For the last 12 years, Lynn Hendrix, DVM, CHPV, owner and consultant at The Palliative Vet, has been working on transferring palliative care to the veterinary world. Unlike curative treatments that focus on eliminating the disease, palliative care seeks to manage symptoms and enhance the quality of life of the animals and their family as the disease progresses. Hemangiosarcoma is one of the conditions that can be palliated.
While it often requires an interdisciplinary team of veterinarians, veterinary technicians, groomers, pharmacists, and professionals providing spiritual and mental health support for the family, in this article by the AAHA, Hendrix references a 2010 study in human medicine by Jennifer Temel that found patients who received it earlier in the course of their disease had better quality of life and more surprisingly, lived longer.
When palliative efforts ramp up as curative medicine tapers off, she has seen many dogs with hemangiosarcoma live well for anywhere from six to eight weeks to up to six months. Outliers for hemangiosarcoma - or presumed hemangiosarcoma - are 10 months, 12 months, and 20 months.
“It’s a longer period on average than if they have no medical intervention,” Hendrix said: “They go through potentially multiple cycles [of bleeding] before we get to the point of euthanasia. It depends on what the client has decided is their crisis point.”
Part of the palliative care process can be supporting the patient with subcutaneous fluids, medications like tranexamic acid, and pain control. Clients have been educated on how to recognize clinical signs of a bleed and what treatments to give in those situations to support them.
Setting up a plan for palliative care requires long conversations with pet owners about the goals of care and what is and isn't feasible for both the pet and their human family members. Pain management is crucial for veterinarians exploring palliative care, as animals don't hide pain and people often don't recognize it. Hendrix recommends that those unfamiliar with advanced palliative care refer to a veterinarian with hospice and palliative care training.
Education opportunities for veterinarians interested in palliative and hospice care are available through the International Association of Animal Hospice and Palliative Care (IAAHPC) certification program and continuing education opportunities at conferences. Hendrix has also authored Animal Hospice and Palliative Medicine for the House Call Veterinarian, aiming to provide additional education on improving the lives of both families and pets.
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