2023 AAFP/IAAHPC feline hospice and palliative care guidelines.

The '2023 AAFP/IAAHPC Feline Hospice and Palliative Care Guidelines' are authored by a Task Force of experts in feline hospice and palliative care convened by the American Association of Feline Practitioners and the International Association for Animal Hospice and Palliative Care. They emphasize the specialized communication skills and ethical considerations that are associated with feline hospice and palliative care, with references to other feline practice guidelines for a more complete discussion of specific diseases, feline pain management best practices and cat friendly interactions. A comprehensive, multi-step hospice consultation allows for tailoring the approach to both the cat and the family involved in the care. The consultation includes establishing 'budgets of care', a concept that greatly influences what can be done for the individual cat. The Guidelines acknowledge that each cat and caregiver will be different in this regard; and establishing what is reasonable, practical and ethical for the individual cat and caregiver is important. A further concept of the 'care unit' is introduced, which is extrapolated from human hospice and palliative care, and encourages and empowers the caregiver to become a part of the cat's care every step of the way. Ethical considerations include a decision-making framework. The importance of comfort care is emphasized, and the latest information available about how to assess the quality of a cat's life is reviewed. Emotional health is as equally important as physical health. Hence, it is fundamental to recognize that compromised physical health, with pain and/or illness, impairs emotional health. A limited discussion on euthanasia is included, referring to the AAFP's End of Life Educational Toolkit for recommendations to help the caregiver and the veterinary professional ensure a peaceful passing and transition - one that reflects the best interests of the individual cat and caregiver.

2021 AAHA Nutrition and Weight Management Guidelines for Dogs and Cats.

The guidelines discuss the components of a systematic approach to nutritional management of dogs and cats. A nutritional assessment, including a body condition score and muscle condition score, is a screening evaluation that should ideally be performed at every examination. Individualized nutritional recommendations, based on the nutritional assessment, should be designed to achieve and maintain an appropriate body weight and meet nutritional requirements. Communicating nutritional recommendations to clients is a challenging aspect of nutritional management because pet owners may interpret the practice team's guidance as advocacy for a particular pet food brand or a judgment of the client's ability to properly care for the pet or of the owner's own nutritional status. The guidelines discuss approaches for effective, nonjudgmental communication of dietary recommendations to clients and strategies to increase acceptance of and adherence to veterinary nutrition recommendations. Other pet nutrition topics of current interest include recommendations for particular pet life stages, breeds, and disease conditions; risk factors for nutritional deficiencies and obesity; and considerations for home-prepared diets.

2016 AAHA/IAAHPC End-of-Life Care Guidelines.

End-of-life (EOL) care and decisionmaking embody the critical final stage in a pet's life and are as important and meaningful as the sum of the clinical care provided for all prior life stages. EOL care should focus on maximizing patient comfort and minimizing suffering while providing a collaborative and supportive partnership with the caregiver client. Timely, empathetic, and nonjudgmental communication is the hallmark of effective client support. Veterinarians should not allow an EOL patient to succumb to a natural death without considering the option of euthanasia and ensuring that other measures to alleviate discomfort and distress are in place. Animal hospice care addresses the patient's unique emotional and social needs as well as the physical needs traditionally treated in clinical practice. An EOL treatment plan should consist of client education; evaluating the caregiver's needs and goals for the pet; and a collaborative, personalized, written treatment plan involving the clinical staff and client. Primary care practices should have a dedicated team to implement palliative and hospice care for EOL patients. How the healthcare team responds to a client's grief after the loss of a pet can be a key factor in the client's continued loyalty to the practice. Referral to professional grief-support counseling can be a helpful option in this regard.

Pain management for veterinary palliative care and hospice patients.

When negotiating the challenges of end-of-life care for animal patients with clients, veterinary health care providers must continually engage in ongoing evaluation of the pet's quality of life, as well as assessing the client's quality of life to ensure that the best decisions possible are made. By combining regular physical evaluations, including careful palpation to unmask pain, with open and honest dialog with the client about the pet's day-to-day reality, the partnership of pet owner and veterinary health care team can accept the challenge of anticipating, preventing, finding, and relieving pain in the veterinary palliative care and hospice patient.

The role of physical medicine and rehabilitation for patients in palliative and hospice care.

Veterinary patients in palliative and hospice care have progressive and often degenerative diseases that can cause pain as well as loss of function and decreased quality of life. These patients can often benefit from the application of physical medicine and rehabilitation techniques to maximize comfort and function. Physical medicine and rehabilitation are most effective as adjuncts to pharmacologic pain management. Physical medicine and rehabilitation can decrease the doses of analgesics required to keep these patients comfortable. The blend of physical and pharmacologic medicine allows an optimum balance between maximum comfort and maximum mentation.

Comfort, hygiene, and safety in veterinary palliative care and hospice.

Hygiene, comfort, and safety during pet palliative care and hospice are usually straightforward. The veterinary health care team must coordinate care to ensure that the pet and the family are fully informed and engaged in the process. End-of-life issues, euthanasia, and death are typically not everyday concerns for the pet owner. Pet owners and veterinary patients rely on the veterinary health care team to help create the structure within which the pet will die. The veterinary team can give the family-pet unit the gift of structure and multifaceted comfort. The veterinary profession must take seriously this unique niche of care.

A case report: veterinary palliative care and hospice for a west highland terrier with transitional cell carcinoma.

In providing palliative care and hospice in a veterinary outpatient primary care setting it is important to manage all aspects of the patient's needs as well as the primary disease process, and to understand that veterinary palliative care and hospice do not require a special degree or board certification. They only require compassion for the terminally ill patient and the human family members, a commitment to keeping patients united with their families for as long as they are comfortable, and a willingness to keep a comprehensive perspective on the patient's changing needs as death nears.

AAHA/AAFP pain management guidelines for dogs and cats.

Pain management in dogs and cats has undergone a dramatic evolution in the past decade. Current approaches focus on anticipation and prevention of pain, as well as both pharmacologic and non-pharmacologic management techniques. The veterinary team plays an essential role in educating pet owners about recognizing and managing pain in their pets.

AAHA/AAFP pain management guidelines for dogs & cats.

Pain management in dogs and cats has undergone a dramatic evolution in the past decade. Current approaches focus on anticipation and prevention of pain, as well as both pharmacologic and nonpharmacologic management techniques. The veterinary team plays an essential role in educating pet owners about recognizing and managing pain in their pets.

Moving toward interdisciplinary pain management.

Pain is an unpleasant and emotional experience associated with actual or potential tissue damage. The current method of caring for a person with multiple issues and problems is a "multidisciplinary" approach; however, the disadvantages of a multidisciplinary approach are many. A more desirable alternative is an "interdisciplinary" approach. Interdisciplinary care is predicated on professionals communicating with one another about a single patient and designing care that is in the overall best interest of the patient. This paper describes the formation of the International Veterinary Academy of Pain Management, whose objective is to promote the interdisciplinary approach to animal pain management.