Small animal veterinarians' opinions were investigated regarding the frequency and nature of ethical dilemmas encountered, beliefs regarding euthanasia and balancing client and animal interests, prevalence and value of ethics training and proposals to mitigate the stressful effects of ethical dilemmas. The majority (52 per cent) of 484 respondents in the USA indicated via an online survey experiencing an ethical dilemma regarding the interests of clients and those of their patients at least weekly. Scenarios involving client financial concerns were commonly reported causes of ethical conflicts. While only 20 per cent of respondents indicated that other practitioners prioritise patient interests, 50 per cent of respondents characterised their own behaviour as prioritising patients. Most respondents (52 per cent) reported that ethical dilemmas are the leading cause, or are one of many equal causes, of work-related stress. Less experienced practitioners, general practitioners and associate veterinarians were more likely to encounter situations they defined as ethical dilemmas, and female respondents were more likely to find ethical dilemmas stressful. Most small animal veterinarians experience ethical dilemmas regularly, which contribute to moral stress. Results suggested that most small animal practitioners believe that greater awareness of moral stress and providing training in ethical theories and tools for coping with ethical dilemmas can ameliorate moral stress.

OBJECTIVE To determine small animal veterinarians' opinions and actions regarding costs of care, obstacles to client education about veterinary care costs, and effects of economic limitations on patient care and outcome and professional career satisfaction and burnout. DESIGN Cross-sectional survey. SAMPLE 1,122 small animal practitioners in the United States and Canada. PROCEDURES An online survey was sent to 37,036 veterinarians. Respondents provided information regarding perceived effects of client awareness of costs and pet health insurance coverage on various aspects of practice, the influence of client economic limitations on professional satisfaction and burnout, and proposals for addressing those effects. RESULTS The majority (620/1,088 [57%]) of respondents indicated that client economic limitations affected their ability to provide the desired care for their patients on a daily basis. Approximately half (527/1,071 [49%]) of respondents reported a moderate-to-substantial level of burnout, and many cited client economic limitations as an important contributing factor to burnout. Only 31% and 23% of respondents routinely discussed veterinary costs and pet insurance, respectively, with clients before pets became ill, and lack of time was cited as a reason for forgoing those discussions. Most respondents felt improved client awareness of veterinary costs and pet health insurance would positively affect patient care and client and veterinarian satisfaction. CONCLUSIONS AND CLINICAL RELEVANCE Results suggested most small animal practitioners believe the veterinary profession needs to take action at educational and organizational levels to inform pet owners and educate and train veterinary students and veterinarians about the costs of veterinary care.

Simple SummaryObesity is a disease of rapidly increasing prevalence in dogs and cats, with significant and often lifelong implications for animal welfare. Veterinarians are expected and mandated to protect animal health and welfare, and provide informed consent. We provide an overview of the causes, risk factors, and consequences of pet obesity; evidence regarding veterinarian compliance in diagnosing and discussing obesity in small animal practice; and outline recommendations to prevent and address overweight and obesity in companion animals. We argue that small-animal veterinarians are not meeting their ethical and professional obligation to speak up about obesity, which is a One-Health problem.AbstractObesity is a modern-day epidemic in both people and companion animals. A summary of the current research on the causes, risk factors, consequences, and implications of overweight and obesity, and the compliance of small-animal practitioners in recognizing and addressing pet obesity, is provided. Ethical and animal welfare concerns are raised regarding these findings. We argue that a patient advocacy posture compels the veterinary profession to confront this issue more reliably. Evidence is presented to support obesity as a One-Health problem, and discrete and practical recommendations for preventing and addressing companion animal obesity are proposed. The One-Health perspective encourages coordinated action by veterinary healthcare professionals in order to address overweight and obesity in companion animals as a public health concern.