Palliative care is more trying to keep your pet comfortable while still trying to treat your pet, and hospice, in general, is thought of as more keeping them comfortable for that end-of-life stage.

Pain can be exhibited in multiple ways. We often think about our pets being vocal. As humans, we may be vocal if we are in pain, but often dogs hide it. Because dogs hide pain, you’re looking for more subtle changes from their normal behavior. If the dog is slower to rise when they get up, they could have some arthritic pain. If they change their eating habits and only eat soft food, they may have dental or mouth pain. If your dog no longer greets you when you come in, they don't jump up like they used to, don’t sleep on the bed with you, or they sleep on the floor; these could be signs that they're uncomfortable and don't want to move around.

That can be a tough question to answer, but your pet may change their breathing habits; they may go into labored breathing. The dog may not want to eat or drink, or they may not want to move around. Those would be signs that your pet isn't doing well.

The clients that I interact with are the best judge of their pet's quality of life because they're with them every day. I get asked whether a client’s pet is doing well or if I know what the quality of life is. And the things that I talk about is your experience at home. I see a skewed version of that when they're here because they may not be getting up at home, and then the dog comes in the exam room, and they're walking around constantly in the room. And that can be due to anxiety or their adrenaline being up. So what you experience at home and how you see their day-to-day life is an excellent way to judge that.

There's not just one answer to that. That could be for many reasons. Sometimes, it is because they are a little disoriented. We sometimes see some cognitive dysfunction as pets age, and they may do things that they didn't normally do. Sometimes, things bother them. Things that didn’t bother people do so more as they age, and the same thing for pets. A pet that didn't care about thunderstorms may suddenly get more excited, so the vocalization can be one way that they express that.

While we associate vocalization with pain, and that can be accurate, it just doesn't always go hand in hand. Because if you think about it, a lot of times, pets hide their pain. So if a dog's in pain, again, it may be more reclusive or stay in one area versus getting up and getting around. And the crying out or the yowling may be more of a cognitive reaction versus a pain response. Sometimes, it's attention-seeking. They may become a little bit more attached and have more separation issues.