April 15, 2009


 Pet hospice movement gaining momentum


Posted April 1, 2009

Leaders in the animal hospice field have been busy in an attempt to codify and coalesce the palliative care movement by launching an affiliated association. 

Modeled after human hospice, pet hospice emphasizes managing a patient's terminal illnesses while preparing the family for the end. This is done in a number of ways, from the use of grief counselors to pain management techniques.

Dr. Amir Shanan, owner of Compassionate Veterinary Care of Chicago, has offered animal hospice services for 15 years in his small animal practice, including private hospital rooms and at-home euthanasia. Spurred by the connections he made at the first pet hospice symposium held March 2008 at the University of California-Davis campus, he and other symposium attendees have launched a new umbrella organization, the International Association for Animal Hospice and Palliative Care, found at www.iaahpc.org. The association hopes to receive its 501(c)3 status before the AVMA Annual Convention this July and before the next symposium over Labor Day weekend.

Dr. Amir Shanan
Dr. Amir Shanan sits in one of three hospital rooms used as
part of the pet hospice services offered at his small animal
practice in Chicago. He is one of the founders of a new
organization, the International Associatio for Animal Hospice
and Palliative Care. 

The organization aspires to educate pet owners about pet hospice and its benefits; develop recommended standards of care; promote research, documentation of experience, and scholarly discussion of pet hospice; and promote future recognition of pet hospice as a specialty area within the professions that provide its services.

The IAAHPC offers voting membership to hospice care professionals, including veterinarians, veterinary technicians, social workers, psychologists, ethicists, and clergy. Organizational and associate memberships also are available.

Though pet hospice has been around for at least two decades, it has struggled to take hold in a large number of practices. Dr. Shanan wrote on the association's Web site that the challenge facing the IAAHPC is many animal owners don't know enough about pet hospice services to seek them out. In addition, many veterinarians don't know enough about the benefits hospice care can offer their patients and clients and, therefore, don't provide hospice services or information about them.

Dr. Shanan says right now there is a strong network of 10 to 20 veterinarians, many of whom are members of The American Association of Human-Animal Bond Veterinarians, including its president-elect, Dr. Tamara S. Shearer, and Dr. Tina Ellenbogen. Those who have expressed support for the new association include Kathryn D. Marocchino, PhD, president and founder of the Nikki Hospice Foundation for Pets; Dr. Alice E. Villalobos, director of Animal Oncology Consultation Service and Pawspice of Southern California; and Dr. Richard P. Timmins, immediate past president of the Association for Veterinary Family Practice. Along with such professionals, Dr. Shanan plans to recruit the core leadership for the organization. He projects 200 IAAHPC members by the end of 2009, and more than 1,000 by the end of 2010.

The association is likely to draw from the base of approximately 135 people who attended this past year's symposium. They came from various backgrounds to learn about the emerging field and included veterinarians, veterinary technicians, veterinary students, pet sitters, massage therapists, animal shelter workers, and grief counselors. 

Symposium organizers facilitated discussion on topics such as pharmacologic protocols, how to set up a veterinary hospice facility, the value of holistic medicine in pet hospice care, and the role of pet nutrition.
animal toys

To better accommodate ailing animal clients, Dr. Shanan
provides toys in the hospital rooms.

Dr. Marocchino, one of the symposium's main organizers, said the symposium centered on sharing the basic philosophy of hospice. The AVMA Guidelines for Veterinary Hospice Care were distributed at the symposium. The symposium's goal was to develop a comprehensive, broad-based approach to pet hospice care. 

Dr. Villalobos lectured at the event on using a quality of life scale. She said the symposium made her and other veterinarians realize how much their presence is needed with animal hospice, or what she refers to as "pawspice."

"What I'm a little fearful of is that some people really seem to feel that being with an animal or taking it through its last days is sort of an enrichment experience. They seem to be doing it like a hobby or something they feel committed to, but if there's not enough veterinary management, pets are suffering. That's what I discovered when listening to the lectures," Dr. Villalobos said. "More veterinary management is needed in hospice care."

She notes that while pet hospice may not be for every practitioner, it's a viable service that veterinarians can offer.

"(Pet hospice) is a philosophy of caring and concern and compassion for clients and their pets. Any doctor can start and practice it as a regular part of their practice ... with appointment times and prescriptions and medications needed to support the pet," Dr. Villalobos said.

The next pet hospice symposium is scheduled for Labor Day weekend, once again at the UC-Davis campus. This time, Dr. Marocchino said, participants need to get more specific and progress to a second level of depth. More symposium information can be found at www.pethospice.org.

"(Animal hospice) will consistently be refined. The basic principles will be reiterated and talked about again," she said.

A seven- to eight-member planning committee of veterinarians and other animal hospice participants is crafting the symposium. They are charged with the task of setting the tenor of pet hospice and taking it forward, Dr. Marocchino said, by developing protocols and guidelines. One of the things that came out of the first symposium was the need to define pet hospice care.

"How are we going to define (pet) hospice care? What is it? Is it exactly like human hospice or does it differ, and if so, in what way? We need to find a definition everyone is comfortable with before we can move on," Dr. Marocchino said.

Other issues exist as well, such as the process of developing a quality of life scale and determining its components. Another is euthanasia and determining its place in veterinary hospice. Some say it shouldn't be a part of the process, according to Dr. Marocchino, and if that's the case, a determination must be made on how to manage pain and replicate the human hospice experience. 

"The next step is to come up with standards of care and a quality of life scale that makes sense. The ones out there don't quite cut the mustard. This group is devoted to putting that together, and I think it's wonderful that they're so fired up by the symposium and want to do so much more," Dr. Marocchino said.