Veterinary Palliative and end-of-life care

Over the last twenty years, the number of companion animals has progressively increased. Dogs and cats are more and more integrated into human daily life, so much so that they are very often considered as family members. Consequently, owners pay particular attention to pets’ physical needs, but are also much more attentive to pets’ emotional and social well-being; they are therefore inclined to provide them with what is necessary to be healthy and happy, such as good quality food, wide physical and mental stimulation, adequate socialization and careful veterinary assistance during all stages of life. Veterinary medicine has answered by encouraging this evolution, and many practitioners now give special attention to the "human-animal bond". Alongside with this evolution of the human-animal bond, giant steps have also been made in the medical field, both in terms of diagnostic capabilities and therapeutic approaches: this has led to an increase of the animal lifespan, and the development of a population of geriatric patients and/or with chronic or terminal diseases. It is precisely in this context that palliative and hospice care fit well, with the veterinarian and the owner collaborating in order to help a pet who has been diagnosed with a chronic, incurable or terminal disease to live and die without suffering, possibly in the warmth of own's home, surrounded by family affections, making the last years, months, weeks of life as pleasant as possible. This type of care is based on the concept of comfort and relief and treat the patient as a whole, i.e., promoting not only its physical comfort, but also its social and emotional comfort. At the same time, hospice and palliative care help owners understand the disease process and make appropriate decisions based on their emotional, social and spiritual needs. Owners are accompanied along the entire path of care of their animal, from the initial diagnosis, through the disease progression and in preparation for the death of their animal, up to the subsequent phase of mourning. The aim of these treatments is therefore to improve as much as possible the quality of life of pets with chronic or terminal illnesses and to emotionally support the owner throughout the treatment phase. This new approach has a great psychosocial component: the medical-nursing aspects are the starting point around which to build the whole treatment protocol, and not the point of arrival. In this context, the role of the veterinarian evolves, becomes more elastic and meaningful, even more central and important: initiative and leadership, care and compassion, honesty and integrity, all these and many more are the components needed to heed a patient included in a palliative and hospice care program. Although veterinarians have basic knowledge of the fundamental elements of palliative and hospice care, its recognition as a distinct area of veterinary medicine is a relatively recent phenomenon, so much so that it still enjoys limited attention in the literature and, unfortunately, in clinical practice. This book aims to provide a guide and a resource for veterinary professionals who decide to carry out such care through an organized and structured system that applies to animals the concepts of human palliative and hospice care.