Animal hospice care: Loss of appetite

Louie, 2 days after his stroke

When a loved one isn’t eating it quickly raises concerns in us. We have become disconnected from an important healing response of our body – fasting. Most people think of abstaining from food as deprivation because they don’t know that fasting’s natural function is to cleanse, detox and reset the system. Though passing up on food does signal a physical or emotional disturbance it is also already its answer. When my stepson was little and a cold or the flu passed through the family, he would curl up in his bed, refusing to eat. Within 24 to 48 hours he was well again whereas the rest of us usually took a week or two to get better.

There is a difference between starving and not being hungry. Starvation happens when we are hungry but have no food available or because of a physical condition are incapable of eating. A lack of appetite on the other hand is the body’s wisdom to abstain from food for healing purposes or because the body is dying and needs little to no nourishment. In order to gain energy from food the body first must expel energy for its digestion, a lot of energy actually. Waxing and waning of appetite is a common and normal symptom when the dying process is unfolding. With it comes another common and normal symptom, the body starts looking emaciated. Under these circumstances there are no animal welfare concerns, the animal is not starving but simply experiencing dying. The Quality of Dying checklist is a helpful tool to recognise that nothing untoward is happening with an animal receiving hospice care.

I’ve heard many people tell me that they knew their dog had come to the end of their life and it was time to euthanise them because they hadn’t eaten in a day or two. They were not even interested in what used to be their very favourite treat. What is done, is done. And it’s not my intention to judge people’s decisions to euthanise their pets. I just want to raise awareness of what the natural dying process looks like. If you know that loss of appetite is normal at the end of an animals life, you are free to perceive your animal ceasing to eat (temporarily or completely) differently than before. There is so much value added to the carer and the dying’s experience when providing hospice care, allowing life to end in its own time.

When my elderly dog Louie suffered a stroke combined with vestibular syndrome, he did not eat or accept water for three days. My vet and I didn’t know if his body was healing or dying. His limbs were cold even though he was wrapped up warmly. He urinated once every 24 hours – releasing a strong-smelling liquid. There were no bowel movements. Throughout the day I offered him water hourly but he always made it clear he was not interested, either turning his head or looking away. Once a day I carried him outside and we laid on a large dog bed, Louie draped over me, and enjoyed the sunshine, fresh air and bird song. Calmness spread within. My angst unclenched and all worries dissolved.

The day after the stroke I discussed my concern of Louie becoming dehydrated with my animal hospice care experienced vet. The emergency vet we had taken Louie to the night before had recommended putting him on a drip. My vet’s opinion was to trust the body’s wisdom, however, she said if it would make me feel better then I could bring Louie to a local vet for a daytime hydrating drip. I trust my vet completely and decided to spare Louie this unnecessary hassle.

Fasting is the greatest remedy –
the physician within.

Paracelsus

On day four, Louie started to drink water again and ate a meal at the end of it. He had come around! The dehydration had made him look like skin and bones. He appeared shrivelled, puckered, like a prune. Look at the photo above and you can see how sunken his face looks. As he recovered and rehydrated, he started to look more normal again.

Weight loss/looking skinny is a common and normal symptom of dying

In the movie “My Octopus Teacher” we can watch a powerful example of the healing power of fasting. The octopus is attacked by a shark who bites off one of her arms and does serious damage. For over a week the injured animal rests in her den, not really interested in the food offered to her, while the wound heals over and a tiny new arm starts to grow and she returns to living her life.

I wonder when it started, that belief that a sick body needs lots of nourishment. The ancient wisdom of fasting is being rediscovered by medical doctors to heal serious diseases. Wild animals have always been in touch with the practice and some pets are too.

Though it is a sign that something is off, your dog not eating is not a reason to panic, neither during their life nor when they are dying. Sometimes we might not know in the moment if our animal is healing or dying and only time will tell. Louie pulled through and improved for a few weeks and then declined again. His appetite waned, only eating a few bites in his final days but continued to take water other than his very last day.

“While each dying process is highly individual, there are also commonalities that have been observed
which can serve as a road map to understand where along the dying process an individual is and
what type of support may be called for along that journey.” writes holistic veterinarian Ella Bittel in her very informative article on the stages of dying.

Familiarising yourself with what the natural dying process looks like will decrease your fears. It’s good to have a reference such as the above mentioned article or a person who has done hospice care for an animal so that when your dying animal displays certain symptoms you have the confidence to know that all is well.

You matter because you are you.
You matter to the last moment of your life,
and we will do all we can, not only to help you die peacefully,
but also to live until you die.

Dame Cicely Saunders

Dame Cicely Saunders (above quote) is the founder of the modern hospice movement. The value of this specialised end of life care for people has become widely recognised. When it comes to pets, hospice care is in its infancy. Now that their status has changed to fully fledged family members and our understanding of animal intelligence and sentience is constantly expanding, more and more people are interested in learning about this option for their furred or winged loved ones. A change is upon us. Euthanasia can become the exception rather than being the rule, reserved for the special cases when an animal’s comfort can not be adequately maintained or the caregiver’s resources (emotional, physical, financial or other) are insufficient.

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