By Teresa Garden, DVM
Pawspice care, hospice care for pets, is a relatively new concept in veterinary medicine. Dr. Alice Villalobos, a well-known and respected veterinary oncologist, practices medicine with an emphasis on compassionate care for terminally ill pets. Dr. Villalobos coined the phrase and integrates the philosophy of pawspice care on a daily basis in her busy practice. She has graciously lent her knowledge and expertise to the rest of us practicing integrative veterinary medicine.
Most pets with cancer are seniors or geriatrics afflicted with other chronic illnesses such as kidney disease, heart disease, arthritis, etc. Dr. Villalobos believes integrative medicine offers the best approach to helping these beloved pets. Integrative medicine combines the best of western medicine (surgery, chemotherapy, radiation therapy) with holistic medicine (natural diets, antioxidants, fish oil, supplements). The goal is to achieve optimal level of health for these sick pets. This approach mirrors our own philosophy at Animal Health & Healing. However, Dr. Villalobos does not stop there. She understands that many of our geriatric pets with cancer may be better served with palliative therapies rather than curative ones. As we all know, sometimes “the cure” can be worse than the disease. Palliative treatments can also be a better alternative than euthanasia. Her work with these special little cancer patients led her to develop her wonderfully compassionate and comprehensive “pawspice” philosophy.
Dr. Villalobos defines “pawspice” as “veterinarians and their staff helping clients to provide end of life care at home for their terminally ill pet”. This entails teaching the pet owner to provide nutrition, medication, hydration, and hygiene. And of course, lots of fun and love are also part of the equation. Pawspice strives to maintain the quality of life of the pet by adhering to the Quality of Life Scale developed by Dr. Villalobos. This scale, made up of seven parameters is abbreviated as HHHHHMM. Each parameter is scored 0-10 (10 is perfect). An overall score of 35 is acceptable and each parameter should have a score of 5 or higher. This scale helps both the pet owner and the veterinarian to evaluate the pet’s overall health and well-being. The scale is as follows:
H HURT 0-10: Must have adequate pain control with special emphasis on ability to breathe.
H HUNGER 0-10: Is your pet eating enough? Is hand-feeding or a feeding tube necessary?
H HYDRATION 0-10: Is your pet drinking enough water? Giving subcutaneous fluids at home can help many pets with cancer or kidney disease.
H HYGIENE 0-10: Your pet needs to be kept cleaned and brushed-paying special attention to rectal and genital regions, wounds, tumors. Watch for pressure sores. Keep face and coat clean if pet cannot groom himself.
H HAPPINESS 0-10: Is your pet still interested in social activities? Does he still interact with you and your family? Is your pet depressed, anxious, or isolating himself? Provide playtime and fun activities such as short walks, petting, brushing, playing ball. Keep the pet’s bed close to family activities.
M MOBILITY 0-10: Can your pet walk? Does your pet need assistance by you or a sling, cart or harness? Is your pet stumbling, falling or seizuring? Does your cat need help getting into or out of the litter box? Mobility is very important for our large and giant dog breeds. It can be extremely challenging for pet owners of these breeds to provide ample assistance due to the pet’s size or weight.
M MORE GOOD DAYS THAN BAD 0-10: Mark the bad days on your calendar. If there are too many bad days in a row quality of life is compromised and the pet may be suffering. This may be the time to consider humane euthanasia although we all pray our much-loved pet will have a peaceful and painless passing at home.
In closing, I would like to encourage my fellow veterinarians as well as pet owners to read Canine and Feline Geriatric Oncology Honoring the Human-Animal Bond by Alice Villalobos, DVM, Blackwell Publishing. As part of our profession, veterinarians should try to incorporate pawspice philosophy into our practice of medicine. One half of all pets greater than 10 years old will get cancer. Cancer is, and will continue to be, our greatest foe for years to come. There are many ways in which we can all improve our knowledge, our sensitivity, and our services to minimize the anxiety and suffering cancer afflicts upon our dear patients and their loving and devoted families. Lap of Love is a wonderful veterinary care provider of in home pawspice care. If you need help caring for a beloved terminally ill pet I encourage you to reach out to them for their compassionate expertise.
Dr. Teresa Garden is chief veterinarian and owner of Animal Health & Healing, a full-service holistic and conventional veterinary practice in the Maplewood/Richmond Heights area. AnimalHealthandHealing.com; phone: 314-781-1738