Ask Dr. B

What is hospice and palliative care for pets?

The original SagePets. Dr. Braithwaite's hounds Pippa and Polly. Pippa passed away in May of 2022 due to kidney disease. Polly is 12 and requires management of several masses and arthritis.

The terms hospice and palliative care are ones we have heard commonly used together; however, if you have not had personal experience with either of these services you may not understand the distinction or how it could apply to your beloved pet. In veterinary medicine we use these terms in a similar way to how they are used in the human medical world with a few key distinctions.

Hospice Care for Pets
Hospice generally refers to care a patient would receive to help ease pain and suffering associated with a life-limiting condition. This term is generally used when we are no longer looking to cure the disease in question, and the focus is on symptom management and improving or maintaining quality of life. In the human world there are often very specific definitions we use for this care, such as a prognosis of less than 6 months.

In both human and animal hospice, the focus is on the physical, social, and emotional needs of the patient. The goal is for the patient to remain comfortable, clean, and safe, while also maintaining social relationships and a sense of dignity. This care is often given by a multidisciplinary team, and can include care and support for the patient’s caregivers that includes bereavement support. The difference in pet hospice (here in the US), is that it includes both humane euthanasia and assisted natural death.

It can be difficult for family members to seek out pet hospice care due to not wanting to face a terminal diagnosis, or simply not wanting to stop seeking a cure. For these situations, palliative care can be a perfect fit.

Palliative Care for Pets
Palliative care is a treatment philosophy that aims to improve a patient’s quality of life and relieve suffering while treating curable or chronic conditions. In this scenario, the treatment that aims to cure the disease in question can proceed alongside palliative care (also termed comfort care). As with hospice care, palliative care for pets focuses on symptom management, pain relief, and quality of life. The main difference is that palliative care is appropriate for a patient at any age or stage of disease.

When considering palliative care for our pets we focus on managing the side effects of medications or symptoms of disease such as nausea, poor appetite, mobility concerns, or pain. Pets who may benefit from this care include those with heart disease, arthritis, chronic kidney disease, cancer, dementia or cognitive decline, and any other chronic illness.

The definitions don’t really matter — we’re talking comfort care for your pet
In human medicine, palliative care can transition to hospice care once the patient has decided to no longer undergo curative-intent treatment. When considering our pets, since we are not governed by the strict definitions applied in human medicine, it doesn’t really matter which term we use. Whether or not you are seeking a cure for your pet’s illness or not, they can benefit from treatment aimed at helping them be happy, social, and pain-free. You do not have to stop seeking a cure for your pet or be at the point of considering in-home euthanasia for your pet to benefit from palliative care.

Hospice and Palliative Care Certification
Though end-of-life care is something all pets will eventually need, it is not taught or emphasized in most veterinary schools. Veterinary professionals who wish to provide this care need to seek out extra training and education to be able to do so effectively. The most widely accepted platform for this is the International Association for Animal Hospice and Palliative Care (IAAHPC) certification. This is a paid certification that consists of a year of instruction and a comprehensive exam. Veterinarians and technicians who are certified must also continue their education and recertify every 5 years.

Relieving animal suffering is my passion and for that reason I have always had a focus on end-of-life care. I see this as a time where pets’ physical, social and emotional needs often go unmet because pet owners don’t have the resources or the support they need. To this end, I became certified in small animal euthanasia techniques via the Companion Animal Euthanasia Training Academy while I was a student and has been helping pet families say goodbye to their companions in their homes since I became a veterinarian. I now embark on the next phase of my learning as I have started the IAAHPC certification. I look forward to continuing to share the wisdom I have learned with pet parents and pet lovers so that we can all support our pets to age with grace.

Resources for further reading:

https://hospicefoundation.org/Hospice-Care/Hospice-Services

https://www.nia.nih.gov/health/what-are-palliative-care-and-hospice-care

https://iaahpc.org/faqs/