For cats, the Feline Musculoskeletal Pain Index is useful. For dogs, the Helinski Brief Pain Index and Canine Brief Pain Inventory provide good options. Hendrix recommends utilizing validated chronic pain assessments. Pain assessment is crucial, as Hendrix finds that “many diseases have pain at the end stage.” It is important that the veterinarian identify signs of pain and help the owner to recognize them as well. The first step in guiding owners through end-of-life decision-making for a pet is an examination. Once an owner can recognize signs of distress in their pet, they are more likely to be open to a conversation about palliative options. We can advise owners on clinical signs to watch for, such as changes in respiratory patterns or posture that may be indicative of respiratory distress or pain. Distress, on the other hand, can be observed. Those without medical training may not perceive that their pet is suffering as we might. She differentiated the idea of suffering from distress. Hendrix reminded the audience that perceptions vary among individuals and are influenced by past experiences. This can be difficult when you and the client are seeing different things when looking at the pet. Trust must be established, and judgment withheld. It is essential for the patient’s well-being that the veterinary team and client be on the same side. She encourages veterinarians to give owners time to process and take the time to discuss with them what they may be fearful of. In Hendrix’s experience, “most people who seem to be in denial are not. The last group are those who seem to be in denial but who are experiencing the freeze response. Those in flight mode may leave the clinic without making a decision or even taking medications. Those whose fear manifests as anger are usually in fight mode. This fear can manifest in many ways, usually through the fight, flight, or freeze response seen when the body is under stress. This fear may be about the impending loss, the cost of treatment, of waiting too long to help their pet, or of feeling shame about their decision. Hendrix said that the reactions to decisions surrounding the death of a pet are often driven by fear. During a recent Fetch dvm360® virtual conference, Hendrix discussed how veterinarians can help their clients prepare for the death of their pet. According to Lynn Hendrix, DVM, CHPV, owner of Beloved Pet Mobile Vet and cofounder and outgoing president of the World Veterinary Palliative Medicine Organization, sometimes it is asked because the owner is looking to an expert for permission to go ahead with a decision they’ve already made, and sometimes it is because they truly do not know. We can provide support and direct you to specialists in grieving the loss of a pet.How do you know when it is time? Veterinarians are commonly asked this question. We are all pet owners ourselves and we understand the difficulty in letting a pet go. It is one of the greatest kindness’ that we can do for our pets, we can prevent pain and suffering, even though it is heartbreaking. Your pet will not be aware of what is happening. As we come to you, most of the time your pet will be relaxed and we can be anywhere where you and your pet are most comfortable. When the time comes we can explain all the steps and options available to you. We look at each case individually and their home life, we are happy to speak to all members of the family and go through everyone’s concerns. We look at all aspects of your pet’s health, physical and mental health, their interactions and natural functions. We will always discuss end of life care with you and look at options. We aim to make the process as stress-free as possible. This will always be one of the toughest decisions that you will have to make when owning a pet.
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