{"product_id":"hospice-and-palliative-care-for-companion-animals-isbn-9781119808787","title":"Hospice and Palliative Care for Companion Animals","description":"\u003cb\u003eHospice and Palliative Care for Companion Animals\u003c\/b\u003e \u003cp\u003e\u003cb\u003eA thoroughly updated and expanded new edition of the only book providing comprehensive treatment of hospice and palliative care in veterinary medicine\u003c\/b\u003e \u003c\/p\u003e\u003cp\u003eAnimals with life-limiting illnesses deserve compassionate, thoughtful, end-of-life care. Their caregivers and families, faced with the loss of a beloved companion, deserve empathy, support, and education, to guide them through an emotionally wrenching period and provide their companion animals with the highest possible quality of life. In recent years, the ethics of care and service to sick and dying animals and their caregivers has been the subject of considerable attention. \u003c\/p\u003e\u003cp\u003e\u003ci\u003eHospice and Palliative Care for Companion Animals, 2\u003csup\u003end\u003c\/sup\u003e Edition\u003c\/i\u003e provides a thorough update to the first and only complete guide to this field of service, its foundations, and its applications. It addresses the needs of pets, caregivers, and veterinary professionals alike, including fundamental ethical and emotional principles as well as detailed discussion of specific illnesses and life-limiting conditions. The expanded second edition incorporates cutting-edge research into animal behavior and cognition to enrich the reader’s understanding of companion animals’ emotional needs and their experience of illness and death. \u003c\/p\u003e\u003cp\u003e\u003ci\u003eHospice and Palliative Care for Companion Animals, 2\u003csup\u003end\u003c\/sup\u003e Edition\u003c\/i\u003e readers will also find: \u003c\/p\u003e\u003cul\u003e\n\u003cli\u003e Existing chapters expanded to incorporate new research and practical experience\u003c\/li\u003e \u003cli\u003e New chapters discussing factors underlying the decision to euthanize, the potential role of ethology in palliative care, and more\u003c\/li\u003e \u003cli\u003e A companion website with educational handouts for use in veterinary practices\u003c\/li\u003e\n\u003c\/ul\u003e \u003cp\u003e\u003ci\u003eHospice and Palliative Care for Companion Animals\u003c\/i\u003e is an indispensable resource for caregivers and veterinary professionals alike. \u003c\/p\u003e\u003cp\u003eList of Contributors xxi\u003c\/p\u003e \u003cp\u003eAcknowledgments xxiii\u003c\/p\u003e \u003cp\u003eAbout the Companion Website xxiv\u003c\/p\u003e \u003cp\u003e\u003cb\u003ePart I Core Concepts 1\u003c\/b\u003e\u003c\/p\u003e \u003cp\u003e\u003cb\u003e1 Introduction 3\u003cbr\u003e \u003c\/b\u003e\u003ci\u003ePierce, BA, MTS, PhD\u003c\/i\u003e\u003c\/p\u003e \u003cp\u003eReferences 5\u003c\/p\u003e \u003cp\u003eFurther Reading 5\u003c\/p\u003e \u003cp\u003e\u003cb\u003e2 What Is Animal Hospice and Palliative Care? 6\u003cbr\u003e \u003c\/b\u003e\u003ci\u003eAmir Shanan, DVM and Tamara Shearer, MS, DVM, CCRP, CVPP, CVA, MSTCVM\u003c\/i\u003e\u003c\/p\u003e \u003cp\u003eIntroduction 6\u003c\/p\u003e \u003cp\u003eHistory of Animal Hospice 8\u003c\/p\u003e \u003cp\u003eScientific and Philosophical Roots 8\u003c\/p\u003e \u003cp\u003eEarly Beginnings 9\u003c\/p\u003e \u003cp\u003eOrganization and Recognition 10\u003c\/p\u003e \u003cp\u003eAnimal Hospice and Human Hospice 12\u003c\/p\u003e \u003cp\u003eEthical and Legal Differences 12\u003c\/p\u003e \u003cp\u003eEconomic Differences 13\u003c\/p\u003e \u003cp\u003eSummary 14\u003c\/p\u003e \u003cp\u003eReferences 14\u003c\/p\u003e \u003cp\u003e\u003cb\u003e3 The Interdisciplinary Team 16\u003cbr\u003e \u003c\/b\u003e\u003ci\u003eTammy Wynn, MHA, LISW, RVT, CHPT and Amir Shanan, DVM\u003c\/i\u003e\u003c\/p\u003e \u003cp\u003eInterdisciplinary Teams in Human Hospice and Palliative Care 16\u003c\/p\u003e \u003cp\u003eInterdisciplinary Teams (IDT) in Animal Hospice and Palliative Care 17\u003c\/p\u003e \u003cp\u003eOperating a Successful Interdisciplinary Team 18\u003c\/p\u003e \u003cp\u003eCommon Mission and Vision 18\u003c\/p\u003e \u003cp\u003eTeam members, Their Roles, and Responsibilities 19\u003c\/p\u003e \u003cp\u003eEffective Communication and Collaboration 22\u003c\/p\u003e \u003cp\u003eSummary 25\u003c\/p\u003e \u003cp\u003eReferences 25\u003c\/p\u003e \u003cp\u003e\u003cb\u003e4 Quality of Life Assessments 26\u003cbr\u003e \u003c\/b\u003e\u003ci\u003eJessica Pierce, BA, MTS, PhD and Amir Shanan, DVM\u003c\/i\u003e\u003c\/p\u003e \u003cp\u003eWhat are Quality of Life Assessments and Why are they Important in End- of- Life Care? 26\u003c\/p\u003e \u003cp\u003eDefinitions of Quality of Life 26\u003c\/p\u003e \u003cp\u003eQuality of Life and Well- being 27\u003c\/p\u003e \u003cp\u003eQuality of Life Assessments and Euthanasia Decisions 28\u003c\/p\u003e \u003cp\u003eThe Importance of Context in Quality of Life Assessment 28\u003c\/p\u003e \u003cp\u003eQuality of Life and Patient- Centered Care 29\u003c\/p\u003e \u003cp\u003ePhysical Discomfort, Emotional Distress, Pain, and Suffering 30\u003c\/p\u003e \u003cp\u003eCoping and Adaptation 32\u003c\/p\u003e \u003cp\u003eMeasuring Quality of Life in Animal Patients 33\u003c\/p\u003e \u003cp\u003eA Variety of Approaches to QOL 34\u003c\/p\u003e \u003cp\u003eMcMillan’s Affect Balance Model 35\u003c\/p\u003e \u003cp\u003eWeighing Positive and Negative Affect at the End of Life 36\u003c\/p\u003e \u003cp\u003eQuality of Life Assessment Tools 36\u003c\/p\u003e \u003cp\u003eQuality of Life Assessment Over Time 38\u003c\/p\u003e \u003cp\u003eSummary 40\u003c\/p\u003e \u003cp\u003eReferences 40\u003c\/p\u003e \u003cp\u003eFurther Reading 42\u003c\/p\u003e \u003cp\u003e\u003cb\u003e5 Recognizing Distress 44\u003cbr\u003e \u003c\/b\u003e\u003ci\u003eEmma K. Grigg, PhD, CAAB, Suzanne Hetts, PhD, CAAB, and Amir Shanan, DVM\u003c\/i\u003e\u003c\/p\u003e \u003cp\u003eStress, Distress, Emotions, and Suffering 44\u003c\/p\u003e \u003cp\u003eThe Stress Response 44\u003c\/p\u003e \u003cp\u003eWhat Is Distress? 45\u003c\/p\u003e \u003cp\u003eBehavioral Needs of Dogs and Cats 46\u003c\/p\u003e \u003cp\u003eAssessing Quality of Life in Nonhuman Animals 47\u003c\/p\u003e \u003cp\u003eRelevance to Animal Hospice and Palliative Care (AHPC) 48\u003c\/p\u003e \u003cp\u003eAre Humans Adept at Recognizing Emotional States in Animals? 49\u003c\/p\u003e \u003cp\u003eBody Language of Fear, Anxiety, and Pain 49\u003c\/p\u003e \u003cp\u003eFear- and Discomfort- Related Body Postures Commonly Observed in Dogs and Cats 49\u003c\/p\u003e \u003cp\u003ePain- Related Facial Expressions Commonly Observed in Dogs and Cats 51\u003c\/p\u003e \u003cp\u003eRelevance to Animal Hospice and Palliative Care (AHPC) 52\u003c\/p\u003e \u003cp\u003eChanges in Behavioral Patterns as Indicators of Pain and Distress 53\u003c\/p\u003e \u003cp\u003eDo Animals “Hide” their Pain? 53\u003c\/p\u003e \u003cp\u003eDecreased Response to and Engagement with their Surroundings 54\u003c\/p\u003e \u003cp\u003eUnusual Patterns of Movement or Positioning 55\u003c\/p\u003e \u003cp\u003eFocused Attention to One Specific Body Part 56\u003c\/p\u003e \u003cp\u003eDisplacement Behaviors 56\u003c\/p\u003e \u003cp\u003eCan Sick Animals Suffer from Boredom? 56\u003c\/p\u003e \u003cp\u003eRelevance to Animal Hospice and Palliative Care (AHPC) 57\u003c\/p\u003e \u003cp\u003eEnd- of- Life Decisions 57\u003c\/p\u003e \u003cp\u003eConclusion 58\u003c\/p\u003e \u003cp\u003eReferences 58\u003c\/p\u003e \u003cp\u003e\u003cb\u003e6 Balancing Efficacy of Treatments Against Burdens of Care 62\u003cbr\u003e \u003c\/b\u003e\u003ci\u003eKristina August, DVM, GDVWHM, CHPV\u003c\/i\u003e\u003c\/p\u003e \u003cp\u003eEstablishing the Goals of Care 63\u003c\/p\u003e \u003cp\u003eAssessing Efficacy and Burdens of Medical Treatment 66\u003c\/p\u003e \u003cp\u003eAssessment of Treatment Efficacy 66\u003c\/p\u003e \u003cp\u003eAppetite and Hydration Needs at the End of Life 66\u003c\/p\u003e \u003cp\u003eEmotional Well- Being 67\u003c\/p\u003e \u003cp\u003eAnimal Individual Preferences 67\u003c\/p\u003e \u003cp\u003eDo- Not- Resuscitate and “Advance Directives” 67\u003c\/p\u003e \u003cp\u003eAssessment of Treatment Burden 68\u003c\/p\u003e \u003cp\u003eAssessing Diagnostic Procedures 69\u003c\/p\u003e \u003cp\u003eAdverse Events: Treatment- Related Consequences 70\u003c\/p\u003e \u003cp\u003eSteroids and End- of- Life Care 71\u003c\/p\u003e \u003cp\u003eAdverse Events: Indirect Consequences of Medical Care 71\u003c\/p\u003e \u003cp\u003eAssessing the Burdens of Caregiving 72\u003c\/p\u003e \u003cp\u003eConclusion 73\u003c\/p\u003e \u003cp\u003eReferences 73\u003c\/p\u003e \u003cp\u003e\u003cb\u003e7 Ethical Decision- Making in Animal Hospice and Palliative Care 76\u003cbr\u003e \u003c\/b\u003e\u003ci\u003eJessica Pierce, BA, MTS, PhD and Amir Shanan, DVM\u003c\/i\u003e\u003c\/p\u003e \u003cp\u003eA Method for Moral Decision- Making 77\u003c\/p\u003e \u003cp\u003ePart 1: Clinical Considerations and Their Moral Dimensions 77\u003c\/p\u003e \u003cp\u003ePart 2: Patient Considerations: How the Animal Feels and What the Animal Wants 78\u003c\/p\u003e \u003cp\u003eUnderstanding What Animals Want 79\u003c\/p\u003e \u003cp\u003eWill to Live 79\u003c\/p\u003e \u003cp\u003eRespecting What Animals Want 80\u003c\/p\u003e \u003cp\u003eSuffering 80\u003c\/p\u003e \u003cp\u003ePart 3: Human Factors Influencing Moral Decision- Making 83\u003c\/p\u003e \u003cp\u003eProviding Adequate Information 85\u003c\/p\u003e \u003cp\u003eGuiding Client Decision- Making: How Much Is Too Much? 86\u003c\/p\u003e \u003cp\u003eGuiding the Choice between Euthanasia and Continued Palliative Care 88\u003c\/p\u003e \u003cp\u003eSocietal Ethics and the Role of Cultural Values 90\u003c\/p\u003e \u003cp\u003eEthical Business Practices 91\u003c\/p\u003e \u003cp\u003eMoral Stress, Decisional Regret, and Mental Health 91\u003c\/p\u003e \u003cp\u003eConclusion: Finding the Path of Least Regrets 92\u003c\/p\u003e \u003cp\u003eReferences 93\u003c\/p\u003e \u003cp\u003e\u003cb\u003e8 Supportive Relationships: Veterinarians and Animal Hospice Providers’ Nonmedical Roles 95\u003cbr\u003e \u003c\/b\u003e\u003ci\u003eAmir Shanan, DVM and Laurel Lagoni, MS\u003c\/i\u003e\u003c\/p\u003e \u003cp\u003eDefining the Nonmedical Roles of Veterinary Professionals and Other Animal Hospice Providers (except licensed mental health professionals) 98\u003c\/p\u003e \u003cp\u003eThe Role of Source of Support 98\u003c\/p\u003e \u003cp\u003eThe Role of Educator 100\u003c\/p\u003e \u003cp\u003eThe Role of Facilitator 100\u003c\/p\u003e \u003cp\u003eThe Role of Resource and Referral Guide 101\u003c\/p\u003e \u003cp\u003eResources 101\u003c\/p\u003e \u003cp\u003eExtended Services 102\u003c\/p\u003e \u003cp\u003eLimiting the Role of Animal Hospice Veterinary Professionals and Other Providers (except licensed mental health professionals) 102\u003c\/p\u003e \u003cp\u003eKnow Thyself, Healer 105\u003c\/p\u003e \u003cp\u003eConclusion 105\u003c\/p\u003e \u003cp\u003eGrief Support Resources 106\u003c\/p\u003e \u003cp\u003eMemorials and Grief Support Resources 106\u003c\/p\u003e \u003cp\u003eCounselors and Grief Support 106\u003c\/p\u003e \u003cp\u003eGrief Support Training 106\u003c\/p\u003e \u003cp\u003eBooks for Caregivers 106\u003c\/p\u003e \u003cp\u003eBooks for Veterinarians 107\u003c\/p\u003e \u003cp\u003eReferences 107\u003c\/p\u003e \u003cp\u003e\u003cb\u003e9 Management and Administration: Business Models 108\u003cbr\u003e \u003c\/b\u003e\u003ci\u003eKathleen Cooney, DVM, MS, CHPV, CCFP\u003c\/i\u003e\u003c\/p\u003e \u003cp\u003eGuidelines for Animal Hospice and Palliative Care Practice 108\u003c\/p\u003e \u003cp\u003eService Delivery Models 109\u003c\/p\u003e \u003cp\u003eModel 9.1 Hospice in the Veterinary Hospital Setting 110\u003c\/p\u003e \u003cp\u003eModel 9.2 Hospice with Specialized Mobile Veterinarians 112\u003c\/p\u003e \u003cp\u003eModel 9.3 Animal Hospice Case Managers 113\u003c\/p\u003e \u003cp\u003eModel 9.4 Animal Hospice Sanctuaries\/Rescues 114\u003c\/p\u003e \u003cp\u003ePracticalities of Starting an Animal Hospice Service 114\u003c\/p\u003e \u003cp\u003eTelehealth as a Bridging Component for all Models 117\u003c\/p\u003e \u003cp\u003eConclusion 118\u003c\/p\u003e \u003cp\u003eReferences 119\u003c\/p\u003e \u003cp\u003e\u003cb\u003ePart II Patient Care 121\u003c\/b\u003e\u003c\/p\u003e \u003cp\u003e\u003cb\u003e10 Cancers in Dogs and Cats 123\u003cbr\u003e \u003c\/b\u003e\u003ci\u003eAlice Villalobos, DVM, FNAP and Betsy Hershey, DVM, DACVIM (Oncology), CVA\u003c\/i\u003e\u003c\/p\u003e \u003cp\u003eApproach to End- of- Life Cancer Patients 124\u003c\/p\u003e \u003cp\u003eTumors of the Skin and Soft Tissues 124\u003c\/p\u003e \u003cp\u003eCanine Lymphoma 125\u003c\/p\u003e \u003cp\u003eHead and Neck Cancer 126\u003c\/p\u003e \u003cp\u003eOropharyngeal and Neck Tumors in Dogs and Cats 126\u003c\/p\u003e \u003cp\u003eNasal Passage Cancer 127\u003c\/p\u003e \u003cp\u003eBrain Tumors 127\u003c\/p\u003e \u003cp\u003eCancer of the Skeletal System 128\u003c\/p\u003e \u003cp\u003eAbdominal Tumors 129\u003c\/p\u003e \u003cp\u003eHemangiosarcoma in Dogs 129\u003c\/p\u003e \u003cp\u003eTransitional Cell Carcinoma 129\u003c\/p\u003e \u003cp\u003eHepatic, Pancreatic, Intestinal, Adrenal, and Renal Cancer 130\u003c\/p\u003e \u003cp\u003eChest Cavity Tumors 130\u003c\/p\u003e \u003cp\u003ePalliative Cancer Medicine 131\u003c\/p\u003e \u003cp\u003eAdvances in Noninvasive Technology for the Diagnosis of Cancer 134\u003c\/p\u003e \u003cp\u003eSummary 135\u003c\/p\u003e \u003cp\u003eConflicts of Interest 135\u003c\/p\u003e \u003cp\u003eReferences 135\u003c\/p\u003e \u003cp\u003e\u003cb\u003e11 Integrative Therapies for Palliative Care of the Veterinary Cancer Patient 138\u003cbr\u003e \u003c\/b\u003e\u003ci\u003eBetsy Hershey, DVM, DACVIM (Oncology), CVA\u003c\/i\u003e\u003c\/p\u003e \u003cp\u003eNutrition and Food Therapy 138\u003c\/p\u003e \u003cp\u003eHerbs and Supplements 141\u003c\/p\u003e \u003cp\u003eHerbal Supplements 141\u003c\/p\u003e \u003cp\u003eAntioxidants 143\u003c\/p\u003e \u003cp\u003eMedicinal Mushrooms 143\u003c\/p\u003e \u003cp\u003eB Vitamins 143\u003c\/p\u003e \u003cp\u003eDigestive Enzymes 144\u003c\/p\u003e \u003cp\u003eProbiotics 144\u003c\/p\u003e \u003cp\u003eVitamin d 144\u003c\/p\u003e \u003cp\u003eOmega- 3 Polyunsaturated Fatty Acids (PUFAS) 145\u003c\/p\u003e \u003cp\u003eCurcumin 145\u003c\/p\u003e \u003cp\u003eHigh Dose IV Vitamin C Therapy 145\u003c\/p\u003e \u003cp\u003eAcupuncture 146\u003c\/p\u003e \u003cp\u003eManual Massage Therapies 147\u003c\/p\u003e \u003cp\u003eEnergy Therapy (Biofield Therapy) 148\u003c\/p\u003e \u003cp\u003eSound Therapy 148\u003c\/p\u003e \u003cp\u003eReiki, Therapeutic Touch, and Healing Touch Therapies 148\u003c\/p\u003e \u003cp\u003eOzone Therapy 148\u003c\/p\u003e \u003cp\u003eHyperbaric Oxygen Therapy 150\u003c\/p\u003e \u003cp\u003eCannabis and Cannabidiol (CBD) Oil 151\u003c\/p\u003e \u003cp\u003eEssential Oils 154\u003c\/p\u003e \u003cp\u003eHomeopathy and Homotoxicology 155\u003c\/p\u003e \u003cp\u003eChiropractic 156\u003c\/p\u003e \u003cp\u003ePhotobiomodulation Therapy (PBM) 157\u003c\/p\u003e \u003cp\u003eSummary 158\u003c\/p\u003e \u003cp\u003eReferences 158\u003c\/p\u003e \u003cp\u003e\u003cb\u003e12 Chronic Kidney Disease 163\u003cbr\u003e \u003c\/b\u003e\u003ci\u003eShea Cox, DVM, CHPV, CVPP and Christie Cornelius, DVM, CHPV\u003c\/i\u003e\u003c\/p\u003e \u003cp\u003eDescription of Disease 163\u003c\/p\u003e \u003cp\u003eDisease Trajectory 163\u003c\/p\u003e \u003cp\u003eClinical Manifestations of Disease 163\u003c\/p\u003e \u003cp\u003eManagement 164\u003c\/p\u003e \u003cp\u003eManagement of Factors that Accelerate Chronic Kidney Disease Progression 164\u003c\/p\u003e \u003cp\u003eDehydration 164\u003c\/p\u003e \u003cp\u003eNonregenerative Anemia 164\u003c\/p\u003e \u003cp\u003eSystemic Hypertension 165\u003c\/p\u003e \u003cp\u003eProteinuria and Activation of the Renin–Angiotensin–Aldosterone System 165\u003c\/p\u003e \u003cp\u003eRenal Secondary Hyperparathyroidism 165\u003c\/p\u003e \u003cp\u003eSymptomatic, Supportive, and Palliative Therapies 166\u003c\/p\u003e \u003cp\u003eOral Ulcerations and Uremic Gastritis 166\u003c\/p\u003e \u003cp\u003eNausea\/Vomiting 166\u003c\/p\u003e \u003cp\u003eConstipation\/Obstipation 167\u003c\/p\u003e \u003cp\u003eLoss of Appetite 167\u003c\/p\u003e \u003cp\u003eUrinary Tract Infection 167\u003c\/p\u003e \u003cp\u003eHyperphosphatemia 168\u003c\/p\u003e \u003cp\u003eHypokalemia 168\u003c\/p\u003e \u003cp\u003eSeizures 168\u003c\/p\u003e \u003cp\u003eDietary Considerations 168\u003c\/p\u003e \u003cp\u003eOther Comfort Measures 168\u003c\/p\u003e \u003cp\u003eConclusion 168\u003c\/p\u003e \u003cp\u003eReferences 169\u003c\/p\u003e \u003cp\u003e\u003cb\u003e13 Congestive Heart Failure 171\u003cbr\u003e \u003c\/b\u003e\u003ci\u003eShea Cox, DVM, CHPV, CVPP and Christie Cornelius, DVM, CHPV\u003c\/i\u003e\u003c\/p\u003e \u003cp\u003eDescription of Disease 171\u003c\/p\u003e \u003cp\u003eDisease Trajectory 171\u003c\/p\u003e \u003cp\u003eClinical Manifestations of Disease 171\u003c\/p\u003e \u003cp\u003ePalliative Management 172\u003c\/p\u003e \u003cp\u003ePulmonary Edema\/Cardiac Function 172\u003c\/p\u003e \u003cp\u003eDiuretics 173\u003c\/p\u003e \u003cp\u003eAce Inhibitors 173\u003c\/p\u003e \u003cp\u003ePositive Lonotrope, Vasodilator 174\u003c\/p\u003e \u003cp\u003eCalcium Channel Blocker 174\u003c\/p\u003e \u003cp\u003ePleural and Abdominal Effusion 174\u003c\/p\u003e \u003cp\u003eHypokalemia 174\u003c\/p\u003e \u003cp\u003ePrerenal Azotemia 174\u003c\/p\u003e \u003cp\u003eBalancing Renal and Cardiac Disease 174\u003c\/p\u003e \u003cp\u003eCoughing 175\u003c\/p\u003e \u003cp\u003eRespiratory Distress 175\u003c\/p\u003e \u003cp\u003eAortic Thromboembolism 175\u003c\/p\u003e \u003cp\u003eDietary Considerations 176\u003c\/p\u003e \u003cp\u003eHeart- Gut Interactions in Heart Failure 176\u003c\/p\u003e \u003cp\u003eOther Considerations 176\u003c\/p\u003e \u003cp\u003eConclusion 176\u003c\/p\u003e \u003cp\u003eReferences 176\u003c\/p\u003e \u003cp\u003e\u003cb\u003e14 Respiratory Distress 178\u003cbr\u003e \u003c\/b\u003e\u003ci\u003eCheryl Braswell, DVM, DACVECC, CHPV, CHT-V, CVPP\u003c\/i\u003e\u003c\/p\u003e \u003cp\u003eAirway Collapse 178\u003c\/p\u003e \u003cp\u003eDescription 178\u003c\/p\u003e \u003cp\u003eTrajectory\/Prognosis 179\u003c\/p\u003e \u003cp\u003eManifestations 179\u003c\/p\u003e \u003cp\u003eManagement 179\u003c\/p\u003e \u003cp\u003ePharmacologic 179\u003c\/p\u003e \u003cp\u003ePhysical 179\u003c\/p\u003e \u003cp\u003eNutritional 180\u003c\/p\u003e \u003cp\u003eSurgery 180\u003c\/p\u003e \u003cp\u003eBrachycephalic Airway Obstruction Syndrome 180\u003c\/p\u003e \u003cp\u003eDescription 180\u003c\/p\u003e \u003cp\u003eTrajectory\/Prognosis 180\u003c\/p\u003e \u003cp\u003eManifestations 181\u003c\/p\u003e \u003cp\u003eManagement 181\u003c\/p\u003e \u003cp\u003ePharmacologic 181\u003c\/p\u003e \u003cp\u003ePhysical 181\u003c\/p\u003e \u003cp\u003eNutrition 181\u003c\/p\u003e \u003cp\u003eSurgery 181\u003c\/p\u003e \u003cp\u003eAirway Inflammation 181\u003c\/p\u003e \u003cp\u003eDescription 181\u003c\/p\u003e \u003cp\u003eTrajectory\/Prognosis 182\u003c\/p\u003e \u003cp\u003eManifestations 182\u003c\/p\u003e \u003cp\u003eManagement 182\u003c\/p\u003e \u003cp\u003ePharmacologic 182\u003c\/p\u003e \u003cp\u003ePhysical 183\u003c\/p\u003e \u003cp\u003eNutritional 183\u003c\/p\u003e \u003cp\u003ePneumonia 183\u003c\/p\u003e \u003cp\u003eDescription 183\u003c\/p\u003e \u003cp\u003eTrajectory\/Prognosis 183\u003c\/p\u003e \u003cp\u003eManifestations 183\u003c\/p\u003e \u003cp\u003eManagement 183\u003c\/p\u003e \u003cp\u003ePharmacologic 183\u003c\/p\u003e \u003cp\u003ePhysical 184\u003c\/p\u003e \u003cp\u003eNutritional 184\u003c\/p\u003e \u003cp\u003eThe Suffering of Dyspnea: Palliative Care 184\u003c\/p\u003e \u003cp\u003eReferences 185\u003c\/p\u003e \u003cp\u003e\u003cb\u003e15 Gastrointestinal Conditions 186\u003cbr\u003e \u003c\/b\u003e\u003ci\u003eShea Cox, DVM, CHPV, CVPP and Christie Cornelius, DVM, CHPV\u003c\/i\u003e\u003c\/p\u003e \u003cp\u003eInflammatory Bowel Disease 186\u003c\/p\u003e \u003cp\u003eDescription of Disease 186\u003c\/p\u003e \u003cp\u003eDisease Trajectory 186\u003c\/p\u003e \u003cp\u003eClinical Manifestations of Disease 186\u003c\/p\u003e \u003cp\u003ePalliative Management 186\u003c\/p\u003e \u003cp\u003eMedical Support 186\u003c\/p\u003e \u003cp\u003eImmunosuppressive Therapy 186\u003c\/p\u003e \u003cp\u003eAntibiotic Therapy 187\u003c\/p\u003e \u003cp\u003eAdditional Support Therapy 187\u003c\/p\u003e \u003cp\u003eNutritional Support 188\u003c\/p\u003e \u003cp\u003eFecal Microbial Transplantation (FMT): The Ultimate Probiotic 188\u003c\/p\u003e \u003cp\u003ePancreatitis 188\u003c\/p\u003e \u003cp\u003eDescription of Disease 188\u003c\/p\u003e \u003cp\u003eDisease Trajectory 188\u003c\/p\u003e \u003cp\u003eClinical Manifestations of Disease 189\u003c\/p\u003e \u003cp\u003ePalliative Management 189\u003c\/p\u003e \u003cp\u003eMedical Support 189\u003c\/p\u003e \u003cp\u003eAnalgesia 189\u003c\/p\u003e \u003cp\u003eAntiemetics 189\u003c\/p\u003e \u003cp\u003eAntibacterials 189\u003c\/p\u003e \u003cp\u003eImmunosuppressants 189\u003c\/p\u003e \u003cp\u003eSubcutaneous Fluid Therapy 189\u003c\/p\u003e \u003cp\u003eNutritional Support 189\u003c\/p\u003e \u003cp\u003eCholangitis\/Cholangiohepatitis Syndrome 190\u003c\/p\u003e \u003cp\u003eDescription of Disease 190\u003c\/p\u003e \u003cp\u003eDisease Trajectory 190\u003c\/p\u003e \u003cp\u003eClinical Manifestations of Disease 190\u003c\/p\u003e \u003cp\u003ePalliative Management 190\u003c\/p\u003e \u003cp\u003eMedical Support 190\u003c\/p\u003e \u003cp\u003eAntimicrobial Therapy 190\u003c\/p\u003e \u003cp\u003eImmunosuppressive Therapy 190\u003c\/p\u003e \u003cp\u003eAnalgesia 191\u003c\/p\u003e \u003cp\u003eAntiemetics 191\u003c\/p\u003e \u003cp\u003eSupport Therapy 191\u003c\/p\u003e \u003cp\u003eSubcutaneous Fluid Therapy 191\u003c\/p\u003e \u003cp\u003eNutritional Support 191\u003c\/p\u003e \u003cp\u003eConclusion 191\u003c\/p\u003e \u003cp\u003eReferences 191\u003c\/p\u003e \u003cp\u003e\u003cb\u003e16 Musculoskeletal Disorders 193\u003cbr\u003e \u003c\/b\u003e\u003ci\u003eTamara Shearer, MS, DVM, CCRP, CVPP, CVA, MSTCVM\u003c\/i\u003e\u003c\/p\u003e \u003cp\u003eOsteoarthritis 193\u003c\/p\u003e \u003cp\u003eDescription 193\u003c\/p\u003e \u003cp\u003eTrajectory\/Prognosis 194\u003c\/p\u003e \u003cp\u003eManifestations 194\u003c\/p\u003e \u003cp\u003eManagement 195\u003c\/p\u003e \u003cp\u003eCranial Cruciate Ligament Pathology 197\u003c\/p\u003e \u003cp\u003eDescription 197\u003c\/p\u003e \u003cp\u003eTrajectory\/Prognosis 197\u003c\/p\u003e \u003cp\u003eManifestations 197\u003c\/p\u003e \u003cp\u003eManagement 197\u003c\/p\u003e \u003cp\u003eMedical Management 198\u003c\/p\u003e \u003cp\u003eSurgical Management 198\u003c\/p\u003e \u003cp\u003eStrains, Sprains, and Myofascial Pain 199\u003c\/p\u003e \u003cp\u003eDescription 199\u003c\/p\u003e \u003cp\u003eTrajectory\/Prognosis 199\u003c\/p\u003e \u003cp\u003eManifestations 199\u003c\/p\u003e \u003cp\u003eManagement 199\u003c\/p\u003e \u003cp\u003eCoxofemoral Luxation 200\u003c\/p\u003e \u003cp\u003eDescription 200\u003c\/p\u003e \u003cp\u003eTrajectory\/Prognosis 200\u003c\/p\u003e \u003cp\u003eManifestations 200\u003c\/p\u003e \u003cp\u003eManagement 200\u003c\/p\u003e \u003cp\u003eFractures 201\u003c\/p\u003e \u003cp\u003eDescription 201\u003c\/p\u003e \u003cp\u003eTrajectory\/Prognosis 201\u003c\/p\u003e \u003cp\u003eManifestations 201\u003c\/p\u003e \u003cp\u003eManagement 201\u003c\/p\u003e \u003cp\u003eConclusion 201\u003c\/p\u003e \u003cp\u003eReferences 202\u003c\/p\u003e \u003cp\u003e\u003cb\u003e17 Nervous System Disease 204\u003cbr\u003e \u003c\/b\u003e\u003ci\u003eTamara Shearer, MS, DVM, CCRP, CVPP, CVA, MSTCVM\u003c\/i\u003e\u003c\/p\u003e \u003cp\u003eIntervertebral Disc Disease 204\u003c\/p\u003e \u003cp\u003eDescription 204\u003c\/p\u003e \u003cp\u003eTrajectory\/Prognosis 205\u003c\/p\u003e \u003cp\u003eManifestations 205\u003c\/p\u003e \u003cp\u003eManagement 206\u003c\/p\u003e \u003cp\u003eCervical Spondylomyelopathy 207\u003c\/p\u003e \u003cp\u003eDescription 207\u003c\/p\u003e \u003cp\u003eTrajectory\/Prognosis 208\u003c\/p\u003e \u003cp\u003eManifestations 208\u003c\/p\u003e \u003cp\u003eManagement 208\u003c\/p\u003e \u003cp\u003eFibrocartilagenous Embolic Myelopathy 208\u003c\/p\u003e \u003cp\u003eDescription 208\u003c\/p\u003e \u003cp\u003eTrajectory\/Prognosis 209\u003c\/p\u003e \u003cp\u003eManifestations 209\u003c\/p\u003e \u003cp\u003eManagement 209\u003c\/p\u003e \u003cp\u003eVestibular Disorders 209\u003c\/p\u003e \u003cp\u003eDescription 209\u003c\/p\u003e \u003cp\u003eTrajectory\/Prognosis 210\u003c\/p\u003e \u003cp\u003eManifestations 210\u003c\/p\u003e \u003cp\u003eManagement 210\u003c\/p\u003e \u003cp\u003eLaryngeal Paralysis\/Geriatric Onset Laryngeal Paralysis Polyneuropathy 211\u003c\/p\u003e \u003cp\u003eDescription 211\u003c\/p\u003e \u003cp\u003eTrajectory\/Prognosis 211\u003c\/p\u003e \u003cp\u003eManifestations 211\u003c\/p\u003e \u003cp\u003eManagement 211\u003c\/p\u003e \u003cp\u003eDegenerative Myelopathy 212\u003c\/p\u003e \u003cp\u003eDescription 212\u003c\/p\u003e \u003cp\u003eTrajectory\/Prognosis 213\u003c\/p\u003e \u003cp\u003eManifestations 213\u003c\/p\u003e \u003cp\u003eManagement 213\u003c\/p\u003e \u003cp\u003eDisorders of Micturition\/Urination 214\u003c\/p\u003e \u003cp\u003eDescription 214\u003c\/p\u003e \u003cp\u003eTrajectory\/Prognosis 214\u003c\/p\u003e \u003cp\u003eManifestations 214\u003c\/p\u003e \u003cp\u003eManagement 214\u003c\/p\u003e \u003cp\u003eBladder Is Difficult or Cannot Be Expressed 215\u003c\/p\u003e \u003cp\u003eBladder Can Be Expressed with Effort 215\u003c\/p\u003e \u003cp\u003eStraining to Urinate with Spurts of Urine Produced 215\u003c\/p\u003e \u003cp\u003eBladder Easily Expressed with Continuous Leakage 216\u003c\/p\u003e \u003cp\u003eUrine Leakage when Urine Accumulates 216\u003c\/p\u003e \u003cp\u003eAncillary Therapies for Micturition Disorders 216\u003c\/p\u003e \u003cp\u003eConclusion 216\u003c\/p\u003e \u003cp\u003eReferences 216\u003c\/p\u003e \u003cp\u003e\u003cb\u003e18 Cognitive Dysfunction 219\u003cbr\u003e \u003c\/b\u003e\u003ci\u003eTamara Shearer, MS, DVM, CCRP, CVPP, CVA, MSTCVM\u003c\/i\u003e\u003c\/p\u003e \u003cp\u003eDescription 219\u003c\/p\u003e \u003cp\u003eTrajectory\/Prognosis 220\u003c\/p\u003e \u003cp\u003eManifestations 220\u003c\/p\u003e \u003cp\u003eManagement 221\u003c\/p\u003e \u003cp\u003eClient Education and Prevention 221\u003c\/p\u003e \u003cp\u003eBehavior Modification and Environmental Enhancement 221\u003c\/p\u003e \u003cp\u003eDiet Modification 222\u003c\/p\u003e \u003cp\u003eSupplements 222\u003c\/p\u003e \u003cp\u003eAlternative Care 223\u003c\/p\u003e \u003cp\u003ePharmaceutical Interventions 223\u003c\/p\u003e \u003cp\u003eConclusion 224\u003c\/p\u003e \u003cp\u003eReferences 225\u003c\/p\u003e \u003cp\u003e\u003cb\u003e19 Pharmacology Interventions for Symptom Management 227\u003cbr\u003e \u003c\/b\u003e\u003ci\u003eShea Cox, DVM, CHPV, CVPP\u003c\/i\u003e\u003c\/p\u003e \u003cp\u003eIntroduction 227\u003c\/p\u003e \u003cp\u003ePain 227\u003c\/p\u003e \u003cp\u003eClinical Signs of Pain 227\u003c\/p\u003e \u003cp\u003eBehavioral Indicators of Pain 227\u003c\/p\u003e \u003cp\u003ePharmacology for Pain Management 228\u003c\/p\u003e \u003cp\u003eNonsteroidal Anti- Inflammatory Drugs 228\u003c\/p\u003e \u003cp\u003eGlucocorticoids 229\u003c\/p\u003e \u003cp\u003eAcetaminophen 229\u003c\/p\u003e \u003cp\u003eOpioids 229\u003c\/p\u003e \u003cp\u003eTricyclic Antidepressants 231\u003c\/p\u003e \u003cp\u003eSerotonin- Norepinephrine Reuptake Inhibitors 232\u003c\/p\u003e \u003cp\u003eAnticonvulsants 232\u003c\/p\u003e \u003cp\u003eN- methyl- d- aspartate Receptor Antagonists 232\u003c\/p\u003e \u003cp\u003eMonoclonal antibodies 233\u003c\/p\u003e \u003cp\u003ePharmacologic Protocols 233\u003c\/p\u003e \u003cp\u003eAssessing Response to Treatment 234\u003c\/p\u003e \u003cp\u003eAnxiety 234\u003c\/p\u003e \u003cp\u003eDysphoria 236\u003c\/p\u003e \u003cp\u003eWeakness or Fatigue 237\u003c\/p\u003e \u003cp\u003eRespiratory Symptoms 237\u003c\/p\u003e \u003cp\u003eDyspnea 237\u003c\/p\u003e \u003cp\u003eCough 239\u003c\/p\u003e \u003cp\u003eNausea and Vomiting 239\u003c\/p\u003e \u003cp\u003eAnorexia and Cachexia 240\u003c\/p\u003e \u003cp\u003eDehydration 241\u003c\/p\u003e \u003cp\u003eConstipation 241\u003c\/p\u003e \u003cp\u003eOral Health 242\u003c\/p\u003e \u003cp\u003eUlcers 242\u003c\/p\u003e \u003cp\u003eDry Mouth (Xerostomia) 242\u003c\/p\u003e \u003cp\u003eConclusion 242\u003c\/p\u003e \u003cp\u003eReferences 242\u003c\/p\u003e \u003cp\u003e\u003cb\u003e20 Physical Medicine and Rehabilitation for Hospice and Palliative Care Patients 245\u003cbr\u003e \u003c\/b\u003e\u003ci\u003eTamara Shearer, MS, DVM, CCRP, CVPP, CVA, MSTCVM\u003c\/i\u003e\u003c\/p\u003e \u003cp\u003ePhysical Medicine vs. Physical Rehabilitation 245\u003c\/p\u003e \u003cp\u003eConsiderations for Physical Medicine with Hospice and Palliative Care Patients 245\u003c\/p\u003e \u003cp\u003eAssistive Devices: Priority in Hospice Care 247\u003c\/p\u003e \u003cp\u003eSlings and Harnesses 247\u003c\/p\u003e \u003cp\u003eStraps and Bands 248\u003c\/p\u003e \u003cp\u003eProtective Footwear 248\u003c\/p\u003e \u003cp\u003eSupport of Joints: Orthotic Devices 249\u003c\/p\u003e \u003cp\u003eSupport for Paralysis\/Pararesis: Carts and Drag Bags 250\u003c\/p\u003e \u003cp\u003eFour Simple but Important Manual Therapies and Therapeutic Exercises 250\u003c\/p\u003e \u003cp\u003eRange of Motion 250\u003c\/p\u003e \u003cp\u003eAssisted Standing and Walking 251\u003c\/p\u003e \u003cp\u003eProprioceptive and Balance Techniques 251\u003c\/p\u003e \u003cp\u003eMassage and\/or Tui-na 252\u003c\/p\u003e \u003cp\u003eThe Role of Acupuncture for Hospice and Palliative Care Patients 252\u003c\/p\u003e \u003cp\u003eInnovative and Noninvasive Techniques 254\u003c\/p\u003e \u003cp\u003eKinesiology Taping 254\u003c\/p\u003e \u003cp\u003eExtracorporeal Magnetotransduction Therapy: EMTT 257\u003c\/p\u003e \u003cp\u003eExtracorporeal Shockwave Therapy 257\u003c\/p\u003e \u003cp\u003eTargeted Pulsed Electromagnetic Field Therapy 258\u003c\/p\u003e \u003cp\u003eOther Therapeutic Modalities for Hospice and Palliative Care Patients 259\u003c\/p\u003e \u003cp\u003eThermal Modalities 259\u003c\/p\u003e \u003cp\u003ePhotobiomodulation Therapy (also known as Laser Therapy) 260\u003c\/p\u003e \u003cp\u003ePulsed Signal Therapy 261\u003c\/p\u003e \u003cp\u003eElectrotherapy 261\u003c\/p\u003e \u003cp\u003eTherapeutic Ultrasound 262\u003c\/p\u003e \u003cp\u003eManual Therapy\/Medical Manipulation\/Chiropractic Care 262\u003c\/p\u003e \u003cp\u003eConclusion 263\u003c\/p\u003e \u003cp\u003eReferences 263\u003c\/p\u003e \u003cp\u003e\u003cb\u003e21 Integrative Medicine in Animal Hospice and Palliative Care 265\u003cbr\u003e \u003c\/b\u003e\u003ci\u003eKristina August, DVM, GDVWHM, CHPV\u003c\/i\u003e\u003c\/p\u003e \u003cp\u003eTerms 265\u003c\/p\u003e \u003cp\u003eGoing Mainstream 266\u003c\/p\u003e \u003cp\u003eSafety and Adverse Reactions 267\u003c\/p\u003e \u003cp\u003eHealing Philosophies 268\u003c\/p\u003e \u003cp\u003eNutritional Supplements 269\u003c\/p\u003e \u003cp\u003eHerbal Medicine 269\u003c\/p\u003e \u003cp\u003eEssential Oils 271\u003c\/p\u003e \u003cp\u003eOther Therapies 272\u003c\/p\u003e \u003cp\u003eEnsuring Quality of Life 273\u003c\/p\u003e \u003cp\u003eReliable Choices and Client Education 273\u003c\/p\u003e \u003cp\u003eConclusion 274\u003c\/p\u003e \u003cp\u003eEducational Opportunities 274\u003c\/p\u003e \u003cp\u003eReferences 274\u003c\/p\u003e \u003cp\u003e\u003cb\u003e22 Nursing Care for Seriously III Animals: Art and Techniques 278\u003cbr\u003e \u003c\/b\u003e\u003ci\u003eShea Cox, DVM, CHPV, CVPP and Mary Ellen Goldberg, CVT, LVT, SRA-retired, CCRVN, CVPP, VTS-lab animal-retired, VTS-Physical Rehabilitation-retired, VTS-anesthesia\/analgesia-Honorary\u003c\/i\u003e\u003c\/p\u003e \u003cp\u003eIntroduction 278\u003c\/p\u003e \u003cp\u003eNurses’ Medical Roles 279\u003c\/p\u003e \u003cp\u003eIntake 279\u003c\/p\u003e \u003cp\u003ePlanning of Care 279\u003c\/p\u003e \u003cp\u003eOngoing Monitoring and Assessments 279\u003c\/p\u003e \u003cp\u003eFrequency of Assessments 279\u003c\/p\u003e \u003cp\u003eParameters of Assessments 279\u003c\/p\u003e \u003cp\u003eAssessment of Pain 280\u003c\/p\u003e \u003cp\u003ePain Scales 280\u003c\/p\u003e \u003cp\u003eAssessment of Other Signs of Discomfort 282\u003c\/p\u003e \u003cp\u003eAssessment for Dehydration 282\u003c\/p\u003e \u003cp\u003eAssessment of Medication Administration 282\u003c\/p\u003e \u003cp\u003eAssessment of Mobility 282\u003c\/p\u003e \u003cp\u003eAssessment of Mental and Emotional Status 283\u003c\/p\u003e \u003cp\u003eDelivery of Care: Nursing Care Considerations 284\u003c\/p\u003e \u003cp\u003eComfort for the Patient 284\u003c\/p\u003e \u003cp\u003eOral and Ocular Comfort 284\u003c\/p\u003e \u003cp\u003eNutrition 286\u003c\/p\u003e \u003cp\u003eHydration 287\u003c\/p\u003e \u003cp\u003eTreating Fluid Deficit (Dehydration) 287\u003c\/p\u003e \u003cp\u003eMaintenance Fluids Administration 288\u003c\/p\u003e \u003cp\u003eCalculating Fluid Deficit 288\u003c\/p\u003e \u003cp\u003eHygiene 288\u003c\/p\u003e \u003cp\u003eBedding 288\u003c\/p\u003e \u003cp\u003eEnvironment 289\u003c\/p\u003e \u003cp\u003eMobility 289\u003c\/p\u003e \u003cp\u003eRange of Motion (ROM) 289\u003c\/p\u003e \u003cp\u003eTransitions 290\u003c\/p\u003e \u003cp\u003eStandby Assisted Standing 290\u003c\/p\u003e \u003cp\u003eWeight Shifting Exercises 290\u003c\/p\u003e \u003cp\u003eAssisted Standing Exercises 290\u003c\/p\u003e \u003cp\u003eAids for Assisted Standing 290\u003c\/p\u003e \u003cp\u003eMobility Carts 290\u003c\/p\u003e \u003cp\u003eNursing Care for Recumbent Patients 290\u003c\/p\u003e \u003cp\u003eUrination 291\u003c\/p\u003e \u003cp\u003eDefecation 291\u003c\/p\u003e \u003cp\u003eRespiration 291\u003c\/p\u003e \u003cp\u003eSkin Care 292\u003c\/p\u003e \u003cp\u003eMobilizing the Recumbent Patient 292\u003c\/p\u003e \u003cp\u003eNurses as Advocates and Educators 292\u003c\/p\u003e \u003cp\u003eNurses’ Role as Advocates for Patient and for the Caregiver 293\u003c\/p\u003e \u003cp\u003eNurses’ Role as Educators 293\u003c\/p\u003e \u003cp\u003eAwareness of Signs of Pain 294\u003c\/p\u003e \u003cp\u003eHygiene and Safety 294\u003c\/p\u003e \u003cp\u003eDeath and Dying 295\u003c\/p\u003e \u003cp\u003eConclusion 295\u003c\/p\u003e \u003cp\u003eReferences 296\u003c\/p\u003e \u003cp\u003eFurther Reading 298\u003c\/p\u003e \u003cp\u003e\u003cb\u003e23 Comfort Care During Active Dying 299\u003cbr\u003e \u003c\/b\u003e\u003ci\u003eGail Pope and Amir Shanan, DVM\u003c\/i\u003e\u003c\/p\u003e \u003cp\u003eNatural Death and Euthanasia 299\u003c\/p\u003e \u003cp\u003eGoals of Caring for the Dying Patient 301\u003c\/p\u003e \u003cp\u003eAdvance Preparation and Education of Caregivers and Hospice Team 301\u003c\/p\u003e \u003cp\u003eDesirable Environment of Care 302\u003c\/p\u003e \u003cp\u003ePrognostication 303\u003c\/p\u003e \u003cp\u003eChanges During Early and Late Stages of Active Dying 303\u003c\/p\u003e \u003cp\u003eAvailable Information 303\u003c\/p\u003e \u003cp\u003eChanges During Early Stages of Active Dying 303\u003c\/p\u003e \u003cp\u003ePhysical Changes 303\u003c\/p\u003e \u003cp\u003eBehavioral Changes 304\u003c\/p\u003e \u003cp\u003eIndications of Pain 304\u003c\/p\u003e \u003cp\u003eChanges During Late Stages of Active Dying 305\u003c\/p\u003e \u003cp\u003eBehavior, Sleeping Pattern, Responsiveness 305\u003c\/p\u003e \u003cp\u003eRespiration 305\u003c\/p\u003e \u003cp\u003eEyes, Mucus Membranes, Jaw, and Extremities 306\u003c\/p\u003e \u003cp\u003eMuscle Twitching, Stretching, and the Agonal Position 306\u003c\/p\u003e \u003cp\u003eOdor 306\u003c\/p\u003e \u003cp\u003eSummary 306\u003c\/p\u003e \u003cp\u003eAt the Time of Death 306\u003c\/p\u003e \u003cp\u003eThe Different Types of Active Death 308\u003c\/p\u003e \u003cp\u003eManaging Clinical Signs During Active Dying 309\u003c\/p\u003e \u003cp\u003eManagement of Pain 309\u003c\/p\u003e \u003cp\u003eManagement of Anxiety and Agitation 310\u003c\/p\u003e \u003cp\u003eFatigue and Weakness 310\u003c\/p\u003e \u003cp\u003eLoss of Ability to Swallow 311\u003c\/p\u003e \u003cp\u003eRespiration 311\u003c\/p\u003e \u003cp\u003eCardiac Dysfunction and Renal Failure 311\u003c\/p\u003e \u003cp\u003eDiminished Skin Vitality 311\u003c\/p\u003e \u003cp\u003eMucosal and Conjunctival Care 312\u003c\/p\u003e \u003cp\u003eIncontinence 312\u003c\/p\u003e \u003cp\u003eAdministration of Medications, Fluids, and Food 312\u003c\/p\u003e \u003cp\u003eAdministration of Fluids 313\u003c\/p\u003e \u003cp\u003eAdministration of Food 314\u003c\/p\u003e \u003cp\u003eAdministration of Medications 314\u003c\/p\u003e \u003cp\u003eSummary 315\u003c\/p\u003e \u003cp\u003eReferences 315\u003c\/p\u003e \u003cp\u003e\u003cb\u003e24 Euthanasia in Animal End- of- Life Care 318\u003cbr\u003e \u003c\/b\u003e\u003ci\u003eKathleen Cooney, DVM, CHPV, DACAW\u003c\/i\u003e\u003c\/p\u003e \u003cp\u003eDecision- Making for the Animal Hospice Patient 318\u003c\/p\u003e \u003cp\u003eAdvance Preparation and Education of the Professional Team 319\u003c\/p\u003e \u003cp\u003eAdvance Preparation and Education of Caregivers and Family 321\u003c\/p\u003e \u003cp\u003eEuthanasia Setting: Desirable Environment of Care 323\u003c\/p\u003e \u003cp\u003eEuthanasia Techniques and Criteria 324\u003c\/p\u003e \u003cp\u003eIntravenous Injection 325\u003c\/p\u003e \u003cp\u003eIntracardiac Injection 325\u003c\/p\u003e \u003cp\u003eIntraperitoneal Injection 327\u003c\/p\u003e \u003cp\u003eIntrahepatic Injection 328\u003c\/p\u003e \u003cp\u003eIntrarenal Injections 329\u003c\/p\u003e \u003cp\u003eVariability and Unpredictability 330\u003c\/p\u003e \u003cp\u003eReferences 331\u003c\/p\u003e \u003cp\u003e\u003cb\u003ePart III Caregiver Needs: Providing Support 333\u003c\/b\u003e\u003c\/p\u003e \u003cp\u003e\u003cb\u003e25 Caregivers’ Emotional Burden: Understanding, Acknowledging, and Addressing Caregivers’ Emotional Burden 335\u003cbr\u003e \u003c\/b\u003e\u003ci\u003eAmir Shanan, DVM\u003c\/i\u003e\u003c\/p\u003e \u003cp\u003eCaregiving Experience 336\u003c\/p\u003e \u003cp\u003eThe Mental Health Impact of Caregiving 339\u003c\/p\u003e \u003cp\u003eSupporting caregivers’ Emotional Needs 340\u003c\/p\u003e \u003cp\u003eThe Role of a Licensed Mental Health Professional 343\u003c\/p\u003e \u003cp\u003eQualified Mental Health Professionals 345\u003c\/p\u003e \u003cp\u003eSummary 346\u003c\/p\u003e \u003cp\u003eReferences 347\u003c\/p\u003e \u003cp\u003e\u003cb\u003e26 Caregiver Burden in the Companion Animal Owner 349\u003cbr\u003e \u003c\/b\u003e\u003ci\u003eMary Beth Spitznagel, PhD and Mark D. Carlson, DVM\u003c\/i\u003e\u003c\/p\u003e \u003cp\u003eWhat Is Caregiver Burden? 349\u003c\/p\u003e \u003cp\u003eA Word About Research Data, the Terminology Used, and this Article’s Audience 349\u003c\/p\u003e \u003cp\u003eCaregiver Burden Is Present in Owners of Seriously Ill Companion Animals 350\u003c\/p\u003e \u003cp\u003eHow Caregiver Burden Differs from Other Client Experiences in this Context 350\u003c\/p\u003e \u003cp\u003eHow Does Caregiver Burden Affect the Veterinary Client? 351\u003c\/p\u003e \u003cp\u003eImpact of Caregiver Burden on the Client 351\u003c\/p\u003e \u003cp\u003eImpact of Caregiver Burden on the Patient 352\u003c\/p\u003e \u003cp\u003eResearch- Based Suggestions for Interacting with the Burdened Owner 352\u003c\/p\u003e \u003cp\u003eUnderstand the Owner’s Perspective 352\u003c\/p\u003e \u003cp\u003eCollaborate on the Care Approach 353\u003c\/p\u003e \u003cp\u003eLighten the Load 353\u003c\/p\u003e \u003cp\u003eOne Size Does Not Fit All: Toward Individualized Client Interactions 354\u003c\/p\u003e \u003cp\u003eInteracting with the Distressed Client 354\u003c\/p\u003e \u003cp\u003eInteracting with the Resilient Client 355\u003c\/p\u003e \u003cp\u003eInteracting with the Non- Distressed Client 355\u003c\/p\u003e \u003cp\u003eInteracting with the “Other Influences” Client 355\u003c\/p\u003e \u003cp\u003eMore than Compassion Fatigue: When Client Burden Transfers to the Clinician 355\u003c\/p\u003e \u003cp\u003eThe Burden Transfer DANCE 356\u003c\/p\u003e \u003cp\u003eConclusions 357\u003c\/p\u003e \u003cp\u003eReferences 357\u003c\/p\u003e \u003cp\u003e\u003cb\u003e27 Addressing Spiritual Needs of Caregivers 360\u003cbr\u003e \u003c\/b\u003e\u003ci\u003eCarol Rowehl, LVT, MAR, STM\u003c\/i\u003e\u003c\/p\u003e \u003cp\u003eSpiritual Needs of Caregivers 361\u003c\/p\u003e \u003cp\u003eSpiritual Distress 362\u003c\/p\u003e \u003cp\u003eTaking a Spiritual History 363\u003c\/p\u003e \u003cp\u003eWhen to Call in the Experts (and Who Are the Experts?) 364\u003c\/p\u003e \u003cp\u003eSpiritual Questions Unique to Veterinary Practice and Hospice and Palliative Care 366\u003c\/p\u003e \u003cp\u003eIncluding a Chaplain on the Interdisciplinary Veterinary\/Hospice Team 367\u003c\/p\u003e \u003cp\u003eResources 370\u003c\/p\u003e \u003cp\u003eReferences 371\u003c\/p\u003e \u003cp\u003e\u003cb\u003e28 Factors Contributing to the Decision to Euthanize Pet Dogs and Cats 374\u003cbr\u003e \u003c\/b\u003e\u003ci\u003eNathaniel Cook, DVM, CVA, CVFT, CTPEP and Beth Marchitelli, DVM, MS\u003c\/i\u003e\u003c\/p\u003e \u003cp\u003eIntroduction 374\u003c\/p\u003e \u003cp\u003ePet Factors: Symptoms and Clinical Signs that Affect Quality of Life 374\u003c\/p\u003e \u003cp\u003eAppetite and Weight Loss 375\u003c\/p\u003e \u003cp\u003eAppetite 375\u003c\/p\u003e \u003cp\u003eWeight Loss 377\u003c\/p\u003e \u003cp\u003eElimination Disorders 377\u003c\/p\u003e \u003cp\u003eImpaired Mobility 379\u003c\/p\u003e \u003cp\u003eSensory and Cognitive Decline 380\u003c\/p\u003e \u003cp\u003eDyspnea and Respiratory Compromise 381\u003c\/p\u003e \u003cp\u003ePerception of Pain 382\u003c\/p\u003e \u003cp\u003ePet Factors: Severe Illness Diagnosis 382\u003c\/p\u003e \u003cp\u003eCancer 382\u003c\/p\u003e \u003cp\u003eOrgan Failure: Congestive Heart Failure 383\u003c\/p\u003e \u003cp\u003eEndocrine Disorders: Diabetes Mellitus 384\u003c\/p\u003e \u003cp\u003ePet Owner Factors: Psychosocial Factors of Caregiving 384\u003c\/p\u003e \u003cp\u003eConclusion 385\u003c\/p\u003e \u003cp\u003eReferences 385\u003c\/p\u003e \u003cp\u003e\u003cb\u003e29 Supporting Other Needs 389\u003cbr\u003e \u003c\/b\u003e\u003ci\u003eShea Cox, DVM, CHPV, CVPP and Mary Ellen Goldberg, CVT, LVT, SRA-retired, CCRVN, CVPP VTS-lab animal-retired, VTS-Physical Rehabilitation-retired, VTS-anesthesia\/analgesia-Honorary\u003c\/i\u003e\u003c\/p\u003e \u003cp\u003eCaring for the Caregiver: Addressing Emotional and Physical Needs 389\u003c\/p\u003e \u003cp\u003eMaintaining Self- Care 390\u003c\/p\u003e \u003cp\u003eMaintain Personal Nutrition and Sleep 390\u003c\/p\u003e \u003cp\u003eEngage in Exercise 390\u003c\/p\u003e \u003cp\u003eMake Time for Relaxation 390\u003c\/p\u003e \u003cp\u003eTime Considerations of Hospice Care 391\u003c\/p\u003e \u003cp\u003eManaging Time Commitments of Care 391\u003c\/p\u003e \u003cp\u003eTips for Balancing Caregiving with Ongoing Responsibilities 391\u003c\/p\u003e \u003cp\u003eUnderstanding the Physical Labor of Care 391\u003c\/p\u003e \u003cp\u003eUtilizing Proper Body Mechanics During Delivery of Care 392\u003c\/p\u003e \u003cp\u003eEnvironmental Considerations of Hospice Care 393\u003c\/p\u003e \u003cp\u003eAssessment of the Physical Space 393\u003c\/p\u003e \u003cp\u003eHousehold and Environmental Modifications 393\u003c\/p\u003e \u003cp\u003eFinancial Considerations of Hospice Care 393\u003c\/p\u003e \u003cp\u003eCost of Medications 394\u003c\/p\u003e \u003cp\u003eCost of Diagnostics 394\u003c\/p\u003e \u003cp\u003eCost of Other Healthcare Providers 394\u003c\/p\u003e \u003cp\u003eCost of Environmental Modifications 394\u003c\/p\u003e \u003cp\u003eCost of End- of- Life Care 394\u003c\/p\u003e \u003cp\u003eHelping to Defer Costs of Hospice Care 395\u003c\/p\u003e \u003cp\u003ePet Health Insurance 395\u003c\/p\u003e \u003cp\u003eEquipment Rental, Recycling, and Reduced Cost Programs 395\u003c\/p\u003e \u003cp\u003eCreating a Memorial Fund 395\u003c\/p\u003e \u003cp\u003eCreating a Donation Bank 395\u003c\/p\u003e \u003cp\u003eReferences 396\u003c\/p\u003e \u003cp\u003eFurther Reading 396\u003c\/p\u003e \u003cp\u003e30 Aftercare 398\u003c\/p\u003e \u003cp\u003eColeen A. Ellis, CT, CPLP\u003c\/p\u003e \u003cp\u003eHospice Options and Accompanying Rituals 398\u003c\/p\u003e \u003cp\u003eEmotional Support: Honoring the Journey 401\u003c\/p\u003e \u003cp\u003eAssisting Children, Other Pets, and Family Members in Their Journey 402\u003c\/p\u003e \u003cp\u003eAfter- Death Care Options 402\u003c\/p\u003e \u003cp\u003eSummary 406\u003c\/p\u003e \u003cp\u003eReferences 406\u003c\/p\u003e \u003cp\u003eIndex 407\u003c\/p\u003e  \u003cp\u003e\u003cb\u003eThe editors\u003c\/b\u003e \u003c\/p\u003e\u003cp\u003e\u003cb\u003eAmir Shanan, DVM, \u003c\/b\u003eis the Founding President of the International Association for Animal Hospice and Palliative Care and a Founding Partner of the Animal Hospice Group. He owns Compassionate Veterinary Hospice, a veterinary practice dedicated to end-of-life care, in Chicago, Illinois, USA. \u003c\/p\u003e\u003cp\u003e\u003cb\u003eJessica Pierce, BA, MDiv, PhD, \u003c\/b\u003eis a bioethicist and Faculty Affiliate at the Center for Bioethics and Humanities, University of Colorado, Anschutz Medical Campus, in Aurora, Colorado, USA. \u003c\/p\u003e\u003cp\u003e\u003cb\u003eTamara Shearer, DVM, CCRP, CVPP, CVA, MSTCVM, \u003c\/b\u003eowns Shearer Pet Health Services and Smoky Mountain Integrative Veterinary Clinic in Sylva, North Carolina, USA, and serves on the faculty of Chi University.   \u003c\/p\u003e\u003cp\u003e\u003cb\u003eA thoroughly updated and expanded new edition of the only book providing comprehensive treatment of hospice and palliative care in veterinary medicine\u003c\/b\u003e \u003c\/p\u003e\u003cp\u003eAnimals with life-limiting illnesses deserve compassionate, thoughtful, end-of-life care. Their caregivers and families, faced with the loss of a beloved companion, deserve empathy, support, and education, to guide them through an emotionally wrenching period and provide their companion animals with the highest possible quality of life. In recent years, the ethics of care and service to sick and dying animals and their caregivers has been the subject of considerable attention. \u003c\/p\u003e\u003cp\u003e\u003ci\u003eHospice and Palliative Care for Companion Animals, 2\u003csup\u003end\u003c\/sup\u003e Edition\u003c\/i\u003e provides a thorough update to the first and only complete guide to this field of service, its foundations, and its applications. It addresses the needs of pets, caregivers, and veterinary professionals alike, including fundamental ethical and emotional principles as well as detailed discussion of specific illnesses and life-limiting conditions. The expanded second edition incorporates cutting-edge research into animal behavior and cognition to enrich the reader’s understanding of companion animals’ emotional needs and their experience of illness and death. \u003c\/p\u003e\u003cp\u003e\u003ci\u003eHospice and Palliative Care for Companion Animals, 2\u003csup\u003end\u003c\/sup\u003e Edition\u003c\/i\u003e readers will also find: \u003c\/p\u003e\u003cul\u003e\n\u003cli\u003e Existing chapters expanded to incorporate new research and practical experience\u003c\/li\u003e \u003cli\u003e New chapters discussing factors underlying the decision to euthanize, the potential role of ethology in palliative care, and more\u003c\/li\u003e \u003cli\u003e A companion website with educational handouts for use in veterinary practices\u003c\/li\u003e\n\u003c\/ul\u003e \u003cp\u003e\u003ci\u003eHospice and Palliative Care for Companion Animals\u003c\/i\u003e is an indispensable resource for caregivers and veterinary professionals alike.\u003c\/p\u003e","brand":"Wiley-Blackwell","offers":[{"title":"Default Title","offer_id":47989371568357,"sku":"NP9781119808787","price":99.99,"currency_code":"USD","in_stock":false}],"thumbnail_url":"\/\/cdn.shopify.com\/s\/files\/1\/1842\/7735\/files\/9781119808787.jpg?v=1761783854","url":"https:\/\/k12savings.com\/products\/hospice-and-palliative-care-for-companion-animals-isbn-9781119808787","provider":"K12savings","version":"1.0","type":"link"}