Hospice-Supported Natural Death
Animal hospice and palliative care shares the majority of its clinical, philosophical, and ethical principles and objectives with human hospice and palliative care. Animal hospice and palliative care is unique, however, in that euthanasia is a legal and widely-practiced intervention aimed at relieving an animal’s suffering by ending life peacefully and humanely when other efforts to alleviate suffering have failed or cannot be pursued. Under such circumstances, euthanasia is recognized as an acceptable option for alleviating animal hospice patient’s suffering.
When an emotional attachment exists between a companion animal and a caregiver, the decision if and whether the animal’s life should end by euthanasia or natural death is made by the caregiver in collaboration with the hospice team. Both euthanasia and natural death need to be considered in the process of providing animal hospice care, and should be discussed by hospice providers and caregivers once a relationship has been established. It should be discussed in great detail when a caregiver has personal or religious beliefs against euthanasia.
Preparedness
All parties involved in a planned natural death must be adequately educated and prepared for likely scenarios during the last hours of their companion’s life. It is encouraged to research experienced euthanasia providers in your area so that should the need arise for euthanasia, they will know who to contact. Our practice is open M-F 7am-3pm. We cannot be reached outside these hours. Other options include our referral partners or the Animal Emergency and Specialty Center of NWA at (479) 927-0007.
*Suggested reading: Into the Light by Gail Pope
Excruciating conditions
Some diseases and conditions are not conducive to natural death. The suffering caused by the conditions can become too extreme and uncontrollable by medications but still not result in death. A good example of this is bone cancer, or osteosarcoma. When bone is affected by cancer, the cancer eats through the normal structure of the bone and can fracture the bone. A bone fracture is very, very painful but will not cause death by itself. The level of pain resultant is difficult or impossible to control even with high doses of opioids and sedation. Fortunately, we can prevent this suffering with euthanasia.
Another example is urinary bladder cancer. Often these cancers will block the urethra and the animal will be unable to urinate. The bladder becomes very distended and flow is backed up into the kidney. The animal then goes into kidney failure and passes within days, very painfully.
Respiratory diseases such as severe asthma, lung cancer, and tracheal collapse prevent the ability to breathe normally and can become severe in nature. These conditions often progress to the point that even oxygen therapy does not improve their breathing, and they may suffocate.
Other conditions that may be poor candidates for hospice-supported natural death generally include diseases that prevent normal biological behavior but do not cause death. Examples include: oral cancer, heart failure, kidney failure, and liver disease. If you are interested in hospice-supported natural death but are not sure if it is right for you, please speak to your veterinarian or our hospice team.
Stages of Dying
A variety of biological changes occur at the end of life. Below are signs and changes common at the end of life, in the early and final phase of active dying.
Early Phase of active dying
Increased sleep/lethargy
Restlessness
Agitation
Inability to be made comfortable
Withdrawal from social interaction
Confusion
Decreased food and water intake
Pale and/or blue mucous membranes (gums, eyelids)
Inability to heal wounds
Final Phase of Active Dying
Loss of consciousness
Muscle spasms/twitching
Severe agitation
Abnormal breathing
Accumulation of respiratory secretions
Personality changes
Refusing food
Open mouth
Cold extremities (paws)
Loss of sensation in extremities
Incontinence
Dark urine