When owners hear the words palliative care, they often think it means their dog is very close to the end of life, or that there is not much more we can do.
That is not how I approach it.
For me, palliative care starts when a dog is diagnosed with a terminal illness. That does not mean the dog is immediately dying. It means we know the disease cannot be cured, so from that point onwards, part of our job is to keep the dog feeling as well and as comfortable as possible for as long as we can.
Palliative care can start while your dog still feels quite well
In the early stages of a terminal illness, a dog may still be eating well, moving comfortably and enjoying their normal routine.
At this stage, they may need very little additional support.
We may simply be monitoring more closely, treating symptoms early and watching for changes that tell us the disease is starting to have more of an effect on the dog.
As the illness progresses, the amount of care usually increases.
So I do not think of palliative care as something that begins only at the very end. I think of it as a process that starts earlier and changes gradually as the patient’s needs change.
Palliative care can still include active treatment
Starting palliative care does not mean active treatment has stopped.
In fact, particularly in the earlier stages, treatment can still be quite active.
A dog with an incurable cancer may still receive medication aimed at slowing the cancer or reducing the problems it is causing.
A dog with chronic kidney disease may still receive fluids, medication for nausea, appetite support or other treatment aimed at helping them remain hydrated and stable.
The fact that a condition cannot be cured does not mean there is nothing useful left to do.
At this stage, I am still thinking about the disease, but I am also paying close attention to how the dog is feeling while we are treating it.
Starting early can help us manage symptoms before they become severe
One of the main reasons I prefer to start palliative care early is that it gives us more opportunity to recognise and treat symptoms before they begin to have a bigger effect on quality of life.
Nausea is a good example.
If we recognise nausea early and treat it, we may be able to maintain appetite for longer and reduce weight loss.
If we wait until a dog has already stopped eating for several days, lost weight and become weak, then we are trying to manage several problems at once.
The same principle applies to pain, inflammation, mobility and other symptoms.
I would much rather intervene earlier, while the dog is still relatively stable, than wait until the discomfort has become much harder to control.
The amount of care usually increases as the disease progresses
A dog with a terminal illness may need very little extra care at first.
Later, as the disease progresses, we may need to adjust medications more often, add better pain or nausea control, monitor appetite more closely or provide more nursing care at home.
There may also come a point where the disease itself is no longer responding well to treatment.
When that happens, the focus often begins to shift more towards comfort.
This does not happen at exactly the same point for every dog.
I keep asking the same question: is this patient still stable and comfortable on the treatment we are giving?
If they are, then the plan is probably still helping.
If they are not, then we need to reassess and change something.
Palliative care does not mean your dog cannot still enjoy life
Dogs receiving palliative care can still have good days and still enjoy time with their family.
They may still enjoy food, short walks, being outside, seeing familiar people or simply resting somewhere they feel comfortable.
In the earlier stages, this can still be a very meaningful period for the family.
If your dog feels well enough, it is often a good time to enjoy the things they still love, while staying within what they can comfortably manage.
So when should palliative care start?
For me, it usually starts when a terminal illness is diagnosed.
At first, the amount of additional care may be small. As the disease progresses, the support usually increases, and the focus may gradually move from controlling the disease towards keeping the dog comfortable.
Starting earlier gives us more opportunity to recognise problems sooner, treat symptoms before they become severe and help the dog remain comfortable for as long as possible.
Vet-built education. Practical and evidence-led. For informational purposes only; not a substitute for veterinary care. Not for emergencies.