Veterinary end-of-life care
The American Veterinary Medical Association (AVMA) recognizes that clients facing terminal illness in companion animals may desire veterinary end-of-life care for their animals. As offered within the context of veterinary practice, and as consistent with veterinary practice acts, veterinary end-of-life care gives clients time to make decisions regarding a companion animal with a terminal illness or condition and to prepare for the pending death of the animal. The AVMA views veterinary end-of-life care as care that will allow a terminally ill animal to live comfortably at home or in an appropriate facility, and that includes the option of euthanasia. The animal's comfort and quality of life must always be considered when veterinary end-of-life care is provided.
As is the case in human hospice programs, animal patients must have a terminal illness with a short life expectancy. The veterinary end-of-life care team must include a veterinarian and trained staff who provide expertise in palliative care and pain control for such terminally ill animals. It is desirable to include other counseling and care professionals, however advice regarding veterinary care should only be provided by veterinary professionals. The AVMA endorses use of the 2016 American Animal Hospital Association/International Association for Animal Hospice and Palliative Care End-of-Life Care Guidelines.
Maximizing the benefits of veterinary end-of-life care requires that any family/household members attached to the animal participate in the care of the patient. End-of-life care facilities for animals should ensure that care decisions are made with the full participation of a veterinary team empowered to act as advocates for the animal, and that arrangements are made to protect the animals in the event of financial difficulties or change of management.
End-of-life care staff should understand that when using the term end-of-life care, what is generally implied is the provision of palliative care (including medications) for the remainder of a pet's life followed by humane euthanasia if an acceptable quality of life can no longer be maintained. This differs from the human hospice approach where euthanasia is not looked upon as an endpoint.
The respectful closure of each unique human-animal bond through end-of-life services can be time-consuming for the veterinarian with regard to the medical needs of the patient and emotional needs of the client, and not all veterinarians are in a position to offer these services. Veterinary hospitals that are unable to offer end-of-life care should be prepared to refer clients to another veterinarian who is in a position to offer these services. Where available, preference should be given to IAAHPC-certified veterinary end-of-life care services. Referring a client for end-of-life care does not imply that excellent care is not being delivered by the referring veterinarian, but provides an option for those clients specifically desiring more comprehensive end-of-life care.
* Bishop G, Cooney K, Cox S et al. 2016 AAHA/IAAHPC End-of-Life Care Guidelines. J Am Anim Hosp Ass 2016;52:341-356.