An inside look at veterinary hospice care

This content is sponsored by Zomedica.

At the Fetch dvm360® conference in San Diego, California, Kathleen Cooney, DVM, MS, CHPV, CCFP, founder and director of education at Companion Animal Euthanasia Training Academy and chief medical officer of Caring Pathways Inc from Loveland, Colorado, described the animal hospice care fundamentals for veterinarian or technician attendees interested in pursuing this career path.¹

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She first defined hospice care as when veterinary professionals recognize an animal has a terminal illness, a life-limiting condition that’s going to lead to death in a short manner of time or where they see age-related changes advanced enough that they can realize death is coming in about 3 months. “[This is when] we start into a new phase of care. We’re no longer advocating towards life; now we’re moving towards death,” said Cooney. She emphasized that hospice is not about finding a cure, but rather ensuring patients live as comfortably as possible to the end of their lives while helping to provide the most compassionate, satisfactory experience for the family. “Being a hospice worker is looking at [the pet] with a critical eye [to uncover] what is making today unpleasant and how can I make that better?” she added.

5-step hospice strategy

Cooney outlined the 5-step hospice strategy² to follow when approaching these types of cases:

1. Identify caregiver psychosocial factors: This combines both psychological and social elements and can include the family’s availability, if they have any experience with geriatric care or euthanasia, their financial concerns, and more. 
2. Educate on the disease process: Many times clients will think that the end-of-life process will be simple and they prefer a natural death for their pet without realizing the complexities of some diseases. That’s why a hospice worker must inform them on what to expect.
3. Design a personalized care plan: This care plan is going to incorporate themes and patterns from other cases you have done, but it is specific to the pet’s condition and what the family can handle.
4. Apply the care plan and adjust accordingly: This includes teaching the therapy techniques the family is to offer to the pet to make them comfortable and is an excellent place for a veterinary technician to come into play.
5. Provide grief support throughout the process: Advocate for the patient until their last day and do your best to offer compassion for the family.

Care plans

According to Cooney, its important to categorize care plans because this determines the frequency of communication with the pet’s family. The plans include the following: palliative care program (at least once a month communication); early hospice care (at least once a week); and advanced hospice care (at least once a day). The different stages are categorized by the factors below.

Palliative care plan

A palliative plan offers pet comfort medical care and is established when there is no specific disease process that is expected to end its life in the very near future. Cooney noted an important point, “You can have palliative care without hospice, diabetes is a great example…we’re not actually curing [the condition], were managing it…but you can’t have hospice without palliative care.”

Early hospice care

Early hospice care is when the pet has a life-limiting condition with death predicted to come in about 1-2 months. Palliative care is further continued and there are more discussions to prepare the family for the pet’s approaching death.

Advanced hospice care

This plan is when a pet’s death is expected in 1-2 weeks and consists of much more involved care and frequent communication with the pet’s family.

Because there are no available ways to measure when death is coming for sure, Cooney said determining what plan is appropriate for an animal is based on “what we know with disease protectories, such as what we know with lymphoma, end stage heart failure, [and] those things." She added, "So, we go from the literature with that, what’s the likelihood of living 3 months, 6 months, or whatever it might be.”

References

1. Cooney K. What's an animal hospice case really like? Presented at: Fetch dvm360® Conference; San Diego, California. December 2-4, 2022.
2. Shearer TS. Pet hospice and palliative care protocols. Vet Clin North Am Small Anim Pract. 2011 May;41(3):507-18. doi: 10.1016/j.cvsm.2011.03.002.