In Home Palliative Care

[Quirkyhound]

I have read with great interest, all the questions everyone on here is seeking answers to and I was wondering what you thought of an idea like this:

An in-home palliative care service offered by a vet and possibly followed up by her qualified nurse. Kind of like the old fashioned Doctor who made House Calls or like Blue Nurses for Dogs. I know vets with busy clinics to run probably won't want to race out and start doing this, but there are a few vets and vet nurses out there who have taken time off the job to have a family or are not working for various reasons and they could easily do a 'palliative care run' since they have some free time.

Some of the services they could offer would be things like pain management and checking to see that proper hydration levels are maintained, etc. Basically they would drop by on a 'run' to check in on you and this would keep you from racing off daily with your dog to the surgery. You could avoid having to move the patient which could mean a lot for a sick dog, or cat who at the best of times usually doesn't take kindly to a trip in the car.

How often would you want a visit and how much would you feel comfortable paying? Would you also want telephone advice? Would you prefer email advice?

What would everyone want?

[cavNrott]

In our case there was no call for a visiting vet service. All we can do is medicate our terminally ill dogs and we know what medications to give them and when, as prescribed by the oncologist or vet.

We learn very quickly what we need to do for our dogs to keep them comfortable.

Also, since we know our dogs so well we are the first to know if the dog is feeling off colour. We know what is normal for our dogs. A visiting locum vet would not know that.

I think most of us who are caring for terminally ill dogs do a heap of research and embark on a search for alternative therapies and medications to use in conjuction with allopathic meds. Vets, unless they are holistic vets don't have much knowledge of natural therapies or medications.

In my experience only our own long time, trusted vet was prepared to discuss the alternatives that I used. He was very interested in the effect these alternative meds had on my dog and has documented the results. All natural meds were discussed with the vets to ensure nothing I administered was contraindicated with the prescribed medications.

We saw an oncologist regularly and our regular vet who had cared for my dog since she was a puppy. We didn't need home visits. What we did need was to have appropriate pain meds on hand and other such medications as were prescribed. Both the oncologist and the vet were happy for me to administer pain meds on an as needed basis.

Bloods were taken at the surgery regularly and if levels were outside of the normal range the bloods were sent for biochem analysis.

We did not need any home visits. I was able to contact the oncologist at all times. She made her mobile number available to me. I don't think a visiting locum could do anything for my dog that was not already being done for her.

This is my opinion only and I would be interested to hear the opinion of others.

[Quirkyhound]

Thanks for your input Cav. :D That's one thing I did notice, that there was a big call for alternative therapies. I'm actually working with a friend who is a vet, on this idea and this is exactly what she needed. We wanted to see if there was anyone needing such a service. I think in general, many people on DOL might be like yourself, full of knowledge and experience and it might possibly be a service that would be more valuable to the more 'uninformed' general public out there without access to or knowledge of the support found on DOL.

Thanks so much for your time and honesty. You really put a lot of thought into answering this for us. I hope others will also give their opinion.

Maybe we should say 'would like to hear from all members and perhaps especially those without any nursing experience.'

All the best! QH

[Staffyluv]

I have to agree with CnR here.

I know our journey has been a long one (over 3 years now), much longer than originally thought - time given was 12-18 months for us...

Holistic therapy is a wonderful supplement and can keep our dogs otherwise healthy, if not for the cancer. Our vet and canine oncologist did not know much about the holistic therapy. I started by getting the vet to send all results to the holistic therapist so she could see what was going on medically and then she supplemented Ollie's care.

I know that I personally would not use a home service like you suggest (I dare say the costs would be prohibitive and we already spend so much with his ongoing care) because once I found out that Ollie had MCT, I did everything I could to find out about the disease and how to treat it. I spoke with other owners of MCT dogs who have already been through what we are going through. We tend to research, research, research these things when we have to deal with them.

Good luck with what you are trying to do, I don't think it is a bad idea at all - I just would not use it personally. I dare say though that there might be those out there that could use this type of service (people that don't frequent dog forums to find all the good info)...

[Quirkyhound]

I have to agree with CnR here.

I know our journey has been a long one (over 3 years now), much longer than originally thought - time given was 12-18 months for us...

Holistic therapy is a wonderful supplement and can keep our dogs otherwise healthy, if not for the cancer. Our vet and canine oncologist did not know much about the holistic therapy. I started by getting the vet to send all results to the holistic therapist so she could see what was going on medically and then she supplemented Ollie's care.

I know that I personally would not use a home service like you suggest (I dare say the costs would be prohibitive and we already spend so much with his ongoing care) because once I found out that Ollie had MCT, I did everything I could to find out about the disease and how to treat it. I spoke with other owners of MCT dogs who have already been through what we are going through. We tend to research, research, research these things when we have to deal with them.

Good luck with what you are trying to do, I don't think it is a bad idea at all - I just would not use it personally. I dare say though that there might be those out there that could use this type of service (people that don't frequent dog forums to find all the good info)...

Thanks for your time Staffyluv, Just what we needed to hear, another good solid honest opinion. :D

Those journeys are never easy are they. All the best, QH

[HappyGirl83]

I think that there would be some people who would use this kind of service. Especially for elderly clients, who aren’t comfortable driving a lot themselves, or who may have larger breed dogs that are reluctant to get into the car.

Dropping off prescription diets and medication refills on these visits could also be handy. Collection of blood samples to run back at the clinic or to send off may also be useful for owners who do not want to go into the clinic, especially for patients who stress there.

Just my thoughts! Actually I am very interested in holistic and alternative methods myself, I do not know a lot about them. My old Lab was just diagnosed as having tumours on her liver and mets in her chest (likely hepatocellular carcinoma). She has not been biopsied for these just had an ultrasound and radiographs, I decided against a biopsy due to the fact she is 13 and already compromised…didn’t want to go through an anaesthetic. It has already spread to her lungs so she does have a very poor prognosis. In fact, everyone is surprised she is still with us and doing so well. At present we just have her on the L/D diet and are basically just making her comfortable as possible…there isn’t much else I can do.

[cowanbree]

There are times when this is very handy, my vet does home visits. Generally I use them when I have babies needing vaccinations etc that I really don’t want to take in or for home euthanasia. Cost wise it isn’t too bad, $100 vs $45 so while I certainly wouldn’t want to use it all the time there are times it is a great service to have

[Staffyluv]

I think that there would be some people who would use this kind of service. Especially for elderly clients, who aren’t comfortable driving a lot themselves, or who may have larger breed dogs that are reluctant to get into the car.

Dropping off prescription diets and medication refills on these visits could also be handy. Collection of blood samples to run back at the clinic or to send off may also be useful for owners who do not want to go into the clinic, especially for patients who stress there.

Just my thoughts! Actually I am very interested in holistic and alternative methods myself, I do not know a lot about them. My old Lab was just diagnosed as having tumours on her liver and mets in her chest (likely hepatocellular carcinoma). She has not been biopsied for these just had an ultrasound and radiographs, I decided against a biopsy due to the fact she is 13 and already compromised…didn’t want to go through an anaesthetic. It has already spread to her lungs so she does have a very poor prognosis. In fact, everyone is surprised she is still with us and doing so well. At present we just have her on the L/D diet and are basically just making her comfortable as possible…there isn’t much else I can do.

Sorry to hear of your dilemma HG... Liver cancer is often difficult to treat and I fully agree with no anaesthetic if she has tumours on her lungs.

Actually there is more you can do than you think. Holistic therapy is a great source to assist terminallly ill patients. We use lymphodran amongst other things to help support the lymphatic system. High doses of vitamin C are an amazing tonic for ill dogs - Ollie has it intravenously when he is in hospital to give him a boost...

Starting with diet - remove all carbs. Carbs feeds cancer. Another suggestion is to see an holistic vet armed with as much information as possible - see if you can get blood work results from the attending vet to take with you.

Ollie was given 12-18 months back in October 2005 when he was 8 years old.

He will be 12 in June this year and is still with us and just had another surgery to remove a malignant round cell tumour from his toe (they had to remove the whole toe). He is recovering really well and walking on it just days after it was removed.

All the very best