Senior pets often develop medical conditions that require ongoing management. Conditions may be chronic and slowly progressive, such as arthritis, Cushing’s disease, kidney disease, or heart disease, or your pet may be diagnosed with a terminal condition such as cancer. In human medicine, the focus is always on extending life at all costs, but in veterinary medicine, we believe in life quality over quantity. Many chronic conditions and cancers are treatable as long as quality of life (QOL) remains acceptably high, but how do you know when you should stop treatment? Unfortunately, there is no hard and fast answer, as measures for evaluating QOL vary from pet to pet.
Terra Linda Veterinary Hospital is here to help guide you through end-of-life decisions, and ensure your pet remains comfortable until their last day. While no black and white rules for assessing QOL exist, the following guidelines can help you make periodic assessments to discuss with your veterinarian.
The pet quality of life scale
Veterinary oncologist Dr. Alice Villalobos developed a questionnaire and scale that uses seven different categories to rate QOL. Each category is ranked from one to 10 and assigned a point value, and then the points are totalled. Scores above 35 (out of a total of 70 possible points) are considered acceptable, but low scores in any category may be a reason to discuss euthanasia with your veterinarian. While assigning a number can be helpful for measuring changes over time, simply keeping the following criteria and categories in mind can help you determine when your pet may be struggling.
The seven pet quality of life categories
Using Dr. Villalobos’ scale, these are the seven categories you should consider and evaluate to determine whether your pet’s life quality is low. Remember, each pet is unique, and their individual personality and needs must be taken into account.
- Hurt — If pain medications, therapy, and adjunctive pain-control measures are no longer effective for severe pain, QOL is lowered. Difficulty breathing is also a painful condition, and outweighs other concerns.
- Hunger — Is your pet’s appetite still close to normal, or diminished to the point of weight loss and poor nutrition? Does hand-feeding or adding treats help ensure adequate food intake? Surgically placed feeding tubes are an option if the QOL score is still relatively high in other categories.
- Hydration — Is your pet able to drink enough to stay hydrated, or can supplemental at-home fluids keep them well-hydrated? Chronic dehydration from kidney disease or a poor appetite can make your pet feel sluggish and unwell.
- Hygiene — Bedridden pets, or those with poor mobility, may frequently soil themselves. Older cats may have difficulty grooming, and long-haired pets may have hair matting. If you can’t keep them clean and well-kempt, or they have bedsores or chronic wounds from a large tumor, their QOL is diminished.
- Happiness — Is your pet still interacting with the family, spending time with you, enjoying modified activities, and acting like themselves? Are they overly anxious, withdrawn, or senile, or do they seem joyful and content? Encourage your pet to remain physically and mentally active. Moving their bedding into the main family area can help.
- Mobility — Pets with poor mobility can still have a good QOL if their owners are committed to pain management, hygiene, and household modifications. Pets may need lower-sided litter boxes, rugs and runners for traction, or a cart to support some of their weight. However, poor mobility that is causing painful hygiene issues in your pet, or mental distress, may be decreasing their QOL.
- More good days than bad — All older pets have bad days, but when the bad days outnumber the good, their QOL is suffering.
Making end-of-life decisions for your pet
Euthanasia is a tough decision, regardless of your pet’s situation. When deciding whether to continue a certain treatment course, ask your veterinarian whether treatment adjustments can address your concerns. While the quality-of-life scale above can provide guidelines and help you and your veterinarian assess your pet, your abilities as a care-giver should also play a role in your decision. Can you afford to continue heroic treatment that may only give your pet a few more days or weeks? Can you take care of your ill pet, while also dedicating time to your family and job? While the decision can weigh heavy on your heart, remember that euthanasia is a gift to alleviate your pet’s suffering and help them pass with dignity. If you are still unsure, you can consider in-home hospice care provided by a veterinarian dedicated to treating terminally ill pets.
Senior pets go through many changes as they age, and some may diminish their QOL. Terra Linda Veterinary Hospital’s team is dedicated to keeping senior pets comfortable and happy in the face of chronic or terminal diseases. If you’re concerned about your senior pet’s QOL, contact us to schedule a consultation to develop a treatment or hospice plan that’s right for your pet and your family.