Veterinary Hospice
Compassionate Clinical Care Whose Time Has Come
Part 2 of 2

Colorado State University was the pioneer of academic veterinary hospices.6 CSU Pet Hospice was developed in 2003 and, unlike MSU VHC, it is a student volunteer-run program that trains veterinary students in animal hospice care, and matches them with the family and the veterinarian of a terminally-ill pet in the community. In the first five years of this program, 101 veterinary student volunteers provided support to 68 families.

Comparatively, in just over two years, VHC has provided care to 133 patients and their families. There have been as many as 18 active hospice patients on our census at one time. It has been suggested that the reason for higher VHC acceptance within the MSU community is the presence of a veterinarian leading the care, rather than students. While it is undeniable that veterinary students are the future, our program’s establishment was benefited by the credibility of a board-certified veterinarian. Another possible reason is that pet hospice has now been elevated to the mainstream. And as already proven in human medicine, as the public learns more about the hospice option, they are more apt to make use of it.

Similar to human hospice, the majority of VHC patients have been diagnosed with cancer, although most have multiple concurrent debilitating conditions. As the service has progressed, there has been a noticeable change in the patient trajectory—earlier referrals have resulted in longer patient time in hospice care. Similarly, families that have previously experienced hospice care are coming back seeking hospice care for their other pets.

Unlike human hospice, patients receiving care from VHC can concurrently be under the care of specialist or primary care veterinarians for therapeutic treatment of their illnesses. Since the time between terminal diagnosis and death is often shorter for animals than it is for people, families can choose to enroll their pets early in the disease process. This assures that comfort is maintained throughout the remainder of the patient’s life, and support is provided for the family. In order to ensure good communication, VHC provides a medical record that is shared with all members of the pet’s health care team, including the owner.

While I practice traditional Western medicine focused on palliation of symptoms and aggressive, proactive analgesia, alternative therapies (including acupuncture) are offered through referral to two colleagues in the MSU CVM community—Lori Bidwell DVM, DACVA, CVA, and Elizabeth Carr DVM, PhD, DACVIM, DACVECC, CVA. Human mental health care is also provided through referral to the MSU Veterinary Social Work Service, headed by Linda Lawrence MSW, LMSW. Together with Linda Lawrence, I co-facilitate the MSU Companion Animal Loss Support Group. Established in 2006, this group adds another layer of support for owners facing their pets’ deaths. Although I am not a human health care provider, my medical expertise is often useful within the context of the support group, as it is essential for the bereaved to understand the ramifications of the diseases faced by their animals.

MSU CVM has supported our mission to elevate the importance of end of life care by increasing veterinary student training. Since the establishment of VHC, I have been teaching four hours in core curricular classes on subjects including the legal ramifications of euthanasia, practices of euthanasia and end of life care delivery, and ethics surrounding the end of life. This amount of end of life care exposure raises the bar in the academic veterinary community, as most schools average only one hour (within the four-year program); this single hour is typically focused on euthanasia and accompanying legal considerations.7 At present, MSU veterinary students are not able to participate in the in-home care and plan development for active hospice patients. The goal within the next 1-3 years is that students will be offered an elective in end of life care, and will then be able to take on a more active role with hospice patients.

Community outreach is provided in the form of numerous lectures on end of life care topics for local veterinary medical associations and other organizations throughout the state. Data is currently being collected for an observational research project. Future areas of research interest include management of canine cognitive dysfunction and drug research for specific diseases.

I’ve also been instrumental in the establishment of the Veterinary Society for Hospice and Palliative Care, along with co-founder Katherine Goldberg, DVM. This organization aims to bring academic rigor to the discipline of hospice and palliative medicine within the veterinary profession, as well as progressive, evidence-based training to veterinarians interested in providing this care. While in its infancy, one of our major organizational goals is the establishment of a residency training program within a veterinary academic institution.

For More Information

Michigan State University's Veterinary Hospice Care»

Veterinary Society for Hospice and Palliative Care»

Veterinary Hospice Care continues to grow and become more widely accepted within the community and public eye. The public has responded favorably, offering donations to VHC to ensure that it continues. In the future, I hope our MSU VHC Service will be able to develop an elective course in end of life care, as well as engage students in the clinical care of active hospice patients.


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Join us April 15, 2015 for a webinar on end-of-life care presented by Dr. Yaxley. Learn more»

Dr. Page Yaxley

Page Yaxley, DVM, Diplomate of the American College of Veterinary Emergency and Critical Care, is the founder and director of Veterinary Hospice Care at the Michigan State University College of Veterinary Medicine. Dr. Yaxley graduated from The Ohio State University and completed an internship at Michigan Veterinary Specialists. She then completed a specialty internship, followed by a residency in Emergency and Critical Care Medicine at Michigan State University. In the fall of 2013, along with Dr. Katherine Goldberg, Dr. Yaxley founded the Veterinary Society for Hospice and Palliative Care—the first organization dedicated solely to the hospice veterinarian, with the long-term goal of initiating a recognized board certification program within this discipline. Dr. Yaxley is also co-facilitator of the Companion Animal Loss Support Group, established at MSU in 2006. Her primary interest is the human-animal bond, linking both her critical care foundation and her establishment of the country’s second veterinary hospice affiliated with a teaching institution. In her spare time, Dr. Yaxley volunteers at Sparrow Hospice House in Lansing, Mich., and she is currently training a pet therapy dog named "Tucker."


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