by Barry B. Burtis
Quality of Life
Life is a miracle. I think most people would agree. When you think about life - its beginnings, its inner workings, its gifts, its extravagance, its exuberance, its abundance, its tenacity - you just can't help but marvel. No matter at what level you examine or assess life, it is most impressive.
Most people, though, when thinking of the life of an individual, feel it can be measured or graded in its quality. It may be a bit presumptuous to think that we can do this with something like life. Nevertheless, we do make judgments about quality of life (QOL), frequently. In fact, there seems to be a strong intuitive sense as to what QOL means as well as the notion that it carries immense importance in medical care.
Quality of life is involved in every aspect of animal care. Maximizing the QOL for our pets is surely the most important goal of veterinary care. Furthermore, in veterinary medicine, QOL is used very often as a guide for life and death (euthanasia) decisions. Therefore, I think, it is very important to try and have some understanding of the things that contribute to QOL in pets.
There are differences in how pet owners evaluate QOL for their pets. I fondly remember, Lady, a charming, gentle and friendly Bassett hound who was a patient at our hospital for many years. At a young age, Lady was stricken with glaucoma. The disease affected both eyes and our best efforts at treating the problem medically were unsuccessful. Unfortunately, with glaucoma, this sometimes happens. To prevent the pain and suffering caused by this disease, Lady had both eyes removed. Now, I suppose some pet owners would feel such a pet, with no vision, would have a very low quality of life. Yet, I still remember, so well, Lady willingly trotting in, for so many years after her operation, to have her manicure and ear cleaning done. She functioned very well, doubtlessly aided by her breed's renowned sense of smell. To the very end of her natural life Lady always displayed a wonderfully positive, happy attitude and outlook. I would argue, as did her owners, that Lady enjoyed a very high quality of life.
There are, in my opinion, several factors that contribute to QOL. They have their influence through their associated feelings. Knowledge of these factors is important for measuring and maximizing QOL for pets.
Social Relationships: In social animals, a set of pleasant and unpleasant emotions serve to help develop and strengthen social relationships. There is evidence to strongly suggest that positive social affiliations and companionship give rise to pleasant feelings. Separation and isolation cause unpleasant feelings ( e.g. loneliness). These feelings have strong influences - positive and negative - on QOL.
Mental Stimulation: Animals that must live in monotonous, unchanging environments without activities and stimuli to engage them mentally show signs of boredom. On the other hand, if they are challenged, stimulated and encouraged to activity, they display signs of happiness.
Health: No one, I think, would argue that illness and health do not play a major role in the QOL of pets. Illness and injury cause many feelings that are unpleasant -nausea, pain, weakness, difficult breathing and others. Physical disabilities may impact on pleasurable experiences for a pet. A dog will surely miss being able to play ball, go for walks or enjoy other outside activities with its owner.
Food Intake: The taste of food is pleasant and feeling hungry is unpleasant. These sensations stimulate actions necessary to support and life and may impact on QOL.
Stress: If stress causes emotions such as fear, anxiety, pain, boredom or anger, it may contribute to QOL. To maximize QOL we may not be able to eliminate all stress from an animal's life but we aim to alleviate those unpleasant emotions that may result from it.
Remembering these major contributing factors to quality of life, in future columns, we will examine how we can influence them and improve life for pets with certain chronic disease conditions.