Hospice and Palliative Care for Companion Animals

A thoroughly updated and expanded new edition of the only book providing comprehensive treatment of hospice and palliative care in veterinary medicine

Animals with life-limiting illnesses deserve compassionate, thoughtful, end-of-life care. Their caregivers and families, faced with the loss of a beloved companion, deserve empathy, support, and education, to guide them through an emotionally wrenching period and provide their companion animals with the highest possible quality of life. In recent years, the ethics of care and service to sick and dying animals and their caregivers has been the subject of considerable attention.

Hospice and Palliative Care for Companion Animals, 2nd Edition provides a thorough update to the first and only complete guide to this field of service, its foundations, and its applications. It addresses the needs of pets, caregivers, and veterinary professionals alike, including fundamental ethical and emotional principles as well as detailed discussion of specific illnesses and life-limiting conditions. The expanded second edition incorporates cutting-edge research into animal behavior and cognition to enrich the reader's understanding of companion animals' emotional needs and their experience of illness and death.

Hospice and Palliative Care for Companion Animals, 2nd Edition readers will also find:

• Existing chapters expanded to incorporate new research and practical experience
• New chapters discussing factors underlying the decision to euthanize, the potential role of ethology in palliative care, and more

• A companion website with educational handouts for use in veterinary practices

  Hospice and Palliative Care for Companion Animals is an indispensable resource for caregivers and veterinary professionals alike.

  Autorentext

  The editors Amir Shanan, DVM, is the Founding President of the International Association for Animal Hospice and Palliative Care and a Founding Partner of the Animal Hospice Group. He owns Compassionate Veterinary Hospice, a veterinary practice dedicated to end-of-life care, in Chicago, Illinois, USA. Jessica Pierce, BA, MDiv, PhD, is a bioethicist and Faculty Affiliate at the Center for Bioethics and Humanities, University of Colorado, Anschutz Medical Campus, in Aurora, Colorado, USA. Tamara Shearer, DVM, CCRP, CVPP, CVA, MSTCVM, owns Shearer Pet Health Services and Smoky Mountain Integrative Veterinary Clinic in Sylva, North Carolina, USA, and serves on the faculty of Chi University.

  Klappentext

  Hospice and Palliative Care for Companion Animals A thoroughly updated and expanded new edition of the only book providing comprehensive treatment of hospice and palliative care in veterinary medicine Animals with life-limiting illnesses deserve compassionate, thoughtful, end-of-life care. Their caregivers and families, faced with the loss of a beloved companion, deserve empathy, support, and education, to guide them through an emotionally wrenching period and provide their companion animals with the highest possible quality of life. In recent years, the ethics of care and service to sick and dying animals and their caregivers has been the subject of considerable attention. Hospice and Palliative Care for Companion Animals, 2nd Edition provides a thorough update to the first and only complete guide to this field of service, its foundations, and its applications. It addresses the needs of pets, caregivers, and veterinary professionals alike, including fundamental ethical and emotional principles as well as detailed discussion of specific illnesses and life-limiting conditions. The expanded second edition incorporates cutting-edge research into animal behavior and cognition to enrich the reader's understanding of companion animals' emotional needs and their experience of illness and death. Hospice and Palliative Care for Companion Animals, 2nd Edition readers will also find: Existing chapters expanded to incorporate new research and practical experience New chapters discussing factors underlying the decision to euthanize, the potential role of ethology in palliative care, and more * A companion website with educational handouts for use in veterinary practices Hospice and Palliative Care for Companion Animals is an indispensable resource for caregivers and veterinary professionals alike.

  Inhalt

  List of Contributors xxi

  Acknowledgments xxiii

  About the Companion Website xxiv

  Part I Core Concepts 1

  1 Introduction 3
  Pierce, BA, MTS, PhD

  References 5

  Further Reading 5

  2 What Is Animal Hospice and Palliative Care? 6
  Amir Shanan, DVM and Tamara Shearer, MS, DVM, CCRP, CVPP, CVA, MSTCVM

  Introduction 6

  History of Animal Hospice 8

  Scientific and Philosophical Roots 8

  Early Beginnings 9

  Organization and Recognition 10

  Animal Hospice and Human Hospice 12

  Ethical and Legal Differences 12

  Economic Differences 13

  Summary 14

  References 14

  3 The Interdisciplinary Team 16
  Tammy Wynn, MHA, LISW, RVT, CHPT and Amir Shanan, DVM

  Interdisciplinary Teams in Human Hospice and Palliative Care 16

  Interdisciplinary Teams (IDT) in Animal Hospice and Palliative Care 17

  Operating a Successful Interdisciplinary Team 18

  Common Mission and Vision 18

  Team members, Their Roles, and Responsibilities 19

  Effective Communication and Collaboration 22

  Summary 25

  References 25

  4 Quality of Life Assessments 26
  Jessica Pierce, BA, MTS, PhD and Amir Shanan, DVM

  What are Quality of Life Assessments and Why are they Important in End- of- Life Care? 26

  Definitions of Quality of Life 26

  Quality of Life and Well- being 27

  Quality of Life Assessments and Euthanasia Decisions 28

  The Importance of Context in Quality of Life Assessment 28

  Quality of Life and Patient- Centered Care 29

  Physical Discomfort, Emotional Distress, Pain, and Suffering 30

  Coping and Adaptation 32

  Measuring Quality of Life in Animal Patients 33

  A Variety of Approaches to QOL 34

  McMillan's Affect Balance Model 35

  Weighing Positive and Negative Affect at the End of Life 36

  Quality of Life Assessment Tools 36

  Quality of Life Assessment Over Time 38

  Summary 40

  References 40

  Further Reading 42

  5 Recognizing Distress 44
  Emma K. Grigg, PhD, CAAB, Suzanne Hetts, PhD, CAAB, and Amir Shanan, DVM

  Stress, Distress, Emotions, and Suffering 44

  The Stress Response 44

  What Is Distress? 45

  Behavioral Needs of Dogs and Cats 46

  Assessing Quality of Life in Nonhuman Animals 47

  Relevance to Animal Hospice and Palliative Care (AHPC) 48

  Are Humans Adept at Recognizing Emotional States in Animals? 49

  Body Language of Fear, Anxiety, and Pain 49

  Fear- and Discomfort- Related Body Postures Commonly Observed in Dogs and Cats 49

  Pain- Related Facial Expressions Commonly Observed in Dogs and Cats 51

  Relevance to Animal Hospice and Palliative Care (AHPC) 52

  Changes in Behavioral Patterns as Indicators of Pain and Distress 53

  Do Animals "Hide" their Pain? 53

  Decreased Response to and Engagement with their Surroundings 54

  Unusual Patterns of Movement or Positioning 55

  Focused Attention to One Specific Body Part 56

  Displacement Behaviors 56

  Can Sick Animals Suffer from Boredom? 56

  Relevance to Animal Hospice and Palliative Care (AHPC) 57

  End- of- Life Decisions 57

  Conclusion 58

  References 58

  6 Balancing Efficacy of Treatments Against Burdens of Care 62
  Kristina August, DVM, GDVWHM, CHPV

  Establishing the Goals of Care 63

  Assessing Efficacy and Burdens of Medical Treatment 66

  Assessment of Treatment Efficacy 66

  Appetite and Hydration Needs at the End of Life 66

  Emotional Well- Being 67

  Animal Individual Preferences 67

  Do- Not- Resuscitate and "Advance Directives" 67

  Assessment of Treatment Burden 68

  Assessing Diagnostic Procedures 69

  Adverse Events: Treatment- Re…