Peace of Mind for Pet Parents Episode 076: Is Dying Painful? Your Pet’s Body Knows What It’s Doing

RESOURCES MENTIONED & RELATED LISTENING

• PEACEFUL PDF - Free Download
• LIVING Quality of Life Care Assessment Tool — Free download
• BrightHaven Animals YouTube Channel — Search: BrightHaven Animals | @brighthaven_animals
• Animal Hospice Group (animalhospicegroup.com) — professional certification organization in animal hospice and palliative care

You might also find helpful:

• Episode 073: Reading What They Can’t Say: Pain, Comfort, and the End-of-Life Journal
• 🎧 Episode 023: Living to the Last Breath: A Pet Parent’s Perspective on Dying Naturally
• Episode 069: Preparing for Your Pet's Death — Physical, Emotional, and Spiritual Ways to Make Every Moment Count
• Episode 053: From Pet Parent to Caregiver: The Quiet Shift Nobody Warns You About
• Episode 058: Can My Pet Die Peacefully at Home? What Natural Death Really Looks Like

Related reading:

• The Other Doctor in the Room: Trusting Nature at the End of Life
• Walking the BrightPath: A Pet Parent’s Guide to Home Hospice and Natural Transition
• Emotional Support for Pet Owners Facing a Difficult Diagnosis: Coping with Guilt, Fear, and Grief
• Monitoring Your Pet's Health at Home: A Palliative Care Guide for Chronic and Difficult Conditions

---

Episode Transcript: 

Karen Wylie: Hello and welcome back to Peace of Mind for Pet Parents. I'm Karen Wylie. Here as always with Gail Pope, founder and president of BrightHaven. Today's episode is one that we're going to continue talking about myths that keep families from starting hospice care soon enough. We're going to go a little deeper into the myths about what's actually happening in the body of our animals as they begin the dying process, because we often most hear the fear about this part of the process.

This is where the 2:00 AM calls to veterinarians often come about these kinds of questions. "She won't eat. Is she starving?" "He's sleeping so much, is something wrong?" And, "Should I be giving pain medicine, or will that hurt her? What should I do?"

So today Gail and I are going to walk through some of the most common myths and some that can frighten us if we don't know more of the facts behind what's happening. So Gail, I want to start with the first big one, that dying is painful. Because I think almost everyone believes this at some level, that dying is painful. But is it actually painful or is it the disease that causes pain?

Gail Pope: You just asked and answered. Yes, in a nutshell, yes, it's the chronic illness that causes the pain. However, I think we could step back, actually, before that. It's hard to be human, and let's face it, there's more than one kind of pain. There's physical pain and emotional pain, and if you've got an animal who is struggling emotionally, sometimes that can be interpreted as physical pain.

Sometimes you've got an animal who is restless and anxious and those can be part of the actual dying process, so it's hard to know. Your animal's being a little restless, they've got some anxiety. Here we are, the human looking on, and that's painful on our hearts or for our hearts. And so pain is this huge subject, but when you come down to the physical pain, then we know, I think we have to turn to the human world, the world of human hospice, and all the stories from hundreds and thousands of people who have cared for dying humans and written amazing books.

I love reading the stories of the incredible caregivers but the incredible people who have shared their stories. It's just so comforting and we have an amazing array of medicine that can treat symptoms in life and living and death and dying. So I think, you know what I'm going to say, it comes down to education. We know that the dying process is not painful. We also know that many chronic illnesses can be painful, and so it's looking at what's going on and figuring out what is the best medicine to treat that pain. Is it a medicine that will help emotionally? Is it a wholistic medicine that will improve the balance for their healing, for their highest good?

And that brings me to another topic but I'll put that to the side for the moment. I'm sure it'll come up later. But if pain is seen or if pain is perceived, what's come to me as the way I work over the years has been if I'm in doubt, then I treat it as pain. Then I treat it in whatever manner seems appropriate. If the pain medicine works and the situation improves, "Okay, brilliant! Now we've got a balance again. That's what I was looking for."

If it doesn't work, "Is this anxiety? What is this that I'm seeing?" And then I start looking down a different avenue. But I think when we come to the dying process from a place of fear, we lose our rationality sometimes. It is hard to be human and it does make us scared when something is not as we perceive right. So the more we learn about the process of dying— let's face it, for people like you and me, we have been present with humans and animals who have been through the dying process. I've learned so much from so many other beings.

That has helped me to understand that there's not a golden rule. You can't say, "Okay, dying, let me list all the things that you're going to see." You could list hundreds of them or maybe not hundreds but lots of different symptoms that may be part of the dying process but we may only see that one, and that one. Or we may see that one, and that one over there. It's always different. I also think how you live has a bearing on how you die.

Karen Wylie: You have to say more about that.

Gail Pope: I'm going to hand it back to you now because I could go down all sorts of different avenues here.

Karen Wylie: Okay. Just to be reflecting back on what you're saying and trying to sum up a couple pieces of it. If an animal's disease that will ultimately cause their death, if that disease is one that causes pain, they are likely to be on some level of pain medication— the usual prescription process. So part of that could help them understand and distinguish the difference too because their animal would have also been on that pain medication prior to the more serious decline beginning. So how do you help a family tell the difference between what the disease is doing and what the dying process itself is doing or can you?

Gail Pope: Understanding the actual normal winding down, slow, and gradual process of the human body or the animal body or both, I think is probably the key point here. Because if you actually learn, it's a procedure. To me, Mother Nature is that other doctor in the room who has designed this process. The losing of energy. You think of it, I can think of it as I'm growing older, I'm not as energetic now as I used to be. My body is changing. When I look in the mirror, there's a different person who looks back at me these days. As our body changes, so the whole physicality changes. Not only what we see on the outside but as we see on the inside.

If we look at Doctor Mother Nature as orchestrating how our body functions and how all of those amazing organs and cells, millions of them, all function in tandem with each other. So I think when there's something that's out of balance, a disease, if you want to call it that, a chronic illness, Mother Nature is orchestrating the journey of all the different parts of the body so that it can keep a balance. So that it's not just one organ that's failing.

And as time goes on, that balance has to be created right the way through the entire body. So there is a gentle and a slow winding down, so that if the kidneys are failing, then obviously little by little the liver, the heart, the whole of the system has to start winding down. So I think when we understand how that all works, obviously it's a lot more complicated than I've just described - that's very basic. But when we start to trust that there is another doctor in the room, and the body knows how to die. I think sometimes we interfere with that natural process a lot and it doesn't necessarily end well.

But I think in our more modern times now, human hospice has learned so much about finding that balance, not overmedicating but keeping a balance correctly. We're not trying to fix the illness, we're trying to create the best balance for that human. That's where my old saying that I'm always quoted on is "Healing for the Highest Good", and remembering that balance that we're trying to create is for living, perhaps while dying.

It's just keeping a balance for whatever the end result is going to be to make it as peaceful and gentle and natural as possible. And knowing that as we keep the balance as well as we can from our side, that Mother Nature is working with us on the other side. I think if you look at BrightHaven statistics, we've had difficult deaths, of course we have over the years. But a huge percentage have been what we talk about as a natural, peaceful, and easy death. That is what Mother Nature intends. Our job is to help support that, I think, rather than to dictate it.

Karen Wylie: I think this brings us into an area that a lot of people are not aware of the fact that when our bodies are in the process of dying, and this would be true of our animals as well as ourselves, but our body produces a lot of endorphins. And there are other times in our lives where we've heard about endorphins as something that happens in our body chemistry. But in the dying process, the endorphins provide kind of a background source of pain relief — certainly in terms of keeping the individual or the animal calm.

Then there's another and I had to look it up before we were going to talk today because I couldn't remember it. There's another one that has smaller molecules and it affects our nerve endings in our body, and they're called Enkephalins. I'll probably have to put that in the show notes, Enkephalins. But they also are being produced, they're a type of endorphin and they focus on the nerve endings. So if there's any part of the body that's beginning to be painful, our body produces these wonderful natural pain-relieving chemicals. But we always think we have to provide pain relief from the outside.

Gail Pope: Exactly.

Karen Wylie: And that's where I think, the other doctor in the room, that our bodies do know how to die. It's part of the body chemistry aspects of how amazing our bodies are that come into play as our body starts to decline in our active dying. It's a pretty amazing thing, pretty amazing aspect of what our bodies can do for us.

Gail Pope: I think we skipped probably one of the most important parts and we went right to dying, but I think the early stages of dying are perhaps the most difficult. They're the most difficult for me, and with all that I know and do. But when we, being two legs or four legs of course, start to approach transition which can be weeks, months, a long time before actual death, that's when the appetite starts to dwindle.

The appetite and thirst is something that, as a caregiver, we are very attached to. Let's face it, when we have maybe an eight-year-old cat who suddenly decides she doesn't want to eat her dinner, what do we do? We panic. It's when they're elderly or infirm and they lose their appetite even a little, we start, "Oh, my goodness, you haven't eaten all your dinner. Let me try something..."

We become the caregiver with the hat on, the chef. We've got to make it right. So when our animal is declining towards the end of life, the same thing happens. We try baby food, we try all the different things to just help them, and that's good because they still want to taste. I did this journey with my mum, and yes, her appetite dwindled. We all got worried. It dwindled even more. I started to panic. We tried all the different treat foods, and she loved it. She would have a little sip of this and a little bite of that, and she'd say, "Oh, that was... I really enjoyed it." "Could you eat some more? Come on, Mum, you can have more." "No, I'm fine. That was really nice."

That's hard for us to accept in a human but it's even harder in an animal when they just look at you and go, "No, thank you." It hurts our hearts that they can't eat or they won't eat. So we start looking at ways to make them better but we don't need to because the body can't be fed while it's dying. It's got its internal work to do. External processes— it has to push the external away and concentrate on coming back to balance internally.

Karen Wylie: Do I remember correctly that the digestive system is often the first to begin shutting down?

Gail Pope: I think so, I think it generally is. Well obviously the body's energy is really starting to wane first. But then again, as Mother Nature's keeping the balance, then yes, the digestive system is literally sending product to every area of the body, and the heart is working hard to keep pumping. So little by little at that point, the digestive system has to start slowing down so that everything else can work in tandem.

Karen Wylie: I think it's the not eating then that begins to trigger the endorphins and to trigger the natural pain-relieving chemicals in our own bodies which then at least begin to bring a sense of comfort and wellbeing even without the food or hydration.

Gail Pope: Exactly! Especially when you also know that in the process of crying, tears create endorphins. They release endorphins. So when you cry it out. It makes you feel better. We teach our children that.

Karen Wylie: So it's pretty amazing, isn't it? att various points to see what our body can do for us.

Gail Pope: Yes.

Karen Wylie: Even when we're sad and even when someone we love is dying. What would you say, Gail, to a family who feels like they're failing their pet and they're feeling like they need to force feed them because if they don't, they're going to die?

Gail Pope: Again, it comes back to really what we've just been talking about. It really is learning. Let's face it, for us, the difficulty there is knowing that this isn't an illness that they can recover from. That's the bottom line. Because, yes it's perfectly acceptable to force-feed a being who has an illness that they can possibly recover from but you can't recover from life. When it's time to die is not something from which there's recovery generally.

And so force-feeding is never an option. In my experience, the being knows whether it should eat or it shouldn't eat. And I must say, when my animals gradually stop eating, I do use a small syringe and baby food, and I will pop a little baby food in the side of the mouth just to see if they want to taste.

Sometimes they do and sometimes for days, they'll accept just little bits. You know, I'll puree their food and offer them that, like my mum, they'll take a little and then say "It was great". Sometimes they'll lick food off my finger for a few days until it gradually becomes, "Yes I'm done. I don't want anymore. I can't do it." And then I think what can also happen which can be really difficult, is that the animal refuses food. They get forced to eat some to try and help but it makes them throw up.

Then sometimes we're drawn in that instance to treat the vomiting and that can only cause even more confusion for the digestive tract because now we're trying to make them eat, and now we're treating them with drugs or other medicine to relieve the symptoms caused by eating. So now we've got a vicious circle that actually we just need to let go of and put the whole thing to one side.

Karen Wylie: If we're force feeding or attempting to force feed food or provide too much hydration, then we're setting up a situation where the body is fighting. The body is trying to die naturally in the way that it knows how to do because we don't want them to die and they need to eat and drink. We're setting up this struggle between what we want for them and what their body wants for them.

Gail Pope: Exactly. God, it's so hard to be in that position. I know I've been there, particularly with, maybe a cat with advanced kidney disease. I've been giving them subcutaneous fluid therapy. And I can see we're gradually declining more and more, and there comes a point in time where even if you know that continuing to give them fluids is not going to be best for them, it's really hard to stop.

Karen Wylie: Yes.

Gail Pope: It's really hard to stop, and I know lots of people continue to give fluid when it's not beneficial for the body. We've all struggled. We struggle with the water content as much as we do with food, I think sometimes.

Karen Wylie: We do. We do, because in some ways, the hydration, the dehydration is visible in their eyes and in their face.

Gail Pope: Remember too, that's where these endorphins come in. Dehydration, again, produces endorphins. So it's good for the body. It may not be good for us but it is good for the body.

Karen Wylie: And so any nausea that they would be having and those endorphins are going to be reducing that and bringing more comfort.

Gail Pope: Yes.

Karen Wylie: So one of the, the other things of course that happens for our animals at end of life is that they start sleeping more. I think this is one of the things that catches most families off guard because on one hand it can happen gradually where they're sleeping a little bit more day to day, week to week, but then it can also happen all at once.

So why do animals sleep so much more at this point in time and sometimes seem confused or extra tired as they get closer to the end?

Gail Pope: Again, it's all part and parcel of the process of letting go. For us it's the process of acceptance. And in fact, when you've been a busy caregiver with an animal or a human who is declining, you've got toiletry issues, bedding changing, laundry to do, food to prepare, different food, trying something different, going to the store. There are all of these things that create us as caregivers. Then it all starts to change and there's less to do, and that is really hard.

"They're lying there. What do I do? Oh my God. What do I do? I've got to do something." That is, I think, one of the biggest steps for us. We don't know when to stop doing and letting go and just being with them. Understanding, again, that it is very normal and natural towards the end of life that animals and humans rest more. Our humans are in bed, and they sleep during the day, they sleep during the night. They have periods of lucidity or normalness, and they talk and laugh and sometimes want to get up and walk around.

And then they settle back down and they sleep. It's all part of the dying process. When we go with the flow and allow what is. When we see something that isn't listed as normal in the dying process, then absolutely it's time to call our veterinarian and find out if this is okay or not, it's normal or not.

If it's not, then let's figure out what's going on. Obviously, it's most likely something to do with the chronic illness. "Is it pain? Is it... What is it?" It may be something neurological that is part of that animal or that being's process. But if something happens that isn't normal, but then yes, let's do something about it. Otherwise, let's just allow Mother Nature to do her work.

Karen Wylie: That is such a difficult moment, though.

Gail Pope: Isn't it?

Karen Wylie: Every time it happens with any and every pet, is that moment when they truly no longer want to eat anything, not even have a taste of it. You realize that fluids can make them feel worse. And yet if you let go and you don't do anything, they are going to die. It's that moment of reality that is so very difficult to reconcile when we associate food and drink with something we've always provided multiple times a day, and that makes sure that they're in good health. Yet this is a totally different process.

Gail Pope: Well, it's all about love, isn't it? And food and all the things that you're just describing that's how we show our love. However, now we're moving into a place where showing our love is just as important but we have to do it in a different way.

Karen Wylie: In a very different way for sure.

Gail Pope: We have to be there for them. Be a doula. Now we step into a different profession, and we have to learn how to simply be with our animals. Whether it be meditation, whether it be reiki, just being. Whether it just be sitting reading a book beside them. In nature, an animal that knows that their time is drawing near will go, "They'll be out in the wild", or if they're a house animal, very often people will find that their cats or dogs want to go outdoors. They're like, "No, it's getting near the end. He can't be out in the garden."

But he may want to be and Mother Nature will direct him to go to the earth and lie on the earth. The earth is cool and it helps the body lose its warm temperature and can be part of aiding the dying process. Is that something that we as humans tend to do or can do for our animals? You have to leave me out because when my animals have wanted to go and lie on the earth, perhaps on a nice day, I'm happy to be with them and let them lie there for a while but once I have to be indoors, things change. It's getting towards the end of the day. There's no way. I can't do it.

So I don't expect many other people could ever. To us, that verges on cruelty if I was to leave him there to die. It isn't actually cruelty, but no, I couldn't do that.

Karen Wylie: No, I couldn't either. Taking them outside to enjoy some sunlight or to be under a particular bush or shrub or tree that they enjoyed, happy to do all that. But Yes, I'm bringing them back in too just like you're describing. What we're talking about here are the normal signs of active dying that a pet would be showing us when they're in that process. We do have a guide to help you along. It's called "The Peaceful Guide to Quality of Dying", actually.

That's a free resource available on the BrightPathForPets.com website, and we'll put that in the show notes. Because sometimes that helps too to actually look at something that's telling you what is normal in this very difficult process that you don't want to be happening. So Gail, what do you want families to do at 2:00 in the morning instead of panicking and calling the emergency room? What would their presence actually look like if they can be calm for their pet in those kinds of situations?

Gail Pope: Oh and that's a double-edged sword for all of us because it comes down to the more you can accept as normal. If you can't accept it as normal, then the only other option is to contact your hospice provider. Someone like me and you, and say, "I'm struggling. I'm not quite sure if this is okay. I don't want to... I feel like maybe I'm cruel. Is this being kind? Should I consider euthanasia? Please help me."

And that's okay. We all need our hands held sometimes, and very often it is in the darkest hours of night. So if we have someone who can be there to just, again, be there for us, help us. Is it something that I do need to take some kind of action? Am I prepared with the right medicine in case? Restlessness and anxiety, we know, are normal at the end of life. However, there's a difference between restlessness, and we're opening up a much bigger one here. We've got restlessness, anxiety, then comes up the subject of seizures which is quite a long discussion, which I'm very happy to get into, but it's a little longer.

Karen Wylie: A little long for today. A little longer for today.

Gail Pope: Maybe but basically just an odd sentence….Seizures aren't normal at the end of life. However, neurological activity can appear at the end of life. So it's a very fine point. A lot of veterinarians will say, "Yes, we do see seizures at the end of life."

Now, I've been with probably 700 animals by now at the end of life. I've only encountered seizures at the end of life randomly, maybe in, at most half a dozen animals, at most. Very rarely. So that opens up a bigger topic for discussion as to why that would be. But I think, again, it's identifying what's normal and what's not. If you think it's not, then you need to seek some help from somebody who actually understands the process of dying and can address what's urgent that you need to go to urgent care for.

Karen Wylie: Because if your pet is pretty much asleep the whole time, they're well on their way to a peaceful, natural death at home.

Gail Pope: Absolutely. But again, if they're a little restless, absolutely, that's normal for humans. Anxiety, again, that's normal. I think one of the things that is the most difficult thing for us to do as humans and again this depends on what each of us believes as to what happens after death. But if you can look at the body as the house we're living in, it's our house, we're living in it. When we die, we step out of this house. Now, when we've stepped out of this house, where do we go? What does that look like? What comes next?

Great big question mark. Let's face it, we all believe something different and that's a very much longer conversation. But if we can actually look at the body as the house that they're living in and make the separation in our mind. So at this point our caregiving is, yes, it's still for the body, it's still for the bodily functions that are happening, we need to take care of that but let's concentrate more on the being who is actually making the decision as to when the going gets tough, I can step out of this body.

So if the going is too tough, I'm going to step out anyway. We see that in the human world, we see that with people who have told us they stepped out of their body but then they step back in. The going was tough. Frazier is a very well-known cat in the BrightHaven annals of history for stepping out of his body over a period of months, and then stepping back in again. But that really enforces for me that the being can shut the front door and say, "I'm done."

So for us, it's also a switch from living to dying, for living that way to now being part of the dying process and being with our animal, being with the body of our animal but also realizing that there is another part. So focusing on who they are at a deeper level can be so beautiful.

Karen Wylie: Yes, because the natural dying process is really allowing the pet's soul or spirit to leave the physical house.

Gail Pope: Exactly.

Karen Wylie: And that's a different way to begin looking at the physical decline.

Gail Pope: I think so and not only the physical decline but the very last moments of death, the very last moments can be so precious. Again, step into the world of human medicine and you will find many people who have been practitioners, surgeons even, who have been with people who have been going through the dying process. They'll stand up and say they saw the spirit leave the body. There have been people who have come back to life when they've been presumed dead, and they've come back to life, and they have a story to tell.

They knew what happened in a ward-3 three wards away down the corridor or downstairs. And they said, "Oh, yes, I saw so and so and it's irrefutable.” There's an awful lot of spooky occurrences that are actually normal at the end of life. And those can be really exciting to learn about. They can be a little scary to learn about. But when you put all that information together inside of you and you are present, actually present, really can be present with your loved one -  then it can help you to accept what's happening and to let go in a very different way.

Karen Wylie: Yes. Because on one hand, it opens up new questions. On the other hand, it can provide new answers for you, too.

Gail Pope: I love that.

Karen Wylie: I think we need to bring this conversation to a close.

Gail Pope: I think we may have lost a lot of listeners or watchers at this point!

Karen Wylie: End-of-life questions but that's what all of this is. It's all together. It's what getting close to death brings you closer to life and asking questions about it. So it's really an amazing time. Difficult also but can be very eye-opening. But from our conversation today on the physical aspects that we want you to carry with you from our conversation today, the first is that your pet's body knows exactly what it's doing.

It's not eating, not drinking, sleeping more, maybe seeming a little far away from you than typical. Those are not signs of any failure on your part, and they are not signs that your pet is suffering. They're signs that their body is doing the quiet, natural work it was born to do. So you don't have to fix it. You don't have to force food, force water, force them to be awake. What you can do is stay close and stay calm and let your pet's body lead the way, supported by a good pain management plan and a hospice team that you trust to guide you through this and provide support as needed.

As Gail always reminds us, "You do your best, you do it with love, and that is enough."

Gail Pope: Yes, there you go. Thank you.

Karen Wylie: Thank you. Thank you for being with us, and we'll see you next week. Bye-bye.

Gail Pope: Goodbye.