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.

FIRSTLINE


6. "Palliative care and hospice patients can only be evaluated in the home."

This myth has a twin: "Palliative care and hospice patients can only be evaluated in the clinic." For dogs—and the occasional cat—that love nothing more than a ride in the car, periodic evaluations at the practice can be a welcome respite from uninterrupted time at home. Experts have guided veterinarians to do all they can to make visits to the practice as stress-free and enjoyable as possible for pets. The real pay-off for these efforts comes at the end of their lives, when pets need the most intensive care we provide. Palliative care and hospice patients can generally be evaluated both in the home environment and the clinic setting.

Technology has changed so many realities of veterinary medicine, and the delivery of palliative care and hospice is no exception. Now that smartphones are the rule rather than the exception, we can provide real-time, interactive information to veterinarians, team members, and pet owners outside the practice. This liberates pets that are uncomfortable in a clinic to have their evaluations in the comfort of their home environment. Video and still images can be transmitted to the veterinarian in the practice, allowing the veterinarian to guide care-giving from a remote location through the technician visiting the home.

As important as it is to recognize the need to offer palliative and hospice care for animal patients approaching their end of life, it is equally important to recognize that this approach is not a one-size-fits-all solution. Some clients may find the requirements of providing palliative or hospice care overwhelming or impossible in their particular circumstances. Clients should be encouraged to feel safe engaging in an open dialogue with the veterinarian and the veterinary team as they explore their concerns about providing palliative and hospice care for their pets.

Likewise, it is important that clients receive a clear message that at any point along the palliative care or hospice journey, humane euthanasia is available for their beloved pet. At no time should clients be left feeling that they are "bad" pet owners if they cannot provide palliative or hospice care for their pets. Neither should they worry that they cannot change their minds once palliative care has begun.

Veterinary medicine is best delivered using a team approach, and it becomes critical as the pet approaches its end of life. With appropriate training, practice, and ongoing guidance, technicians can play an active role in developing and delivering palliative care and hospice in primary care practices. Facilitating a pet's quality of life as it approaches the end of life is an amazingly rewarding experience. Our patients and clients deserve our attention to this emotionally delicate time, and they need our assistance as they negotiate this part of their beloved pets' lives.

Robin Downing, DVM, CVA, CCRP, DAAPM, is the hospital director for Windsor Veterinary Clinic and The Downing Center for Animal Pain Management. She has practiced veterinary palliative care for 25 years.

REFERENCE

1. Davis LE. Species differences in drug disposition as factors in alleviation of pain. In: Kitchell RL, Erickson HH, Carstens E, eds. Animal pain—perception and alleviation. Bethesda, Md: American Physiological Society, 1983:175.

RECOMMENDED READING

1. AAHA/AAFP Pain Management Guidelines Task Force. AAHA/AAFP pain management guidelines for dogs and cats. J Am Anim Hosp Assoc 2007;43(5):235-248.

2. Palliative medicine and hospice care. Vet Clin North Am Small Anim Pract 2011;41(3).

3. Villalobos A, Kaplan L. Quality of life scale. In: Canine and feline geriatric oncology: Honoring the human animal bond. Ames, Iowa: Blackwell Publishing; 2007;Table 10.1:304.


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