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2016 AAHA/IAAHPC End-of-Life Care Guidelines

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End-of-life (EOL) care and decision-making 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. (J Am AnimHosp Assoc 2016; 52:341-356. DOI 10.5326/JAAHA-MS-6637)

EOL (end-of-life); QOL (quality of life); CF (compassion fatigue); AVMA (American Veterinary Medical Association)

These guidelines were prepared by a task force of experts convened by the American Animal Hospital Association and the International Association for Animal Hospice and Palliative Care for the express purpose of producing this article. This document is intended as a guideline only. Evidence-based support for specific recommendations has been cited whenever possible and appropriate. Other recommendations are based on practical clinical experience and a consensus of expert opinion. Further research is needed to document some of these recommendations. Because each case is different, veterinarians must base their decisions and actions on the best available scientific evidence, in conjunction with their own expertise, knowledge, and experience.