Michigan State University Veterinary Hospice Care: An Academic Hospice Practice 2011 to 2014

Training veterinarians to deal with death and the dying process: a scoping review

The aim of this scoping review was to investigate the range of methods used to guide veterinarians in their approach to the death of their animal patients with the guiding question: how is this topic addressed in the training of veterinarians? We included studies written in Portuguese or English, with a theme aligned with the objective of the review and which answered the guiding question. Studies not fulfilling these criteria were excluded. A total of 22 complete studies were identified by searching the Scopus, Web of Science, PsycINFO and Pubmed databases/libraries, with no restrictions on the date of publication. Studies from 1989 to 2023 were identified, mostly by North American authors. The results were organised into three major themes: topics in the veterinary curriculum about patient death and its impacts on students and future professionals; teaching methods used to cover this topic; and the extracurricular training available to support veterinarians with their direct experience of this topic. Analysis of these papers indicated that the theme of death appeared in three distinct contexts operating at different stages of veterinarians' training: the hidden curriculum, compulsory training initiatives, and extracurricular training. The review included reflections on the challenges inherent in this theme and inferences from the timeline of publications in this area. Our review clearly indicates that there is increasing recognition of the importance of this subject, as well as a feeling within the profession of being unprepared to manage this aspect of veterinary experience and a perception that teaching in this area needs to be improved.

"Veterinary medicine is not finished when I have diagnosed an incurable disease, that's when it starts for me." A qualitative interview study with small animal veterinarians on hospice and palliative care

In the wake of recent medical developments in small animal practice, curing animals of their illnesses and restoring their health can be realized better than ever before. However, the growing medical possibilities are also leading to an increase in demand for better care for patients suffering from terminal illnesses. Consequently, the field of animal hospice and palliative care has become increasingly available, enabling veterinarians to optimize the quality of life of patients, such as dogs and cats, who no longer have a prospect of full recovery. Using qualitative, semi-structured interviews with 20 small animal veterinarians involved in hospice and palliative care, we investigated the factors that motivate veterinarians to become involved in hospice and palliative care and explored the importance of relationships, communication, time and infrastructure in this area. Findings show that personal experiences with their own pets or during training or work life motivated veterinarians to provide this service. Although veterinarians highlighted the importance of empathetic-driven relationships, they were aware that keeping an emotional distance from the patient and caregiver is significant to provide successful care. Further, veterinarians emphasized their high investment of time that resulted primarily from the increased frequency and provided opportunities to communicate with caregivers. The overall conclusion is that having time for patients and the patients' caregivers is one of the most important aspects of work in this field. However, as it will be also shown, veterinarians must consider aspects of self-care management by reflecting on their own time and energy resources while caring for animals and their caregivers.

Research priorities in veterinary palliative care

Veterinary palliative care consists of end-of-life care of companion animals suffering from terminal or life-limiting diseases. Despite the growing need for veterinary palliative care, little research has been conducted on this topic. This perspective intends to provide an overview of the existing concerns and identify knowledge gaps to motivate further research. As a result, three main areas of research have been identified, namely: i) how to provide palliative care considering welfare implications of different diseases (e.g., pain management); ii) what can be considered a "good death", depending on the individual situation of the animal and its caregiver; iii) how to support caregivers' needs during their companion animal's end-of-life. Therefore, veterinary palliative care involves medical, ethical, and sociological considerations that should be addressed through guidelines and training.

Practical Principles of Palliative Care in Veterinary Oncology: Alleviating the Suffering of the Animal, Owner, and Veterinarian

Background

Palliative care for pets is a developing area that encompasses animals with cancer and other chronic and degenerative diseases.

Objectives

To elucidate the guiding principles of palliative care in veterinary oncology.

Methods

This article was structured from an extensive literature review and addresses the growing need for improved palliative care in veterinary medicine. Methods of quality of life assessment in animals with cancer, owner education, and the importance of an interdisciplinary team approach are discussed.

Results

Palliative care aims to improve the animal's quality of life, alleviating its physical, emotional, and social suffering. Through attentive communication, palliative care also seeks to alleviate owners suffering from the moment of diagnosis to mourning the patient's death.

Conclusions

The importance of offering palliative care alongside anticancer techniques and treatments should not be underestimated and should ideally use a multidisciplinary team approach.