If your pet is seriously ill, it's important to understand the basics of palliative care for cats. With the right tips, you can keep your friend comfortable during his illness and make informed, compassionate decisions about his care.
Veterinary Care for Your Sick Cat
If you think your cat may be sick or dying, it is most important to have your cat evaluated by your veterinarian. Cats can develop a variety of diseases, and some of these may respond to treatment. Before resorting to home care or hospice, it is important to try to get your cat diagnosed.
Once You Have a Diagnosis
Your veterinarian may discuss a variety of diagnostic and treatment options for your cat. If a diagnosis can be determined that will make it easier for your vet to give you a prognosis or help you understand what to expect regarding the progression of symptoms. In some cases, a diagnosis may be difficult to determine, either because of the limits of medical science or because the testing may involve more invasive or painful procedures. If your cat's diagnosis is uncertain, it is still possible for a veterinarian to guide you so you know which symptoms can be alleviated, the level of pain your cat may be experiencing, or any special needs your cat has.
Determining Your Cat's Quality of Life
It is important to try to measure and identify your cat's quality of life. Dr. Alice Villalobos has created a system called the HHHHHMM Quality of Life Scale to try to determine your cat's overall condition. In caring for your sick or dying cat, you will need to compare how your pet is doing from one day or week to the next. You can also use the HHHHHMM Quality of Life Scale to help guide the nursing care of your cat at home. The areas to evaluate include:
- More Good Days Than Bad
Veterinary Hospice Options
The International Association of Animal Hospice and Palliative Care (IAAHPC) is a group of veterinary professionals dedicated to hospice care for pets. A directory of veterinary providers who focus on hospice care and end-of-life services can be found through the IAAHPC.
Pain relief is one of the most obvious needs for a sick or dying cat. Cats do not routinely show signs of pain like humans or dogs do, but a recent study published in PLoS One in 2016 identified 25 common symptoms of pain in cats. Felines do not whine or whimper, but may exhibit more subtle behavior changes, such as a reluctance to move around or jump up onto furniture. Some cats may change their litter box habits because it becomes painful to climb over the sides of the litter box while others may show a change in personality.
Cats Are Not Humans
It has been well-established cats have a unique metabolism for numerous medications. For this reason, it is important to only give prescription or over-the-counter medications to your cat under the guidance of your veterinarian. The feline liver is unable to process medications like acetaminophen and ibuprofen. Just a single dose of acetaminophen (paracetamol) can be fatal to your cat.
Medications for Pain
Several types of pain medications are available for cats. These include:
- Narcotic analgesics
These may be available in pill form, a liquid solution or transdermal formulations. The best choice for your cat may vary with the exact condition being treated as well as whether any concurrent liver or kidney disease is present.
Alternative Therapies for Pain
If pharmaceutical intervention is contraindicated or is not adequate to control your cat's pain, there are other therapies to try. These can include:
- Herbal remedies
- Massage therapy
- Laser therapy
According to the American Academy of Veterinary Acupuncture, acupuncture can be effective at alleviating pain and improving the quality of life. A class IV therapy laser is one of the newest therapies in use for pain relief. This is an FDA-approved treatment that only takes a few minutes for a veterinarian to perform, and it can be used for nearly all causes of pain, except cancer.
Fostering Your Cat's Appetite
A poor appetite is often an indication of illness in cats. This can be a tough symptom to treat if the underlying medical problem cannot be resolved. Prolonged anorexia can lead to hepatic lipidosis, a condition in which a cat builds up fat within the liver cells, ultimately leading to liver failure. For a cat with a terminal illness, you can try several approaches to help improve nutrition intake and appetite.
According to Assistfeed.com, you can hand feed your cat using a variety of techniques. These can include using a finger or a syringe to place the food within your cat's mouth. Other methods involve heating up the food, offering a variety of foods (dry and canned), or even giving human foods such as plain chicken, cold cuts or canned tuna.
For medical conditions such as oral or throat cancers, a feeding tube is essential to your cat's nursing care. According to Veterinary Partner, a feeding tube can be placed while your cat is under anesthesia. Feeding tubes are generally well tolerated by cats. Not all types of food can be given through a feeding tube. One of the most popular diets used for sick cats is Hill's Prescription Diet a/d. This is a high calorie and easily digestible food for pets with serious illnesses or accidents.
Most healthy cats do not drink much water in comparison to other species. It is critical for cats with illnesses such as kidney disease, diabetes, cancer, or those on certain medications to receive adequate hydration. This can be easily accomplished for cats with feeding tubes.
Water can either be mixed with the diet or can be given by itself through the tube. In other patients, subcutaneous fluid injections are often recommended. According to the Feline Chronic Renal Failure Information Center, this procedure can be taught to pet owners and is generally well-tolerated.
Hygiene and Wound Care
Cats are diligent about keeping themselves clean. However, when illness strikes, many cats are not able to groom themselves properly. Cats that urinate excessively due to their illness or from certain medications may not always be able to make it to their litter boxes or can have litter stick to their feet and clump there. If your cat spends an undue amount of time laying on hard surfaces, he can develop pressure sores which often become infected and do not heal easily.
For those cats that cannot keep themselves clean, there are a couple of options to help them out. Many cats will tolerate bathing. Use either a specific pet shampoo or baby shampoo. You will want to avoid any medicated products or flea shampoos unless it's recommended by your veterinarian. For smaller areas of cleaning, a pet wipe or baby wipe can be used. If your cat begins to urinate on himself, it is critical to make sure the urine does not stay in contact with the skin. This can lead to urine scald and will develop into painful inflammation and possibly an infection.
Wounds and Sores
Any wound or sore that develops on your cat should be evaluated by a veterinarian. You can try to clean around a sore using warm water or hydrogen peroxide if your cat will tolerate it. A veterinarian will be able to clip away hair, clean with a stronger antiseptic, and decide whether antibiotics or bandaging are necessary. It can be tempting to apply Neosporin or other topical medications to a wound. However, this can attract the cat's attention to the sore and cause your pet to begin licking or chewing at the area.
Environmental Enrichment and Happiness
Any attempts to help improve the emotional well-being of your cat are best guided by you, the pet owner. You know your cat better than anyone else, so you're the best judge of whether your cat prefers attention or would rather be left in a quiet place. Keep the following tips in mind when considering how to provide the best care for your cat's last days:
- If your cat shows interest in his regular activities, then this behavior should be encouraged.
- Any activities at home that may be stressful to your cat should be avoided when possible. These can include adding a new pet to the household, or changes such as new construction projects or even a move.
- In a multi-cat household, it may be necessary to place additional water and food bowls, litter boxes, cat beds or scratching posts to reduce confrontations over these resources.
When a Decision Is Needed
Even with the best of care, cats with chronic terminal illnesses will eventually reach a final stage. You may notice your cat is having more bad days than good days. Sometimes there can be an acute change in your cat's condition. If you have any doubt about whether you should continue home care for your cat, consult your veterinarian. Providing hospice or palliative care for your cat does not preclude considering euthanasia when your pet's quality of life worsens.
It can be helpful to discuss euthanasia with your veterinarian ahead of time. Many veterinarians offer house call services, but others will need you to bring your cat to the hospital for euthanasia. At some hospitals, your veterinarian may be on call for emergencies at night or the weekends, while at other clinics, the veterinarian may refer you to a local emergency facility after hours. The majority of veterinary hospitals work with a crematory service and can offer a variety of options for body care after euthanasia. You can also order special urns for your pet.
Planning for Comfort and Kindness
Like every living creature, cats will become sick and die at some point. Hopefully, your cat's life will be long and healthy, but when it is time to say goodbye, a thorough hospice plan and a good working relationship with your veterinarian can ease your cat's symptoms and help make your feline companion's last days comfortable and kind.