Peace of Mind for Pet Parents Episode 079: The Signs Nobody Told You About: A Gentle Walkthrough of Active Dying

RESOURCES MENTIONED & RELATED LISTENING

• Menu for Healing PDF(opens in new tab) - Free download
• PEACEFUL PDF(opens in new tab) - Free Download
• LIVING Quality of Life Care Assessment Tool(opens in new tab) — Free download
• BrightHaven Animals YouTube Channel(opens in new tab) — 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 077: 3 Caregiver Myths — Your Heart Knows What It’s Doing Too(opens in new tab)
• Episode 076: Is Dying Painful? Your Pet’s Body Knows What It’s Doing(opens in new tab)
• Episode 073: Reading What They Can’t Say: Pain, Comfort, and the End-of-Life Journal(opens in new tab)
• Episode 023: Living to the Last Breath: A Pet Parent’s Perspective on Dying Naturally(opens in new tab)
• Episode 069: Preparing for Your Pet's Death — Physical, Emotional, and Spiritual Ways to Make Every Moment Count
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• Episode 058: Can My Pet Die Peacefully at Home? What Natural Death Really Looks Like(opens in new tab)

Related reading:

• The Other Doctor in the Room: Trusting Nature at the End of Life(opens in new tab)
• Walking the BrightPath: A Pet Parent’s Guide to Home Hospice and Natural Transition(opens in new tab)
• 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

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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 we're going to talk about something that a lot of pet parents are actually afraid to talk about, and it's what actually happens in the body of our pets as death approaches. So we want to walk you through this in a gentle way with what we've observed so that if you ever find yourself in this moment, you'll know what you're seeing and hopefully won't feel so afraid because it can be certainly different from what you're used to seeing.

If you haven't seen it before or heard about it before, that can make it more scary. So Gail, when a pet parent calls you and says, "I don't know what's happening. I don't know if this is normal," what's really going on for them when pet parents at home are beginning to notice a pet entering the active dying phase?

Gail Pope: You do realize what big question that is, do you?

Karen Wylie: It's why we have a podcast. 🙂

Gail Pope: It's so multifaceted because the dying process certainly has similarities, especially to the human way. Dying is dying, it doesn't matter. But each being's story is different. Some of us come to the end of life with no sign of illness other than aging and decline of the body, and this is the kind of death you might experience. Others come with various illnesses that are being cared for, controlled by various medicines of different types. And so, it's hard.

Again, age, age-related death is different, whether young, middle-aged, old aged. So it's such a difficult subject because although the base elements are very much the same, there are all these little pieces that make it very hard. If someone says, "Okay, my cat's 16 years old. He's been gradually declining chronic kidney disease for a year." And they'll either give you a symptom and say, "Is this normal?" Or it may be, "What should I expect?"

It's really hard to know. You can give a general idea and really, I think at the beginning it's about appetite, it's about thirst— appetite and thirst. But when somebody comes to me and says, "I'm really feeling concerned. His appetite's gone down. He's lost a little bit of weight. I'm really getting nervous," then my first question is, "I need you to go back to tell me what's been going on until now."

Because is this something that's heralding something acute or is this a natural process of Mother Nature to start the body winding down? And I think very often it's an overall lack of energy, lack of interest in things that were normal before. But it's important to know what came first, don't you agree?

Karen Wylie: I do, I do agree. And I agree that there are different types of deaths when one is dying of essentially old age and one of the organs might be taking the lead in being the main problem. But the whole system is declining at a similar time. 

I also found deaths with younger pets where one organ was declining while all the other organs were four-year-old organs or five-year-old organs. Those are very different deaths to accompany along the way. So asking about what it's been like in the past is really the only way to go. And so often it's when they aren't eating, when they really haven't eaten for a day or two days that I think the panic begins to set in. Because we all have always been feeding our cats, our dogs, all of our animals. We're very attentive to feeding and making sure they have the hydration they need, and we watch their activity level.

When they're aging and declining gradually, we adapt to that. They're sleeping a little bit more, they're a little less active, and maybe they're not as enthusiastic about their food but they're still eating. When it gets to that point where they're not eating, I think that's when panic sets in. I would think that's when they're looking for you online.

Gail Pope: Sometimes, yes, sometimes earlier than that but that really is our, I don't know what the word I'm searching for is, but it's like that flag goes up because food is life to us, isn't it? If you're not well and you lose your appetite, you worry. So as you get towards the end of life and you lose your appetite, "Oh my God, is he dying?"

So yes it really is a difficult thing. However, as the body is winding down, here's where I have to talk about the very boring subject that I always love to talk about, and that is Doctor Mother Nature. 

Because we tend to think we're in control. It's like driving a car, if you will. We can make it turn left, we can make it turn right, we can slow it down. But when Mother Nature is in control, there's very little we can do at the end of life other than to be with the process and support it in the best way we can. We can't dictate it. Mother Nature has that system in place, and it's a very natural winding down of all the organs which are, of course, all interrelated.

All the millions of cells in the body are receiving oxygen pumped in the blood by the heart, and it goes round and around. In a very advanced age type of death, it's generally a slower, easier way towards the end because it will follow a gentle trajectory of everything winding down in syncronicity. The being ends up with very little energy, lying in bed, sleeping a little more, sleeping a little more, and it's a beautiful process. Unless one organ is the culprit, if you like, who says, "Excuse me, I think I've had enough. I think I'm just winding down."

It's like I'm taking the key out of the lock and the others are all like, "Oh my goodness we have to all get together to support this." And again, Mother Nature will make that happen. Again, it will be a process but it will be different— depending which organ and what the situation is. So it's hard. This is why we designed the checklist that we did to just look at the overall different aspects of dying, whether it's the good, the bad, the difficult. What is most normal.

And of course, it starts with food, with water, with hydration, and restlessness, a little bit of anxiety. Of course, the restlessness and anxiety can also be exacerbated by the caregivers. 

Whether on two legs or four legs, if you're hovering around your grandmother who's in her dying process and you're restless, agitated, worried— it's going to rub off on her, and she's going to become more so... Those things are, again, they are normal. They are normal in the dying process.

Karen Wylie: They're all normal except not normal to each of us if we haven't seen it before. Especially as we were saying with the food and the water, that's something we've been responsible for as the pet parent to provide. So suddenly, none of the different foods we might be trying are being consumed.

Gail Pope: They'll wolf food down for one meal and you're so happy and it's wonderful again.

Karen Wylie: It's all set. Everything's recovered. Everything's fine.

Gail Pope: And of course then the one thing that I do see as well, and it again is perfectly natural for us to do that, if you think about it on the inside of the body, there are the little guys who are working in the digestive system. They've been very gradually getting more tired and older and dealing with less and less.

All of a sudden, oh, my goodness, they look up and down the chute is coming a huge amount of food. "No. No, we can't take anymore." And so what do they do? "Help me. Come on, let's send it back. Send it back." So they send it back and the human or the animal vomits. That's a bigger concern for the caregiver but then the caregiver has to remember, "Ah, did I make him eat that? He really didn't want it, and I guess his body rejected it."

And then sometimes we will treat for nausea or you know, when those kinds of symptoms come, and that can complicate it even more. The lesson is, he doesn't want to eat, don't feed him. Just be with him.

Karen Wylie: That's where the phrasing of "Offer food, but never force it."

Gail Pope: Love it. Yes.

Karen Wylie: And it's hard to do that though because you say in your mind, "If they don't eat, they're going to die", but they're in the process of dying already. So it's a tough pill to swallow.

Gail Pope: It's just determining the time to be able to let go. And letting go of control, not letting go of love. Changing your focus: let's be together in that special love part rather than the control part. Again, we come to the topics of urination and defecation. As the body becomes weaker, it affects all areas. People are incontinent in bed at the end of life, they're wearing diapers.

Same thing for animals. We have to care for them and realize that he's not really doing it on purpose. As the body weakens, he doesn't have the strength to hold it, and it's normal. It's part of us accompanying the journey. Doing what we can as the caregiver to make things as comfortable as possible.

Karen Wylie: And to keep observing what's going on. Now I want to ask you about pain, and we have talked about this in other podcast episodes as our primary topic. But I do want to just ask you for a quick, less than a minute or so, overview.

I'm not asking for the whole thing but just for those people who are perhaps just finding this as their first episode with us, what would you want to point out about dying and pain?

Gail Pope: We know that pain is not a normal part of the dying process. However, we also know that pain is very often present in a chronic illness. And if your human or your animal has had a chronic illness that is painful and they're being treated for that pain, to me the most important part of this equation is knowing that pain is not normal in the dying process. However, if you enter the dying process with pain from a chronic illness, you have to keep treating it. Because if you don't, then it doesn't make sense.

I think people assume that dying is painful, it is just an assumption - that what the body goes through, must be painful - but it isn't. It's part of Mother Nature's process. So the pain is from the third party, as it were, and that does need to be treated in whichever way it's been treated in the past.

Karen Wylie: I think that's a very terrific summary.

Gail Pope: It's about as short as I can go.

Karen Wylie: It's appreciated. We have talked about this last month more about pain and the fact that endorphins and different types of endorphins affect the nerve endings of different parts of the body. So it's a whole lot of discussion about pain specifically. But Gail, how do you explain to a frightened pet parent at the end of life that what they're watching isn't the same as suffering?

Gail Pope: Again, it's a big one. Well suffering is something that's emotional. It takes me back to, gosh, childhood probably. The old expression, "You have to suffer to be beautiful." Suffering is something that is part of everyday life, and we suffer in so many different ways, in so many different situations. It is emotional, it's a reaction to something.

So if someone you love is going through a difficult process, an illness or anything, then it can easily be said that we're suffering watching them. And it can easily be said that in a chronic illness, you think somebody who's got a very severe chronic illness, maybe confined to a wheelchair….are they suffering? The answer could be yes, and it could be no. 

Some people like, I don't know, Christopher Reeve, would certainly be not. His body appeared to be suffering but “he” didn't appear to be suffering. There have been many stories of people who endure very difficult chronic illnesses, but ask them if they're suffering and they'd be like, "Oh, I'm fine. This is the body I live in, and it can do its thing. I'm okay. I'm separate from that."

So it's a really difficult thing, and I think very often towards the end of life the caregiver is actually suffering emotionally more than the animal. I think from my experience anyway, animals accept the process of dying. It's just inherent in them if you like. 

They don't spend their lives looking at what's going to happen tomorrow or what's going to happen next week. They don't generally look beyond, "Is it dinner time?" They're living in the moment. And consequently in and during the dying process, they're not thinking about, "Oh, my God, when's it going to happen? How's it going to feel? Is it going to be awful? Is it going to be wonderful? What will I see?"

And they're not having all those kinds of thoughts. We as the caregiver, oh, my goodness, a million thoughts are flying through our minds. Is it? Could it be? Will it be? When? Should I? Shouldn't I? It goes on and on, and it's terribly hard for us. So I think, yes, suffering is different in every situation for every being. I'll let you talk a bit more about that.

Karen Wylie: Generally I think our animals are more resilient most of the time than we are. We do worry about tomorrow. We worry about the past, we worry about tomorrow, we worry about all the things we could of done, should of done, et cetera. Our animals are just dealing with what is. They adapt so much better than most of us do when there's a change imposed upon our lives.

I remember a long time ago, the first time a friend of ours had a dog and the hind leg was broken in so many places the recommendation was to amputate the leg. Their vet said, "I know it's very upsetting but I guarantee you, your dog will not have pain after we take the leg off and he will adapt in ways that will surprise you." I remember being surprised as a visitor, as a friend who would stop by and see this animal completely accepting a major change to his body, and just moving forward.

And I've seen that with our animals as they decline over time. They seem to accept that they don't have the energy to walk as far as they used to. Or as I often say about the cats, when they're very young, they're at the top of the cat tree and they're jumping all around. When they're at end of life and declining, it doesn't mean they're never going to be at the top or that they're not going to try to be in the middle but they're still going to want to be on that tree. They’re going to adapt to their energy level and their physical strength. 

It's really amazing what we can learn about resilience and adapting to life from our animals.

Gail Pope: I think you've just summed it up in as much as the journey is ours as much as it is their journey but it's a learning process for us. Now, at the moment, you'll remember that I adopted a little girl, a little beautiful black and white girl, literally just a couple of months ago. Her name is Maisie. Her blood work was not good. She has fairly strong kidney disease, and she settled in beautifully. She's full of love. She's sleeping in bed with me.

However, the signs of her very gradual decline are very clearly there. And I was, “Okay. I got this. This is what I do”. 

However, she stopped eating two days ago. I'm sitting listening to us talking in this conversation, and here's me. Because for the last two days, I was not going to say panicking, but yes, I've been panicking, "What else can I feed her? Maybe I could. Maybe it's this, maybe it's that."

But I know that her time's growing close, and yet Maisie, at the moment, she's curled up as happy as a clam on my bed. She had a little canned food this morning mixed with some warm water which she loves. With chicken liver powder sprinkled on it which she totally loves. She licked a little bit, and then she looked at me like, "That was lovely." Did I want her to eat more? Of course I did, and it took me back to when my mother did the same thing to me.

Day by day she would eat a little bit less, and then every now and again she'd eat a bit more, and that would make my day. And here I am, and it's the same journey. Mother Nature is in charge and I have to be respectful. And it's hard.

Karen Wylie: It's very hard.

Gail Pope: It's very hard. But it's part of being human, it's part of Earth School, isn't it? The lessons we learn.

Karen Wylie: One of the many lessons we learn. Some of these lessons I could do without, but we learn anyway.

Gail Pope: It's fascinating. When you look at birth and the process of birth, and you think what that entails and we accept that. We don't treat birth with the negativity that we treat death. The transition we call death, done naturally at the right time in the right place, it's a hell of a lot easier than coming into this world. To me, anyway.

Karen Wylie: Very true.

Gail Pope: I had two children, and trust me, I did not find it an easy process.

Karen Wylie: Of course, I'm right there with you when you're talking about Maisie because you start getting all the different brands of food and raw food and fresh food and canned food. It's like you offer so many different things until you find something that they will nibble on.

Gail Pope: Oh, yes, but then tomorrow they won't.

Karen Wylie: I know, but for the moment when you see them eating one of the 17 things you've put in front of them, it's like, "Okay, we're okay today."

Gail Pope: Yes.

Karen Wylie: That's what it's like. It's okay today, so we just keep observing. Now, I think it's important that everyone understands that this kind of process doesn't usually move in a straight line, like we're talking about with the food. Maybe they'll eat today, maybe they won't. What they'll eat is a question mark. But I think you've had so many different animals that have taught that lesson better than most people can, and Frazier is the one who comes to mind.

Gail Pope: Oh, my God, yes. Frazier as he lived to be 34, 35 years old. He had cancer that he beat which decimated his face. He shone brightly with love through several different dying processes that other people were there to observe as well. He continued to live in his moment, and he was just full of love and joy. Then when he did finally pass out of his body, he just lay down and he smiled. He, very gently over a period of, hard to remember exactly these days, but I would say over a period of two to three hours. He just lay there very gently, his breathing changing, until he just left.

That was so beautiful. So beautiful. But yes they come to teach us lessons, and I think a lot of them come to teach us about the dying process. And maybe some of them come to experience it. So it's our lesson as well as their lesson.

Karen Wylie: That's the truth. Always so much to learn

Gail Pope: And maybe some come to experience euthanasia because sometimes that is the right decision. Again, maybe sometimes it can be the right decision for a human. In that world, we generally sedate our humans if pain can't be controlled, whatever's going on, and they simply can't “be”. We don't necessarily euthanize them but we do heavily sedate them. With our animals, the same thing, the same process can evolve. However, for the most part, animals know how to die

Karen Wylie: Yes, they just go with it.

Gail Pope: They go with the flow.

Karen Wylie: Yes. Not sure how to state this but their body is declining in one way, but their sense of self isn't always timing it with how their body is declining. Sometimes they just want to hang on for a while. They're not quite ready to go. Even if their body may be ready to go. On one hand, that's always so beautiful that they want to stay with us. But it can also be frustrating for them and for us when we see that happening.

Gail Pope: Sometimes we know, I was going to say I think, but I don't think. We know that sometimes animals and humans stay for a particular purpose. They force themselves to stay in that body because somebody's coming to visit or they're waiting for somebody to leave. It can go either way.

It really does come back to being human. The more we know, the more we can understand. I was just thinking too, about the little things that are so normal until you understand them. Like for instance, the jerking, shaking, twitching that you can see the body doing towards the end of life. They can be very scary. "Oh, my goodness, what's happening?"

But then when you know that, as the body's winding down, it's perfectly normal and natural that with the neurological changes going on, you will get the odd twitching here and there. It's okay. Those things are okay. So really it comes down to learning what you can and going with the flow. The important things with animals particularly is having the right telephone numbers, having someone to talk to, someone who can help you through the process. If necessary, someone you can call to help you with euthanasia, if that becomes something you decide and is necessary.

I think once you have those things ready, you have the "Peaceful Checklist" which will tell you what is normal and what is not. You have a counselor, someone like one of us, who you can telephone or email and say, " I'm getting a little nervous. Is this okay?" Someone who can hold your hand and give you the best advice.

Then just remembering that every situation is different. That you're not being cruel. I think a lot of people tend to feel that there's cruelty involved but there is no cruelty. It's all about love and making the right choices at the right time.

Karen Wylie: Yes and being prepared, as you've just described in every way, in terms of having the right phone numbers for a clinic if needed or for people who can support them, like you or me, or other people who provide support. And having a copy of the "Peaceful: Quality of Dying Guide" with all the different signs of a peaceful passing because it'll help you understand what is normal for decline and dying and what is not. Then you can use those phone numbers and reach out and get some clarification.

We'll make sure to have the link to the "Peaceful PDF". It's available on the BrightPathForPets.com website as a free download for anyone who wants or needs it. It's always a good thing to have on hand. Other than that, Gail, what would you want a pet parent to take away if their pet might be entering this phase? Preparation? Is that the key thing for them to focus on?

Gail Pope: Preparation, education, going with the flow, living in the moment. It's all about love. And for me, reading books that have been written by human hospice doctors and nurses. They really tell some wonderful stories, and I find them so supportive. They really can help us. The more you learn, the easier it can be because then you trust in yourself, too.

Karen Wylie: Yes, the more knowledge you can gain, the more confidence you're going to have in understanding what you're seeing and understanding what action to take or not to take. Just to be and support them as always. All right. Once again, we thank you for being with us today at Peace of Mind for Pet Parents, and hope you'll join us next week as well.

Bye-bye now.

Gail Pope: Goodbye. Thank you.