The only management we've had to do with her so far has been managed very well by her pain medication. As she's gotten older, I haven't seen activity decline because they've stayed up on her enough.

There are trigger points that Dr. Robin can find. She does a pain evaluation on every animal that walks in the door. Constant pain suppresses the immune system and causes other health problems.

As it progresses, we'll probably add other therapies for her management to keep her having a good quality of life for as long as I can. She jumps up and down off my couch, and her activity has not slowed down. She runs up and down the stairs like they're nothing.

A fraction of dying patients, even with excellent pain and symptom management, face a dying process that is so prolonged and marked by such extreme deterioration and suffering that for them having the choice for a peaceful and humane death on their own time, on their own terms, is the least worst alternative.

There s a lot that's being done to improve good palliative care. People are getting certified in pain management, there's more communication in communities and more awareness that most people don't have to die in pain.

The marks humans leave are too often scars.