Beth Marchitelli, DVM is a veterinarian with 4 Paws Farewell which provides home hospice and home euthanasia for pets. Our veterinarians work closely with 4 Paws Farewell when clients desire home visits concerning end of life issues. More information about the services of 4 Paws Farewell can found here. Of course, Animal Hospital of North Asheville continues to provide hospice and euthanasia care here at the hospital. You can read more about our Bereavement Room and the care we offer by clicking here.
By: Beth Marchitelli, DVM
Truly understanding quality of life in our animal companions is an especially difﬁcult task due to their inability to verbally communicate with us. I am sure we have all wished our companions could verbalize what they were experiencing whether this was related to understanding which toys they would prefer or whether or not they are in pain. Because they can not communicate directly with us, we are obligated to make certain assumptions related to our perception of what they are experiencing. In the ﬁeld of veterinary medicine, we are working to better understand Quality of Life from a scientiﬁc standpoint based on the latest research in animal cognition, emotional processing and relational capacities. It is our hope that this ongoing process will allow us to continue to serve our pet companions and their caregivers with the very best care and compassion.
Quality of life is a term that encompasses the physical, emotional and relational aspects of an animal’s well-being. Quality of life can be understood best when aspects of daily life are investigated individually for signs of disfunction or compromise. What follows are speciﬁc areas of every-day life and possible ways to evaluate them. Taken individually or evaluated collectively, this investigation can provide insight into our animal companion’s well-being. Although there can be overlap between each category it is helpful to view them separately.
Presence of Pain
- Is my companion painful? If so how often and to what extent?
- Signs of Acute Pain - Vocalizing, panting, pacing, wincing when touched.
- Signs of Chronic Pain - Hiding, reluctant to move or moving slowly, isolating.
- Is my companion eating? If so how much? Is my companion eating only highly palatable food items?
- Dogs may start eating people-food only or eating one type of dog food for only a few days, then tiring of it.
- Cats may start licking only the sauce or juice off of canned food.
Quality of Mobility
- Is my companion able to move about with ease?
- Is my companion slow to rise or to sit or lie down?
- What is the quality of my companions gait? Does it appear stiff or choppy?
- Are the walking on the top sides of their paws or scufﬁng them along the ﬂoor?
How is my companion’s brain functioning?
Signs of cognitive decline in dogs and cats include the following:
- staring into space
- getting caught in corners or under furniture
- elimination accidents
- increased anxiety and fear
** all signs can be particularly evident in the evening hours **
- Has your relationship with your companion been affected? Has your time spent been reduced in quantity or quality?
- Examples seen in dogs include walks being curtailed in duration and play time being modiﬁed or reduced in scope and duration.
- Cats may spend less time enjoying your company and being petted may be reduced due to the inability to position themselves in favorable ares such as your lap or a space close to you.
- Both dogs and cats may no longer be sleeping with you.
Energy Level/Body Condition
- Is your companion moving about with gusto and interacting with the environment or is he more reserved?
- Has his muscle mass remained the same or does he appear to have lost weight?
- Is your companion still enjoying his favorite activities or objects? Examples in dogs include playing catch with a ball, going on walks, and playing with other animals.
- Cats may enjoy being petted, knocking items off counters and engaging with toys.
It is helpful to make a list of your animal companion’s four favorite activities to have a baseline for the level of their daily enjoyment.
- Is your companion able to urinate and defecate without pain or difﬁculty?
- Has he had increased frequency to either urinate or defecate?
- Are his bowel movements normal?
- Has his hygiene been affected by their inability to adequately groom themselves? Cats can have an appearance of an unkept coat.
Other Sources of Suffering:
Areas that cause known and persistent suffering are as follows:
- Difﬁculty breathing or a continuously elevated respiratory rate
- Persistent fear or agitation
If any one of these aspects of daily life is signiﬁcantly compromised or many of them are in question, quality may be compromised. There are several quality of life scales that evaluate companion animal quality of life that can provide an objective viewpoint. These scales are helpful but do not replace the true evaluation of the primary caregiver.
Your veterinarian can be helpful in this process by conveying important insight regarding speciﬁc disease processes and in attributing a particular clinical sign to its possible cause. It can be helpful to obtain different opinions from family members, friends, pet sitters, groomers, and other members of your animal companion’s extended family. Because each individual has their own biases and personal history, these opinions do not replace that of the primary caregiver.
The person who knows best what a particular pet companion is experiencing is without question the primary caregiver. It is the primary caregiver that knows what a particular pet is experiencing throughout the day and throughout the night.
The most important factor to take into account in helping you make a clear assessment of your companion’s quality is making sure you address common fears and misconceptions regarding the end of life process. It is only in illuminating your thoughts and feelings around these issues that allows you to make the best attempt at assessing quality of life.
The following is a list of misconceptions related to making end of life decisions.
- Feelings of fear, guilt or confusion about the care you have or have not given your pet companion during this time
- Feelings of fear, guilt or confusion about pleasing your veterinarian, friends or family regarding end of life decisions or end-of-life care
- Feelings of fear about not being able to continue living life without your pet companion
- Feelings of fear, guilt or confusion about the natural death process
- Feelings of fear, guilt or confusion about humane euthanasia
- Feelings of remorse or guilt about your own physical, emotional and ﬁnancial limitations
- Feelings of guilt or confusion about having to choose the option of humane euthanasia
- Feelings of guilt or confusion about not choosing the option of humane euthanasia at the exact “right” time
Members of your animal companion support team can help you stay focused on what is the most important which is the well-being of your animal companion.
There are many resources available to help us along the way as we do our best to try to determine how contented our animal companion are as they face the challenges of aging, sickness and death. May we continue to do our best to make this time as precious as possible for both our animal companions and ourselves.
Beth Marchitelli, DVM
4 Paws Farewell
Mobile Pet Hospice and Home Euthanasia