2023 AAFP/IAAHPC feline hospice and palliative care guidelines

Abstract

The ‘2023 AAFP/IAAHPC Feline Hospice and Palliative Care Guidelines’ are authored by a Task Force of experts in feline hospice and palliative care convened by the American Association of Feline Practitioners and the International Association for Animal Hospice and Palliative Care. They emphasize the specialized communication skills and ethical considerations that are associated with feline hospice and palliative care, with references to other feline practice guidelines for a more complete discussion of specific diseases, feline pain management best practices and cat friendly interactions. A comprehensive, multi-step hospice consultation allows for tailoring the approach to both the cat and the family involved in the care. The consultation includes establishing ‘budgets of care’, a concept that greatly influences what can be done for the individual cat. The Guidelines acknowledge that each cat and caregiver will be different in this regard; and establishing what is reasonable, practical and ethical for the individual cat and caregiver is important. A further concept of the ‘care unit’ is introduced, which is extrapolated from human hospice and palliative care, and encourages and empowers the caregiver to become a part of the cat’s care every step of the way. Ethical considerations include a decision-making framework. The importance of comfort care is emphasized, and the latest information available about how to assess the quality of a cat’s life is reviewed. Emotional health is as equally important as physical health. Hence, it is fundamental to recognize that compromised physical health, with pain and/or illness, impairs emotional health. A limited discussion on euthanasia is included, referring to the AAFP’s End of Life Educational Toolkit for recommendations to help the caregiver and the veterinary professional ensure a peaceful passing and transition - one that reflects the best interests of the individual cat and caregiver.

2024 ISFM and AAFP consensus guidelines on the long-term use of NSAIDs in cats

“…To decrease protective emotions and lessen their impact on the chronic pain state, environmental modifications can be made in the home that focus on providing for cats' behavioural and emotional needs. As discussed in the '2022 ISFM/AAFP Cat Friendly Veterinary Environment Guide lines' 130 and the '2023 AAFP/IAAHPC Feline Hospice and Palliative Care Guidelines', 131 pillars of an ideal environment for cats include a safe place, multiple and separated resources, opportunities for play and predatory behaviour, positive, consistent and predictable social interactions with humans and other animals, and respect for the importance of a cat's sense of smell and other senses. These all reflect aspects of the natural history that has shaped the domestic cat's environmental needs.…”

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“…The 2023 AAFP/IAAHPC Feline Hospice and Palliative Care Guidelines propose that case management in such situations be guided by respect for autonomy, non-maleficence, beneficence and equity in therapeutic recommendations. 112 This bioethical framework guides clinical decision-making by applying context and thereby consideration for each specific case as its own entity. 112…”

“…112 This bioethical framework guides clinical decision-making by applying context and thereby consideration for each specific case as its own entity. 112…”