking illness, it is often harder to detect.

Cancer used to be a death sentence for cats, but recent advances in feline cancer research have made treatment possible in many cases. Just like with human cancers, early detection is key to successful treatment. Depending on the type of cancer, treatment options may include sugery, radiation, and chemotherapy.

How and whether to treat cancer can be a big decision for cat parents, and factors such as the cat’s age, general health status, temperament all come into play. So do finances: cancer therapies can be expensive.

Sometimes, the right answer may be no treatment, and keeping the cat comfortable with good quality of life for as long as possible may be an appropriate choice.

What is palliative care?

This is where palliative care comes in. The World Health Organization defines palliative care as “an approach that improves the quality of life of patients and their families facing the problems associated with life-threatening illness, through the prevention and relief of suffering by means of early identification and impeccable assessment and treatment of pain and other problems, physical, psychosocial, and spiritual.”

I particularly like the emphasis on psychological and spiritual care for the entire family: when a cat becomes terminally ill, it doesn’t just affect the cat, it also affects the cat’s guardians and other family members, both human and feline.

Palliative care is an interdisciplinary approach to caring for the feline cancer patient that involves your cat’s veterinarian and staff, the cat’s guardian, and, if needed, a social worker or bereavement counselor.

When to choose palliative care

Palliative care is chosen when

  • cat guardians make the decision not to pursue treatment.
  • a terminal illness with no cure is diagnosed.
  • curative treatment failed.
  • long-term care is required.
  • symptoms of the illness interfere with the daily routine of the cat or guardian.

What is involved in palliative care?

Palliative care can include traditional medications such as pain relief, steroids, and fluids, or alternative modalities such as acupuncture, Reiki, homeopathy, and herbal therapy.

Education about the specific cancer your cat is facing is critical. Discuss with your veterinarian what a typical progression of the disease looks like, how to recognize symptoms and manage them, and what kind of medical and nutritional support may be required. Be open about your limitations. Will you be able to provide the level of care your cat may need? Can you monitor vital functions, administer fluids, and give medications?

Quality of life will be your most important consideration. You will want to monitor pain, hydration status, hygiene, mobility and overall happiness of your cat. The Quality of Life Scale developed by Alice Villalobos, DVM, the founder of Pawspice™, is often used to help cat guardians determine whether it may be time to stop treatment.

As your cat’s illness progresses, and if your desire is to avoid hospitalizing your cat, you may need to set up an “at home clinic.” Soft bedding, easy access to litter boxes, clean water, and food in your cat’s favorite part of your home can make this time as comfortable as possible for your cat.

If you make the decision for palliative care, be aware of something often called “caregiver aversion.” Depending on your cat’s temperament, giving frequent or long term medications can cause anxiety for both cat and human. You will need to decide whether risking breaking the bond you share with your cat is worth the additional time the medications may give you.

Discuss end of life issues

It is also important to discuss your personal views about death and euthanasia with your cat’s veterinarian. Even though euthanasia in veterinary medicine is widely accepted as a gentle way to put an end to potential pain and indignity for dying patients, some cat guardians may prefer a natural to an assisted death. You’ll want to work with a veterinarian who respects your personal beliefs.

If and when the time comes that you will need to choose euthanasia, consider asking your vet to come to your home, rather than taking your cat to the clinic. Even though few vets advertise this service, many will perform it when requested. You can find veterinarians who perform in home euthanasias through the In Home Pet Euthanasia Directory or the American Association of Housecall Veterinarians.

Despite the logistic and emotional challenges palliative care may present for cats and their humans, it can also be a time of great peace and increased bonding with your beloved feline companion.  It allows for a gentle preparation for the impending loss for both cat and human.

A cancer diagnosis does not have to be the end – it can be the beginning of a deepening, peaceful, final phase of life for both cat and human.

Palliative care is not just for cancer patients; it can apply to any terminal illness. I chose palliative care for Buckley’s heart disease when she stopped responding to treatment. The photo above was taken three weeks before she passed away. 

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19 Responses to “Palliative Care for the Feline Cancer Patient”

  1. Bernadette says:

    It’s wonderful advice that most people don’t know exists, even though it’s often what they ask for when their pets are in the end stages of any disease, but euthanasia isn’t appropriate yet. Our local hospice veterinarian treats many illnesses in their end stages, including chronic renal failure and even extreme old age with insightful palliative solutions to discomfort.

  2. JaneA says:

    I’m so glad that more attention is coming to hospice care/palliative care for our pets. I tried my best to give Dahlia palliative care in the short course of her illness and keep her comfortable until I knew what we were dealing with. At its best, I think palliative care can give us some time to spend with our beloved animal companions and allow us to take our time saying goodbye to one another.

    • Ingrid says:

      I agree wholeheartedly, Janea – one of the most important aspects of palliative care is that it gives cat guardians a chance to get used to the idea of losing a beloved cat. I’m just so sorry that you didn’t have more time with Dahlia.

  3. Thank you for mentioning that you’ll want to work with a vet that respects your wishes. When Ryker so suddenly threw a blood clot and we rushed him to emergency care, it was such a shock and I was unprepared for the vet’s recommendation that we euthanize. I could not let my baby go – and I didn’t care if he only had a 10% chance of making it, nor that he might be paralyzed if he made it through – I clung to that remote possibility of survival with every fiber of my being. I would have done anything to keep Ryker with me!

    They sent us home after a bit, encouraging us to consider letting him go. We discussed it, and did a bit of research, and just as we were about to get in the car to return and say goodbye to Ryker, to let him go…. they called to tell us he’d passed away.

    When we arrived, the vet – very dissaprovingly – told me the manner in which Ryker had died and that it would have been much kinder if we had agreed to euthanize. Perhaps in retrospect, that is so…but it was NOT what a grieving ‘mom’ needed to hear at that moment. Though I appreciate their efforts to keep my baby alive, I did not appreciate the reproof by the vet at the end.

    Having a skilled vet is one criteria, but having a compassionate one is equally important.

    • Ingrid says:

      Lisa, I didn’t know you lost Ryker in such a traumatic fashion – I’m so sorry. It’s really unbelievable that a vet would tell a client whose pet has just died that they caused their pet suffering. Skill does not make up for a lack of compassion.

  4. Wonderful article!! By educating as many pet parents as we can we can start educating the veterinary community! You are your pets’ voice. You are your pets’ advocate. There’s some great information available as well as not so great information. Do your homework. Dr. Alice Villalobos was one of our mentors when we started our Healing Heart Pet Hospice 4 years ago. We are a 501c3 non profit. Visit our site to learn more about Veterinary Hospice and Palliative Care as well as our other 2 programs which honor the Human Animal Bond. Thank you again for printing this! http://www.hhfipethospice.org

  5. AmyR says:

    We are no where near this point yet, but a question occurred to me.
    How does in-home euthanasia effect other animals in the home?

    Thanks
    Amy

    • Ingrid says:

      Unfortunately, there is no way of telling how it will affect other animals in your home, Amy. Some may remain completely unaffected, others may be upset and/or grieving after the fact. At the risk of anthropmorphizing, I have to believe that it would be easier on an animal to see or sense what’s happening rather than having their companion just disappear one day and never return home. It’s a very individual decision. You know your animals best. Trust your intuition.

    • Kim says:

      Hi Amy,

      I know this is two years after you asked your question, but I thought it might give some insight to another pet parent who is considering in-home euthanasia.

      My husband and I had one of our four cats euthanized at home yesterday, after his almost year-long battle with cancer. They all hid in the bedroom while the vet was here, and didn’t witness the euthanasia, but the vet recommended that we show them his body so it would make it easier than just a disappearance.

      At first, his litter-brother was frightened, and hid in a closet. The other two sniffed him and moved on. They all three have been a little sad today – I’m not sure how they’d react had he simply disappeared. But, after the initial shock, they’re eating normally and not hiding. I’m hoping it’s easier on them. It seems to be different based on their relationship to Max and on their own personalities.

      I would recommend it wholeheartedly, though. Our poor sweet Max was so much more comfortable in his last moments than he would have been in a vet’s office.

      • Ingrid says:

        I’m sorry about Max, Kim. Thank you for sharing your experience. I am a firm advocate of in-home euthanasia. It’s never easy, but having it done in the cat’s familiar environment makes it so much less stressful.

        • Kim says:

          Thank you, Ingrid. Yes, it didn’t make it easier for us, but it did make it easier for Max, and that’s what was important.

          Love this site, and thankful to find like-minded cat parents. :)

  6. You know, I’ve had many years to look at this area of grief and loss. And, I have some great stories, both personal and others. My strongest sense, though, is this: I think animals work on a different energy frequency than we do. And, I’ve always thought they do the whole ‘leaving’ thing better. I think they get all this hashed out ahead of time. My sense is they talk it over and get it all settled and it’s all so intuitive to them they we expect them to react the way we do and they can’t. Isn’t that what we love about them? Like I said, in my own life I’ve been privy to witness some pretty amazing transitions and reactions that have surprised me, but sometimes I think our pets feel sorry for us!

    • AmyR says:

      Thank you Valerie.
      I’ve only had to help one of my cats along and that was in an emergency situation. He had a saddle thrombosis and lost the use of his rear legs. The vet was unable to restore any bloodflow so between that and his very enlarged heart, it was best to let him go. The whole experience was awful.

      Right now, one of our girls has been diagnosed with a small primary tumor in her lung. From what they can tell we caught it very early so we do have a fighting chance. She’s scheduled for a lobectomy on Monday and based on the findings, we will probably follow with chemo. I do look at things realistically and so I’m trying to prepare myself for the inevitable. I don’t know if if in-home is an option in St. Louis but I’m doing as much research as I can in advance.

    • Ingrid says:

      Valarie, I, too, feel that animals view dying differently than we do. When I euthanized Buckley, Amber was in the room. I felt like she was holding the space for me and Buckley (and I wrote about this in my book). She also didn’t seem to grieve much. I felt that the reason for this was because she knew Buckley wasn’t really gone. Her spirit lives on, and Amber seemed to intuitively connect with her on this different level.

  7. Maybe I should add one more thing from my observations. I have also been witness to how the INDIVIDUAL animal deals with loss. I hate to generalize about people or animals and it’s been clear to me that they each deal with loss in a different way……some quite deeply and yet, when I would have expected a dramatic outward expression I haven’t seen it. Lovely!! Again, this is why they have my heart!!

  8. Bernadette says:

    I’m with all of you that they have it all figured out long before we do, and I often look to my other cats for signs of how one who is critically ill or in final stages is doing.

    I’ve done nearly all my euthanasias at home, and with my regular house call veterinarian except for only two, so everything is pretty familiar to all of them. I do think if they choose not to be present that is their decision, but because I hold them here for several hours after they’ve passed, and I’ve also carried them around the house and yard to say goodbye afterward, everyone has a chance to visit if they choose.

    Some people think home euthanasia is worse for themselves because they don’t want that memory in their home, and it’s a consideration.

  9. Dani says:

    A few days before we had to take our dog to the vet to cross over, our cat Huck sat by Iggy , laid by him, he never has done that. I believe he was saying his good-byes. After we came home from the vet without Iggy, Huck the cat seemed very natural behaving. Iggy’s little canine brother Peanut, however, cried out in pain as soon as we came home; as soon as we opened the door to our house. Peanut kept looking up and to the left a bit at a 45 degree angle. I strongly believe he saw Iggy’s spirit. It’s been almost 2 years and now it’s poor Huck’s turn to cross over. I hope Iggy greets him. I believe wherever you choose to euthanize is up to the humans and the pets are more connected to eachother anyway before and after death.

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