Over the past four decades, the population of companion animals has grown rapidly and today Australia has one of the highest pet ownership rates in the world. 62% of Australian households own pets and Australians are spending more on their pets than ever before. With increasing interest in human palliative and hospice care, veterinary medicine is also seeing a rise in palliative care for companion animals.
In Australia, palliative care has been somewhat of an emerging field, despite it being an established part of veterinary practice in other parts of the world such as North America.
Palliative care is not about extending the quantity of life, but the quality of life for pets. The management of pain is central to palliative care, together with alleviating disease-related symptoms that compromise the comfort of the patient. A challenge in veterinary practice is finding a consistent way to measure pain in an objective and simplistic way since animals are unable to communicate their pain or discomfort.
As veterinary professionals, the task of negotiating end-of-life care with clients whilst maintaining the role of advocate for what is in the best interest of the animal is a delicate one. An added layer of complexity is considering the owners quality of life. Finding an equilibrium between the benefits of intervention and the short-term discomfort to the patient extends to the client also.
A fundamental point of contention in veterinary practice is that palliative care requires time, a distinct scarcity in general practice today. Hospice is a system, which delivers palliative care and offers a practical alternative to premature euthanasia. Palliative care in the USA is an established interdisciplinary practice, which meets the needs of dying patients in a compassionate way.
Each client has a unique set of circumstances and respective bond with their pet, which determines how decisions are made. Corresponding support is provided to pet owners and caregivers alike. Hospice services typically offer on-call availability of a vet, extended appointments which include client counselling and support during decision-making, practical guidance, in-home care and administration of medications or therapies to alleviate discomfort, stress and pain.
The goals in veterinary palliative care differ to those in general practice; a departure from curative to comfort and contentedness. The field is becoming increasingly specialised and raises questions around how it may complement general practice in Australia.
More recently animal sentience has been brought to the forefront in scientific research, raising awareness around animal intelligence, cognition and sensitivity.
Today, attitudes towards our pets are subsequently changing. We are witnessing a paradigm shift, where clients are beginning to expect more from vets in terms of working through difficult decisions following terminal diagnoses, quality of life and euthanasia. More attention is being afforded to the final stages of life for companion animals.
In light of the rising expectations of Australian pet owners, could palliative and hospice care represent a new opportunity in the veterinary profession?
- Pet ownership in Australia Report https:// animalmedicinesaustralia.org.au/pet-report/
- Goldberg, K.J., 2016. Veterinary hospice and palliative care: a comprehensive review of the literature. Veterinary Record, 178(15), pp.369-374.
- Downing, R., 2011. Pain management for veterinary palliative care and hospice patients. Veterinary Clinics: Small Animal Practice, 41(3), pp.531-550.
- Shanan, A., Shearer, T. and Pierce, J. eds., 2017. Hospice and palliative care for companion animals: principles and practice. John Wiley & Sons.
This article originally appeared in the July 2019 Australian Veterinary Journal.