2023 AAFP/IAAHPC feline hospice and palliative care guidelines

summary of:
2023 AAFP/IAAHPC feline hospice and palliative care guidelines
Cat lying on autumn leaves
Eigner, D.R., Breitreiter, K., Carmack, T., Cox, S., Downing, R., Robertson, S. and Rodan, I.
Published in:
September 2023
Type of access:

Open access

In our edition of: Dec 2023
In our categories of: small animals

our summary:

Eigner, D.R. et al. (2023) 2023 AAFP/IAAHPC feline hospice and palliative care guidelines. Journal of Feline Medicine and Surgery. 25 (9).

These consensus guidelines, authored by a task force of experts from the American Association of Feline Practitioners and the International Association for Animal Hospice and Palliative Care, provide information for practitioners on all aspects of the hospice and palliative care of cats.

The guidelines introduce the idea of the ‘unit of care,’ a concept derived from human hospice practice, which includes both the feline patient and the caregiver and their needs. Using this approach, the caregiver is encouraged to become part of the cat’s care at every step.

A five-step care plan, through which a tailored approach to both the individual cat and caregiver can be taken, is proposed:

  1. Evaluation of the caregiver’s goals for the cat and their needs and beliefs.
  2. Discussion about the diagnostic and treatment options for the cat and their prognosis.
  3. Development of a personalised plan for the cat and caregiver.
  4. Application of hospice and palliative care techniques.
  5. Provision of emotional support during the care process and after the death of the cat.

A key part of step 1 is the establishment of a ‘budget of care’ in which the amount of financial, time, physical, and emotional resources that the caregiver has available to them are identified as this helps establish what can be done for the cat which is reasonable, practical and ethical.

The guidelines emphasize the importance of communication with the caregiver so as better to understand their preferences and to help them through the process.  Other issues covered include nutrition and hydration management, ethical considerations, quality of life, the importance of comfort care, feline emotional health, and end of life.

Supplementary material includes a caregiver brochure, a video ‘Teaching our cat to get used to medication’ and a hospice and palliative care patient questionnaire. Where applicable the guidelines signpost other relevant resources including related guidelines from the AAFP and WSAVA.

There is no explicit statement of the methodology used to develop the guidelines.

Take Home

These guidelines provide a practical guide to best practice when managing cats approaching the end of their lives. The structured approach will be helpful to veterinary professionals in guiding discussions with caregivers.

The following may also be of interest:

Gruen, M.E. et al. (2022) 2022 AAHA Pain Management Guidelines for Dogs and Cats. Journal of the American Animal Hospital Association, 58 (2), pp. 55–76. https://doi.org/10.5326/JAAHA-MS-7292
An inFOCUS summary is available

Ray, M. et al. (2021) 2021 AAFP Feline Senior Care Guidelines. Journal of Feline Medicine and Surgery, 23 (7) pp. 613-638  https://doi.org/10.1177/1098612X211021538
An inFOCUS summary is available.

Monteiro, B.P. et al. (2023)  2022 WSAVA guidelines for the recognition, assessment and treatment of pain. Journal of Small Animal Practice, 64 (4), pp. 177-254. https://doi.org/10.1111/jsap.13566

Steagall P.V. et al. (2022)  2022 ISFM consensus guidelines on the management of acute pain in cats. Journal of Feline Medicine and Surgery, 24 (1) pp. 4-30.  https://doi.org/10.1177/1098612X211066268

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