Plus-Hex CLINICAL
It is vital that owners understand that EoLC is not an alternative to euthanasia; it is the provision of tailored care that enables the journey a pet takes towards the end of its life to be the best possible. Where the decision to provide EoLC is made, owners should be reminded that there will be a point in the future when the patient experiences pain and suffering, and medical intervention and care will no longer be able to maintain the patient ' s QoL. By having this conversation with the owner early on, they will be better prepared for when EoLC is no longer deemed to be in the animal ' s interest and consideration of euthanasia is required. These decisions are often made easier by using QoL assessments.
When completing QoL assessments with owners, it is paramount that veterinary professionals consider the owner ' s personal ethical / moral views and their financial constraints. It may not be feasible for some owners to fund the full range of diagnostic investigations for a condition or all potential treatment options. This is especially true in the current financial climate. Therefore, veterinary professionals should support owners to make decisions within their constraints, while ensuring that the animal ' s wellbeing is at the forefront of all decisions. Consideration should always be given to ensuring that EoLC does not cause the animal ' s QoL to deteriorate.
Continuity of care is a key aim for any patient receiving veterinary treatment. However, rotas, part-time staff, sick leave and other factors can impinge on this. Where possible, each patient should be designated a VS and a VN to oversee their care. This is especially true for terminal or geriatric patients receiving EoLC. When these staff members are not available, as much notice as possible should be provided to the owners, and covering staff should be up to date with all aspects of the animal ' s care and prognosis. In this way, owners will not only feel informed and supported, but they will also feel empowered and better able to seek support from the veterinary team when they need it.
The role of the VN in QoL assessment
Completion of QoL assessments fulfils criterion 1.1 of the RCVS Code of Professional Conduct to‘ constantly endeavour to ensure the health and welfare of animals’ [ 23 ]. Given the time constraints faced by VSs [ 3 ], delegating QoL assessments to VNs is a practical solution. It may be beneficial for VNs with more understanding and experience of certain conditions to perform QoL assessments for individuals diagnosed with, or predisposed to, these conditions. Under the RCVS Code of Professional Conduct, the information VNs provide during a QoL assessment must be given in an open and honest manner [ 23 ]. Advice and information must be offered in a way that is impartial and respectful of the client ' s needs, beliefs and opinions [ 23 ]. All this must be carried out while ensuring the requirements of the Animal Welfare Act 2006 [ 5 ] are met.
It is crucial that VNs remain within their professional boundaries when conducting QoL assessments [ 23 ]. To achieve this, they must be fully aware of their scope of practice, such as not making diagnoses and maintaining open communication with the VS responsible for the case. This transparency allows the VS to monitor the case and step in if tasks assigned to the VN exceed their professional remit. To support this process, it may be helpful for the supervising VS to identify and clearly communicate specific intervention points, enabling VNs to refer cases appropriately when necessary.
Conclusions
QoL assessment is central to end-of-life decisionmaking for pets [ 7 ]. It is essential to evaluate each animal individually, as perceptions of good QoL differ between species, breeds, and individual pets and owners. Although QoL depends on a range of factors, physical aspects such as continuing pain create a very poor QoL, regardless of other factors being assessed, and may heavily influence the decision to consider euthanasia.
Cooney [ 24 ] describes euthanasia as being more than the singular act of administering an injection; it encompasses elements such as appropriate timing, empathic personnel, proficient techniques and the supportive presence of loved ones. The same can be said for ensuring QoL: it is more than simply administering analgesia and alleviating pain.
Puppy parties are commonplace in the VN ' s repertoire, but supporting older animals and their owners is less so. Providing owners with the resources to properly care for their senior pet will help them when the animal approaches the end of its life. Ultimately, this will result in patients having better QoL and owners feeling more informed and confident when having to make decisions. As veterinary costs increase, so too do owners ' expectations of the treatment and care of their pets, with owners expecting the veterinary industry to match, or even surpass, the level of care provided in human healthcare.
In summary, the overriding aim of QoL assessments should be to maximise the period between the diagnosis of a terminal condition and death, while ensuring the patient is able to live free from pain and suffering. Although EoLC occurs during the final chapter of a pet ' s life, this does not mean that this period should be any less meaningful than the rest of its life. The goal of good EoLC should be to maximise QoL during this final period, regardless of its duration. For many owners this period will provide the opportunity for them to absorb a terminal diagnosis, understand the condition their pet is experiencing and relish precious time with their pet, resulting in increased QoL for both the owner and their pet.
Volume 40( 4) • August 2025
23