Welcome to the all-new Vetlearn

  • What’s new on Vetlearn?
  • The latest issues of Compendium and
    Veterinary Technician
  • New CE articles for veterinarians and technicians
  • Expert advice on practice management
  • Care guides on more than 400 subjects
    to give to your clients
  • And more!

To access Vetlearn, you must first sign in or register.

registernow

Become a Member

Practice Management

5 Myths About Veterinary Hospice

by Dani McVety, DVM
    Girl and old dog

    Dr. McVety is a founder of Lap of Love Veterinary Hospice and In Home Euthanasia.

    Veterinary hospice is a new and developing aspect of practice that clients are beginning not just to ask for, but to expect. As pets make their way from the back yard to orthopedic beds, owners are no longer satisfied with being sent home on that second-to-last veterinary visit and being told, “call me when you’re ready.” They want a guideline for how to handle the last few days, weeks, or months with their pet. They need adequate pain management with backup options, education on what to expect, and options for end-of-life care. Don’t drop the ball on this all-too-important geriatric life stage! This is when you should be strengthening your bond with your client, ensuring compliance, satisfaction, and customer retention.

    Let me try to debunk some of the common myths I hear across the country about veterinary hospice. I have heard each of these statements uttered by technicians, veterinarians, and even a former professor.

    1. Hospice means prolonging suffering. Absolutely not. Lap of Love defines veterinary hospice as, “A family-centered service dedicated to maintaining comfort and quality of life for the terminally ill pet until a natural death is achieved or the family elects euthanasia.” It is not about prolonging a painful condition, but about keeping the pet as comfortable as possible until the quality of life is no longer adequate. As veterinarians, it is our job to assist the family in making this decision, not to make the decision ourselves.

    2. Hospice means natural death and is anti-euthanasia. This is a common misconception, exacerbated by many nonveterinary groups across the country that call themselves “pet hospice.” Nonveterinary hospice is a very dangerous trend that is talked about quite often in the animal hospice community. The single most important reason why we professionals must embrace the term veterinary hospice is the need to educate clients about how this option is different than the human equivalent. Veterinarians have the unique and significant privilege of relieving pain and suffering, and that gift must be given at the appropriate time. Hospice is about giving families the tools to feel educated, prepared, and equipped to handle that difficult time when it arises.

    3. It’s too complicated to set up a hospice program. Actually, it’s as simple as providing clients with a “hospice handout” folder containing information about end-of-life care options. Here are some items Lap of Love recommends putting in this folder (see our Web site for examples or e-mail us for more details):  

    • Detailed information on the pet’s disease, including end-stage signs. Families need to know what to expect so that they can avoid painful conditions like severe dyspnea or pathologic fractures.
    • Quality-of-life scale. Many are available and easy to replicate (click here for ours).
    • Daily diary. Families should be tracking daily parameters such as appetite, hydration, and elimination. Families may also track more specific signs that might indicate a developing problem, such as syncope, heavy panting, or bloody diarrhea.
    • Information on adjunctive services (preferably mobile). Acupuncture, massage, mobile grooming, in-home pet sitters, or other services available in your area may be able to help the pet. Simply knowing these services are available can ease families’ minds and reduce anxiety about the impending decline of their pet.
    • Information on when and how to schedule euthanasia at your clinic. If you have specific protocols (e.g., you must have seen the pet within the last 6 months), explain them. Also, explain the euthanasia process briefly so families are prepared.
    • Information on in-home euthanasia services in your area (if available). Mentioning this service can greatly reduce the anxiety a family is feeling about making the decision, particularly with a large dog or a fearful cat. Families often delay the euthanasia appointment simply because the trip to the clinic is so stressful for their pet. In-home euthanasia also avoids a negative association with your clinic and may increase client retention when the family returns with another pet.
    • Information on aftercare. List the services your clinic provides along with prices and, if appropriate, local crematories that will pick up the pet at the home should it pass naturally. Many families do not know this is an option and panic if faced with this reality unprepared.
    • Information on local pet-related groups such as pet-loss groups. Although most families may not need this extra support, it’s important for pet owners who are grieving (or anticipatorily grieving) to know they are not alone. Owners experiencing a difficult loss feel isolated with their sadness. They do not think others understand their pain and should at least have options for local support. Your local human hospice group may occasionally organize pet-loss groups.

    4. It takes too long to talk about hospice. It’s as simple as saying the word “hospice”! Families have a very calm reaction to this powerful word, and it usually evokes emotions of calmness and compassion while being completely clear about the reality of the situation. Although in-home consultations generally last about 45 minutes, in-hospital discussions should take less than half this time. I find it necessary to frequently repeat the word “hospice” to remind owners that we are not curing anything, but rather keeping their pet as comfortable as possible until quality of life has become a concern. The conversation should be supported by your hospice handouts and by kindly reminding clients that you are there if they need anything. An empathetic and calm technician can do the rest, explaining what to look for, how to use the pain medication you will be giving, what to do in a crisis, and so on.

    5. Clients need to bring their pet in to get more pain medication. I am a firm believer in planning. Families absolutely need to have the options and tools to make the right decision at the right time. At minimum, they should be given a few doses of tramadol or an injectable pain medication (e.g., buprenorphine), even if they don’t need it right away. As the pet’s condition progresses and signs like panting, pacing, whining, and crying (particularly at night) begin to develop, clients should have something they can give to ease discomfort. Tramadol, although not a perfect pain medication, is a favorite of mine because of the safety of its dose range and frequency. It eases nocturnal signs that seem to disappear during the day and gives families some reprieve when they are still not ready to make the final decision.

    ***

    The success of the veterinary hospice model and the availability of this service starts with general practitioners. We must understand that it is our job to properly evaluate the patient and educate the owner, all while remaining objective and nonjudgmental (within boundaries) of the desires and wishes of the family. Family members know their pet best and will most likely have better insight into their pet’s quality of life. The education we provide to pet owners about recognition and management of pain, as well as the progression of their pet’s disease, will give them the tools to navigate the hospice stage and make the best decision for their pet. By approaching the hospice phase as thoroughly and thoughtfully as we do the pediatric stages, we will continue to ensure our success and solidify our role as animal advocates and truly compassionate veterinarians.

    didyouknow

    Did you know... 83% of veterinarians believe that running a veterinary practice is as much a people business as it is a medical service. Read More

    These Care Guides are written to help your clients understand common conditions. They are formatted to print and give to your clients for their information.

    Stay on top of all our latest content — sign up for the Vetlearn newsletters.
    • More
    Subscribe