Animal Hospice and Palliative Medicine for the House Call Veterinarian
- 1st Edition - October 20, 2022
- Author: Lynn Hendrix
- Language: English
- Paperback ISBN:9 7 8 - 0 - 3 2 3 - 5 6 7 9 8 - 5
- eBook ISBN:9 7 8 - 0 - 3 2 3 - 5 6 7 9 9 - 2
Gain the understanding you need to provide compassionate, end-of-life pet care. Animal Hospice and Palliative Medicine for the House Call Veterinarian provides an all-in-on… Read more

Purchase options
Institutional subscription on ScienceDirect
Request a sales quoteGain the understanding you need to provide compassionate, end-of-life pet care. Animal Hospice and Palliative Medicine for the House Call Veterinarian provides an all-in-one guide to the skills and challenges related to this growing area of veterinary care. From setting up your business and performing your first in-home consultation to managing pain, performing in-home euthanasia, and providing grief support to the family, this book walks you through each step of care. Written by Dr. Lynn Hendrix, a leading expert and researcher in veterinary palliative medicine, this practical resource shows how to improve the quality of care for pets in the final stages of life.
- Comprehensive coverage addresses the essential topics of palliative care, hospice, and euthanasia.
- Key topics range from setting up a mobile business, in-home consultations to pain management, euthanasia, physical support for the pet, and much more.
- Information on the diseases commonly seen at the end of life includes disease progression and trajectories.
- Single-source review covers animal end-of-life care and consulting, specifically through mobile veterinary services.
- 100 full-color clinical photos depict the concepts and procedures of animal palliative care.
- Practical insights are provided in the areas of family grief support, compassion fatigue, managing difficult home visits, and dispelling the myths of animal hospice and euthanasia.
- Author Lynn Hendrix is an expert veterinarian with than a decade of experience in the field of Veterinary Palliative Medicine and is also the owner/founder of Beloved Pet Mobile Vet, a company providing in-home animal hospice and euthanasia.
- Cover image
- Title page
- Table of Contents
- Copyright
- Contributors
- Preface
- Chapter 1. Introduction to animal hospice
- Paradigm shift
- Increasing awareness
- Founding organizations
- Similarities to human hospice and differences
- Evidence-based medicine
- Conclusion
- Chapter 2. Veterinary Palliative Medicine changes the paradigm
- Highlights
- Introduction to palliative medicine
- Veterinary palliative medicine versus animal hospice
- Goals of veterinary palliative medicine and hospice
- Challenges faced in starting veterinary palliative medicine or animal hospice
- Myths and other FAQs
- Conclusion
- Chapter 3. House call business basics
- Setting up a housecall practice
- Marketing for hospice, palliative medicine, and in-home euthanasia services
- Conclusion
- Chapter 4. Your first appointment
- Prior to the visit
- Setting up the appointment
- First meeting in the home
- Legal
- Informational white sheets
- The exam
- Distress versus suffering
- Quality-of-life scales
- The HHHHHMM scale
- Brambell's Five Freedoms
- JOURNEY's quality-of-life scale
- JOURNEYS quality of life scale for pets considers the following
- Lap of Love quality-of-life scale
- Animal advanced directives
- Prescribing medication in the home setting
- Planning for death and body care
- What to do in a crisis
- Wrapping up the consultation
- Making follow-up visits
- One last thing …
- Calendar your life
- Conclusion
- Chapter 5. Palliative symptom and disease management
- Anxiety
- Ascites
- Bleeding
- Head and neck bleeding
- Oral bleeding
- Bleeding dermal masses
- Bleeding internal organs
- Hemoptysis
- Disseminated intravascular coagulopathy and other coagulopathies
- Breathlessness
- General symptoms that may occur with breathlessness
- Specific diseases that may cause breathlessness in end-of-life patients
- End-stage pulmonary disease
- Pulmonary neoplasia
- COPD
- Late-stage pneumonia
- Cachexia and other muscle loss in the end-of-life patient
- Identifying factors involved in cachexia
- Carcinomatosis
- Chronic kidney disease, end-stage
- Constipation
- Delirium
- Dementia
- Etiology/DDX
- Diarrhea
- Dysphagia
- Dysrexia
- Fever
- Frailty
- Hydration/nutrition for the late-stage patient
- Hypercalcemia
- Hypertension
- Liver cancer and other late-stage liver diseases
- Metastasis
- Nausea/vomiting
- Neuromuscular disease
- Laryngeal paralysis/Geriatric Onset Laryngeal Paralysis and Polyneuropathy (GOLPP)
- Musculoskeletal issues
- Osteosarcoma
- Nonmedical therapies
- Oral care for diseases of the head and neck
- Pancreatic disease, late-stage
- Pancreatic cancer
- Insulinoma
- Glucagonoma
- Gastrinoma
- Seizures
- Sleep/wake disturbances
- Skin care, end-of-life
- Interventional therapies
- Integrative care
- Conclusion
- Chapter 6. Chronic pain management in the home setting
- Recognizing chronic pain
- The physiology of pain
- Types of pain
- Summary of pain terminology
- Evaluating chronic and cancer pain in the late-stage patient
- Dog-specific chronic pain behavior
- Cat-specific chronic pain behavior
- Common pain-related behavior for dogs or cats
- Assessing chronic pain
- Validated chronic pain scales
- Chronic pain in specific diseases
- Organ failure and other comorbidities
- Treatment: Pharmaceuticals for chronic pain in veterinary patients
- Non-steroidal anti-inflammatory drugs (NSAIDs)
- Recommended NSAID dosages and indications
- Cox-1 inhibitors
- Cox-2 selective inhibitors
- Cox-3/Cox1-V1 inhibition
- PGE-4 receptor antagonist
- Steroids
- Gabapentinoids
- Antidepressants
- Cerenia® (maropitant)
- Local anesthetics
- Medication to treat acute pain in the home setting
- Tramadol
- Non-pharmaceutical pain management
- Palliative radiation
- Weight loss therapy
- Physical therapy, rehabilitation
- Nutraceuticals
- Herbal therapies
- Cannabis
- Acupuncture
- Low-Level Therapeutic Laser
- Heat/Cold therapy
- Music
- Targeted pulsed electromagnetic field therapy
- Developing a crisis kit
- Chapter 7. Physical support
- Supporting mobility and quality of life
- Benefits of improving mobility
- Dealing with mobility complications in chronic and life-limiting disease
- Multimodal analgesia
- A personalized plan for mobility
- Managing the environment
- Assistive devices
- Toe grips and pad treatments
- Business aspects of wheelchair/cart sales and rentals
- Other mobility aids
- Orthotics and prosthetics
- Splints
- Booties and socks
- Physical therapy
- Tools utilized by veterinary physical therapists/rehabilitators
- TENS unit
- Assisi loop
- Chiropractic
- Conclusion
- Chapter 8. Creating your interdisciplinary team
- The ideal team
- Additional skills needed by veterinary technicians in veterinary hospice and palliative care
- Communication
- Analytical skills
- Technical patient skills
- Caregiver/client skills
- Body care of deceased animals
- Hospice/Palliative additional team skills
- Knowledge of animal hospice ethics
- Other team members
- Chapter 9. Supporting grief
- A brief overview of mental health professionals
- Common understanding of grief
- Stages of expected grief
- Trajectories of grief
- Postdeath expected grief
- “Atypical” grief
- Complicated grief
- Clinical signs of complicated grief
- How complicated grief differs from “Typical” grief
- Disenfranchised grief
- Delayed grief
- Traumatic death
- Traumatic grief
- Suicidal ideation
- Suicide risk factors
- Health factors
- Environmental factors
- Historical factors
- Talking to children about end-of-life issues
- Four cognitive stages for child development: infancy through adolescence
- Infants and toddlers (birth to 2 years)
- Preschoolers (2–5 years)
- School-age (6–11 years)
- Tweens and teens (12–18 years)
- At-home discussions with children
- Memorializing
- Adult support: finding mental health professionals to help you help clients
- Adult and youth support books
- Grief in animals
- Chapter 10. Supporting a palliated death⋆
- Changing our definitions
- Death is the natural conclusion of life
- Utilizing veterinary palliative medicine at the end of life
- The physiology of death
- Clinical signs of impending death
- Pathophysiology of death
- Cardiopulmonary
- Neurologic changes
- Altered oxygen and carbon dioxide levels
- Altered blood flow
- Increased intracranial pressure
- Delirium
- Palliated death
- Palliative sedation
- Holding vigil
- Planning for imminent death
- Medications to have on hand for imminent death
- Post-palliated death
- Postmortem changes (0min–2h)
- Postmortem changes (30 min–36 h)
- Unusual postmortem phenomena
- Postmortem (within a few minutes to days, months)
- Conclusion
- Checklist for the veterinarian caring for a palliative-supported patient (regardless of the death)
- Chapter 11. Providing a gentle death-Euthanasia
- The client's experience
- The animal's experience
- Routes for medication
- α-2 agonists
- Seratonin reuptake inhibitors
- Injectable medications
- Opioids
- α-2 agonists
- Benzodiazepines
- Difficult euthanasias
- Additional tips and challenging situations to prepare for
- Conclusion
- Chapter 12. Respectful aftercare of the beloved pet
- Types of cremation
- Rituals around body care
- Herbs/incense
- Crystals
- Personal items of animal
- Religious and cultural traditions
- Catholic
- Judaism
- Muslim
- Hinduism
- Buddhist
- Pagan
- Chapter 13. Dealing with compassion fatigue, burnout, and impostor syndrome
- The difference between compassion fatigue and burnout
- What can you do to change your path?
- Impostor syndrome
- Conclusion
- Chapter 14. Personal safety and difficult home visits
- Personal safety
- Phone contact
- An angry call
- An example of a call that sounded dangerous
- Drug-seeking phone calls
- Arriving at the house
- Physical abuse
- Angry and emotionally abusive clients
- Case example
- Weapons in the home
- When families disagree
- Emotional and verbal abuse
- Complicated grief
- What can you do for those who you are concerned might be considering suicide?
- A word on self-defense
- Start creating plans
- Cancellations
- Firing clients
- Firing a client letter
- The euthanasia that has gone poorly
- Conclusion
- Chapter 15. Expanding access to palliative medicine education and organization
- Hospice or palliative medicine?
- Current organizations
- IAAHPC
- IVAPM
- The future of veterinary palliative medicine organizations
- WVPMO
- Local organizations around the world
- The Australian Veterinary Palliative Care Advisory Council
- Other conferences
- Online education
- VIN folder
- Facebook group—Veterinarian Palliative Medicine Group
- Conclusion
- Chapter 16. Redefining veterinary medicine: The future of veterinary palliative medicine and animal hospice
- Where do we need to go?
- Getting veterinary palliative care to more people and their pets
- Certification to specialization
- What more could we do?
- Involving more veterinary technicians and mental health
- Research
- Building other interdisciplinary organizations
- Technology for veterinary palliative medicine
- Integration of early palliative care into practice
- Appendix
- Index
- No. of pages: 444
- Language: English
- Edition: 1
- Published: October 20, 2022
- Imprint: Elsevier
- Paperback ISBN: 9780323567985
- eBook ISBN: 9780323567992