Hospice Information

Quality Care Monitoring:

What is my pet’s diagnosis and how does it normally progress? Is it curable?

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 What is my pet’s prognosis or life expectancy at this point in time?

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Different TX options avail:                      Est. Cost:                     Est. Duration:

_______________________                ____________              _____________

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Will treatment increase my pet’s life expectancy? _______   By how long? ____________________________

Can we provide adequate pain control and/or relief of some symptoms? ___________________________________

Is there a specialist who could consult with us?____________________

When should we focus on care and quality of life instead of a cure?

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Do you prefer in-hospital care?__________

Can you spend time at home with your pet to monitor his/her care? Provide nursing care?___________

Are you willing to adjust the number of potty breaks for ____________

(Some medications increase urine output and may cause some bowel disturbances)

Are you willing to look into animal massage therapy?_____________

Can I help my pet with mobility?________________

Can I provide strict cage rest?_____________________

Can I change bandaging/dressing if needed?________________________

---When deciding on treatment options, take into strong consideration your pet’s individual personality. Determining how your pet will react during treatment will ensure a good quality of life during treatment.

                                                                   *chart is compliments of Oakland Veterinary Referral Services

Your Pet’s Mobility

It is important for your pet to be able to move around on its own or with help. This can become an issue for people with large breed dogs.

For Dogs: the use of harnesses, slings, carts, ramps and rugs for traction are helpful

For Cats: a shallow litter box and moving litter closer to its sleeping area helps him or her get to the box

Pets, like humans, can get sores from lying for extended periods of time. Rotating your pet and adding extra padding to their bedding prevents these sores.

Your Pet’s Pain Management

Animals can become accustomed to living with pain. They usual modify their habitual behavior so slightly that you will not notice. (e.g., movement, eating and drinking habits.) Stoic behavior is not always a signal for lack of pain. There are many medications and therapies we can discuss with you to provide additional comfort to your pet. When assessing your pet’s pain, include your pet’s ability to breathe properly. Insufficient breathing can cause anxiety, discomfort, fatigue and pain for your pet.

The degree of pain your pet is experiencing is hard to assess depending on the pet’s personality. If your pet is slow to rise, panting, trembling, restless, acting out of character, has a change in appetite, whining or not vocalizing at all and not wanting to be touched he or she may be experiencing pain and discomfort. Cats may stop self-grooming and you may notice matting on your long-haired cat. Shaving your cat to a shorter coat helps manage their hygiene.

Your Pet’s Nutrition Needs

Many pets change their eating habits when they are experiencing discomfort. Follow the suggestions of your veterinarian. You can also consider trying different foods, textures of foods or cook for your pet. It will be important to monitor your pet’s caloric intake when he or she is ailing. Tube feedings and fluids under the skin may be and option and something your veterinarian can teach you to perform at home. Your comfort level is a large part of these decisions.

Your Pet’s Hygiene

Pets who are ill or are elderly may have issues going outside or using the litter box. The use of disposable pads, pet diapers and frequent bathing will help keep your pet clean, comfortable and free of skin irritations and infection.

You Pet’s Quality of Life

The only voice your pet has is your voice. You have always been an advocate for your pet’s well-being and happiness. When your pet is facing a health crisis, your recommendations and considerations for his or her comfort is now of most importance. You will be the most important person in determining your pet’s quality of life. You will now advocate for your pet and remember that your pet is only concerned with the “quality” not “quantity” of their life.

Terminally ill pets have many special needs. When pets decline slowly, it makes it difficult to gauge the quality of life because we, as their companion have become accustomed to their behavior. We can have clouded judgment when our need for our pet to stay with us forever overshadows everything else.

Please refer to Quality of Life Scale, used by author, Dr. A.E. Villalobos in her pet hospice program called Pawspice.

Quality of Life Scale (The HHHHHMM Scale)  Score patients using a scale of: 0 to 10 (10 being ideal).

Score Criterion --*TOTAL *A total over 35 points represents acceptable life

0-10 HURT - Adequate pain control & breathing ability is of top concern. Trouble breathing outweighs all concerns. Is the pet's pain well managed? Can the pet breathe properly? Is oxygen supplementation necessary?

0-10 HUNGER - Is the pet eating enough? Does hand feeding help? Does the pet need a feeding tube?

0-10 HYDRATION - Is the pet dehydrated? For patients not drinking enough water, use subcutaneous fluids

daily or twice daily to supplement fluid intake.

0-10 HYGIENE - The pet should be brushed and cleaned, particularly after eliminations. Avoid pressure sores

with soft bedding and keep all wounds clean.

0-10 HAPPINESS - Does the pet express joy and interest? Is the pet responsive to family, toys, etc.? Is the pet

depressed, lonely, anxious, bored or afraid? Can thepet's bed be moved to be close to family activities?

0-10 MOBILITY - Can the pet get up without assistance? Does the pet need human or mechanical help? (e.g., a

cart) Does the pet feel like going for a walk? Is the pet having seizures or stumbling? (Some caregivers

feel euthanasia is preferable to amputation, but an animal with limited mobility yet still alert, happy and

responsive can have a good quality of life as long as caregivers are committed to helping their pet.)

0-10 MORE GOOD DAYS THAN BAD - When bad days outnumber good days, quality of life might be too compromised. When a healthy human-animal bond is no longer possible, the caregiver must be made awarethat the end is near. The decision for euthanasia needs to be made if the pet is suffering. If death comespeacefully and painlessly at home, that is okay.

 We provide hospice care:        

Compassion Fatigue

The illness or injury to your pet will take an emotional toll on you and your family. The exhaustion may cause physical depletion, affect your mood, and the ability to care for yourself. Your wish to relieve the suffering of your pet and the overall awareness of its suffering is what causes Compassion Fatigue. Symptoms include but are not limited to, bottling up of emotions, isolation from others, sadness and/or apathy, lack of interest in self-care practices, nightmares, flashbacks, persistent physical ailments, difficulty concentrating, mental fatigue and being prone to accidents (Smith 2008). Please ask your physician or veterinarian for some coping resources to help you through this time with your pet. You will need both strength and physical fortitude to provide for yourself as well as your pet. It is only by taking care of ourselves that we find the stamina to care for those we love. (Please see our list of caregiver resources put together by OVRS and Ann P. McClenaghan, BS CVT)

                         *Thank you to Oakland Veterinary Referral Services and Katherine Dobbs RVT, CVPM, PHR for the use of                                                   their printed materials.