CASO CLÍNICO 690 Revista Científca da Ordem dos Médicos www.actamedicaportuguesa.com RESUMO Existem casos em que os objetivos tradicionais dos cuidados médicos não apresentam soluções realistas para curar os doentes que enfrentam doenças devastadoras; devendo outros métodos ser aplicados. Os autores apresentam o caso clínico de uma mulher de 76 anos admitida numa unidade de Cuidados Paliativos devido a um adenocarcinoma do cólon estadio IV, e descrevem o papel que um Yorkshire terrier, de seis anos, teve no controlo sintomático desta doente. A terapia assistida por animais pode ser de grande utilidade quando usada com um objetivo terapêutico em cuidados paliativos, ajudando a reduzir a dor e o sofrimento dos doentes, aumentando a qualidade de vida. A terapêutica assistida por animais pode ser de grande utilidade nos cuidados paliativos, contribuindo para a gestão da dor dos doentes, alívio do sofrimento e melhoria da qualidade de vida. Palavras-chave: Cuidados Paliativos; Saúde Holística; Terapia Assistida com Animais; Terapias Complementares Animal-Assisted Therapy in Palliative Care Terapia Assistida com Animais nos Cuidados Paliativos 1. Unidade de Cuidados de Saúde Personalizados Sete Rios. Agrupamento de Centros de Saúde de Lisboa Norte. Lisboa. Portugal. 2. Unidade de Cuidados Paliativos Bento Menni. Casa de Saúde da Idanha. Sintra. Portugal. 3. Centro de Medicina Paliativa. Faculdade de Medicina. Universidade de Lisboa. Lisboa. Portugal.  Autor correspondente: Paulo Reis-Pina. paulopina@medicina.ulisboa.pt Recebido: 19 de novembro de 2019 - Aceite: 01 abril de 2020 - First published: 15 de setembro de 2020 - Online issue published: 01 de outubro de 2021 Copyright © Ordem dos Médicos 2021 Vanessa QUINTAL 1 , Paulo REIS-PINA 2,3 Acta Med Port 2021 Oct;34(10):690-692 ▪ https://doi.org/10.20344/amp.13164 ABSTRACT There are still many cases where traditional medical care does not provide a realistic solution for patients with devastating diseases so other interventions should be adopted. We present a case report of a 76 year-old woman admitted to a Palliative Care unit due to stage IV colon adenocarcinoma, and we describe the contribution of a six-year-old Yorkshire terrier in her symptom management. Animal-assisted therapy can be of great use in palliative care, contributing to the patients’ pain management, relief from suffering and improvement of quality of life. Keywords: Animal-Assisted Therapy; Complementary Therapies; Holistic Health; Palliative Care INTRODUCTION The American Medical Association described palliative care as a “therapy focused on decreasing pain and suffer- ing by providing symptom-relieving treatments, along with comfort and support for patients of all ages”. 1 In a time when medical treatment strategies are in profound and continu- ous development, there are still many cases where tradi- tional medical care does not provide a realistic solution for patients with devastating health problems. For those cases alternative methods must be adopted. 2 There has been a greater interest in the impact that the animal company can have on patients and their physical, emotional and spiritual well-being. 3,4 Animal-assisted thera- py (AAT) is a group of interventions involving the incorpora- tion of trained animals in a healthcare setting to achieve a specifc therapeutic outcome. 1 Trained animals can be of great beneft in palliative care when used for therapeutic purposes in pain control, suffering management and better quality of life. 1 These benefts have been observed particu- larly among the elderly. 5 Although some studies have con- sidered the physical and psychological benefts of AAT, the overall results are inconclusive. 3,6 In conventional medicine, the use of animals is rare because the health system barely addresses the real needs of the patients and is often not centered on the healing process of a vulnerable human be- ing. The authors describe a clinical case which originality lies in the use of an animal at the service of the human person, with full respect for the patient’s self-determination. This re- port reinforces the importance of the non-pharmacological approach in the holistic treatment of patients in palliative care. CLINICAL CASE 76-year-old woman, former maid, recently active as a volunteer at the Parish Council and attending a senior uni- versity. She had been a widow since 2012, and her fam- ily support system included her daughter, son-in-law and granddaughter. She was diagnosed with stage IV colorectal cancer in 2012 with bone and liver metastasis. Due to can- cer, she suffered pulmonary thromboembolism in 2016 and portal system thrombosis in 2017. As the disease progressed, she had to be admitted in a Palliative Care unit for symptomatic control. On admission, her palliative performance scale was 50%. 7 It was found that the patient’s main companion since her husband’s death and diagnosis, was a six year-old Yorkshire terrier named Cookie, a gift from her daughter, with whom the dog was currently staying. According to the unit’s philosophy, the patient was informed that she could be visited by her pet, which made her visibly pleased. Considering the distance between the unit and the daughter’s residence, the family and the pet could only visit the patient during the weekends.