Pain and suffering and their impact on quality of life are the issues most often used to determine the right time for euthanasia. Oftentimes that outcome is right and proper and the only course of action, but very often animals can live on in comfort and dignity if pain is expertly controlled in palliative care. Many times I have heard that cats and dogs do not feel pain as we humans do, but modern research is now showing that animals and humans have similar neural pathways for the development, conduction and modulation of pain, as indicated in the 2015 AAHA/AAFP pain management guidelines for cats and dogs (pdf).
According to the principal of analogy, because cats and dogs have neural pathways and neurotransmitters that are similar, if not identical, to those of humans, it is highly likely that animals experience pain similarly. Based upon the statement above, it would appear that we must make our own judgment based upon our animals’ behavior and apparent need. If in any doubt, one should seek advice from a professional in whichever field of medicine one has chosen to follow.
Find a place (inside) where there’s joy, and the joy will burn out the pain. ~ Joseph Campbell
Pain is a part of life. It is a symptom of a “something.” Just another simple analogy: if we chop off a finger we feel terrible pain, even possibly faint right away, but we are not euthanized. We work proactively to relieve the pain. Our discussion of pain in the context of animal hospice and the dying process would therefore not be complete without a brief look at pain as part of life in general. Pain is a natural part of our lives from the moment we begin our physical existence, as evidenced by the process of human childbirth. Both mother and child experience pain, yet we do not equate this pain with suffering. Instead, we recognize this painful process as a natural part of our physical existence, just as we do the various painful physical injuries we experience as we grow older (skinned knees, bumps, bruises, headaches, etc.).
As natural a part of the birth process as pain is, so too is some pain a natural part of the dying process. For all beings, be they human or animal, it is in many ways as much a struggle to leave this world as it is to enter it. Yet for the most part, we humans equate the dying process with extreme suffering—a manifestation of our own fear of the unknown. We have found, however, that through the use of natural medicine, and the gradual elimination of drugs, the dying process can be a peaceful one, and we realize that much of the perceived pain is more a manifestation of what is going on within us than with the animals.
Frequently asked questions about pain.
Q How can pain be identified?
A Animals sometimes do not show pain, and so the first priority is to identify its presence and degree as accurately as possible. Some signs might be: changes in behavior, personality or appetite, reactivity to touch in affected areas, dilated pupils, physiologic changes.
Q How can the level of pain be determined?
A Perhaps the best way to evaluate pain levels is to look at the symptom as expressed. For example, some expressions of these changes could be: the inability to jump or walk well, limping, lethargy, hiding, panting; also open-mouthed breathing, vocalizing, screaming, restlessness, discomfort.
Q Are these the aches and pains of old age, or do they need addressing?
A It is always good to consult a practitioner for advice. Sometimes a change in diet, or treatment by homeopathy or acupuncture or other form of energy medicine, can make a world of difference.
Q How can I help?
A Remain calm and soothing. Do not panic and remain loving. Work with your veterinarian and other hospice practitioners on your hospice team to mitigate the animal’s pain. Holistic approaches including flower essences, essential oils and Reiki may help.
Q How do I deal with my own emotional pain?
A Focus on living in the moment and rely on the support of your hospice team for help and guidance.
Q Does untreated pain affect the quality of life?
A Yes, it does, and that is when we must become proactive.
Q Does pain always need managing?
A Good question! Ask the animal… It is the physical body that is dying—not them. Very often it may not need managing and will be temporary. Drugs are often prescribed due to the fear of pain by the human without taking into account the wisdom of Mother Nature. We have often contemplated the use of a drug, but by the time we have it prescribed, the animal is no longer evincing pain.
Q Does the presence of pain warrant euthanasia?
A This is a personal decision to be made, if pain cannot be controlled, and should be based upon the facts and the animal and not the person’s discomfort or pain.
Q Do you think the pain of death is similar to that of birth?
A Pain always seems present during birth, although at various levels. We have learned that death itself is not painful but that disease causes pain, so it may be that those dying of a disease rather than old age experience pain that requires pain control.
Q Humans faint if experiencing awful pain. Can animals do the same thing?
A Mother Nature provided this as an escape for pain and yes, animals often “step out” or away from their physical bodies during transition. They return, we believe, when the level of pain is less.
Q Is there ever a downside to administering drugs?
A Once drugs are given, very often they are continued, as no one knows when, if or how to stop, as pain is assumed. The suppression of symptoms may not always be the best thing. One must die of “something,” and when symptoms are heavily suppressed, other issues can be triggered, rather than allowing for the natural progression of the body to its demise.
What is palliative care?
Palliative care is:
- comfort care aimed at relieving and soothing symptoms and pain rather than affecting a cure;
- medical care or treatment that concentrates on reducing the severity of disease symptoms, rather than striving to stop, slow down, delay, or reverse progression of the disease itself or provide a cure;
- supportive treatment that focuses on physical, psychological and spiritual needs;
- treatment that can help the patient live more comfortably;
- specialized care provided by a team of professionals.
Palliative care goes hand-in-hand with hospice care and is very important for the patient’s day-to-day comfort. BrightHaven philosophy embraces palliative care in our regimen but we continue to seek healing (balance) all the way to end of life.
Palliative care at BrightHaven
BrightHaven uses classical veterinary homeopathy as our principal form of healing. We continue to offer homeopathic care to the very end of life, as we view healing as essential for continued life as well as for transition. Remedies stimulate the body to heal itself and we firmly subscribe to the belief that, while the body is able to express its out of balance state by producing symptoms, it is still able to heal. Sometimes this process will be followed until continued life occurs—or death approaches. So if symptoms are present, we are still treating, and if symptoms are not, and death is imminent, then there will be no need to treat. Hence, no symptoms indicate no pain or suffering? This could be one key to the magic that is BrightHaven.
Some BrightHaven animals who undoubtedly conquered their pain
Suffered major brain damage after being thrown from a car at the age of two weeks, resulting in a life filled with many seizures. He lived to double figures. Read Furbee’s Story
Our 800 lb. paraplegic pig. Now ten years old and determined to live forever! Read Harley’s Story
A German Shepherd who disliked cats and yet spent her last weeks as a paraplegic, surrounded in the love of cats! Read Patti’s Story
There are occasionally those following a path to transition who are not responsive to constitutional remedies, and those we care for with remedies best suited to the acute.
Only rarely, when we cannot get a good response from homeopathic remedies or Reiki, do we then evaluate the need for palliative drugs. In human and animal hospice care the taking of drugs can lead to a buildup of toxicity in the system, which in turn may accentuate feelings of nausea and sickness and can also lead to premature inappetite and often depression, both physically and mentally.
A distinct fogginess of mind and spirit often occurs. As a patient’s body becomes more toxic and s/he is unable to eat or be active, then it is understandable that a veterinarian may then pronounce their inability to do more—often leading to an understandable recommendation for euthanasia. Animals possess an inherent understanding of the circle of life and death, and sometimes it can be seen that palliation of symptoms offers palliation for the guardian, when in fact the animal may have no need. A sweeping statement!! Let us enlarge upon it as we discuss quality of life and suffering.
The great art of life is the sensation, to feel that we exist, even in pain. – Lord Byron