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Companion Animal End of Life Care for the Veterinary Technician
Alyssa Eslinger (Edited by), Joye Sears (Edited by)
9781394266067, Wiley
Paperback / softback, published 10 November 2025
352 pages
24.9 x 17.5 x 2.3 cm, 0.703 kg
A practical, one-stop resource for veterinary technicians offering end-of-life services for companion animals In Companion Animal End of Life Care for the Veterinary Technician, an experienced interdisciplinary team delivers a comprehensive guide for veterinary technicians seeking a resource covering all aspects of the veterinary technician’s role in companion animal end-of-life care. The book explores everything from palliative nursing strategies to euthanasia techniques, with special attention to supporting and communicating with caregivers throughout the end-of-life period. The editors offer invaluable support, knowledge, and skills to enhance your ability to provide patients with comfort and offer empathy to caregivers in challenging situations. In this book, you will find a practical approach and user-friendly format, a handy and accessible reference for daily veterinary practice. you will also discover: Perfect for practicing veterinary technicians with a desire to improve their standard of end-of-life care, Companion Animal End of Life Care for the Veterinary Technician will also benefit students of veterinary technology start their careers with the mindset and tools to lean into the meaningful experiences that can be accessed through compassionate end-of-life care.
List of Contributors xvii Acknowledgments xix Introduction xxi About the Companion Website xxv Part I Overview of Hospice and Palliative Care 1 1 Introduction to Animal Hospice and Palliative Care 3 1.1 Introduction 3 1.2 Terminology and Definitions 4 1.3 Psychosocial Considerations 5 1.4 The Interdisciplinary Team 5 1.4.1 Role of Veterinary Technicians 8 1.4.2 Role of Veterinary Social Workers 8 1.4.3 Effective Use of Interdisciplinary Teams 9 1.5 Hospice Care Approach 9 1.6 End-of-Life Care Delivery Models 10 1.6.1 Role of Telemedicine 11 1.6.2 Informed Consent and Liability Considerations 13 1.7 Takeaways 13 References 13 2 Pain Recognition and Assessment 15 2.1 Introduction 15 2.2 The Physiology and Classification of Pain 15 2.2.1 Somatic and Visceral Pain 17 2.2.2 Acute vs Chronic Pain 17 2.2.3 Neuropathic Pain 17 2.3 Pain Recognition 18 2.3.1 Fear, Anxiety, Stress, and Pain Recognition 19 2.4 Pain Assessment Tools 20 2.4.1 Simple Pain Scales 20 2.4.2 Multidimensional Acute Pain Scales 21 2.4.3 Multidimensional Chronic Pain Scales 22 2.5 Practical Pain Assessment 28 2.6 Caregiver Communication and Education 29 2.6.1 Caregiver Myths and Misconceptions 29 2.7 Takeaways 30 References 31 3 Pain Management 33 3.1 Introduction 33 3.2 Role of Veterinary Technicians and Approach to Pain Management 33 3.3 Pharmaceutical Pain Management 35 3.3.1 NSAIDs 35 3.3.2 Opioids 36 3.3.3 Corticosteroids 38 3.3.4 Gabapentinoids 38 3.3.5 NMDA Receptor Antagonists 39 3.3.6 Other Adjunctive Analgesics 40 3.3.6.1 Local Anesthesia 41 3.3.6.2 Monoclonal Antibody Therapy 41 3.3.6.3 Bisphosphonates 41 3.3.6.4 Cannabidiol 41 3.4 Physical Modalities 42 3.4.1 Manual Therapy Techniques 43 3.4.2 Thermotherapy 43 3.4.3 Therapeutic Laser 43 3.4.4 Electrotherapy 44 3.4.5 Therapeutic Ultrasound and Extracorporeal Shockwave Therapy 45 3.4.6 Acupuncture 47 3.5 Nutrition, Nutraceuticals, and Herbal Medicine 47 3.5.1 Nutrition 47 3.5.2 Chondroprotectants 48 3.5.3 Herbal Medicine 48 3.6 Pain Management Case Studies 48 3.6.1 “Leo” – Canine Osteosarcoma 48 3.6.2 “BB” – Feline Osteoarthritis and Intestinal Lymphoma 49 3.7 Exotic Pet Pain Management 50 3.8 Caregiver Education and Communication 51 3.9 Takeaways 51 References 52 4 Hospice and Palliative Nursing Care 55 4.1 Introduction 55 4.2 General Comfort Care 56 4.2.1 Environmental Modifications 56 4.2.2 Mobility 57 4.2.3 Hygiene and Toileting 60 4.2.4 Nutrition 61 4.2.5 Mucous Membrane Comfort 63 4.2.6 Fluid Support 63 4.2.7 Medication and Treatment Administration 64 4.2.8 Mental and Emotional Wellbeing 65 4.3 Sign-Specific Nursing Care 65 4.3.1 Recumbency 66 4.3.2 Wounds 66 4.3.3 Gastrointestinal Signs 67 4.3.4 Respiratory Distress 67 4.3.5 Musculoskeletal Signs 68 4.3.6 Neurological Signs 68 4.3.6.1 Neuromuscular or Spinal Disease 68 4.3.6.2 Intracranial Disease 69 4.3.6.3 Cognitive Dysfunction (CD) 69 4.3.7 Neoplastic Signs 69 4.4 Comfort Kits 70 4.5 Takeaways 73 References 74 5 Understanding and Assessing Quality of Life 75 5.1 Introduction 75 5.2 Quality-of-Life Assessments 76 5.2.1 Effective Use of Quality-of-Life Assessments 76 5.3 Components of Quality-of-Life Assessments 78 5.3.1 Physical Wellbeing 78 5.3.2 Social Wellbeing and Mental Stimulation 79 5.3.3 Emotional Wellbeing and Autonomy 80 5.3.4 Other Considerations 80 5.3.4.1 Global Score 80 5.3.4.2 Caregiver Burden 80 5.4 Selected Quality-of-Life Assessment Tools 80 5.4.1 Selected Quality-of-Life Assessments 81 5.4.2 Individualized Quality-of-Life Questionnaire 83 5.5 Role of Telemedicine 85 5.6 Large Animal and Exotics Considerations 87 5.7 Takeaways 87 References 88 Part II End-of-Life Communication and Decision-Making 91 6 Building Essential Communication Skills 93 6.1 Introduction 93 6.2 Core Communication Skills 93 6.2.1 Nonverbal Communication 94 6.2.2 Asking Questions 95 6.2.3 Active Listening 97 6.2.4 Showing Empathy 100 6.3 Emotional Intelligence 101 6.3.1 Self-Awareness 102 6.3.2 Self-Management 103 6.3.3 Social Awareness 104 6.3.4 Relationship Management 104 6.4 Team-Based Communication 104 6.4.1 Getting the Team on Board 104 6.4.2 Building Skills Within the Team 105 6.5 Takeaways 105 References 105 7 Supporting Difficult Conversations 107 7.1 Introduction 107 7.2 Difficult Clients vs Difficult Situations 107 7.3 Applying Communication Skills to Difficult Conversations 108 7.3.1 Partnership Statements 108 7.3.2 Warning Shots 108 7.4 A Model for End-of-Life Conversations 109 7.4.1 Setting 109 7.4.2 Perspective 109 7.4.3 Invitation 109 7.4.4 Knowledge 109 7.4.5 Empathize 110 7.4.6 Summarize and Strategize 110 7.5 Conflict Resolution 110 7.6 Types of Difficult Conversations 112 7.6.1 Grief 112 7.6.2 Delivering Bad News 112 7.6.3 Anger 113 7.6.4 Financial Conflict 114 7.6.5 Disagreement Within the Team 116 7.6.6 Disagreement Among Caregivers 119 7.7 Assess for Success 121 7.8 Takeaways 121 References 121 8 Ethical End-of-Life Decision-Making 123 8.1 Introduction 123 8.2 Communication in EOL Decision-Making 124 8.3 Caregiver Perspectives on EOL Decision-Making 124 8.3.1 Conflicting Caregiver Perspectives 127 8.4 Factors for Veterinary Team Consideration in EOL Decision-Making 128 8.4.1 Quality-of-Life Assessments in EOL Decision-Making 128 8.4.2 Caregiver Burden and EOL Decision-Making 129 8.4.3 Caregiver Preferences and Euthanasia Timing 130 8.5 Considerations for Hospice-Supported Natural Death 131 8.6 Ethical Dilemmas and Moral Stress 132 8.6.1 Convenience Euthanasia 133 8.7 EOL Decision Documentation and Debriefing 134 8.8 Takeaways 134 References 134 9 Death and Dying 137 9.1 Introduction 137 9.2 Animal Experience of Dying 138 9.2.1 Signs of Dying 138 9.2.2 Signs of Death 140 9.3 Natural Death vs Hospice-Supported Natural Death 140 9.4 Informed Consent for Hospice-Supported Natural Death 142 9.5 Ethical Challenges in Hospice-Supported Natural Death 143 9.6 Nursing Care in Hospice-Supported Natural Death 145 9.6.1 Environment and General Comfort 146 9.6.2 Anxiety 146 9.6.3 Pain 146 9.6.4 Nutrition and Fluids 147 9.7 Takeaways 147 References 148 Part III Euthanasia 149 10 Providing a Compassionate Euthanasia Experience 151 10.1 Introduction 151 10.2 Defining Euthanasia and Dysthanasia 152 10.3 Meaningful Components of the Euthanasia Appointment 154 10.3.1 Grief Support Materials Provided 155 10.3.2 Outline Caregiver and Pet Preferences 155 10.3.3 Offer Privacy Before and After Death 156 10.3.4 Deliver Proper Technique 156 10.3.5 Establish Rapport 156 10.3.6 Use Pre-euthanasia Sedation or Anesthesia 157 10.3.7 Thorough, Complete Consent 157 10.3.8 Helpful and Compassionate Personnel 157 10.3.9 Adequate Time 157 10.3.10 Narrate the Process 158 10.3.11 Avoid Pain and Anxiety 158 10.3.12 Safe Space to Gather 158 10.3.13 Inclusion of Loved Ones 158 10.3.14 Assistance with Body Care (Aftercare) 158 10.4 Technicians in the Role of Euthanasia Provider 159 10.5 Communicating Effectively Before, During, and After Euthanasia 160 10.5.1 Establish Rapport 161 10.5.2 Find Comfort with Silence 162 10.5.3 Use the Basics of Good Communication 162 10.5.4 Offer Praise 162 10.5.5 Piece It Out 163 10.5.6 Create Partnership 164 10.5.7 Attend to Emotional Intelligence 164 10.6 Medical Records 165 10.7 Takeaways 165 References 166 11 Anatomy of a Humane Euthanasia 167 11.1 Introduction 167 11.2 Technicians as Euthanasia Attendants 167 11.3 Euthanasia Methods and the Physiology of Death 168 11.3.1 Methods of Euthanasia 168 11.3.2 Body Changes 169 11.4 Pre-euthanasia Sedation and Anesthesia Protocols 171 11.4.1 Effects of Pre-euthanasia Sedation and Anesthesia Protocols 173 11.4.2 Administration of Pre-euthanasia Sedation or Anesthesia 174 11.5 Euthanasia Room Comforts 177 11.5.1 Euthanasia in the Hospital Setting 177 11.5.2 Euthanasia in the Home Setting 179 11.6 Balancing EOL Work and Well-Being 180 11.7 Takeaways 181 References 181 12 Euthanasia Techniques in Companion Animals 183 12.1 Introduction 183 12.2 Euthanasia Injection Techniques 185 12.2.1 Intravenous (IV) Injections 186 12.2.2 Intracardiac (IC) Injections 188 12.2.3 Intrarenal (IR) Injections 190 12.2.4 Intrahepatic (IH) Injections 191 12.2.5 Intraperitoneal (IP) Injections 193 12.3 Alternative Euthanasia Administration Techniques 194 12.3.1 Oral Administration of Euthanasia Drugs 194 12.3.2 Intrathecal Anesthetic Euthanasia 194 12.3.3 Physical Methods of Euthanasia 194 12.3.4 Euthanizing Fetuses 195 12.4 Physical Changes During Death and Pronouncing Death 195 12.5 Exotic Pet Considerations 197 12.5.1 General Considerations for Patient Comfort 198 12.6 Unique Circumstances 199 12.7 Takeaways 200 References 201 13 Respectful Deceased Body Care 203 13.1 Introduction 203 13.2 Aftercare Ordering Models 205 13.2.1 Veterinary Aftercare Ordering Model (VAOM) 205 13.2.2 Client Aftercare Ordering Model (CAOM) 205 13.3 Respectful Body Containment 205 13.4 Moving a Deceased Body 208 13.5 Modern Options in Aftercare 209 13.5.1 Cremation 211 13.5.2 Burial 212 13.5.3 Aquamation 214 13.5.4 Body Preservation 215 13.5.5 Educational Memorial Body Donation 216 13.6 Minimizing Aftercare Mistakes and Exceeding Expectations 217 13.7 Expected Postmortem Changes and Decomposition 218 13.7.1 Decomposition 219 13.8 Takeaways 221 References 221 Part IV Grief and Memorialization 223 14 Introduction to Grief 225 14.1 Introduction 225 14.2 The Fundamentals of Grief 225 14.3 The Human–Animal Bond: A Unique Loss 227 14.3.1 Guilt and Regret 229 14.3.2 Anger 231 14.4 Recognizing Grief Responses 231 14.4.1 Uncomplicated Grief 231 14.4.2 Disenfranchised Grief 232 14.4.3 Anticipatory Grief 232 14.4.4 Prolonged Grief Disorder and Suicidality 234 14.5 Factors Impacting Grief Responses from Pet Loss 234 14.5.1 Euthanasia 235 14.5.2 Sudden Loss 236 14.5.3 Loss of Service Animals 236 14.5.4 Culture and Spirituality 237 14.5.5 Perceived Social Support 238 14.5.6 Age 239 14.6 Considerations for a Grieving Pet 241 14.7 Takeaways 241 References 243 15 Pet Loss Support 245 15.1 Introduction 245 15.2 Language Sensitivity in Grief Support 246 15.3 Providing Grief Support and Memorialization 246 15.3.1 Aftercare Services 246 15.3.2 Memorial Activities and Keepsakes 249 15.3.3 Follow-Up Care and Support 252 15.3.3.1 Post-Death Phone Call 252 15.3.3.2 Sympathy Cards 253 15.3.3.3 Picking Up Remains 255 15.4 Developing a Pet Loss Resource Guide 255 15.4.1 Essential Components of a Pet Loss Resource Guide 255 15.5 Addressing Specific Grief Responses 256 15.5.1 Anticipatory Grief: Preparing Caregivers 256 15.5.2 Integrating Cultural Sensitivity in Grief Support 258 15.5.3 Integrating Spiritual Sensitivity in Grief Support 259 15.5.4 Supporting Grieving Pet Owners with Suicidal Ideation 259 15.6 Takeaways 260 15.a Pet Loss Resource Guide Template 262 15.b Suicide Response Guidelines for Veterinary Practices 263 References 264 16 Children and Pet Loss 267 16.1 Introduction 267 16.2 The Role of Technicians in Supporting Families with Children 268 16.3 Children’s Perceptions and Age-Specific Advice 269 16.4 Talking to Children About Death and Loss of a Pet 272 16.4.1 Use Simple and Direct Language 272 16.4.2 Validate Feelings 272 16.4.3 Be Patient and Nonjudgmental 274 16.4.4 Avoid Euphemisms 275 16.4.5 Avoid Lying 275 16.4.6 Avoid Blame 276 16.4.7 Spiritual and Religious Considerations 276 16.4.8 Parent/Caregiver Resources for Children of All Ages 277 16.5 Supporting Children Through Diagnosis and Treatment of a Pet’s Serious Illness 278 16.6 Involvement of Children Through Euthanasia 279 16.6.1 Preparing the Family for Euthanasia 279 16.6.2 Explaining Euthanasia to Children 280 16.6.2.1 Why Is This Happening? 280 16.6.2.2 What Does It Mean? 280 16.6.2.3 How Does It Happen? 281 16.6.3 The Presence of Children During Euthanasia 281 16.6.3.1 Children Under the Age of Five 282 16.6.3.2 Middle to Late Childhood (6–13 Years) 283 16.6.3.3 Teens and Young Adults (14–21 Years) 283 16.6.4 Preparing the Veterinary Team for Children-Present Euthanasia 283 16.6.4.1 EOL Comfort Kits for Children 284 16.7 Preparing for the Unexpected 286 16.8 Supporting Children’s Grief Through Memorialization 287 16.9 Considerations for Getting a New Pet 289 16.10 Takeaways 289 References 291 Part V Team Wellness and Growth 293 17 Empathic Strain and Veterinary Team Wellness 295 17.1 Introduction 295 17.2 Empathic Strain in Veterinary Practice 295 17.2.1 Causes of Empathic Strain 297 17.2.2 The Role of Moral Distress in Empathic Strain 297 17.3 Personal Approaches to Mitigating Empathic Strain 298 17.3.1 Empathic Strain Personal Warning System 298 17.3.2 Mindfulness Practices 299 17.3.3 Professional Support and Mentorship 300 17.4 Organizational Strategies for Enhancing Well-Being 300 17.4.1 Leadership’s Role in Ensuring Psychological Safety 300 17.4.2 Developing Policies and Procedures 301 17.4.3 Peer Debriefing 302 17.4.4 Integrating Veterinary Social Work 303 17.5 Takeaways 303 References 304 18 The Future Is Bright 307 18.1 Technician Utilization and Lifelong Learning 307 18.2 Meaningful Purpose and Leadership 307 18.3 Business Considerations 308 18.4 Veterinary Social Work 309 18.5 Specialization and Collaboration 309 18.6 Quality of Life Perspectives 309 18.7 Research Priorities 310 18.8 Conclusion 310 References 310 Index 311
Alyssa Eslinger
Alyssa Eslinger and Amy Birchall
Alyssa Eslinger
Alyssa Eslinger
Alyssa Eslinger
Joye Sears and Becky Taylor
Joye Sears
Alyssa Eslinger
Alyssa Eslinger
Kathleen Cooney
Kathleen Cooney
Kathleen Cooney
Kathleen Cooney
Sarah Bernardi
Sarah Bernardi
Sarah Bernardi and Amy Sugar
Sarah Bernardi and Kathleen Dunbar
Alyssa Eslinger and Joye Sears
Subject Areas: Veterinary medicine [MZ]
