“While saying people need to have their pets vaccinated because it is the law may achieve the goal of getting the pet vaccinated the day it is in your hospital, it does not fully educate them about the benefits and reasons.” Photo courtesy Caring Pathways Senior pets are living longer, healthier lives than ever before and are becoming a substantial portion of the patient load (nearly 45 percent1) for many veterinary hospitals. However, along with increased longevity comes a host of age-related health concerns, many of which pet owners can dismiss as simply “old age.” As veterinarians, we must adapt our approach to senior pet care to ensure not only their physical well-being, but also their overall quality of life. One powerful tool in this endeavor is the utilization of quality-of-life (QoL) assessment tools into our practice. This way, as patients transition from adulthood to senior status, we can enhance treatment compliance, encourage more frequent senior pet visits, improve collaboration with the pet family, and engage in proactive end-of-life discussions. In a recent survey, it was shown 55 percent of cats and 40 percent of dogs did not see a veterinarian in the 18 months before they were euthanized.1 This trend is something end-of-life care providers encounter daily. Many of these patients simply fall through the cracks when end-of-life priorities shift for the pet family and the veterinary team has not set the communication and logistical framework ahead of this shift. Understanding QoL assessment tools Quality-of-life assessment tools are designed to evaluate various aspects of a pet’s well-being, including physical health, behavior, and emotional state. These tools provide a structured framework for the pet’s family and their veterinary care team to assess a senior pet’s overall quality of life and make informed decisions regarding their care. While there are several generic (not specific to one disease process) QoL assessment tools available, each with its unique features and scoring systems, the common goal is to provide a holistic view of the pet’s well-being. Increasing treatment compliance One of the key challenges in senior pet care is ensuring treatment compliance. Senior pets may suffer from multiple chronic conditions requiring ongoing management, such as arthritis, diabetes, or kidney disease. However, pet owners may need help adhering to treatment protocols due to financial constraints, time limitations, or perceived lack of improvement in their pet’s condition. By incorporating QoL assessment tools into practice, we can empower pet owners to actively participate in their pet’s care and make informed decisions regarding treatment options. For example, if a QoL assessment reveals a pet’s current pain management plan is positively impacting their overall well-being, families are encouraged to continue utilizing the medications as prescribed. If the prescribed plan does not show improvements in the pre-set timeframe, veterinarians can work with the owner to adjust the plan accordingly. This may involve exploring alternative treatment options, modifying medication dosages, or implementing supportive therapies to improve the pet’s quality of life while managing their condition effectively. Without tracking tools, families may simply stop giving medications and assume that nothing else can be done. As such, regular QoL assessments can serve as a valuable communication tool between veterinarians and pet owners, fostering trust and collaboration in the decision-making process. By openly discussing the results of QoL assessments with pet owners, veterinarians can address any concerns or misconceptions they may have regarding their pet’s care, ultimately increasing treatment compliance and improving outcomes. Knowing a family’s caregiving budget (financial, emotional, physical, and time) and checking in regularly can help maintain the relationship and allow treatment suggestions to be tailored to the family and pet. Photo courtesy Caring Pathways Encouraging vet visits Despite the importance of regular veterinary care for senior pets, many owners may delay or forgo veterinary visits due to various reasons, including financial constraints, transportation issues, fear, anxiety, and stress concerns, or simply a lack of awareness of the need for regular wellness. As a result, age-related health conditions may go undetected or untreated until they reach advanced stages, significantly impacting the pet’s quality of life and prognosis. QoL assessment tools can play a crucial role in encouraging pet owners to prioritize senior and geriatric visits to the veterinarian. By incorporating QoL assessments into routine wellness exams in adulthood, veterinarians can identify subtle changes in a pet’s well-being that may indicate underlying health concerns. For example, a decline in mobility or appetite, changes in behavior or temperament, or signs of discomfort or pain may all warrant further investigation and intervention. Beginning therapy for common older pet diseases, such as cognitive decline and arthritis, earlier can significantly impact a pet’s longevity and overall quality of life. By proactively addressing these issues during veterinary visits, veterinarians can educate pet owners about the importance of regular monitoring and early intervention in senior pet care. This proactive approach not only improves the detection and management of age-related health conditions, but also fosters a sense of trust and accountability between veterinarians and pet owners, leading to more frequent and proactive veterinary visits. Facilitating conversations End-of-life decision-making is an inevitable aspect of pet ownership, yet it can be one of the most challenging and emotionally fraught experiences for pet owners and veterinarians alike. Many pet owners may struggle with the decision to euthanize a beloved companion, grappling with feelings of guilt, grief, and uncertainty about when is the right time to say goodbye. Frailty scales tailored for pets are currently in development by a few different researchers. These scales aim to provide a structured framework for assessing and monitoring the health status of senior pets, aiding in the transition from adulthood to their senior years. In human medicine, frailty scales have proven invaluable in understanding and managing the health of the elderly. Frailty scales for pets promise to be a vital tool in veterinary practice, too. By offering a standardized way to evaluate factors such as muscle mass, mobility, cognitive function, and overall vitality, frailty scales will enable us to detect subtle changes early on and implement appropriate interventions to optimize the quality of life for our senior animal companions. Incorporating these scales into our practice will enhance our ability to provide comprehensive care for aging pets and provide good lead-in conversations for quality-of-life monitoring. QoL assessment tools can facilitate end-of-life decision-making conversations by providing an objective framework for evaluating a pet’s overall well-being and quality of life. When a pet’s QoL assessment indicates a significant decline in their quality of life, veterinarians can initiate open and honest discussions with pet owners about the pet’s prognosis, treatment options, and end-of-life care considerations. By having these conversations early and regularly, veterinarians can help pet owners navigate the complex emotions and practical considerations involved in end-of-life care. This may involve exploring palliative care options to improve the pet’s comfort and quality of life in their final days, discussing the logistics and process of euthanasia, and providing emotional support to pet owners throughout the decision-making process and beyond. Incorporating QoL assessment tools into senior pet care can have profound benefits for both pets and their owners. By leveraging these tools, veterinarians can enhance treatment compliance, encourage more frequent senior and geriatric visits to the veterinarian, and facilitate proactive end-of-life decision-making conversations. Veterinarians are encouraged to find a QoL tool they find useful, ensure the entire clinic team is trained to discuss it, and begin introducing this tool earlier in the pet’s life. Ultimately, the goal of incorporating QoL assessment tools earlier in a pet’s life is to improve the overall quality of life as they transition into their golden years, helping to ensure that they continue to receive the compassionate care and support they deserve. By equipping our team with a standard assessment and communication tool, we can serve pets and pet families in this especially intricate phase of their pet’s life. Tyler Carmack, DVM, CVA, CHPV, CVFT, CTPEP, is the director of Hospice and Palliative Care for Caring Pathways. She founded Hampton Roads Veterinary Hospice, an AAHA-accredited end-of-life practice, and has practiced exclusively hospice and palliative care since 2011. Dr. Carmack has served on the board of directors of the International Association for Animal Hospice and Palliative Care (IAAHPC) since 2016 in various roles, including president in 2020 and 2025. Tyler holds certifications in animal hospice and palliative care, peaceful euthanasia, veterinary acupuncture, TCVM food therapy, and TCVM end-of-life care. References Gardner, Mary. Are You Seeing Enough Senior Pets? AAHA Trends Magazine. February 2023. Noble CE, Wiseman-Orr LM, Scott ME, Nolan AM, Reid J. Development, initial validation and reliability testing of a web-based, generic feline health-related quality-of-life instrument. Journal of Feline Medicine and Surgery. 2019;21(2):84-94. International Association for Animal Hospice and Palliative Care. (n.d.). Helpful Links. Retrieved May 13, 2024, from https://iaahpc.org/helpfullinks/
