6 myths of veterinary palliative care - Firstline
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6 myths of veterinary palliative care
Pain management is a critical component of a pallative care program that offers relief for pets with terminal illnesses. Learn the facts about palliative care, including how to assess a pet's pain and offer relief.


Common myths

Now that you know the value of pain management for terminal patients, let's dispel some common myths about veterinary palliative care and hospice.

1. "Palliative care and hospice merely delay or prolong the inevitable and are not fair to the pet."

Veterinary palliative care and hospice focus on the pet's comfort. Compassionate comfort care is the No. 1 priority. There is almost always time between rendering a terminal diagnosis and the need for humane euthanasia. The role of palliative care and hospice is to engage in an active dialogue among the client, the veterinarian, and the veterinary healthcare team and to provide ongoing patient assessments and fine-tuning of the management plans. The goal is not to prolong suffering. In fact, the goal is to prevent suffering and allow the pet to live well as long as possible, until death occurs or euthanasia is necessary.

2. "Palliative care and hospice is a substitution for euthanasia."

Veterinary palliative care and hospice principles are drawn from the human medical experience and practice. Unlike human medicine, however, veterinary medicine is able to provide a humane and compassionate end to suffering by performing euthanasia. For animal patients, palliative care and hospice techniques focus on sustaining comfort, relieving pain, and maintaining the family-pet relationship as long as possible. While the occasional animal patient dies on its own, far more often the veterinarian is called on to provide euthanasia.

3. "Just looking at an animal is enough to determine its comfort level."

This myth is similarly expressed as "Clients know when their pets are painful," or "Only veterinarians can appropriately assess patients for pain." Most pet owners are not well-equipped to understand when their pets are in pain. But with appropriate training and practice, technicians can effectively evaluate pain in palliative care and hospice patients that are seen at home. By using a standard pain assessment scoring system, a trained technician can easily convey his or her evaluation findings to the veterinarian so that the patient's pain management strategy may be fine-tuned. For example, a technician may stream video of the pain examination to the veterinarian from a smartphone, allowing the veterinarian to witness the reactions and responses of the pet. During a home visit, the technician will also review the medications that have been prescribed and confirm that they are being given appropriately. With the veterinarian's input, medications can be added, subtracted, or modified to respond to the patient's need. Technicians can also deliver other pain management modalities at home with the veterinarian's guidance.

The importance of ongoing, regular, and reciprocal communication among the veterinarian, the veterinary technician team, and the client cannot be overemphasized. It is only through ongoing dialogue and open, supportive conversation that the well-being of both the client and the patient can be adequately and appropriately assessed. For most clients, the time surrounding the impending death of a pet is uncharted territory. While it is an emotionally rewarding time, it can also be an emotionally stressful time. The veterinarian and the veterinary healthcare team have an obligation to support both the client or family and the patient during this special time of a pet's life.

To continue their education, veterinary technicians can pursue credentials as Certified Veterinary Pain Practitioners through the International Veterinary Academy of Pain Management. They can also become credentialed in canine physiotherapy and rehabilitation as well as canine medical massage. These credentials dramatically expand the positive effect the technician can have on the palliative care or hospice patient's quality of life.

4. "Clients can't—or won't—perform supportive medical treatments at home."

With a little guidance, most clients are delighted to take an active role in the day-to-day care of their pets. This is one area where the technician can play crucial supportive roles as a teacher, a coach, and an advocate for the hospice patient. The pet may benefit from the application of moist heat or cold therapy. The technician can demonstrate precisely how to accomplish this. Some palliative care and hospice patients develop chronic wounds that will not heal and must be kept clean and covered appropriately to prevent infection, pain, and discomfort. Technicians can teach and supervise wound care, and the client can help keep the veterinarian in the loop with transmitted images and the occasional practice visit.

The technician may also teach and coach clients about the delivery of injectable medications or subcutaneous fluids. Remember, we teach insulin administration to diabetic patients routinely. So injectable medications for end-of-life patients do not provide an insurmountable challenge.

5."It is difficult to adjust the home environment to accommodate a hospice pet."

The pet supply industry has exploded in recent years. If a pet needs something, chances are, someone has invented it. As a result, modifying home environments to accommodate a palliative care or hospice patient is generally pretty easy. Raised food and water dishes, steps up to the sofa or the bed, nonskid flooring squares, fabric slings, body vests with handles, and wheelchairs for two-legged or four-legged support are just some of the multitude of innovative items available. And baby gates can prevent unauthorized access to rooms or stairs. Clients can often create their own customized adaptations with a bit of guidance from the healthcare team.



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