Your veterinary clinic is the place you want to be if your pet has a treatable disease or needs a regular checkup. But what happens when age or a terminal diagnosis takes over? What happens when your pet is beyond a cure?
Palliative care refers to the ideals of ensuring patient comfort even if curative care is no longer possible, providing access to individualised age-appropriate health care and supporting families through the difficulties of end-of-life decision making. Palliative care is something that more and more families are turning to in an effort to ensure their pets quality of life is well managed, even when the end is near. Often this is care that can be, at least in part, delivered in the home by a dedicated Palliative Care team.
Dr Ashlee from Sunset Vets Palliative and End of Life Care (Sunset Vets) is a Canberra based Veterinarian who works specifically with pets approaching the end of their life. A powerhouse in the industry, she is one of a small number of Australian Vets who hold a IAAHPC Certification (International Association for Animal Hospice and Palliative Care) in addition to her Veterinary qualifications.
“Palliative medicine is quite a new field of focus in the Veterinary world, but it’s one that allows me the luxury to provide a level of care where I can build relationships with my patients as well as my clients”, said Dr Ashlee.
“I studied at James Cook University and originally worked in General Practice before joining Sunset Vets. During my time in clinic, I saw a lot of older patients and performed euthanasia’s. But, in a ten-to-15-minute time slot, I felt like I was unable to provide the level of care that I wanted to. The luxury of providing at-home end-of-life care, whether it be palliative or euthanasia, is that I can take my time. I can build relationships and develop trust and connection with my patient and with the family. It’s how end-of-life care should be managed.”
Because palliative medicine is relatively new within the Veterinary industry; it’s also unfortunately one that can be misunderstood. It is sometimes assumed that palliative care delays the inevitable and potentially cause unnecessary suffering. But this couldn’t be further from the truth.
“Palliative care is so important,” Dr Ashlee explains. “Pets are notorious for hiding their pain, and they suffer through it. In General Practice it’s common to see a euthanasia patient who’s been struggling with unmanaged pain for years. Palliative medicine can help manage that pain and improve a pet’s quality of life. I want to increase awareness and education on palliative medicine so pets can be comfortable during their final years.”
It’s this mentality, alongside her impressive experience and qualifications that makes Dr Ashlee so loved by her Canberra clients, both human and animal alike. And palliative care for Dr Ashlee, is as much about the owners, as it is about the pet.
“Owners are actually very involved in palliative care,” explains Dr Ashlee. “it’s empowering for a loving owner to be involved and actively do things that support their beloved pet’s well-being.
“I had a patient I only recently said goodbye to; a beautiful Labrador named Star. Star presented with quite common old age symptoms as well as a back leg that was partially paralysed and was affecting her ability to walk. Because she had stomach issues and was unable to tolerate certain medication, we had to think outside the box regarding her oral medication plan, and we had to monitor this very closely. I worked with her owner to adjust her diet to include supplements for joint support, and we tried quite a few mobility aid options before we finally found something that worked for her – a special paint for her pawpads that increased grip. This allowed her to walk with more confidence. She had long-term monthly injectable arthritis medication to help control her pain given that we were limited in what we could give her orally. These combined changes made quite the impact; Star was comfortable and her pain was well managed. She was my palliative patient for a year and a half and along with improving her quality of life I was really able to build a connection with her and her family. It’s such a gift to earn the love and trust of an animal, but it does make it even more heartbreaking when it’s time to say goodbye.”
The decision to say goodbye is one that is usually agreed upon in advance. This is because palliative care is unique and open discussion is encouraged so a plan is in place which all parties are comfortable with.
“The benefit of palliative care is that it’s tailored to each family. One of the first things we do on an initial visit is discuss the end and put parameters in place so we know when a palliative patient will become a euthanasia patient,” said Dr Ashlee. “Our goal is comfort; we do not want to extend an animal’s life if they are uncomfortable and unhappy.”
Sunset Vets is spread across four states and is a dedicated palliative and euthanasia service. This means, although palliative care is the why behind Sunset Vets; compassionate, at-home euthanasia is one of the more common services provided. And saying goodbye isn’t easy. Even when it’s done every day.
“If people are crying, I’m going to be crying,” says Dr Ashlee.
“It’s easy to feel the sadness and the grief of others, and it can get very emotional. But as the Vet, it’s not my grief to own. Families grieve because there’s love and memories. And they deserve to feel their emotions as raw and devastating as it can be to witness. And it breaks my heart. But I do find positives in the peace I bring by providing euthanasia in the comfort of their own home.
“When the time has come to say goodbye, a pet is old and sore. They’re scared and they feel vulnerable and while clinics are incredible and they’re the place you want to be when something is treatable, it’s not home, and it’s not as comfortable. Knowing I’m taking that stress away from a beautiful pet who already doesn’t feel well, brings me peace and comfort. And that’s something I hold onto when a goodbye is particularly tough.”
And so when asked what she wished owners knew more about when it comes to end-of-life care, Dr Ashlee said.
“Changes due to old age are normal. But they can still have a big impact on quality of life, and how enjoyable those final years will be. We’re not going to cure old age, but there’s plenty we can do to make them comfortable and manage these changes. If I can impact even one person to consider palliative care, I’m happy. I want pets to be comfortable in their final years, that’s why I do what I do.”