Page 384 - WSAVA2018
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 25-28 September, 2018 | Singapore
effects of the unpleasant feelings, the emphasis of maximizing QOL in the presence of disease is directed toward the alleviation of the discomforts associated with the disease. Restoration of health is the most effective means to regain the diminished QOL, but also effective is alleviation of unpleasant feelings when cure is not attainable. Numerous interventions may help achieve this objective, for example, medications and oxygen supplementation to aide oxygenation, analgesics, antiemetics, laxatives, anxiolytics, antihistamines, corticosteroids, chemotherapy agents, and gentle and soothing human contact such as stroking, petting, and talking to the animal, which research suggests can attenuate feelings of pain, anxiety, fear, and loneliness. Attention should be prioritized according to the distress potential of the specific unpleasant feelings.
It is also crucially important to include mental health and well-being in the spectrum of animal health disorders. Emotional illnesses, such as phobias and separation anxiety, elicit unpleasant feelings as distressing
as physical illness. Although the primary focus for
QOL in ill animals is the alleviation of unpleasant feelings, the vastly underappreciated potential for
QOL maximization—a key element to tipping the QOL scales toward the pleasant side—is the promotion of pleasant feelings. Providing the ill animal with more pleasurable experiences will enhance QOL (this is
what “pampering” is—an effort to flood the animal with pleasurable feelings). Sources of pleasurable feelings include social interaction and companionship (with humans and other animals), mentally stimulating and engaging activities (variety, challenges, play, chase- and-pounce games, fetch games, hunting for hidden objects and food treats, outings, interactive toys, leash walks outside, a continuous supply of novel objects to investigate and explore such as cardboard boxes, tree branches, objects), taste pleasures (palatable foods, snacks), human contact (petting, massage, laying in
lap), climbing, digging up things, lounging in sunlight,
and enjoyable sights, sounds, and smells. Because of
the individual nature of QOL, the type and quantity of pleasure-eliciting stimuli must be individualized for each animal. Accordingly, the person who is most familiar with the animal’s unique personality and nature is best suited to compile the list of pleasures to be used in the QOL maximization program.It is critically important to be sure that attempts to offer pleasant activities are suitable for the specific disease or disability. For example, when an animal (or human) is very ill and simply desires rest, trying to provide a lot of social interaction or mental stimulation might be unappreciated and possibly even harmful to the healing process. However, in some cases activities which elicit unpleasant feelings may be beneficial to QOL, as long as the net effect is to tip the QOL scales toward
the pleasant side. For example, if going on walks leads a dog to feel some discomfort of arthritis, but the walks
are highly pleasurable and desired, then continuing the walks would be expected to result in a net improvement to QOL.
The paramount objective in veterinary care is to maximize QOL. This goal is accomplished, in both ill and healthy animals, by the dual effort of minimizing unpleasant feelings and promoting pleasurable feelings. This keeps the QOL scales tipped as far toward the pleasant side as possible, giving the animal the greatest possible emotional pleasantness in life. By expanding medicine’s focus to include the promotion of pleasant feelings in addition to the traditional medical objective of treating disease, the veterinary clinician’s ability
to improve QOL in ill animals is greatly enhanced. Moreover, by including all aspects of life as contributors to an animal’s QOL – not just those directly related to
the medical disorder – the ability for us to enhance QOL increases. Lastly, by including mental health and well- being in our calculation of QOL we can expand enhance even further our ability to maximize the animal’s QOL.
Pet owners and veterinarians should work as a team
to improve each animal’s QOL, paying attention to the individual nature of every animal. As research continues to elucidate the emotions, feelings, and diseases of animals, our ability to assess and maximize QOL will steadily improve. As it does, the potential for animals with medical disorders to lead the most enjoyable lives will be greatly enhanced.
References available from author on request

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