The veterinarian’s role in end-of-life management of animals : an exploration of veterinary training and the perspectives of New Zealand cat owners : a thesis presented in partial fulfilment of the requirements for the degree of Doctor of Philosophy in Veterinary Science at Massey University, Manawatū, New Zealand

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Littlewood, Katherine
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Massey University
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Domestic cats are living longer and more of them are living with chronic conditions. It is up to the owner(s) to make the decision about when, and how, to end the life of their cat. Owners may find such end-of-life decisions difficult, as they are influenced by many factors relating to their cat and to themselves. Owners often involve their veterinarian in the decision-making process; therefore, it is essential that veterinarians understand the role they play in end-of-life management of animals. To ensure veterinarians are effectively supporting owners to make end-of-life decisions, there is also a need to know how veterinary students are taught relevant topics and skills. The central question this research aimed to answer was: 'what is the veterinarian's role in end-of-life management of older and chronically ill cats in New Zealand?' Study 1 investigated how aspects of end-of-life management – technical euthanasia skills, end-of-life decision-making, and grief management – were taught to Australasian veterinary students. Study 2 then explored the role veterinarians play in end-of-life management from the perspective of owners of older and chronically ill cats, as well as how those owners made the decision to end their cat’s life. Study 1 demonstrated some gaps that, if filled, could improve veterinary training in end-of-life management of animals. Technical aspects of euthanasia were not taught consistently for companion animals and this needs to be improved to ensure new graduates meet client expectations – that is, they are as competent as my cat owner participants assumed. There also appeared to be gaps in teaching end-of-life decision-making relative to what was important to cat owners. Owners expected their veterinarian to be the professional or ‘expert’ when it came to knowledge of animal health and welfare, but not all veterinary students were taught how to assess animal welfare or quality of life in the context of end-of-life decisions. In contrast, teaching of grief-related topics left only a few gaps to fill. Grief management teaching best reflected many of the features my cat owner participants wanted from their veterinarian, and particularly the human-centred themes taught to students. Most of this grief management teaching was performed by student counsellors and psychologists in earlier (preclinical) years. This means these human-centred themes may not have been explicitly linked to the decision-making process, and, more importantly, to the veterinarian’s role in end-of-life management. Without explicit alignment, veterinary students may be left thinking that veterinarians have only a limited role, or even no role at all, in managing their clients’ emotions and that this should be left to trained professionals. However, my cat owner participants emphasised the important role their veterinarian had played in the end-of-life process, suggesting that training, in New Zealand at least, is effective in this regard. Significant methodological developments in this research include designing and conducting in-depth interviews using social science methodology, in addition to the analysis and interpretation of qualitative data. Future studies should compare owner and veterinary perceptions of the same euthanasia event to obtain a detailed picture of the veterinarian’s role in end-of-life management of animals.
Veterinary medicine, Study and teaching, New Zealand, Australia, Euthanasia of animals, Decision making, Human-animal relationships, Veterinarian and client, Cat owners, Attitudes