Anticipatory grief is the emotional response that pet owners experience when they foresee the inevitable loss of a beloved companion animal. For many, this begins with a diagnosis of a terminal illness or the gradual decline of a pet’s quality of life or a combination of chronic and age-related conditions. Unlike grief that occurs after a loss, anticipatory grief unfolds while the pet is still alive, and it can be a lengthy, roller-coaster–like experience as owners juggle feelings of hope, sadness, fear, and acceptance.

As veterinarians, understanding anticipatory grief is essential for supporting clients who may be struggling with complex emotions. It also provides insight into how these emotions can shape decision-making and impact caregiver burden, both of which are key to providing empathetic and effective end-of-life care.

Key characteristics of anticipatory grief include the following:

Emotional volatility: Owners may feel a mix of sadness, guilt, denial, anger, or fear on any given day.

Worry and anxiety about the future: Many fear the when and how of their pet’s death.

Guilt and doubt: Questions of whether they’re doing enough or if they’re making the right choices are common.

Recognizing and naming these feelings can be therapeutic for pet owners, who may not realize that the heavy emotions they’re experiencing are both normal and valid.

How anticipatory grief affects decision-making

For pet owners, each decision—from pursuing a treatment to choosing hospice care, to ultimately deciding on euthanasia—can be charged with emotional weight. Anticipatory grief influences these choices in several ways. 

1 Procrastination and delayed decision-making

Anticipatory grief can lead to avoidance because owners fear making any decision that might hasten their pet’s death. This can result in prolonged suffering for the animal and emotional stress for the owner. Educating owners on options for palliative care or hospice services can help them feel they are actively supporting their pet’s well-being rather than avoiding hard choices. 

Conversely, some pet owners may feel guilty and worry that they are not doing enough for their pets, leading them to pursue aggressive treatments. Guilt-driven decisions often lead to regret later. As a veterinarian, you can help by discussing quality-of-life assessments with owners and providing guidance on balancing treatment options with the pet’s comfort and quality of life in mind. 

3 Conflicted choices in balancing personal needs

Pet owners may face internal conflict when their pet’s needs start to impact their own lives and quality of life significantly. Caregivers can feel torn between attending to their pet and managing their responsibilities, such as work and family. It is helpful for veterinarians to remind pet families that it’s OK to consider their well-being because it affects their ability to care for their pets effectively. 

Society often imposes unspoken expectations on pet owners to go above and beyond for their animals. Owners may feel pressured to pursue every possible intervention. Veterinarians play a pivotal role in providing owners with objective information about what constitutes humane and compassionate care, helping them make choices that align with their values, budgets, and their pet’s best interest 

As anticipatory grief intensifies, it often leads to caregiver burden, where the physical, emotional, and financial demands of caring for a declining pet become overwhelming. Pet owners can experience fatigue, depression, anxiety, and even physical symptoms caused by stress. This burden not only affects the caregiver but can also inadvertently impact the pet’s quality of life.

Ways veterinarians can help alleviate caregiver burden 

Simple acknowledgment of an owner’s emotional burden can be incredibly powerful. Assuring them that it’s OK to feel overwhelmed can provide a sense of relief and a safe space for them to share their concerns. 

Pet owners may need support in setting boundaries on how much time, energy, or resources they’re able to devote to caregiving. Provide realistic advice on self-care ,and encourage them to lean on supportive networks, whether that’s family, friends, caregiving and anticipatory grief support groups, or a mental health professional. 

Directing owners to pet loss support groups or counseling resources can be beneficial, especially for those deeply impacted by the thought of losing their pet. These resources offer a community where owners can feel understood and less isolated. For example, Caring Pathways is an end-of-life practice with a grief support specialist on staff who connects with families who are experiencing anticipatory grief. A standard packet of information about anticipatory grief is provided to all Caring Pathways hospice and palliative clients. Many crematories also employ grief specialists who may be available to your clients, and local pet loss support groups often welcome those anticipating a loss to attend. Additionally, the Association for Pet Loss and Bereavement hosts a free chat-based anticipatory grief support group on the first Thursday of each month from 8 to 10 pm EST. 

4 Providing educational tools and quality-of-life assessments

Many owners struggle to gauge their pet’s comfort objectively, making it hard to recognize when a pet is suffering. Quality-of-life assessment tools can help owners make informed decisions about their pet’s well-being. These tools can be introduced early in the caregiving journey to help owners track changes and adjust care decisions over time. Virtual quality-of-life consultations are available nationwide from dedicated end-of-life veterinary professionals and can provide reassurance as well as second (and even third) opinions for families struggling with decisionmaking. Caring Conversations (https://caringconversations.pet/) has also provided support to families all over the country and reinforces the veterinary care they are receiving through the end-of-life process.

Communication strategies for veterinarians

Navigating conversations with owners dealing with anticipatory grief requires sensitivity and openness. Here are some key strategies for providing support. 

Use language that validates their feelings. Acknowledging that grief often begins long before a pet dies can help owners feel less alone in their experience. 

Asking questions like, “How are you feeling about [pet’s name]’s current state?” or “What are your hopes and worries about the upcoming months?” can invite owners to share openly. Listening with empathy and without judgment can help them feel heard. 

3 Provide clear information and reassurance

Be transparent about the pet’s health but avoid overwhelming them with medical jargon. Offering reassurance, such as “Our goal is to ensure [pet’s name] is as comfortable as possible,” can help reduce anxiety and promote trust. 

Help owners understand the range of options for their pet’s care and the potential outcomes. Knowing that they have choices can provide them with a sense of control, which can ease the stress of anticipatory grief.

As veterinarians, understanding anticipatory grief can deepen our empathy and improve our ability to support pet owners through difficult times. By recognizing how grief affects decision-making and caregiver burden, we can guide our clients in making choices that honor their pet’s quality of life and help alleviate their emotional strain. With compassionate communication, we can ensure that pet owners feel supported, understood, and empowered throughout their journey, ultimately helping both them and their beloved pets experience a dignified end-of-life transition.

Anticipatory grief is challenging, but with the right tools, support, and guidance, veterinarians can make a meaningful difference in the lives of pet owners. Compassionate care can turn a difficult journey into one of peace, love, and healing for both the caregiver and the pet.

Tyler Carmack, DVM, CHPV, CVPP, CVA, CVFT, CTPEP, CPEV, 

is the director of hospice and palliative care for Caring Pathways. She founded Hampton Roads Veterinary Hospice, an end-of-life practice based in Virginia and accredited by the American Animal Hospital Association and has exclusively practice hospice and palliative care since 2011. She has served on the board of directors of the International Association for Animal Hospice and Palliative Care since 2016 in various roles, including president in 2020 and 2025. Carmack holds certifications in animal hospice and palliative care, veterinary pain management, peaceful euthanasia, veterinary acupuncture, and traditional Chinese veterinary medicine in food therapy and end-of-life care.

Articles

Learn about caregiver burden, how to improve communication with clients, and why their decision-making is affected by a pet’s end-of-life journey

Understanding anticipatory grief in pet owners

Susan E. Little, DVM, PhD, DACVM, shares the most important control strategy for protecting dogs against parasites

Tackling parasites with year-round care

In an interview on her lectures from the 2025 Veterinary Meeting & Expo, Susan E. Little, DVM, PhD, DACVM, Krull-Ewing professor of parasitology at the Center for Veterinary Health Sciences at Oklahoma State University in Stillwater, stresses the importance of attention to monthly parasite control in dogs. As Little explains, the growing resilience of parasites in recent years calls for veterinarians to have a plan in place for protecting their patients.

 The most important control strategy for protecting dogs from parasites is going to be diligent attention to monthly parasite control. So, we've got to have protection in place, whether we're worried about fleas, ticks, intestinal parasites, heartworm, tapeworms—for all of those infections, we have to be doing something because otherwise nature will intervene.

If we don't have tick control in place, then the ticks will have their way. And we know that there's year-round tick activity in most places in North America now, or in the United States and so we know that we have to have year-round tick control.

The parasites have really upped their game in recent years. And so we as veterinarians have to come in with a plan in place to make sure that the patients are protected.

Videos

Tackling parasites with year-round control

The time for our profession to increasingly thrive is here. This 2025 will be the year of not reinventing the wheel but rather exploring how innovations, hot topics, trends, and legislation can drive meaningful progress, even when we may struggle to find a silver lining. This type of change implies a focus on challenging the status quo to enhance outcomes, streamline workflows, and elevate the overall standard of veterinary medicine. Let’s explore some topics that will continue to generate interest in our profession this year.

1 Veterinary professional associate (VPA).

Although supporters argue this new role would improve access to care, critics highlight concerns about its overlap with registered veterinary technicians (RVTs) and veterinary technician specialists (VTSs), the limited training of VPAs compared with veterinarians, and the lack of national standards for the education or licensure of VPAs.

Colorado has recently expanded the scope of practice for RVTs and VTSs through thoughtful legislation, emphasizing their roles in veterinary practices and granting new regulatory protections, which many believe have not yet been fully implemented or supported. However, critics argue the VPAs’ proposed training would not adequately prepare them for the complexities of even routine procedures, potentially compromising the quality of animal care. Advocates for technicians stress the importance of leveraging the newly expanded technician roles rather than introducing an entirely new, underdefined position into the profession.

The cost of pet insurance premiums is rising. With its heavy regulation, pet insurance seems to be heading toward the human health insurance model of a managed care system. This may lead to concerns that insurance providers may dictate care. Additionally, it will be intriguing to see how claims are processed with the growing usage of artificial intelligence. That’s where further pet owner education will come into play.

The use of artificial intelligence (AI) in veterinary medicine is just beginning and this year will fuel its advancement. Dictation software, removal of language barriers, phone call efficiency, diagnostic tools, and medical records are just a few of the many areas in which AI is expected to improve our workflows and patient care.

We know that the costs of veterinary care have increased, resulting in changes in how we do business. There is discussion among veterinary professionals on whether that will lead to a fall in demand for, or decrease in, veterinary visits this year.

Understanding the wants and needs of dog and cat breeds has become increasingly relevant. DNA testing, 3D printing, cancer screening tools, and an interest in extended life spans relating to particular breeds and mixed breeds are shaping the way we practice preventive medicine and patient care.

Methods such as hysterectomy and vasectomy are ways to sterilize pets without impacting hormone loss. Additional discussion on these—and whether they should be taught in veterinary schools—will be of interest in 2025.

New drug therapeutics from the past 2 years (pain management, parasitic control, dermatology, oncology, and internal medicine, just to name a few) have made significant and positive impacts on the way we treat our patients.

8 New veterinary schools and veterinary technician schools.

Our profession is popular and we recognize the need for more veterinary professionals to enter our field. It’s exciting to see these schools develop, enroll their first classes, and make a difference in their communities as well as the profession.

Not reinventing the wheel—rethinking it!

A new artificial intelligence (AI)-based technology for performing quick in-clinic screenings of common lymph node and subcutaneous lesions at the point of care, AI Masses, was recently announced. The product, developed by Zoetis, is a new addition to their Vetscan Imagyst platform. AI Masses is expected to launch in the United States in the second quarter of 2025. 

According to Zoetis, this addition to the Vetscan Imagyst platform—a multi-use diagnostic tool—was trained by human clinical pathologists.

 The new technology allows veterinary professionals to quickly analyze in-clinic lesions that may indicate cancer. Specifically, AI Masses analyzes potentially neoplastic cells in lymph nodes and subcutaneous lesions.

“Waiting for results can be stressful for pet owners—even more so when it involves a cancer screening,” Richard Goldstein, DVM, DACVIM, DECVIM-CA, global chief medical officer at Zoetis said in a release.

“Our research shows that up to 75% of pet owners find abnormal results highly stressful.AI Masses is yet another point-of-care capability to deliver results in-clinic, further exemplifies Zoetis’ purpose to advance care for animals, shortening anxious wait times to allow for faster care decisions that help provide the best possible outcome.”

The technology, which is Vetscan Imagyst’s 7th capability, was exhibited for the first time at the 2025 Veterinary Meeting & Expo (VMX) in Orlando, Florida late last month. According to a company release, the new capability requires just one round of sample preparation with access to an add-on expert review from a network of board-certified specialists via a Zoetis virtual laboratory. The add-on expert review may incur additional costs.

“With this latest expansion, Vetscan Imagyst becomes the only commercially available veterinary diagnostic tool of its kind to offer 7 unique testing applications: AI Masses, Digital Cytology, AI Urine Sediment, AI Fecal, AI Equine Fecal, AI Dermatology, and AI Blood Smear, in one compact tabletop design,” wrote Zoetis in a news release.

According to Zoetis, the AI Fecal application has the ability to detect parasitic ova, cysts, and oocytes, and offers results within minutes. Meanwhile, the AI Dermatology diagnostic can identify yeast, inflammatory cells and bacteria, as well as differentiates between cocci and rods. Additionally, the AI Blood Smear analysis works to supplement complete blood count results in minutes. The platform’s Digital Cytology Image Transfer capability offers cytology results for all species through a digital review from board-certified clinical pathologists in hours.

According to the company’s website, the Digital Cytology application can be used for all non-human species.

 Although a dedicated computer is not necessary for the Vetscan Imagyst, clinics should have a high-speed connection to best support the technology. Additionally, the platform works with most practice information management software systems.

In addition to showcasing its AI Masses technology, Zoetis also exhibited its Vetscan Opticell, a new “point-of-care” hematology analyzer at VMX.

Zoetis to Preview AI-Powered Cytologic Analysis Technology at VMX. January 24, 2025. News release. Zoetis.

Zoetis Diagnostics vetscan Imagyst. Zoetis. Accessed February 11, 2025. 

https://www.zoetisdiagnostics.com/us/point-of-care/vetscan-imagyst/

AI Masses is an addition to Zoetis’ Vetscan Imagyst platform

New AI tool for in-clinic cancer screening is announced

 After our doctors discuss pets’ dental diagnoses with clients, we email them estimates. A small number of clients call to schedule procedures. How can we improve our dental adherence?

After clients hear that their pets have periodontal disease, they want to know, “How can I fix my pet’s health problem?” Two-way conversations need to happen during appointments—not later in emails. You cannot have an engaging discussion, share visual aids, and answer questions by email. Delaying delivery of treatment plans tells clients that professional care is not urgent or important.

Increasing pet owner education and leading clients to schedule procedures during appointment will improve dental adherence.

Stop saying estimate, which makes conversations all about the money. The term treatment plan shifts the focus to necessary medical care. A treatment plan serves 4 purposes:

Avoid saying teeth cleaning because nearby groomers may offer a service with a similar name for a fraction of the cost, advises Paul Camilo, CVPM, of Veterinary Consultation Services in Fort Lauderdale, Florida.

 Better phrases are oral assessment, treatment, and prevention or comprehensive oral health assessment and treatment.

2 Present treatment plans on the day of diagnosis

After veterinarians explain dental diagnoses and the health benefits of treatment, have technicians or assistants present treatment plans. For examination efficiency and fee consistency, create templates for Grade 1 to 4 dental treatment plans with core services and then add extractions and specific services based on patients’ diagnoses. List services in the order they will be delivered because technicians and assistants will explain each item line by line. For example, preanesthetic testing should be listed before anesthesia. Treatment plans will have a high and low range.

Because it is human nature to look at the total cost first, share slideshows, videos, or photo books of the steps of a dental procedure before giving treatment plans. When creating slideshows or photo books, photograph each service on your treatment plan, such as preanesthetic testing, surgical monitoring, intravenous catheter, and dental x-rays. Design slideshows or photo books using PowerPoint or Canva. Include your hospital’s logo, photos, and captions on each slide or page. Play slideshows on computers or digital photo frames in examination rooms.

Covina Animal Hospital in California worked with Veteos to create a customized video on “What to Expect From a Dental Cleaning.” The short video—available on the hospital’s website—explains the exam, anesthetic safety, dental cleaning, probing, x-rays, recovery, and discharge. Because the video features Covina Animal Hospital’s staff and facility, clients see exactly what their pets will experience during professional dental care.

Clients may hear a parental “don’t worry” from veterinarians but have real concerns about anesthetic safety and potential risks. How you handle conversations about anesthesia can have different results, advises Ryane E. Englar, DVM, DABVP (Canine and Feline Practice), associate professor at the University of Arizona College of Veterinary Medicine in Tucson and author of A Guide to Oral Communication in Veterinary Medicine.

 The directness of asking, “What makes you uncomfortable about placing your cat under anesthesia?” may make the client reluctant to share. Using the third person when phrasing your question can allow a hesitant client to speak up. Say, “Some of my clients are concerned about anesthesia for older pets. Can we talk about that?”

Do not wait until the end of the appointment to mention financing. Address cost head-on because it is the elephant in the room, according to the American Veterinary Medical Association’s Language That Works: Changing the Way We Talk About Veterinary Care.

Explain that “we can help you with payment options for veterinary care.”

Let pet owners know they do not have to come up with all the money up front and share the monthly payment plan. Include links or QR codes to third-party financing on treatment plans and provide brochures. Say, “The expected amount for your pet’s dental procedure ranges from $__ to $__. Our hospital accepts cash, checks, and credit cards. We offer financing through [third-party provider]. The treatment plan includes a link to learn more about payment options.”

After presenting the treatment plan and answering questions, ask for a treatment commitment. Use the yes-or-yes technique. Say, “Dr [Name]’s next available procedure days are [date 1] and [date 2]. Which do you prefer?”

Have technicians schedule procedures while in exam rooms. It is not just what you say but where you say it. Do not leave booking procedures up to client service representatives (CSRs) at the checkout desk. When pet owners leave exam rooms, they have mentally checked out and may dismiss CSRs’ attempts to schedule follow-up care.

An American Animal Hospital Association study found that 38% of pet owners will return for procedures as directed by their veterinarians if the team follows up.

Create Grade 1, 2, 3, and 4 “dental procedure needed” codes that will print the medical recommendation on today’s receipt and trigger a callback in 1 week. Your invoice description might say, “Your pet was diagnosed with Grade 2 dental disease today. Please schedule treatment. We will follow up with a courtesy reminder call in 1 week.” Calling within 7 days is key—do not wait 30 days because clients will not remember details of exam conversations.

Say, “Dr [Name] needs to schedule [pet’s name] dental procedure so we may treat their infection and slow the progression of the dental disease. We can perform the dental procedure on [date 1] or [date 2]. Which do you prefer?” Using the veterinarian’s name brings credibility and authority to the call. “Infection” indicates treatment is urgent and medically necessary.

Talk with your team about these strategies and write a standard operating procedure for your staff’s steps when pets are diagnosed with periodontal disease. Map out scripts, callbacks, reminders, and actions that will improve adherence. Dentistry represents 6.3% of revenue.

 Your goal is to meet or exceed this benchmark. Go for it.

, is best known as the Queen of Scripts. Myers knows the right words will lead clients to accept your medical advice, driving patient and practice health. As founder of Communication Solutions for Veterinarians, she teaches practical skills through online courses, conferences, and onsite consulting. Myers’ experience as a partner in a specialty and emergency hospital helped her understand issues that owners and managers face. Learn how Myers can train your team at csvetscourses.com.

Six Steps to Higher Quality Patient Care. American Animal Hospital Association; 2009.

Burke J. 3 tips for marketing veterinary dental services. 

. January 18, 2023. Accessed January 3, 2025. https://www.dvm360.com/view/3-tips-for-marketing-veterinary-dental-services

A Guide to Oral Communication in Veterinary Medicine

New ebook reveals the best language to use with clients. American Veterinary Medical Association. September 20, 2021. Accessed January 2, 2025. https://www.avma.org/blog/new-ebook-reveals-best-language-use-clients

The Path to High-Quality Care: Practical Tips for Improving Compliance. American Animal Hospital Association; 2003.

Larkin M. Increasing practice profitability requires benchmarking, defining core values. American Veterinary Medical Association. November 18, 2024. Accessed January 2, 2025. https://www.avma.org/news/increasing-practice-profitabilityrequires-benchmarking-defining-core-values

Do you need a script for a client conversation? Submit your scenario to info@csvets.com for consideration in future columns.

Follow 8 tips for confident client conversations

Power up your dental conversations

Burnout. Simply put, it’s the emotional, physical, and or mental state of feeling overwhelmed. This word is probably on my list of Top 10 words heard throughout my veterinary school career and throughout the profession as a whole. It’s something that I had never really experienced until I reached veterinary school and is something most people in the veterinary profession will continue to experience throughout our careers.

Burnout and mental health have been an emerging topic lately in veterinary medicine. I personally believe this is because we are all so passionate about animals and their well-being that whenever we experience something upsetting, whether it’s failing an exam in veterinary school or losing a patient in the clinic, it tends to linger in our minds and damages our mental health by making us question ourselves and our abilities. 

As veterinary students, we worked very hard in our undergraduate courses to reach veterinary school. With limited spots in only 33 accredited veterinary schools in the United States, getting accepted into veterinary school is quite the feat. Once in veterinary school, the curriculum difficulty increases along with semester credit hours, time needed for studying, and more. Our brains have been programmed to tell ourselves that we 

 the highest grades and highest GPA. While getting all A’s is possible in veterinary school, it’s also a difficult, strenuous task that can take a toll on our mental health if not achieved.

I have always been hard on myself when I don’t achieve an A in every class. While aiming for all A’s is a good mindset to have, I tend to beat myself up mentally when I don’t succeed. Not only that, but the veterinary school schedule is also very demanding. Most of my days consist of 8 am to 5 pm classes, usually 2 exams every week, and studying at home for more than 4 hours outside of the classroom. It truly feels as if there is no time for anything outside of school, which is fuel for burnout.

For me, burnout has taken a toll on my motivation to do even the things love—often, my brain feels so exhausted that all I want to do is lie down and sleep. Still, through these struggles with burnout, I have learned different ways to manage the exhaustion.

Now, here’s the light at the end of this treacherous tunnel: there are plenty of ways to combat burnout. One of the best ways I combat burnout is through hobbies. Weightlifting, playing sports, video games, and spending time with friends have been some of the best ways I have been able to take my mind off the stressors of veterinary school and give it the break it needs. I 

 recommend taking the time out of your busy schedule to do the things you love. Even if your schedule seems swamped with school and other responsibilities, it is also your responsibility to take care of yourself. It’s worth taking a few hours of your day to be yourself. We aren’t robots, we are human beings that need a reset from the rigorous life of veterinary school. I believe the better you care for yourself and your mental health, the better you will perform in your studies.

Another way I’ve learned to combat burnout in veterinary school is by relaxing about my grades. This has been emphasized so much since the first day by faculty and professors at my school, but it took me a very long time to actually accept this advice. While I may not have a 4.0 GPA in veterinary school or be one of the top students in my class, I’ve taken more time for myself and have been a happier person overall, while continuing to properly study and learn the material needed to be a great veterinarian.

Finally, having a strong support system throughout your veterinary career is essential to your mental health. Whether it’s your family, friends, or pets, don’t be afraid to rely on them for support. Hearing words of support from my loved ones has continued to motivate me to keep going even when I have felt like giving up. Without my support system, I wouldn’t be able to make it through the rigor of veterinary school. I used to keep my stresses and troubles inside because I didn’t want to complain and put my problems on someone else, but I’ve learned that your loved ones are the ones who want to take care of you and be there for you. They can’t do that if they don’t know your struggles. Since I’ve opened up more, I have become closer to my friends and know that if I ever feel overwhelmed, my support system will have my back.

Burnout is a very scary thing. It can bring depression, imposter syndrome, and other negative thoughts into your mind, making you question yourself and your abilities as a professional. While you may carry it throughout your career, it is very possible to combat and overcome it. Through trial and error, I’ve learned a lot about myself in veterinary school, including how my mental health directly correlates with my performance in learning and school.

I still continue to struggle with burnout and lack of motivation. I even continue to still question if I belong in veterinary school, but by continuing to take care of my mental health, taking things day by day to not overwhelm myself, and relying on my peers and support system, I’ve felt happier with myself and put myself in a better mental space to continue my path on becoming the best veterinarian I can be.

 received his Bachelor of Science in Biomedical Sciences at Texas A&M University and is currently a class of 2026 veterinary student at Auburn University College of Veterinary Medicine in Alabama, where he is focusing on small animal medicine. His goals are to be a “voice for the voiceless,” working on the well-being of animals and motivating others by emphasizing mental health.

Student ambassador Connor Velasco shares how he manages burnout in veterinary school