Ellen Behrend, VMD, PhD, MS, DACVIM explains the differences between bexagliflozin and velagliflozin, and how to determine if a patient is a good candidate

Veterinarian discusses the 2 FDA-approved SGLT2 inhibitors for cats

Ellen Behrend, VMD, PhD, MS, DACVIM (SAIM), a consultant at Veterinary Information Network, talks about the 2 FDA-approved sodium-glucose cotransporter-2 (SGLT2) inhibitors available for treating type 2 diabetes in cats, in this interview with 

. Behrend also outlines which patients are ideal candidates for this new class of oral medications and discusses off-label use.

Ellen Behrend, VMD, PhD, MS, DACVIM (SAIM): 

There are 2 SGLT2 inhibitors that are now FDA-licensed in the United States for treatment of diabetes in cats as a sole agent. Those are Bexacat [bexagliflozin] and Senvelgo [velagliflozin].

I, at this point, look at them very similarly. Until someone does a study that compares one to the other, head on, we're not going to know if there's any real differences between them. So right now, I think about them interchangeably.

The basic difference to me is that Bexacat is a pill. It is given 1 pill per cat for any cat that is greater than 3.3 kilograms in weight, or whatever that is—7 pounds-ish.

Senvelgo is a liquid that is based on weight for the dose at one milligram per kilogram. So to me, it really comes down to what the owner prefers at this point, whether they would rather give their cat a pill or whether they would try and give their cat a liquid.

I think that SGLT2 inhibitors should be considered in any newly diagnosed diabetic cat. They are one of the first line treatments in type 2 diabetics in people. And remember that we think the majority of cats are type 2 diabetics.

Basically, in order to be a candidate for either one—an SGLT2 inhibitor—there's a few guidelines. One is the cat has to be happy or healthy, meaning that it is eating fine, drinking fine, urinating well, no vomiting, no diarrhea. It's a happy cat, with the exception that it's a diabetic.

Number 2, according to the FDA, these drugs should not be used in a cat that has ever gotten insulin before. I do use the SGLT2 inhibitors off-label and cats that have had insulin before, but that is off-label.

We also want to make sure that the cat doesn't have any ketones in its urine or an elevated beta hydroxybutyrate blood level. And by elevated, that typically means—depends who you ask—greater than 2.4 millimoles per liter, for sure. Once it gets above 1 millimole per liter, you're getting into a gray zone [of] whether or not you should start the drug...

Videos

Ellen Behrend, VMD, PhD, MS, DACVIM (SAIM) explains the differences between bexagliflozin and velagliflozin, and how to determine if a patient is a good candidate

Exploring the FDA-approved SGLT2 inhibitors for cats

With 30 years of experience and a great bedside manner, our practice owner has loyal—yet sometimes demanding—clients. Our client service team struggles with what to tell clients when their favorite doctor isn’t available for 2 or more weeks. What should we say?

Saying, “Sorry, the doctor can’t see your pet for 2 weeks,” could disappoint clients and delay patients’ medical care. Although the right words will improve the client experience, you also need to consider strategic scheduling techniques. Follow these 7 tips: 

Before blurting out that Dr Favorite isn’t available, ask, “What is the reason for [pet name]’s visit?” A patient with vomiting and diarrhea for 3 days should be seen today, whereas a wellness appointment can be booked a week or more out.

Rather than risk a negative conversation, express empathy and share options for care. For a sick patient, say, “Based on [pet name]’s symptoms, a veterinarian needs to examine your pet today. Although Dr Favorite has a full schedule today, Dr Next has urgent care appointments available at [time 1] and [time 2]. Which do you prefer so we can help [pet name] feel better?”

If the client requests Dr Favorite for a wellness appointment, offer the option of seeing the requested veterinarian or another doctor. Say, “Dr Favorite’s next available wellness appointment is [date, time 1], or Dr Next can see your pet sooner on [date, time 2]. Which do you prefer?”

3. Maintain a compassionate, understanding tone.

Use empathetic statements, such as “I understand that you want [pet name] to feel better. Let’s see what options we have.”

4. Preblock urgent care slots for same-day appointments.

Each veterinarian should have 4 to 6 urgent care slots reserved in their daily outpatient schedules. Most practices have higher sick patient demands on Mondays because they were closed over the weekend, Fridays because clients had sick pets earlier in the week but took a wait-and-see approach, and Saturdays when clients may be off work. Preblock 6 urgent care appointments on Mondays, Fridays, and Saturdays, while you should have 4 slots on Tuesdays, Wednesdays, and Thursdays. Stagger urgent care blocks by 1 hour in multidoctor hospitals to avoid traffic jams in the treatment area, laboratory, and radiography when several patients need workups (

Six urgent care blocks with 2 outpatient doctors

Urgent care is reserved for same-day appointments—don’t be tempted to steal slots from the next day’s schedule or you won’t have any urgent care slots available tomorrow. Book the next available sick patient appointment and encourage clients to call tomorrow as soon as you open about urgent care appointments. You can say, “Let’s schedule [pet name] for the next available appointment on [date, time]. We also reserve several urgent care slots for same-day appointments and fill them on a first-come, first-serve basis. Call us tomorrow morning as soon as we open at [time] to check on availability.”

Book the next available appointment but also offer to place the client on a wait-list. For example, for a client who has a pet with a possible ear infection, say, “Let’s schedule [pet name]’s appointment this week for [date, time]. I will also add you to our wait-list in case we have a cancellation and can see your pet sooner. Is [cell number] the best number to contact you if an earlier appointment becomes available?”

6. Be strategic if you double-book patients.

Avoid saying you can “squeeze” the patient into the schedule. Check with the veterinarian before making promises. If the doctor agrees, have the client arrive when other wellness appointments are scheduled. Checkups are shorter and more predictable appointments.

Have the client complete an online history form so the doctor can zero in on the chief complaint and ask follow-up questions. Explain this by saying, “Although the doctor’s schedule is full today, I explained your pet’s symptoms and they asked for you to arrive at [time] and wait to be seen. I will text/email you an online form to complete now so [Dr Name] can review it before you arrive. You also may want to bring a book or tablet with headphones while you wait. Are you able to be here at [time]?”

The doctor may be able to examine the pet between 2 wellness appointments, explain needed diagnostics to the client, and have the inpatient technician team begin workups. The client will wait in the lobby while the inpatient team performs diagnostics and the doctor continues seeing appointments. Once the results are ready, the doctor will review them with the waiting client between other appointments. Charge the client for an urgent care exam for this work-in appointment.

7. Forward book progress exams and wellness appointments.

If a veterinarian sees a patient today that requires follow-up care, book it now to ensure appointment availability and continuity of care. Whether checking out in the exam room or at the front desk, say, “[Dr Name] will need to see [pet name] for a progress exam in 10 days on [date]. Do you prefer [time 1] or [time 2]?” Use the term “progress exam” to communicate you are moving forward to resolve the health issue. Never say “recheck,” which clients may misinterpret as optional or free care.

If clients want the same veterinarian for wellness appointments, forward book them when the next care will be due 6 or 12 months from today. Compare the preappointment strategy to that of dentists, which clients already understand. Use the yes-or-yes technique and say, “Just as your dentist has you schedule your next appointment at checkout, we do the same to proactively manage your pet’s health. By scheduling today, you will get your first choice of doctor, day, and time. Do you prefer to see [Dr Name] at [date, time 1] or [date, time 2]?”

Setting clear expectations with clients and implementing proactive scheduling strategies will help your team provide timely care with their favorite providers.

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

is best known as the “Queen of Scripts.” She knows that the right words will lead clients to accept your medical advice, driving patient and practice health. As founder of Communication Solutions for Veterinarians, Myers 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.

Articles

These scripts for confident client conversations are compassionate and provide options to help ease pet owners’ concerns

How Do I Say...? When clients can’t see their favorite doctors

On this week's episode, Karl Maritato, DVM, DACVS-SA, shares his diagnosing and treating tips and tricks for veterinary professionals dealing with canine cranial cruciate ligament patients 

Vet Blast Podcast Epsiode: Approach to the CCL dog

On this week's episode of The Vet Blast Podcast presented by dvm360, Adam Christman, DVM, MBA, welcomes Karl Maritato, DVM, DACVS-SA, and a 2024 Veterinary Hero award winner, on the show to chat all about cranial cruciate ligaments (CCL) in canine patients. Throughout the episode, Maritato and Christman go over the surgical options for these patients, the importance of proper techniques, the use of braces and rehabilitation protocols, and how he encourages pet owners to consider long-term care as well as the benefits of timely surgery. 

: Where do you begin in terms of physical exam on your approach, when you're thinking, 'Oh, this one might have torn their CCL'?

Well, the first thing I do is try to not think that. I try to be unbiased, and I try to do the same exact physical exam every single time that I do it, when it's the hind limb, I always start in the toes, and I start just pushing and moving every digit through range of motion. And I'll be honest with you, if I do think the ACL is the problem, I'll actually kind of skip over that joint, because I don't want to run out of doggy minutes before they get upset with me. So I'll guide my hands up and down their legs. I just try to feel for symmetry. I try to feel for muscle atrophy. The biggest thing that I'm feeling for, if I'm feeling for an ACL just by when I'm rubbing my hands on their legs, is I'm feeling for a medial buttress in comparing the 2 sides. 

The biggest trick, I think, or thing that tricks most of the veterinarians, is the partial tears, and especially when they're somewhat early. You know, I certainly get a lot of texts saying I'm going to send you a dog. I'm not getting any drawer. So I don't know if it's an ACL. And then when I feel it, you know, I know immediately it is an ACL, because you can feel that medial buttress just really sticking out compared to the other side. So start at the toes, work my way up, just feeling muscle mass, manipulate the ankle, make sure that's all good. Another thing that can trick people is when they think it's an ACL, particularly if it's an Australian shepherd or breed like that, is luxation of the superficial physical flexor tendon. So I always try to feel the ankle to make sure that there's no popping going on down on the caudal aspect of that calcaneus. And then I run my hands up, and then that's where I start to feel for buttresses, as well as for muscle atrophy in general.

Podcasts

Learn more on diagnosing and treating canine patients with cranial cruciate ligament tears on this episode of The Vet Blast Podcast presented by dvm360

Approach to the CCL Dog

Hill's Pet Nutrition announced that it recently published the first 2025 World of the Cat Report. The report is a 28-page resource offering insight on global cat demographics, advances in feline food, new feline treatments and diagnostics tests, the impact of veterinary care costs, and more. The new resource comes at a time when the need for feline-focused veterinary care is on the rise, according to the Veterinary Medical Association (AVMA).

Cats: The stragglers in veterinary medicine

Cat ownership worldwide has been steadily increasing over the past few decades, with the number of cat-owning households in the US growing from 27 million in 1996 to 42.3 million by 2024.

 According to the 2025 World of the Cat Report, China has an estimated 53 million pet cats. Russia trails behind with about 23 million pet cats, with 59% of Russians owning a cat, making Russia the country with the highest share of cat owners in the world.

The US, meanwhile, is home to the highest number of domesticated cats in the world, with approximately 74 million of these felines.

 Currently, 1 in 3 households in the US has a cat.

 Despite the high number of cat ownership, cats continue to be the underdogs when it comes to veterinary care, with feline medicine lagging behind canine research.

Previously, it was common for veterinarians to treat cats as smaller versions of dogs, using tests and treatments designed for dogs, for feline patients, according to a report by 

 Even students in veterinary school received training that was based on the standard model of the dog.

Still, cats have a different response to drugs compared to dogs, with some drugs having a toxic effect on these felines.

 For example, drugs relying on metabolic conjugation, such as aspirin, propofol, acetaminophen, and carprofen, are cleared more slowly in cats than in dogs.

 Piroxicam, meanwhile, which is metabolized primarily by oxidation, is eliminated faster in cats than in dogs.

 Additionally, the elimination of half-life values for metabolized drugs—oxidized and/or conjugated drugs—varies between cats and dogs.

Although research in feline medicine has progressed in the past years, this area of veterinary medicine is “still considered a bit of a niche interest,” Karen Lisette Perry, BVM&S, CERTSAS, DECVS, MRCVS, MSC Vet Ed, FFCP-I, professor of feline medicine and associate professor of orthopedic surgery at the Michigan State University College of Veterinary Medicine said in a 

 met with Sandra Koch, DVM, MS, DACVD, professor at the University of Minnesota College of Veterinary Medicine and director of the school’s Veterinary Medical Center Dermatology Service, to talk about 

—a recently proposed name for environmental allergies or atopic dermatitis in cats. In the interview, Koch raised one issue feline medicine is facing: a lack of options for treating cats for skin conditions compared to dogs. “Research is moving very slowly in the understanding of the pathogenesis of this condition in cats compared [to] dogs. And if we don't understand the disease very well, it becomes more of a challenge to treat, right?” Koch said, highlighting the need for more research in feline medicine.

The inaugural 2025 World of the Cat Report is Hill’s first feline-focused comprehensive effort, according to the AVMA. The report stems from Hill's' Cat Advisory Team (CAT)—an initiative formed in 2024 as a response to the need for resources focused on feline medicine and research.

“With the rise in feline ownership comes a rise in the need for feline-focused veterinary care,” David Quinter, regional sales director at Hill’s said in an AVMA report.

 “The biggest takeaway from the report is the need for veterinary health care teams to feel equipped with feline-focused resources and tools to help with the increased demand in feline care.”

According to the report, only 40% of pet owners take their cats to the veterinarian each year. Meanwhile, 82% of dogs visit the veterinarian annually. The report suggests the stress cats and clients experience from veterinary visits may play a role in fewer pet owners seeking veterinary care for their cats.

Tips for making veterinary visits less stressful for patients

Additionally, the top conditions diagnosed in cats are gastrointestinal disease, dental disease, urinary tract disease (both upper and lower), upper respiratory tract diseases, obesity/being overweight, kidney disease, and behavior concerns.

 The report also notes that the feline immunodeficiency and feline leukemia viruses remain the 2 most common feline infectious diseases globally.

Among the content in the report are mentions of new feline-specific textbooks, as well as one that will be released in 2026; various new lab tests; the new oral hypoglycemic agents bexagliflozin and velagliflozin, which are sodium-glucose cotransporter-2 (SGLT2) inhibitors; recent Feline Veterinary Medical Association/International Society of Feline Medicine guidelines; accredited Cat Friendly Practices; and the antiviral drug GS-441524 for treating feline infectious peritonitis.

Hill’s has plans to release updated World of the Cat reports each year with the goal of developing a reference guide on feline nutrition and behavior materials. The move comes as the company embraces a “feline-first” attitude, according to the AVMA.

“Feline-first approaches not only get felines in the door but keep them coming back, allowing for effective preventive care and the early detection of common conditions,” said Quinter in an AVMA report.

Do you know a feline veterinarian who goes above and beyond for patients, clients, and the veterinary team? Nominate them for dvm360's 2025 Veterinary Heroes® Awards! These awards honor veterinary professionals, including those specializing in feline medicine, who makes a meaningful impact on patient outcomes through exceptional communication, compassion, and dedication. Submit your nomination

2025 Hill’s Pet Nutrition World of the cat report. Hill’s Pet Nutrition. Accessed April 16, 2025. 

https://na.hillsvna.com/en_US/resources-2/view/244

Won C. Hill’s releases inaugural global cat report amid push to focus on felines. American Veterinary Medical Association. April 2, 2025. Accessed April 16, 2025. 

https://www.avma.org/news/hills-releases-inaugural-global-cat-report-amid-push-focus-felines

Pet population continues to increase while pet spending declines. American Veterinary Medical Association. October 10, 2024. Accessed April 16, 2025. 

https://www.avma.org/news/pet-population-continues-increase-while-pet-spending-declines

Anthes E. Why are cats such a medical black box? 

March 11, 2025. Accessed April 16, 2025. 

https://www.nytimes.com/2025/03/11/science/cats-veterinarians-health.html

Court MH. Feline drug metabolism and disposition. 

Veterinary Clinics of North America: Small Animal Practice

. 2013;43(5):1039-1054. doi:10.1016/j.cvsm.2013.05.002

Bautista-Alejandre A, Koch S. Treatment options for cats with feline atopic skin syndrome. 

. March 13, 2025. Accessed April 16, 2025. https://www.dvm360.com/view/treatment-options-for-cats-with-feline-atopic-skin-syndrome

The inaugural 2025 World of the Cat Report highlights the latest advances in feline diagnostic tests and treatments, food, statistics, and more

New global cat report released as feline medicine continues to lag behind its canine counterpart

Christopher Pachel, DVM, DACVB, CABC (IAACB), discusses one way to help calm a canine patient in fear.

Creating safe spaces to mitigate fear in dogs

Discernible objects or situations such as thunderstorms, fireworks or other sudden and loud noises can trigger phobia, distress and a behavioral reaction in a pet. Christopher Pachel, DVM, DACVB, CABC (IAACB), a practitioner at the Animal Behavior Clinic in Portland, Oregon, offered a variety of phobia and anxiety intervention strategies while presenting an educational session at the 

2025 Fetch dvm360 Conference in Charlotte

, North Carolina. The lecture included discussion of pets that may need spaces that they feel safe in, such as a quiet area with bedding or other comfort items. In a 

interview recorded at the conference, Pachel further discussed the need for safe spaces as one way to help calm a patient experiencing fear.

Understanding phobia and anxiety in patients

The following is a transcript of the video:

Christopher Pachel, DVM, DACVB, CABC (IAACB

 “Being able to access safety, whatever that means for the animal, and to have a sense of agency, to be able to make some choices, to be able to choose that, addresses both the exposure level, to be able to help them manage that situation, that noise, that stimulus, more effectively. The ability to have some agency and choice actually helps to address some of the anxiety components. What we find is that by giving animals the ability to choose between options that are meaningful for them—in this case, talking about meaningful because of safety or reduced exposure—that actually addresses some of the anxiety component. So we're coming at it from multiple angles. And what I love about really helping caregivers to understand what the animals needs are is they said, ‘Well, what do I do? What's going to make my pet feel better?’ And the honest answer is, ‘let's ask your dog. Let's ask your cat. Let's observe them.’

“I remember one particular case, which was a noise phobia case, and the owner said, ‘I don't know why, but in the storm noises, when we have fireworks, the dog always comes here’—and they pointed to a space just in the middle of their basement family room—'always here.’ And we said, ‘well, I don't know why.’ So, because I'm weird and I don't mind being awkward, I'm like, ‘Cool. Let me get down at your dog's level.’ And I'm down on my hands and knees in the middle of their living room. And I have no idea how to explain it from an acoustic standpoint, but it was like a little dead zone right there. And once you got into this 3 by 3 space, you could just kind of feel the reverberations of noises getting really, really muffled. The dog is clearly going to be able to recognize that and know that ‘I feel better here,’ rather than any other space. And so simply observing, they didn't know why yet, but observing that this is where my dog feels more comfortable, let's make sure they have access to that, and let's see why that might be meaningful. Can we replicate that? So then having that knowledge that, okay, your dog is more comfortable when their acoustics are buffered. Let's see if we can layer that into so many other scenarios as a way to, again, give them that sense of safety and control and agency.”

Christopher Pachel, DVM, DACVB, CABC (IAACB), a practitioner at the Animal Behavior Clinic in Portland, Oregon, discusses one way to help calm an animal that's afraid.

Creating safe spaces to mitigate fear in pets

Pet owners living with senior pets or a pet with a terminal disease often come to their veterinarian asking, “When is it time?” or “How will I know when it’s time to euthanize?”. There is not a one-size-fits-all answer to this question. As veterinarians, it is our duty to respond compassionately and provide owners with the education and tools they need to assess their pet’s quality of life. During a recent session at the Fetch dvm360 Conference in Charlotte, North Carolina, Leigh Ann Collins, DVM, CVA, CPEV, regional veterinary director with Lap of Love, discussed strategies veterinarians can use to help their clients with this difficult assessment.

In many disease processes, there is not an obvious time when euthanasia becomes appropriate. Instead, there is often a range of time during which euthanasia is appropriate, depending on the individual pet and family. Collins suggested that veterinarians discuss 4 factors with clients to help them answer the question of “When is it time?”: ailment, family beliefs, pet personality, and budgets.

“Every disease is different,” Collins said, and death looks different in each. Veterinarians must educate clients on the disease process their pet is experiencing and set expectations for how the disease will progress and what they may expect. Conversations will look different depending on the disease process as well.

In general, diseases can be divided into 3 categories:

Imminent, such as a hemoabdomen or respiratory distress, where a decline happens quickly and often does not allow families to plan for euthanasia or schedule in-home care.

Intermediate, such as heart failure, where there will be ups and downs over time. Some changes can happen quickly.

Non-imminent, such as chronic kidney disease or osteoarthritis, where the decline is slow and families will have time to plan for end-of-life care, including scheduling euthanasia or utilizing an in-home euthanasia service.

Collins likened imminent diseases to a cliff, whereas intermediate diseases are a winding road, and non-imminent are a slow fade. Identifying which category of disease a pet family is facing can help frame the conversation around quality of life and euthanasia.

Euthanasia is an emotional decision for families and can be impacted by many factors. This includes cultural and/or religious beliefs, personal experiences, relationship with the individual pet, and the pet’s use, which is a particularly important factor for working animals. Collins encouraged veterinary teams to ask questions if you aren’t sure how a family’s beliefs are affecting their decision.

Collins encouraged veterinarians and pet owners to consider this question: “Just because there are options [for treatment], is it appropriate for the pet?” Families should consider how easy treatment will be and what their pet’s tolerance for medication, diet change, recheck veterinary appointments, and other treatment considerations may be. Treatment plans should be tailored to the individual pet’s personality. Although some pets may tolerate strict rest for medical management of intervertebral disc disease in dogs or subcutaneous fluids for chronic kidney disease, others could be extremely stressed. This will impact not only the pet’s quality of life but the relationship between pet and client.

The last factor to consider includes the family’s budgets. Although finances are often a factor, there are other budgets that need to be considered, including:

Physical ability to medicate and provide nursing care

Time to perform treatments like bathing or maintain a medication schedule

Caregiver burden can be experienced when caring for a sick pet and may be influenced by many factors including caregiving responsibilities for other pets or human family members as well as past experiences with sick pets. Collins encouraged veterinary teams to ask questions about clients’ previous experiences with euthanasia and end-of-life decisions to guide conversations about the current pet.

Objective approaches to measure quality of life

In Collins’ experience, “the [pet owner] who is doing the majority of the caretaking comes to the decision to euthanize first.” However, other family members may have differing opinions, and it is important that veterinarians compassionately guide the family through the decision-making process. Often, this starts with a discussion of assessing a pet’s quality of life.

Quality of life can be difficult to define and often looks different for each individual pet and family. Six major categories can be considered: mobility, hydration, appetite, hygiene, happiness, and pain. Collins noted that there are also many sensations that can detract from a pet’s quality of life, including physical pain, nausea, pruritus, breathlessness, thirst, and hunger. Additionally, social and emotional factors like anxiety or phobias, fear, isolation, loneliness, boredom and frustration, and stress can have major negative effects on quality.

Ultimately, we must find a way to measure a subjective concept. Collins encourages veterinary teams to give owners ways to evaluate quality of life at home and not assume that pet families know how to do this. Some common strategies for measuring quality of life include:

Make a list of the pet’s 5 favorite things to do and assess if they are still able to do them.

Consider things the pet hates/dislikes and determine if they are still reacting in the same way to these events (ie, mail delivery, thunderstorms).

Assess whether the pet still has their five freedoms, as defined by the ASPCA: freedom from hunger and thirst, freedom from discomfort, freedom from pain, injury or disease; freedom to express normal behavior, and freedom from fear and distress.

Quantify good and bad days on a calendar or with colored marbles in a jar. This requires families to agree on how they define “good” and “bad” and what percentage of the day needs to fall into the category.

Provide quality of life assessments to owners. There are numerous tools available including Lap of Love resources (quality of life scale, calendar, daily assessment), the Ohio State University’s quality of life scale, and Dr. Alive Villalobos’ H5M2 scale.

Make a bucket list of experiences for the pet to celebrate their life together.

Encourage families to compare videos or pictures over time to see how the pet’s appearance and activity compares to previous times.

At times, pet families may not see how bad things are, even when it seems obvious to us as veterinary professionals. It is essential that we avoid judgment during these conversations. Collins suggested that veterinarians start by discussing the disease process and setting expectations for how the disease will progress, including what death without assistance will look like. She also encouraged owners to set a “line in the sand” that they would not want to cross, such as their pet entering respiratory distress or being unable to stand.

Another approach is to have the owner do a quality of life scale in the office and compare their answers to one filled out by the veterinarian. Ultimately, end-of-life decisions belong to the pet family. Veterinarians can discuss the family’s beliefs, concerns, and fears to determine how best to help both the pet and family. Veterinarians should consider the pet’s condition and prescribe pain and sedation as needed to maximize the pet’s comfort.

“In traditional general practice, we don’t have as much time to have these conversations,” Collins noted. General practitioners should be aware of resources for pet owners to help with anticipatory grief and consider referring clients to a hospice and palliative care veterinarian to continue the end-of-life conversations, often in the home environment.

When guiding owners through end-of-life decision making, assessing quality of life is an essential component. Veterinarians should maintain compassion and withhold judgment throughout the process while educating owners and providing tools clients can use to objectively assess their pet’s quality of life.

, is a 2013 graduate of the University of Pennsylvania in Philadelphia, a practicing veterinarian, and freelance speaker and author in western Pennsylvania. She is passionate about mentorship, spectrum of care, and addressing common sources of stress for veterinary teams and recent graduates. Outside of clinical practice, Boatright is actively involved in organized veterinary medicine.

Collins L. Helping owners with assessing quality of life. Presented at dvm360 Fetch Charlotte 2025: Charlotte, NC. March 16, 2025.

Five freedoms. ASPCA. Accessed April 16, 2025. 

https://www.aspca.org/sites/default/files/upload/images/aspca_asv_five_freedoms_final1.ashx_.pdf

Helping owners assess their pet’s quality of life is an important part of the end-of-life decision making process