What is Veterinary Palliative Medicine?
Photo by Kelly Lacy/Pexels- a common use photo website. 6/2021
The veterinarian walked in to the room with a grim, yet compassionate look on his face. Sam and Betty had seen that look before, it meant bad news was coming. Their beloved dog, Bennie had collapsed that morning and they had rushed him to the local specialty hospital. Bennie sat next them them now, hooked up to IV's and looking a bit brighter when the vet with the sad, concerned face walked in. "Bennie has advanced cancer" he started. Their hearts dropped, "It is in his spleen, liver, lungs and lymph nodes, he probably has 2 months or less to live." Sighs and tears flowed.
"What can we do?" Sam asked. The vet continued, " Well, you could do surgery and remove the spleen, which had the bleed this morning, but because it has spread, I wouldn't recommend that." "What are our other options?" Betty interjected. The vet continued, " You should consider euthanasia, with all the spots of cancer, he is likely to live less than 2 months." Betty and Sam gasped... up until this morning, Bennie had been doing well, he was still going on long walks, eating, maybe he had been slowing down a little, but... they were not ready for euthanasia. "What are our other options?" They asked. The vet replied... " I guess we can send him home with pain meds."
(This is based on a true story, names and details have been changed. However the dialog is approximately what was conveyed to me from the client perspective.)
They actually had a third option and that is palliative care.
Palliative care is the care of a person, or animal, by a team of caregivers that may include a doctor, nurse(s), mental health professional. They support decision making for families, and provide medical comfort and support for the patient. There is a saying in human medicine, "They live each day until the day they die, so let's make each day good." This is the goal of palliative care. The sooner after a diagnosis of a progressive, chronic disease, the better the animal and their family can live.
Palliative medicine has been a field of study for medical doctors to care for people with advanced progressive disease for many years. However, for veterinarians, it is a new field of study. Veterinary Palliative Medicine can help your animal live better. We can build a team of people who can help you care for your beloved, as you go the the progression of the disease, to help guide you in the process, keep your animal comfortable. The field focuses on the medicine of advanced, progressive disease, and terminal illness, and comfort rather than cure, though we work with other veterinarians as they provide curative care. We also help plan for the future as the animal progresses through the disease, and should be able to provide you a "roadmap" as to what to expect. There are more frequent check in's, as pain can be a moving target, symptom management cannot always be planned for.
The team can include your regular veterinarian, specialists, if we need extra help, veterinary nurses, groomers, spiritual guides, in addition to your palliative team, a specifically trained veterinarian, veterinary technicians, or assistants with additional training, and mental health support/grief support.
What happened with "Bennie"? On palliative care, he lived 20 months (nearly 2 years), and he lived that time well and we did help him achieve a gentle passing when it was time.
(PS: He is an outlier, on a bell curve, and this case may not reflect what may happen with your pet in palliative care. We use this case to illustrate a point, that palliative care can be a 3rd option.)
Dr Lynn Hendrix