Image Credit: © Gorodenkoff | stock.adobe.com

Cancer is a leading cause of illness and death in older dogs and cats, affecting roughly 50% of dogs and about 30% of cats older than 10 years. The American Animal Hospital Association’s (AAHA) 2026 Oncology Guidelines synthesize current evidence and expert consensus into actionable recommendations for the primary care team from diagnosis and staging to treatment options, supportive care, referral triggers, and follow-up.

Here are a few key takeaways. A link to the full guidelines can be found in the reference list below this article.

Make a definitive diagnosis before planning therapy

AAHA emphasizes that a cytologic or histopathologic diagnosis is necessary to determine prognosis and guide therapy.

 When fine-needle aspirate is inconclusive or additional information is required (for example, tumor grade), pursue biopsy and histopathology rather than assuming tumor behavior.

Use staging to guide treatment intent and timing

Staging is more than local vs metastatic classification. It clarifies treatment intent (curative vs palliative) and identifies appropriate imaging and nodal assessment. AAHA provides tumor-specific staging checklists and recommends thoracic imaging, abdominal ultrasound, and regional lymph node cytology or biopsy as indicated.

Frame chemotherapy around quality of life

The primary goal of systemic therapy in veterinary oncology is maintaining the best possible quality of life while controlling disease. Most veterinary chemotherapy protocols are generally well tolerated. Adverse events are usually manageable when clinicians and owners anticipate them and monitor appropriately.

Educate owners proactively about the likelihood of appetite changes during chemotherapy and provide concrete management strategies. Addressing appetite loss early helps pets remain on recommended treatment plans and improves overall well-being during therapy.

Evaluate new drugs and biologics carefully

The guidelines stress understanding the risks, benefits, cost, and regulatory status of novel therapeutics (such as small-molecule inhibitors, monoclonal antibodies, and other biologics). Clinicians should not adopt new agents without reviewing available evidence, registration status, and monitoring requirements.

Integrate supportive and symptomatic care from diagnosis onward

Supportive care—nutrition, pain management, antiemetics, wound and infection management, and psychosocial support for owners—is fundamental and begins at diagnosis. AAHA provides screening and treatment checklists aimed at maintaining function and comfort throughout therapy and survivorship.

When initiating symptomatic care, thoroughly evaluate for comorbidities that may alter drug choice, dosing, or prognosis. This ensures supportive measures truly improve quality of life rather than introducing harm.

Technicians and other team members play a central role in oncology workflows, including intake screening, weight and appetite tracking, pain scoring, client education, medication administration training, and documentation. Standardized technician checkpoints improve early detection of complications and support better quality-of-life decisions.

Know when to refer and how to collaborate

AAHA outlines clear referral triggers: complex staging that requires advanced imaging, specialized surgery, administration of advanced systemic protocols, or when weighing curative versus palliative intent. Good referral relationships and succinct transfer-of-care notes streamline transitions and may improve outcomes.

Adopt structured post-treatment monitoring

Tumor-specific follow-up schedules and standardized monitoring (physical exam, imaging, and laboratory testing) are recommended to detect recurrence or late treatment effects early. Integrating these schedules into practice management software reduces the risk of patients being lost to follow-up.

American Animal Hospital Association. 2026 AAHA oncology guidelines for dogs and cats. American Animal Hospital Association. Published January 1, 2026. Accessed January 7, 2026. 

https://www.aaha.org/resources/2026-aaha-oncology-guidelines-for-dogs-and-cats/

American Animal Hospital Association. Section 1: overview of common cancers. American Animal Hospital Association. Published January 1, 2026. Accessed January 7, 2026. 

https://www.aaha.org/resources/2026-aaha-oncology-guidelines-for-dogs-and-cats/section-1-overview-of-common-cancers/

American Animal Hospital Association. Section 3: tumor diagnostics and staging. American Animal Hospital Association. Published January 1, 2026. Accessed January 7, 2026. 

https://www.aaha.org/resources/2026-aaha-oncology-guidelines-for-dogs-and-cats/section-3-tumor-diagnostics-staging/

American Animal Hospital Association. Section 5: therapeutic interventions. American Animal Hospital Association. Published January 1, 2026. Accessed January 7, 2026. 

https://www.aaha.org/resources/2026-aaha-oncology-guidelines-for-dogs-and-cats/section-5-therapeutic-interventions/

American Animal Hospital Association. Section 6: consultations and referrals. American Animal Hospital Association. Published January 1, 2026. Accessed January 7, 2026. 

https://www.aaha.org/resources/2026-aaha-oncology-guidelines-for-dogs-and-cats/section-6-consultations-and-referrals/

American Animal Hospital Association. Section 2: what's new in veterinary oncology. American Animal Hospital Association. Published January 1, 2026. Accessed January 7, 2026. 

https://www.aaha.org/resources/2026-aaha-oncology-guidelines-for-dogs-and-cats/section-2-whats-new-in-veterinary-oncology/

American Animal Hospital Association. Section 7: supportive and symptomatic care. American Animal Hospital Association. Published January 1, 2026. Accessed January 7, 2026. 

https://www.aaha.org/resources/2026-aaha-oncology-guidelines-for-dogs-and-cats/section-7-supportive-and-symptomatic-care/

American Animal Hospital Association. Section 8: technician and team optimization. American Animal Hospital Association. Published January 1, 2026. Accessed January 7, 2026. 

https://www.aaha.org/resources/2026-aaha-oncology-guidelines-for-dogs-and-cats/section-8-technician-and-team-optimization/

American Animal Hospital Association. Section 9: post-treatment monitoring and follow-up care. American Animal Hospital Association. Published January 1, 2026. Accessed January 7, 2026. 

https://www.aaha.org/resources/2026-aaha-oncology-guidelines-for-dogs-and-cats/section-9-post-treatment-monitoring-and-follow-up-care/

Articles

AAHA’s 2026 oncology guidelines aim to update diagnostics, staging, treatment priorities, and team workflows to help primary care clinics detect, stage, and manage cancer while preserving patient quality of life.

Key takeaways from AAHA’s 2026 oncology guidelines 

As someone who finds the field of science fascinating, I often consider the roles that human and veterinary medicine play in advancing science, particularly through cardiac surgical programs. With industry change and scientific advances, the boundaries between human and veterinary medicine have become increasingly permeable, as demand for advanced intervention in companion animal medicine continues to grow. As a result, a paradigm shift has occurred in what was previously considered an exclusive domain of human medical intervention, with the development of cardiac surgical programs in veterinary medicine. This novel scientific development in veterinary medicine now allows both human and veterinary practitioners to achieve improved cardiac-specific outcomes not only for the individuals holding the leash but also for their furry counterparts at the end of that leash.

The field of cardiac surgery has made significant advances since the early 1900’s. Before the creation of the cardiopulmonary bypass machine in the mid-1950’s, novel research using systemic hypothermia in dogs to permit cardiac surgery on an open heart laid the foundation for the first successfully recorded cardiac surgical procedure in dogs.

A short number of years later, the first successful human heart surgery using total-body hypothermia was recorded at the University of Minnesota, sparking the beginning stages of open-heart surgery.

Upon creation of the cardiopulmonary bypass machine, arguably one of, if not the most significant, life-altering developments in the field of cardiac surgery, studies involving canines at the University of Minnesota were completed to assess the feasibility of cardiopulmonary bypass on the repair of ventricular septal defects, with promising results.

Likewise, these initial results found in the canine population allowed for further development, leading to one of the first successful surgical repairs of an atrial septal defect in the human medicine field through the use of the cardiopulmonary bypass machine.

As displayed, animals have played a significant role in the development of many modern-day technologies utilized in the field of cardiac surgery.

Veterinary cardiac research shows promise for improving both human and veterinary medical industries due to the similarities between human and companion animal hearts (canine-specific), the pathophysiological processes of common valvular diseases, and the use of similar echocardiographic techniques to those of the human heart.

As such, an opportunity exists for canine cardiac patients to help construct relevant clinical models that may translate and, as a result, address cardiac disease in the human heart.

Therefore, collaborative efforts between human and veterinary medical professionals enable both scientific fields to benefit in terms of scientific improvement and improved cardiac-specific outcomes for human and veterinary patients alike.

Due to the high degree of interconnectedness among veterinary and human medicine cardiac fields, the concept of One Health provides an integrative framework that enables both industries to bridge the knowledge gap concerning clinical research in each respective field, thus increasing the likelihood of transitional medical approaches between sectors.

A representation of this concept is depicted in the tendency for both companion animals and humans to develop similar diseases in similar ways such as weakening of cardiac musculature with increased age.

The One Health concept also brings to light the importance of ethics throughout the clinical trial process, in both veterinary and human medicine fields. More specifically, it highlights that animal health and well-being, like human health and well-being, must be well understood and considered before, during, and after completing any clinical trial process. When ethics are considered, bidirectional translational knowledge can be effectively formed in cardiovascular research. This is best accomplished through cyclical research, starting with basic research, followed by preclinical testing in animals, and culminating in clinical application and observation.

An example includes interventional cardiology in veterinary medicine, especially procedures such as balloon valvuloplasty and cardiac pacing, which were initially researched and developed in veterinary patients and ultimately led to advancements in human-grade medical infrastructure as well as clinical data generation, which enables continued improvement of cardiac medical infrastructure in both veterinary and human medicine fields.

Likewise, given the fact that cardiomyopathies are among some of the most common inherited cardiac diseases in both humans and animals (hypertrophic cardiomyopathy, dilated cardiomyopathy, and right ventricular cardiomyopathy, to name a few), collaboration between veterinary and human medicine cardiac surgical specialists shows promise to provide insight and strategies to mitigate risk and disease well before needing to intervene surgically.

 is a current first-year veterinary student at the University of Calgary Faculty of Veterinary Medicine in Calgary, Alberta, Canada.

Bradshaw A, Bradshaw JC, Quinn R, Briscoe JB, Lawton JS. 80 Years After the First Blalock- Thomas-Taussig Shunt: Cardiac Research in Canines That Saved Lives. Journal of Surgical Research. 2025;312:252-262. doi:https://doi.org/10.1016/j.jss.2025.06.003

Augusto C, Alonso I, González RM, et al. Translational Echocardiography: The Dog as a Clinical Research Model of Cardiac Dysfunction. Applied Sciences. 2023;13(7):4437-4437. doi:https://doi.org/10.3390/app13074437

Han L, Lee Y, Lee H, Lee H, Lee JI. Overcoming Challenges in Interdisciplinary Collaboration Between Human and Veterinary Medicine. Veterinary Sciences. 2024;11(11):518-518. doi:https://doi.org/10.3390/vetsci11110518

Popiel-Dziewierz S, Agnieszka Noszczyk-Nowak, Artur Dziewierz. From bench to bedside and back: translational cardiovascular interventions in veterinary medicine. Advances in Interventional Cardiology. 2025;21(3):295-304. doi:https://doi.org/10.5114/aic.2025.154190

Rivas VN, Stern JA, Ueda Y. The Role of Personalized Medicine in Companion Animal Cardiology. Veterinary Clinics of North America: Small Animal Practice. 2023;53(6):1255-1276. doi:https://doi.org/10.1016/j.cvsm.2023.05.016

Explore the intersection of veterinary and human cardiology, enhancing outcomes for both patients and clients through innovative surgical advancements.

Advancing human and veterinary medicine fields through veterinary-specific cardiac surgery 

aRed Bank Veterinary Hospital PET/CT launch

PET/CT machine. (Image courtesy of Red Bank Veterinary Hospital)

Red Bank Veterinary Hospital (RBVH) recently announced it is adding PET/CT to its advanced diagnostic services. The technology offers insight into the presence, location, and severity of cancer. The service is able to detect metabolic activity at the cellular level, allowing veterinary professionals to diagnose the disease earlier and with better accuracy than conventional imaging options, RBVH said in a news release.

Currently, PET/CT is only available to a few veterinary hospitals throughout the United States.

“Offering PET/CT at RBVH places us among a very select group of veterinary hospitals nationwide,” Peter Chapman, BVetMed (Hons), DECVIM-SA, DACVIM, MRCVS, medical director of RBVH, said in the announcement.

 “This technology empowers our team to diagnose cancer earlier, tailor treatment plans more precisely, and ultimately improve outcomes for our patients.”

Shenandoah Veterinary Associates (Roanoke, Virginia)

An independently owned veterinary emergency hospital, Shenandoah Veterinary Associates, has opened its doors in Roanoke, Virginia. The modern hospital features 16,000 sq ft, advanced diagnostic and imaging capabilities, and an in-house laboratory. The facility was also built using a layout that incorporates separate areas for cats and dogs. The location is currently open Monday through Friday from 6:00 PM to 12:00 AM and Saturday and Sunday from 10:00 AM to 10:00 PM, although the hospital said it has plans to expand to 24/7 hours.

 The hospital also plans to include board-certified veterinary specialists in surgery, internal medicine, radiology, cardiology, and more in the future.

“Our model of emergency and specialty care is built on compassion, connection, and continuity—where pets stay close to their people, and referring veterinarians remain connected to the care of their patients and clients,” said Keena Van Horn, DVM, CVA, who founded the hospital alongside her husband, Mike Van Horn, DVM.

Oregon State University Lois Bates Acheson Veterinary Teaching Hospital (Corvallis, Oregon)

A patient receiving care at Oregon State University. (Image courtesy of Oregon State University)

Oregon State University (OSU) has opened a new emergency care veterinary teaching hospital in Corvallis, Oregon. The Lois Bates Acheson Veterinary Teaching Hospital, providing small-animal service to only cats and dogs, will give OSU veterinary students more hands-on opportunities to develop their emergency care skills while streamlining patient transitions to other OSU veterinary specialists as needed, Pia Martiny, DVM, DACVECC, an assistant clinical professor in the Department of Clinical Services at OSU's Gary R. Carlson, MD, College of Veterinary Medicine, and head of the small-animal emergency service, said in an OSU news report.

According to OSU, staffing varies by shift, with 1 to 2 receiving veterinarians, up to 4 final-year veterinary students, and as many as 3 certified veterinary nurses on duty each day. Fourth-year veterinary students on their emergency rotation handle the first triage, take patient histories, and perform initial exams. Then while the veterinarian is examining the patient, the students step back to review the case in their own before meeting with the veterinarian to map out a treatment plan together.

“Emergency cases historically are very scary cases for students,” Martiny said, noting that student demand has helped drive the expansion of the small-animal emergency service.

 “It’s all well and good to have a couple of days or weeks to research your case, but in emergency cases, sometimes you have minutes to make life-changing decisions. And that’s really hard to do if you don’t have training and mentorship in it.”

Red Bank Veterinary Hospital introduces PET/CT imaging for early cancer detection in pets. Red Bank Veterinary Hospital. https://www.redbankvet.com/blog/red-bank-veterinary-hospital-introduces-pet-ct-imaging-for-early-cancer-detection-in-pets 

Shenandoah Veterinary Associates Hospital opens as a local pet emergency room serving Roanoke and Southwestern Virginia. News release. Shenandoah Veterinary Associates. December 18, 2025. https://www.businesswire.com/news/home/20251218454973/en/Shenandoah-Veterinary-Associates-Hospital-Opens-as-a-Local-Pet-Emergency-Room-Serving-Roanoke-and-Southwestern-Virginia 

Rosbach M. OSU opens veterinary ER for cats and dogs. Oregon State University. December 12, 2025. Accessed January 8, 2026. https://today.oregonstate.edu/all-stories/osu-opens-veterinary-er-cats-and-dogs

The latest updates relating to animal care establishments and platforms.

Clinic center: Oregon State University opens veterinary teaching hospital ER, and more

Chronologic age, physiologic age, and the balance between lifespan and health span

Chronologic age, time since birth, is the most straightforward metric we have. It is easy to measure, universally consistent, and often serves as a shorthand for determining when to initiate “senior” or “geriatric” care protocols. For example, cats over 10 years of age and large-breed dogs over 7 years are often automatically classified as seniors.

 Chronological markers can be useful for structuring wellness reminders and creating population-level guidelines.

However, physiologic age, a measure of how “old” the body is biologically, is a far more powerful predictor of medical needs and overall quality of life. Physiologic aging is shaped by multiple factors, including genetics, nutrition, disease burden, prior medical interventions, lifestyle, and environmental influences. A 10-year-old Labrador who has maintained a healthy weight, engaged in consistent low-impact exercise, and remained free of chronic disease may function more like a much younger dog. By contrast, another Labrador of the same chronological age who has battled obesity, joint injury, osteoarthritis, and endocrine disease may present with markedly reduced mobility with evidence of cognitive decline and frailty.

This variability is now being captured through structured frailty assessments. In dogs, validated instruments such as the Canine Frailty Index and Canine Frailty Scale have been shown to predict vulnerability and survival. 

 In cats, Elizabeth Colleran, DVM, DABVP (feline practice), and fellow researchers piloted a feline frailty questionnaire modeled after human medicine, focusing on weight loss, exhaustion, weakness, slowness, and reduced activity.

These tools help veterinarians move beyond age in years to quantify functional reserve and tailor care accordingly.

From seniors to geriatrics: monitoring and tools

The transition from adult to senior to geriatric care does not occur at a single point in time but rather unfolds gradually. Veterinary teams that establish early benchmarks and engage in regular monitoring are best positioned to identify changes before they become crises.

For senior pets, chronological markers remain useful starting points. These pets should be flagged for more frequent check-ups and baseline diagnostics. At this stage, preemptive education for families is essential. Conversations about expected aging changes, such as mild lens opacities, changes in activity tolerance, or the possibility of osteoarthritis, help normalize the aging process and reduce panic when these signs appear.

For geriatric patients, physiologic rather than chronologic age becomes the more relevant guide. At this stage, veterinarians should incorporate structured assessment tools that capture the full complexity of aging.

 are particularly valuable. The canine frailty phenotype incorporates parameters such as nutritional status, sarcopenia, mobility, activity, and exhaustion.

 offer additional insight. Tools such as client-specific outcome measures, mobility scoring systems, validated chronic pain scales, and simple caregiver diaries (journals or calendars) allow families to document subtle trends over time. This longitudinal approach often reveals a pattern of decline earlier than single clinical visits.

Clinics can utilize the concept of a Comprehensive Geriatric Assessment (CGA), adapted from human medicine, which provides a holistic framework. Beyond medical conditions, the CGA considers functional ability, cognitive and behavioral health, psychological well-being, caregiver capacity, social support, environmental factors, and advanced care planning.

Because geriatric assessments are inherently more complex, they demand extended appointment times, often involving both a veterinarian and technician. Pre-appointment questionnaires and caregiver surveys can streamline data collection, while follow-up resources such as handouts, videos, and proactive check-ins reinforce continuity of care. The combination of longer visits, structured tools, and ongoing communication transforms geriatric care from reactive to proactive, ensuring that interventions are timely, targeted, and centered on maintaining quality of life.

In short, moving from senior to geriatric care requires a shift in mindset: from relying on age-based guidelines to using functional, individualized assessments that capture the nuances of aging. These tools not only enhance medical decision-making but also empower families to participate actively in their pet’s care journey.

Families are often overwhelmed by the changes that aging brings, and uncertainty can quickly translate into fear, guilt, or reactive decision-making. Structured education provides reassurance, fosters trust in the veterinary team, and empowers caregivers to make informed choices throughout the aging journey.

Educational materials should be practical, accessible, and reinforced at multiple touch points—during appointments, in take-home packets, and through digital resources. Simple checklists and handouts can help families recognize early signs of pain, cognitive decline, or frailty. For example, pain scales paired with illustrations or “skin maps” make it easier for caregivers to track subtle changes that might otherwise go unnoticed.

Instructional videos are another powerful tool. Demonstrations on how to safely use ramps, lift harnesses, traction socks, or mobility carts give caregivers confidence and reduce the risk of injury to both pet and owner. Similarly, short clips on medication administration techniques—whether pilling a cat, giving subcutaneous fluids, or applying topical therapies—help normalize new skills and improve compliance.

Because chronic pain is one of the most under recognized challenges in geriatric pets, providing education on how it manifests, such as reluctance to jump, changes in posture, or altered sleep patterns, equips families to distinguish discomfort from “just getting old.” Pairing this education with validated pain scales not only enhances monitoring but also helps families feel like active partners in care.

Equally important are cognitive enrichment activities. Just as humans benefit from mental stimulation in later life, so do pets. Encouraging owners to use puzzle feeders, scent games, or low-impact training exercises can slow cognitive decline while deepening the human–animal bond. By giving families concrete strategies, veterinarians reframe aging as a stage where pets can continue to thrive, not merely decline.

Finally, normalizing common aging changes is essential. Conditions such as lenticular sclerosis, vestibular episodes, or early cognitive dysfunction can appear alarming to unprepared owners. When practices proactively educate families about these scenarios, explaining what they are, what they mean, and what can be managed at home, they prevent panic-driven emergency visits and preserve caregiver confidence.

Training: Practical skills for daily life

When caregivers feel capable in the day-to-day management of their aging pets, they are less likely to experience panic during health changes and more likely to follow through with veterinary recommendations.

A key area is medication administration. Geriatric pets often require multiple prescriptions, sometimes in different formulations. Teaching caregivers how to safely pill a cat, disguise medication in food, or transition to liquid or transdermal formulations can mean the difference between compliance and treatment failure. Demonstrating these techniques in the clinic and supplementing with short instructional videos helps families troubleshoot challenges at home.

Mobility support is another common need. Veterinary teams can show families how to use ramps, steps, and lift harnesses safely, minimizing strain on both pet and owner. This not only prolongs mobility but also preserves the pet’s independence and dignity. Training in traction support, from trimming nails and paw hair to using products like toe grips or traction socks, reduces the risk of slips and falls on slick flooring.

Strength and balance exercises are equally important for pets at risk of frailty. Low-impact activities such as supported standing, gentle weight-shifting, or controlled sit-to-stand repetitions can help maintain muscle tone and joint stability. These exercises are often well-tolerated and can be framed as interactive “bonding activities” between pet and family.

Beyond physical skills, training also encompasses adaptations for daily routines. Helping cats accept alternative food textures, or acclimating dogs to mobility devices ensures smoother transitions as conditions evolve. By proactively preparing pets and families, veterinary teams prevent frustration and reduce the likelihood of abandonment of treatment plans.

Most importantly, this hands-on coaching builds trust. Families see their veterinary team not only as medical providers but as partners in caregiving. This trust enhances compliance, improves patient outcomes, and strengthens the long-term relationship between clinic and client.

The aging journey is as much emotional as it is medical. For many families, watching their pet slow down or struggle with age-related decline evokes feelings of grief, helplessness, or anticipatory loss. A well-designed geriatric program acknowledges this reality and seeks not only to preserve the pet’s health but also to protect and strengthen the human–animal bond during this sensitive stage.

Structured activities can play a significant role. Group classes for senior pets have shown measurable benefits for both animals and caregivers. Research demonstrated that participation in a 4-week senior dog class improved cognitive function and enhanced caregiver engagement, suggesting that shared activities can delay dysfunction while fostering connection.

 These classes provide not only mental enrichment for the dog but also social and emotional support for the owner, who meets others navigating similar challenges.

Daily routines can also be modified to sustain the bond. Encouraging low-impact exercise routines, such as gentle walks, swimming, or controlled play, helps maintain mobility without overexertion. These activities allow pets to remain engaged with their families and environment, reinforcing a sense of purpose and joy. Similarly, providing sleep support, whether through comfortable bedding, environmental modifications, or treatment of underlying conditions, improves rest for pets and reduces nighttime disruption for families, benefiting overall well-being.

Not all interventions need to be medical. In fact, some of the most powerful strategies are simple, joy-filled activities that celebrate the relationship. Holiday photos, milestone birthdays, and special treats remind families to cherish the time they have. Even small rituals—like taking an elderly cat into the garden for a daily sunbath or offering a favorite chew in a quiet moment—create cherished memories that counterbalance the challenges of decline. This shift not only improves caregiver resilience but also reframes geriatric care as a stage of life worth honoring, rather than one to dread.

Pre-planning: Reducing fear and uncertainty

Few topics are more difficult for families than talking about end-of-life care. Many pet owners avoid the subject altogether until a crisis arises, which can leave them feeling blindsided, guilty, or rushed into making decisions under emotional duress. Proactive, compassionate conversations about pre-planning not only normalize the subject but also dramatically reduce trauma for both families and veterinary teams.

A structured approach to pre-planning can cover several key areas:

Families benefit from knowing what to expect as conditions progress and when follow-up visits should occur. Outlining a “roadmap” for when to recheck mobility, re-stage kidney disease, or adjust pain management helps owners feel prepared rather than caught off guard.

Consider and communicate what options the practice can offer as obstacles present themselves. Does the practice offer house calls for its geriatric patients? Is there a partnership with a mobile veterinary service or end-of-life care service that can help serve these clients when transportation barriers present themselves?

End-of-life decisions and cost transparency: 

Fear of euthanasia recommendations or unexpected financial burdens is a major source of anxiety for families. Discussing options early—ranging from palliative care to euthanasia logistics—gives clients a clearer sense of what is possible and what fits within their means. Cost transparency is especially important; by clarifying expenses in advance, practices can prevent feelings of shock or guilt at a later, more vulnerable time.

Just as in human medicine, veterinary teams can invite families to articulate their core values: What quality-of-life markers matter most? Is maintaining mobility the priority? Is eating a favorite food essential? These conversations guide future decisions and help ensure that veterinary recommendations align with the family’s definition of comfort and dignity.

Discussing cremation, burial, or memorialization before the moment of loss allows families to reflect thoughtfully on what feels right. Providing resources such as urn selections, paw print keepsakes, or community grief support services demonstrates respect for the emotional significance of these decisions.

By initiating these conversations early, veterinarians shift the decision-making process from one of fear and urgency to one of love and preparation. Families who have had the chance to consider scenarios ahead of time often experience less guilt and greater confidence that they acted in their pet’s best interest. For veterinary teams, pre-planning reduces last-minute scrambles, clarifies expectations, and strengthens trust with clients who feel guided rather than pressured.

Ultimately, pre-planning reframes end-of-life care not as an abrupt, chaotic event but as a thoughtful, compassionate transition—honoring the bond between pet and family while safeguarding the patient’s comfort.

Financial incentives and practice sustainability

For practices to successfully adopt geriatric programs, they must not only deliver exceptional patient care but also operate in a financially sustainable way. A structured approach ensures that these services remain accessible for families while providing predictable revenue for the veterinary team.

Bundled services are one of the most effective strategies. Packaging diagnostics—such as biannual bloodwork, urinalysis, or blood pressure checks—into clear “senior care plans” removes the uncertainty of piecemeal billing and helps family’s budget in advance. When combined with technician-driven visits for nail trims, mobility checks, medication review, or pain scoring, these bundles expand access to care while optimizing the skill sets of the whole team. Scheduling CGAs at regular intervals further ensures that changes are identified early, reducing costly emergencies and increasing client satisfaction.

Pre-scheduling these services has dual benefits: it guarantees consistent monitoring for the pet and provides the clinic with a stable revenue stream. Much like wellness plans for puppies and kittens, these packages reduce the likelihood that clients will defer care due to financial concerns. In fact, many families express appreciation for predictable monthly or annual costs rather than unexpected large bills during crises.

Geriatric programs also represent an opportunity to deepen client loyalty. Just as puppy and kitten packages set the tone for long-term relationships, senior and geriatric programs reinforce trust by showing that the practice is committed to guiding families through the full life course of their pets. Clients who value transparency, proactive care, and emotional support are more likely to remain loyal to a practice that demonstrates foresight and compassion.

Finally, building sustainability into geriatric care is not only about revenue but also about team wellbeing. Practices that charge appropriately for time-intensive appointments, caregiver education, and extended follow-up reduce the risk of burnout while validating the expertise of their staff. In this way, financial incentives become aligned with patient comfort, caregiver trust, and veterinary team resilience—creating a model of care that is both compassionate and sustainable.

Designing a geriatric program is only the first step—it’s true value lies in how well it is implemented and integrated into everyday practice. Success requires both clinical foresight and operational commitment. Several principles consistently emerge as critical for building programs that are sustainable, effective, and embraced by both clients and teams.

Starting early is essential. Conversations about senior and geriatric care should not begin when pets are already in these life stages, but rather during adult wellness visits. By planting the seed early—introducing families to concepts such as aging trajectories, preventive diagnostics, and eventual preplanning—practices can normalize the idea that end-of-life care is part of a continuum, not an abrupt transition. Early education also makes families more receptive when interventions become necessary.

Utilizing the whole team amplifies impact and efficiency. Veterinarians are not the only voices clients need to hear. Technicians can conduct mobility scoring, administer monitoring questionnaires and pain/mobility scales, and provide hands-on training with harnesses or ramps. Client service representatives can manage the scheduling of routine senior check-ins and reinforce the importance of follow-up. By delegating roles, the veterinary team demonstrates a unified commitment to the pet’s well-being while preventing bottlenecks in care delivery.

Charging appropriately is another cornerstone of sustainability. Geriatric care often requires extended appointments, additional counseling, and more frequent monitoring than standard wellness visits. If practices undervalue their time and expertise, programs quickly become unsustainable, and staff may experience burnout. Transparent pricing—whether through bundled services or pre-scheduled packages—validates the work of the team and reassures families that they are investing in quality of life for their pet.

Consistency ensures clarity and builds trust. Families navigating the stress of aging pets can quickly become overwhelmed if different team members give conflicting recommendations. Standardized protocols for frailty screening, pain scoring, or preplanning discussions reduce confusion and create a predictable experience for clients. This consistency also strengthens the confidence of staff, who can follow structured guidelines while still personalizing care for each patient.

xpand the reach and depth of care. Collaborating with hospice and palliative care providers, rehabilitation specialists, nutritionists, and even mental health professionals allows practices to offer comprehensive support without overextending their internal resources. These partnerships ensure that families feel guided through every stage of the aging journey and that pets benefit from the collective expertise of a multidisciplinary team.

When these elements come together, a geriatric program transforms from an aspirational concept into a practical reality. The practice becomes not only a provider of medical services but also a trusted partner in one of the most meaningful phases of a pet’s life.

A well-designed geriatric program is far more than a collection of diagnostics and treatment protocols; it is a framework for compassionate, anticipatory care. By reducing fear and confusion, these programs empower families to become confident caregivers and allow pets to age with dignity. They honor the profound human–animal bond that has developed over a lifetime, ensuring that the final stages of that relationship are supported with as much thought and care as the beginning. Structured senior and geriatric programs reinforce that aging is not a disease to be feared but a natural stage of life to be supported and celebrated.

Ray, Michael et al. “2021 AAFP Feline Senior Care Guidelines.” 

 vol. 23,7 (2021): 613-638. doi:10.1177/1098612X211021538

 A Frailty Index based on clinical data to quantify mortality risk in dogs. 

https://doi.org/10.1038/s41598-019-52585-9

Russell, Katharine J., et al. "Establishing a Clinically Applicable Frailty Phenotype Screening Tool for Aging Dogs." 

, vol. 11, 2024, p. 1335463, https://doi.org/10.3389/fvets.2024.1335463. Accessed 6 Nov. 2025.

Colleran, Elizabeth J et al. “A non-randomized pilot study to test the feasibility of developing a frailty scale for pet cats.” 

 vol. 12 1549566. 26 Feb. 2025, doi:10.3389/fvets.2025.1549566

O'Brian, Maggie L et al. “Effects of a four-week group class created for dogs at least eight years of age on the development and progression of signs of cognitive dysfunction syndrome.” 

Journal of the American Veterinary Medical Association

 vol. 259,6 (2021): 637-643. doi:10.2460/javma.259.6.637

Learn how structured frailty assessments and proactive caregiver education can transform the aging journey from a reactive crisis into a dignified, quality-focused partnership.

Strategic design of geriatric pet programs in veterinary practice: Part 2

Learn how to increase resilience in your career through intentional physical and emotional warm-ups before the start of a shift.

Resilience isn’t built at work: How pre-shift “warm-ups” can help veterinary professionals thrive

The Resilient Vet: Mind and Body Strategies for Success

, hosts Aaron Shaw, OTR/L, CHT, CSCS, and Jennifer Edwards, DVM, ACC, CPC, ELI-MP, discuss how physical and emotional preparation before shifts can help veterinary professionals become more resilient in their careers. They explain that resilience is not a "switch" one flips, nor a product that can be bought. Rather, it is a skill set developed through intentional physical and emotional warm-ups before a shift even begins.

They also explore the concept of the “veterinary athlete”: The idea that surviving the physical and emotional demands of a long shift requires the same kind of intentional warm-up and training an athlete brings to game day. To help veterinary professionals build this resilience, Shaw and Edwards share tips and exercises that veterinary professionals can use to strengthen their mental and physical resilience in their roles.

If your day sometimes feels like you’ve been run over before lunch, this episode is for you, because resilience does not start at the clinic; it starts with how you prep your body, [as well as] how you prep your emotions and your brain, long before that shift even begins. We know that's the case for our clinical skills; we take years learning, preparing, [and] practicing, and it's the same for skills to build our physical and emotional resilience for a career in vet medicine. Today, we're going to give you a preshift physical and emotional warm-up to boost your resilience.

My name is Aaron Shaw. I am an occupational therapist, coach for [veterinarians] and vet teams, and founder of Project Vetspan and the Vetspan Collective community. I am also married to a veterinarian—lucky me—so I can speak firsthand to seeing the experiences of what it takes to survive and thrive in the demanding vet profession. And thankfully…I also have a cohost.

Hi, I am Dr Jennifer Edwards. I am a veterinarian, a former practice owner, and I am now a leadership and energy coach and speaker. As Aaron mentioned, you can tell I, too, understand firsthand the demands and the toll that this profession can take, and does take, on ourselves from an emotional standpoint, physical standpoint—pretty much from every standpoint. So, I now help people with conscious leadership. I work with veterinarians and veterinary professionals and leaders to help them uncover the patterns that are driving [their lives] and driving the things that are holding [them] back so [they] can create an amazing life and career that really feels aligned and fulfills [them].

So, I'm curious: Have you or someone on your team ever experienced that your day starts out, and all of a sudden, it just goes sideways? Things just don't go well at all, and it's because you were not properly prepared?

Podcasts

Resilience isn’t built at work: How preshift warm-ups can help veterinary professionals thrive

The American Heartworm Society (AHS) is seeking insight from veterinarians about their understanding of heartworm disease in the US, with a request to participate in the 2025 

. Using survey data, a heartworm incidence map will be created.

These maps are widely used by veterinarians, animal shelters, and pet owners to understand the threat of heartworm disease, according to the AHS. The maps also provide insights for veterinary professionals about heartworm incidence trends and the spread of heartworms into new areas of the country.

“Every veterinary practice that submits data helps the AHS to create a more comprehensive and useful map, which in turn helps veterinarians provide valuable information to clients on the threat of heartworms in their practice areas,” Marisa Ames, DVM, DACVIM (Cardiology), president of the AHS, said in a news release.

 Ames emphasized that neither size nor location of practice—nor the number of heartworm cases seen—should be a factor, adding that the brief 

Veterinary cardiologist named president of the American Heartworm Society

The AHS has generated maps every 3 years since 2001. The most recent AHS map was released in April 2023, following a survey taken early the same year that collected information based on heartworm incidence in 2022.

 survey data for the 2026 survey is February 14, 2026. “Whether yours is a large or small practice—or whether you live in a warm- or cold-weather state—we urge you to submit your information,” Ames said.

The 2022 map showed an increase in heartworm prevalence in certain areas of the country. These areas include states in and adjacent to the lower Mississippi Delta that historically experience a convergence of conditions fostering widespread heartworm infection. However, states with historically low heartworm rates also saw unexpected increases and the development of new “hot spot” areas in 2022, such as Washington, Oregon, Kansas, North Dakota, Massachusetts, and Connecticut. 

In the 2023 survey, approximately 17% of responding veterinarians reported decreases in heartworm rates in 2022. The most common reasons cited for the drops were changes in pet owner behavior, including an increase in heartworm preventives administered by pet owners (33% of respondents reporting drops) and improvements in preventive adherence (31%).

2025 Fetch dvm360 Conference in Kansas City

, Missouri, Michael W. Dryden, DVM, MS, PhD, DACVM (Parasitology), a professor (emeritus) at Kansas State University in Manhattan, Kansas, emphasized the need for parasiticides to be administered properly and consistently to prevent heartworm disease. Monthly parasiticide products are essentially “deworming” tools used to kill heartworm once in the subcutaneous stage (L3 and L4), according to Dryden. “They must be administered before L4 molt to the immature adult to be consistently effective,” he said.

The FDA recommends prescription heartworm preventives approved by the agency as the best way to combat heartworm disease in dogs. The FDA has also approved injectable melarsomine dihydrochloride for killing adult heartworms in canines, as well as a topical combination of imidacloprid and moxidectin for ridding a dog’s bloodstream of microfilariae.

Oral products administered monthly can kill L3 and L4 from up to 30 days prior with a short-term “pulse” of macrocyclic lactones anthelmintic activity that lasts a few days. Other products with different pharmacokinetic formulations can also “reach back” 30 days. Injectable moxidectin is a slow-release formulation that provides an additional 6 to 12 months of protection, and transdermal moxidectin/imidacloprid features a slow dermal absorption and slow elimination from the blood, which allows it to achieve protection 30 days back and 30 days forward, according to Dryden.

The AHS anticipates releasing the 2025 AHS map in April 2026, which is National Heartworm Awareness Month. The new map will be available for public viewing.

Numbers needed: veterinarians urged to contribute clinic data for 2025 heartworm incidence map. News release. American Heartworm Society. January 6, 2026. https://www.heartwormsociety.org/in-the-news/974-numbers-needed-veterinarians-urged-to-contribute-clinic-data-for-2025-heartworm-incidence-map 

New heartworm incidence map shows increase in parasitic cases. 

. April 20, 2023. Accessed January 6, 2026. 

https://www.dvm360.com/view/new-heartworm-incidence-map-shows-increase-in-parasitic-cases

Keep the worms out of your pet’s heart! the facts about heartworm disease. FDA. December 22, 2022. Accessed January 6, 2026. https://www.fda.gov/animal-veterinary/animal-health-literacy/keep-worms-out-your-pets-heart-facts-about-heartworm-disease?utm_source=chatgpt.com 

Crossley KC. Breaking down how parasite preventives work. 

. August 24, 2025. Accessed January 6, 2026. 

https://www.dvm360.com/view/breaking-down-how-parasite-preventives-work

The American Heartworm Society has generated data-driven maps every 3 years since 2001. 