2016 AAHA/IAAHPC End-of-Life Care Guidelines

Abstract

End-of-life (EOL) care and decisionmaking embody the critical final stage in a pet's life and are as important and meaningful as the sum of the clinical care provided for all prior life stages. EOL care should focus on maximizing patient comfort and minimizing suffering while providing a collaborative and supportive partnership with the caregiver client. Timely, empathetic, and nonjudgmental communication is the hallmark of effective client support. Veterinarians should not allow an EOL patient to succumb to a natural death without considering the option of euthanasia and ensuring that other measures to alleviate discomfort and distress are in place. Animal hospice care addresses the patient's unique emotional and social needs as well as the physical needs traditionally treated in clinical practice. An EOL treatment plan should consist of client education; evaluating the caregiver's needs and goals for the pet; and a collaborative, personalized, written treatment plan involving the clinical staff and client. Primary care practices should have a dedicated team to implement palliative and hospice care for EOL patients. How the healthcare team responds to a client's grief after the loss of a pet can be a key factor in the client's continued loyalty to the practice. Referral to professional grief-support counseling can be a helpful option in this regard.

Exploring veterinarians’ use of practices aimed at understanding and providing emotional support to clients during companion animal euthanasia in Ontario, Canada

“…Interestingly, three support practices (ie, offering comfort items, sympathy and empathy) were reported to almost always be used to support pet owners, while the other seven support practice were used irregularly. While the three most commonly used support practices are well recognised and encouraged methods of support in veterinary literature,4 5 17 participants’ partiality towards these select few support practices may suggest that there is an opportunity for veterinarians to more consistently employ a greater variety of support practices when supporting pet owners. For example, in addition to communicating empathetically, using sympathy and providing comfort items, veterinarians can ensure they always normalise a clients’ emotions and provide reassurance.…”

“…A client’s attachment to their companion animal, previous life experiences and existing support network are known to be important predictors of the severity of an individual’s grief 10 15. Furthermore, the importance of emotional support of clients during companion animal euthanasia has been widely described and encouraged among the existing literature 4 17–19. There is also a growing consensus among experts in the field of animal end-of-life care5 17 that emotional support could be further expanded by incorporating professional counsellors and resources into veterinary clinics to support clients and the veterinary staff dedicated to their care.…”

Continuous Education in Palliative Care: an Action Research Proposal / Educação Permanente em Cuidados Paliativos: uma Proposta de PesquisaAção

“…Palliative Care has been the focus of discussions by health professionals and managers in the area of human health, including animal health 1 . Realizing that aging with longer longevity and associated with chronic diseases and complex conditions is what characterizes the present and future of human beings 2 and animals in the world1 the discussions have demonstrated the urgent need to change paradigms related to this care.…”

Principles for ethical treatment decision‐making in veterinary oncology

“…In addition to the diagnostic and therapeutic options, veterinary palliative care and hospice options are emerging in certain countries with the aim of "addressing patient's unique emotional and social needs as well as physical needs (…)" upon terminal illness. [3][4][5] However, regarding treatment of animal compared with human patients, several aspects remain different, as owners must mostly bear the costs themselves and only a fraction of owners have pet health insurance. In addition, the option to euthanize animal patients can sometimes be considered as an alternative to treatment of disease.…”