Both euthanasia and hospice-supported natural death are medically and ethically acceptable options in veterinary EOL care and animal hospice. Deciding between humane euthanasia and hospice-supported natural death should be the result of a collaborative discussion involving the caregiver and the animal hospice team.

Animal hospice principles do not accept a pet owner’s decision to allow a pet to die without effective palliative measures while under the care of a licensed veterinarian. If pain and suffering cannot be relieved by other means, withholding palliative sedation or euthanasia is considered unethical and inhumane.

The following guidelines will help the healthcare team to engage in ethical, collaborative EOL decision making:

1. Discuss all euthanasia and natural-death options with the pet owner (do not exclude or minimize any single option).
2. Recognize that many pet owners rely on a veterinarian’s recommendation for the best approach to a pet’s end of life, while others prefer the primary decision-making role.
3. Describe EOL options to pet owners in language they can understand.
4. Describe EOL options in a factual and non-judgmental manner, articulating pros and cons of each option.
5. Avoid a biased presentation of information designed to steer a client’s EOL choices in the direction of the veterinarian’s preferences.
6. Support the pet owner’s EOL decision for the pet, accepting that their values and beliefs may be different from the veterinarian’s.

Euthanasia, a universally legal and widely accepted tool in veterinary care, is a two-edged sword. On one hand, it provides an end to animal suffering when it becomes medically, financially, or physically impossible to maintain the patient’s quality of life. On the other hand, it leaves significant numbers of caregivers struggling with doubts regarding the decisions they made, which prolongs and complicates their grief experience. As the value of animal hospice care and its availability increase, so will the feasibility of ethically managed, high quality, hospice-supported natural death, and the decision to euthanize will become more nuanced. A satisfactory decision to euthanize is heavily dependent on open, honest, and empathetic communication with the client.

Following the death of a pet, a significant number of owners will experience profound grief. In some cases, the client’s sense of bereavement may be accompanied by anger that is directed at the practice team. The power of appropriate follow-up by the healthcare team to offset the depth and duration of the client’s grief response cannot be overestimated. This type of outreach can take the form of a condolence card, phone call, sponsorship of a pet-loss support group facilitated by a professional counselor, or referral to counseling services or online resources.

Compassionate communication opportunity

After the death of the pet, check in with clients to see how they are coping.