IV-hydration in palliative care – to give or not to give

I shared this article yesterday, but I’m not sure if you have read it: https://envisionhospice.com/considering-iv-hydration-for-your-loved-one-heres-what-you-need-to-know/

I’ve noticed that each time I post an article on FB which is not written by me, we don’t get any likes at all!

I think the contents of this article is very helpful, so I’m going to copy some parts of it out. I’ll also put my own photo on this post because again, I notice that if I don’t put one of my own photos, again, we don’t get any likes at all! It’s not that I’m concerned about the likes, I just feel there’s so much helpful information in this article, so I hope animal caregivers will read the article in its entirety.

Here are some excerpts:

IV hydration is often brought up as a means to extend the longevity of a patient. It is common to see a patient live for more time through this method. The body requires water, even more so than food, to function, and being hydrated can slow down the decline. 

This method may also cause changes in the balance of electrolytes, which are important minerals that balance the water content in the body. Increased hydration could likely add to the overall balance of electrolytes, but could potentially worsen it, too. IV hydration may also be used to transition a patient from the hospital to their home. 

When family members seek hospice care for their loved one, they want to do something to prolong life. We understand. On the whole, IV hydration supports the overall quantity of life. Using this method could help to give you a sense of peace. 

There are other factors to consider, however when deciding whether or not to use IV hydration. To draft the best plan of care for your loved one, let’s take a look at the negatives of this method.

Choosing Care Without IV Hydration

Families who are seeking hospice care for their loved one usually want to prioritize:

  • Consistent and healthy nutrition — food and water supply that meets the needs of their specific family member.
  • A comfortable body and calm atmosphere to ease the effects of end-of-life ailments.
  • Sustaining life for extended time — holding onto the time left with a precious loved one.

Because of your love for them, we understand. With the limited medical resources many families have at home, it can be hard to tell if extra hydration helps or harms the well-being of the patient. What could be the benefits of not using IV hydration?

Once the end-of-life dehydration process and organ failure begins, certain toxins are produced. However, these toxins can cause beneficial side effects! These typically include feelings of tranquility, sleepiness, and pain relief, as endorphins are produced. These feelings can be interrupted through the use of IV hydration. The more hydration the body is given, the harder it must work to process it. 

While coping with organ dysfunction, many patients are faced with added distress through IV hydration. Why? There are many possibilities. We often see patients struggle through increased secretions (the buildup of extra fluid in the respiratory system, leading to difficulty breathing). We also see them challenged with loose bowels, skin irritations, painful movement, or nausea. Simply put, it’s common that patients live more comfortably without the use of IV hydration. As a result, we often provide our hospice care without the use of this method. 

Quality of life is also important to consider. We listen to the wonderful memories shared by family members, and we understand. The touches, the looks, and the words spoken during the end-of-life process are precious. When patients go without IV hydration, there is more likelihood of tactile interaction between them and their families. There is typically less overall pain, and less restrictive movement. It decreases family anxiety to see the patient comfortable and interactive.

Deciding whether or not to use IV hydration can seem like choosing between the quality and quantity of life for your loved one. It can be a difficult decision for your loved one. 

According to the article above, end-of-life dehydration releases toxins which may have beneficial effects like feelings of tranquility, sleepiness and pain relief because it contains endorphins. Endorphins are hormones that are released when your body feels pain or stress. They are produced in your brain and act as messengers in your body. Endorphins are produced to help relieve pain, reduce stress and improve mood. 

Nature is pretty amazing, isn’t it? Our body is wired to take care of us all the way until the end.

So, to give subcut fluids or not – I have never encountered this decision before previously because none of our cats had heart failure. I have always given subcut fluids to our CKD cats (Vincent, Pole, Bunny, Cleo) as well as Zurik who had FIP (before GS was readily available) and Rosie who had hepatic cholestasis. They did not have heart failure. And I found that the subcut fluids really helped them.

But now, Cow is a heart patient and there is a very real danger that the fluids will accumulate around his heart and lungs and impede his breathing. Yet, Cow is quite dehydrated now and refuses to drink water.

He has asked to sit with me now. So we are together, listening to soothing chanting.

More photos coming up…







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