Image Credit: © methaphum | stock.adobe.com

Kathleen Cooney, DVM, MS, CHPV, CCFP, founder of the Companion Animal Euthanasia Training Academy, discusses emerging ethical issues in companion animal euthanasia and practical strategies clinics can use to improve the quality of end-of-life care. In this Q&A, Cooney addresses communication techniques, team roles, hospice and palliative care integration, workforce well-being, cost and access concerns, common misconceptions and mistakes, and the evolving aftercare landscape.

Editor’s note: Answers have been lightly edited for clarity and length while adhering to the original spirit of the discussion as much as possible.

What are the most important emerging ethical issues in companion animal euthanasia today?

Euthanasia will always be part of veterinary medicine, and it brings potential moral conflict and moral distress when owners’ wishes differ from those of the veterinary team. Overall, veterinary teams are doing well at considering ethical issues and caring for owners during end-of-life events, and research suggests pet owners are generally satisfied with care during these times. Emerging issues to monitor include rising costs of specialized euthanasia services, [including mobile and specialty experiences], greater use of hospice and palliative care earlier in the disease course, more intentional team utilization and role definition for technicians and assistants, and environmental considerations related to drugs and disposal practices.

How should veterinary teams structure conversations about end-of-life care with clients?

Start by listening. The initial goal is to get the client talking so you can understand their prior experiences, psychosocial factors [finances, time constraints], and what matters most to them and their pet. Use prompts such as “tell me more” to draw out details and build a picture of the pet’s condition and the client’s priorities. If team members are concerned that the client’s perspective differs from the team’s, give a clear but gentle “warning shot,” such as, “I’m worried what you are seeing might be different than what I’m seeing. Let’s review what we’re observing.” Slowing down, building rapport, and creating trust are essential. With that foundation, honest recommendations and explanations are more likely to be heard and accepted.

How do you handle owners who ask to “do everything” for their pet?

Again, begin by listening to understand why the client wants to pursue all possible interventions. There are often underlying reasons such as guilt from prior experiences, fear of regret, or a desire to do everything possible. After understanding the motivation, discuss what is important for the pet’s welfare and quality of life. Will repeated interventions improve or worsen the pet’s experience? Be open to alternatives that may preserve quality time, such as robust pain management, palliative procedures, or referral for treatments you cannot provide. If an intervention would clearly do more harm than good, the clinician has an ethical responsibility to voice concerns and explain why.

What can practices do to protect staff emotional well-being around end-of-life work?

Build an intentional end-of-life culture that includes standards and written protocols for euthanasia, hospice, bereavement support, and aftercare. Creating manuals and norms that everyone helps develop reduces intrateam conflict and clarifies expectations for new staff. Regular discussion forums, like euthanasia rounds held monthly or at least quarterly, provide space for debriefing and continuous improvement. Leadership should monitor workload, mood, and cumulative death exposure to make adjustments where needed. Promote emotional intelligence across the team—self-awareness, empathy, social skills, and self-regulation—and lead with kindness, tolerance, and grace.

How should clinics think about cost and access for euthanasia services?

Clinics need to pay attention to costs while preserving quality, which encompasses drugs, supplies, and trained personnel. Home euthanasia is important and should be kept as affordable as feasible. Consider the total cost picture, including aftercare, and be creative about matching [the client’s] ability to pay. Payment plans, angel funds, and tiered service offerings can help. Clinics should review their supply, personnel, and operational costs to identify where efficiencies are possible without compromising care.

Are there common mistakes clinicians make during euthanasia appointments?

Most mistakes are unintentional and result from not recognizing how much the appointment involves beyond the injection itself. A frequent issue is approaching euthanasia too clinically or matter-of-factly…rushing rather than building rapport at the outset. Slowing down, establishing trust early, ensuring correct drug administration and dosing, allowing adequate time for questions, and providing meaningful support reduce the chance that technical problems will result in client distress or regret. Another misconception is believing there is only 1 proper technique. For example, pentobarbital can be administered by multiple routes as long as it reaches the vascular system.

What practical communication tools do you recommend for teams?

Train staff to “seek first to understand” and use short, open prompts such as “tell me more.” Provide role-specific scripts for receptionists, technicians, and veterinarians for handing the client to an aftercare partner, explaining options, and discussing hospice vs euthanasia. Use the team to operationalize roles, such as who speaks with the client pre-procedure, who coordinates aftercare, and who follows up. Implement laminated desk cards or printable 1-page handouts with aftercare options and sample language to standardize communication.

What is “end-of-life culture,” and how is it implemented?

End-of-life culture encompasses written standards and practices for euthanasia, hospice and palliative care, bereavement support, and aftercare. Implementation includes creating manuals, involving the entire team in developing norms, scheduling regular euthanasia rounds, and training staff in emotional intelligence and resilience. The goal is to reduce variability, make expectations explicit, and provide safe places for staff to voice concerns and suggest improvements.

What role should hospice and palliative care play in veterinary medicine?

Hospice and palliative care should be integrated earlier, not just in the final hours. These approaches can preserve quality of life and sometimes extend meaningful time for the pet and family. Organizations such as the International Association for Animal Hospice and Palliative Care provide education and accreditation; the field is growing and moving toward formal recognition, including an emerging college of veterinary hospice and palliative care. Practices should offer information about hospice options and consider accreditation or referral pathways as the field expands.

How can clinics better use aftercare partners?

Many clinics operate under an outdated paradigm that they must act as funeral directors and manage every aspect of aftercare. Partnering with reputable aftercare companies lets vendors handle pickup, cremation or aquamation, and memorialization, which meets client needs and reduces clinic workload. Clinics should vet vendors on service types, ID tracking and guarantees, pricing transparency, transport logistics, environmental practices, permits, and client education materials. When partnered appropriately, aftercare vendors can provide more choices to clients and save clinic staff time.

Any final practical advice for clinicians who perform euthanasia?

Practice the right skills and stay within your competence. If a requested procedure is outside your experience, refer or seek training. Keep euthanasia affordable while using quality supplies and trained personnel. Always discuss all options with clients. Some may prefer hospice or palliative measures and want more time. Lead with honesty to reduce regret, leverage the full team, provide preplanning resources, and invest in modern best practices. Above all, slow down, build trust, and maintain compassion for both clients and staff.

Articles

Expert guidance on emerging ethical dilemmas, clinic workflows, communication strategies, and aftercare partnerships to help veterinary teams improve end-of-life care for companion animals.

Modern ethical issues and best practices in companion animal euthanasia

A domestic cat has died of highly pathogenic avian influenza H5N1 in Grant County, Washington, becoming the first confirmed domestic feline case in the state linked to exposure from an infected wild bird. Around the same time, state health officials confirmed that a backyard poultry flock from a separate household in the county had also tested positive for the virus. The 2 detections underscore how H5N1 continues to circulate across shared outdoor environments, moving between wildlife and domestic animals.

The Grant County Health District (GCHD) and the Washington State Department of Agriculture (WSDA) have been working closely with the animal owners to provide guidance, testing, and preventive treatment, GCHD said in an announcement.

According to the WSDA, the cat was an outdoor pet who likely contracted the virus after contact with an infected wild bird.

Sudden flock health changes in Washington state should be reported to WSDA at 1-800-606-3056.

In terms of the poultry case, GCHD said the flock consisted of a small group of chickens and ducks. According to the county health district, the flock owner took the appropriate response steps, reporting the sudden deaths of several birds to the WSDA’s sick bird hotline.

A total of 161 wild birds in Grant County have been confirmed positive for the virus since the outbreak began. Twelve mice also tested positive for avian influenza during an outbreak in poultry at a large commercial facility in 2025.

“Many migratory birds overwinter in fields, backyards, and around water sources across Washington,” Amber Itle, DVM, WSDA state veterinarian, said in a WSDA announcement.

 “As birds concentrate, so does the avian influenza virus, increasing the risk of environmental contamination and spillover into domestic poultry, wild predatory species, and even our beloved outdoor domestic cats.”

The state agency is advising pet owners to take precautions to reduce the risk of exposure, including keeping pets indoors or in covered areas and avoiding contact with wild birds. The department is also recommending taking good hygiene measures and cautioning against feeding pets raw milk or uncooked meat.

State and local health officials emphasized that the feline case was not linked to contaminated pet food and that no human infections have been associated with either detection. Although the case marks Washington’s first confirmed feline infection tied directly to wildlife exposure, it is not the state’s first encounter with avian influenza in cats. The state has recorded 4 cases of the virus in cats linked to contaminated raw pet food since the start of the avian influenza outbreak in 2022, according to the WSDA.

Across the US, 149 domestic cats have tested positive for the virus since 2022.

Veterinary staff are at an increased risk of bird flu infection

Public health officials have identified certain groups at increased risk of infection, including veterinary teams, backyard poultry owners, dairy and poultry workers, hunters, and others whose work or daily routines bring them into close contact with animals or contaminated environments. Prolonged exposure without appropriate protective measures also increases the likelihood of infection, especially for people who are immunocompromised, very young, or older.

GCHD is urging individuals who spend time around potentially infected animals to wear personal protective equipment (PPE). The county is offering free PPE to local residents who are at an increased risk of exposure to avian influenza.

“People who had contact with infected birds or other animals will be contacted by public health to discuss exposure risk and symptom monitoring to ensure prompt testing and treatment of any suspected human cases,” the WSDA said.

Health officials emphasize that vigilance, clear communication, and basic protective measures are essential to managing risk. The WSDA encourages practicing good biosecurity, including wearing recommended PPE and washing hands. For veterinary teams with clients who own poultry, clear communication on the importance of keeping flocks separated from wild birds can further help protect people and poultry.

“This first detection of the season is a sobering reminder that highly pathogenic avian influenza remains a threat to all domestic poultry—large or small—statewide,” Itle said in a state news release.

 "Keeping birds away from wild waterfowl, limiting access to your flock, and keeping species separate are some of the best ways to reduce the risk of this devastating disease.”

Grant County reports bird flu activity. News release. Grant County Health District. January 27, 2026. Accessed January 30, 2026. 

https://granthealth.org/m/newsflash/home/detail/120

Avian influenza confirmed in outdoor cat in Grant County: WSDA urges pet precautions. News release. Washington State Department of Agriculture. January 27, 2026. Accessed January 30, 2026. 

https://agr.wa.gov/about-wsda/news-and-media-relations/news-releases?article=46070&culture=en-US

A fatal highly pathogenic avian influenza infection in a domestic cat linked to wildlife and a separate backyard poultry detection point to ongoing spillover risks for animals sharing outdoor environments.

Washington reports first wildlife-linked bird flu case in domestic cat and separate poultry detection

Happy Friday dvm360 readers! For those impacted by the winter storm throughout the country, like most of our dvm360 teams has, we hope you remained safe and warm during the storm and continue to do so as temperature continue to dip and stay cold.

With the cold weather in full force, we are now looking forward to the warmer spring weather, which also brings us closer to Fetch Charlotte, our first Fetch conference of 2026! On March 13-15, join the dvm360 team, amazing faculty, including keynote speakers Rebecca L. Stepien, DVM, MS, DACVIM (Cardiology), and Christopher Lee, DVM, MPH,DACVPM, DACVM (Parasitology), and fellow veterinary professionals for a weekend full of learning, networking, and fun! You can learn more, and register, 

For all those hiding from the winter weather, or just want to catch up on the veterinary industry, here is what was popular this week on dvm360.com:

 shared the results after testing an intravenous, nanoparticle prodrug formulation of niclosamide stearate in client-owned dogs with naturally occurring osteosarcoma and found encouraging pharmacokinetics and survival signals that support further trials.

 tied to her lecture at the 2026 Veterinary Meeting & Expo, Jane Sykes, BVSc, DACVIM (SAIM), PhD, MPH, MBA, FNAP, broke down more on how leptospirosis moves through both human and animal populations.

DoveLewis Veterinary Emergency and Specialty Hospital in Portland, Oregon, recently reported that a 7-year-old canine patient ingested massive doses of multiple human psychotropic drugs, amounts associated with sudden death in dogs, and 

 after suffering from cardiopulmonary arrest and underwent 17 minutes of continuous CPR.

 of The Vet Blast Podcast presented by dvm360, our host Adam Christman, DVM, MBA, welcomed Mark Besançon, DVM, to talk about how is original career path has played a part in his veterinary one, plus his passion for surgery and innovation within the veterinary industry.

 from Australia revealed the complex evolutionary history of canine heartworms, and in result, is challenging previous beliefs about heartworms global spread and origin, although the research caution the results are currently not conclusive.

with dvm360, Darin Dell, DVM, DACVD,explains the importance of client communication for effective treatment, the story of Baby Girl, a patient of Dell’s, and the advantages of long-acting injectable antibiotics in veterinary dermatology.

Wrap up: Study finds promising results for niclosamide stearate in treating canine osteosarcoma, and other news

On this episode of Vet Watch, our host welcomed Heidi Pretzel, Associate Editor at AG Daily, to talk about cyber bulling after an incident last year sparked conversations around large animal medicine, cyberbullying, and more. 

When the herd turns: A conversation on cyberbullying in veterinary medicine

: This conversation contains topics of mental health struggles and suicide. If you or someone you know needs help, text or call the National Suicide Hotline at 988. 

Last year, Shawn Frehner, DVM, went missing on April 6, 2025, after a video surfaced online allegedly showing him kicking a sedated horse he was treating a few days before his disappearance. The video quickly went viral and prompted angry comments and threats, plus the local sherrif’s office opened an animal cruelty investigation. On April 18th, 2 weeks later, Frehnber’s body was discovered at the Lake Mead National Recreation Area.

After this event, Heidi Pretzel, Associate Editor for AG Daily, wrote an article on the event and cyberbullies that came for Frehner. In this episode of Vet Watch, Christopher Lee, DVM, MPH, DACVPM, DACVM (parasitology); Cert: FFC, CFV, RECOVER-ALS, sat down with Pretzel to have an in depth conversation on the what happened leading up to the video going viral, and the aftermath, cyberbullying, mental health in veterinary medicine, and more. 

Below is a partial transcript, edited lightly for clarity

Christopher Lee, DVM, MPH, DACVPM, DACVM (parasitology); Cert: FFC, CFV, RECOVER-ALS

: here seems to be a little bit of a disconnect, too. I think. On one side you have people outside the large animal industry and some within that are horrified when they see that video and they watch that kick. On the other side, you have people within the large animal industry, that say, Well, I mean, it's not necessarily okay, but far worse occurs. So isn't this video maybe more about that disconnect, rather than Frehner himself,

 I think you really hit on an important topic there for me, personally, coming from the production AG industry, from the livestock industry, horses are still livestock. As much as people have put this spiritual value on horses, and as much as Americans, we love horses, and they're beautiful, wonderful animals, I love my horses probably more than I love like a lot of people, but at the end of the day, they're large animals who are going to react how they are designed, either by their creator or natural selection, how they're designed to react, which is based on their survival as individuals and their survival as a species. 

I think part of that disconnect between the general population and even the population of horse owners, is that as Americans, we're 3 generations removed from the farm, and so the average American doesn't understand how production agricultural works. The average American hasn't handled large animals. If they have, it's been in very controlled environments or smaller numbers of horses. So it's different when you're handling even 1000s of animals a day, like some large animal vets, do. They're out there checking 1200 head of cows a day going through a shoot, versus even a horse owner that owns 1 or 2  animals and have a really minimal interaction with them. 

And in this case, this horse was not halter broke, he was not well handled. That was supposedly part of the reason why he was being castrated, is so that he could go on and be handled more safely. But some of that onus, ends up falling on large animal veterinarians, farrier, equine professionals, [etc.] in situations like that that the average horse owner isn't equipped to handle. And I think it's fair to say, based on the facilities and fact that this horse wasn't adequately prepared to be handled by a veterinarian that that was probably the case here.

Which is a good point, which is also part of it, is that choice of him to work with that horse under those circumstances. I mean, that is also part of the choices that led to this.  You mentioned this a little bit, but speaking about horse, specifically, according to KTNV, the owners had purchased a wild mustang, now named Big Red, for $50 and we're trying to break the horse to resell it. And according to News8, Brainer said, as you had mentioned, he was attempting to reposition the horse to help it breathe, but he did recognize and admit that he did kick the horse and wish that the situation had never happened.

Las Vegas veterinarian found dead after animal cruelty investigation. News release. American Veterinary Medical Association.  May 2, 2025. Accessed January 27, 2026. https://www.avma.org/news/las-vegas-veterinarian-found-dead-after-animal-cruelty-investigation

Videos

Explore the impact of cyberbullying on veterinary professionals in this episode of Vet Watch.

The 2023 ACVIM leptospirosis consensus marks a turning point in canine care, shifting vaccination to a universal core protocol while updating diagnostic standards and shortening handling precautions.

A UC Davis veterinary specialist breaks down key updates from the 2023 ACVIM Leptospirosis Consensus Statement

The 2023 American College of Veterinary Internal Medicine (ACVIM) Consensus Statement was a major milestone for leptospirosis guidance. In this video, Jane Sykes, BVSc, DACVIM (SAIM), PhD, MPH, MBA, FNAP, lead author of the 2023 consensus statement and a professor at the University of California, Davis, discusses the most important updates contained in document, sharing why these changes were necessary for modern clinical practice. The discussion highlights a major shift in preventative care, specifically the recommendation to move leptospirosis vaccination from a lifestyle-based option to a yearly core vaccine for all dogs regardless of geography or breed. Sykes also explains how the statement updates diagnostic criteria and provides a first-of-its-kind formal case definition for the disease. Additionally, she describes the practical relief veterinarians might experience from the shortened handling protocols.

Below is a partial transcript, lightly edited for clarity.

The 2023 ACVIM leptospirosis consensus statement update was overdue because of advances in our knowledge about the diagnosis of leptospirosis, about its epidemiology, about treatment, and very importantly, about vaccination. And there’s been a lot of changes in diagnostic tests for leptospirosis since the very first ACVIM consensus statement was published in 2010, as well as improvements in vaccines.

Some of the most important aspects of the consensus statement relate to, for example, our understanding of how leptospirosis is transmitted and the public health risk of leptospirosis. For example, when owners or veterinarians are handling dogs that are suspected to have lepto. Also, the use of point-of-care tests, which have been well integrated into many practices, more information on risk factors for leptospirosis in dogs, and then also some new recommendations for vaccination.

Perhaps the most impactful recommendation in the updated statement is that every dog should receive a leptospirosis vaccine every year. And the reason why that’s really significant is because it means that now veterinarians are moving from every-3-year core vaccination of dogs using distemper, hepatitis, parvo vaccines and rabies, to vaccinating dogs every year as core, with lepto being given every year, and then obviously DHP would still be given every third year.

We made that recommendation based on a growing amount of evidence that all dogs are at risk of leptospirosis, and that has really been based on findings that since the advent of leptospirosis vaccination and widespread leptospirosis vaccination, we are seeing lepto in primarily unvaccinated dogs that have not been vaccinated because they’ve been considered not at risk for the disease. 

[These include] especially small breed dogs in urban environments, maybe geriatric dogs not being vaccinated. But what we’re finding is that we’re now seeing lepto more in those dogs. So, small breed dogs, often dogs that have just gone for walks on the street [with] no significant contact with wildlife that’s known, those are the dogs that are getting lepto. [We’re also seeing] lepto in very young puppies and in geriatric dogs, [as well as in] in every part of the country…

A UC Davis veterinary specialist breaks down key updates from the 2023 ACVIM leptospirosis consensus statement

India confirmed 2 laboratory-confirmed cases of Nipah virus infection in West Bengal in January 2026. Both patients were 25-year-old nurses employed at the same private hospital in Barasat and developed neurologic complications after symptom onset in late December 2025.

The cases were first flagged as suspected Nipah infections by the Viral Research and Diagnostic Laboratory at a government hospital in Kalyani on January 11 and were confirmed by the National Institute of Virology (Pune) on January 13. As part of the public health response, authorities identified, traced, monitored, and tested 196 contacts. All tested negative and, as of January 27, no additional cases had been detected. The World Health Organization (WHO) reports 1 patient improving, whereas the other remains critically ill, and it characterizes the subnational risk in West Bengal as moderate but national and global risk as low.

Nipah virus is a zoonotic paramyxovirus maintained in fruit bat reservoirs and can transmit to humans via contaminated food or close contact with infected animals or people. Clinical presentation ranges from mild or asymptomatic infection to severe respiratory illness and fatal encephalitis, with historically reported case fatality ratios between approximately 40% and 75% depending on the outbreak and quality of care. There is no licensed vaccine or specific antiviral therapy. Management remains supportive with early intensive care where indicated.

The detection of infections in health care workers has prompted intensified infection prevention and control measures in affected facilities and heightened surveillance in neighboring countries. Several Asian authorities implemented enhanced entry screening and thermal checks at ports of entry in response to the West Bengal cases, although India assessed the local outbreak as contained and has not recommended travel or trade restrictions.

Although historical Nipah outbreaks have tended to be localized or limited to health care settings and close contacts, past experience in the region implies the need for rapid detection and cross-sector collaboration to interrupt transmission chains. Media and regional reports indicate that the January 2026 situation has triggered airport and border screening in some neighboring countries as a precautionary measure. Veterinarians with animals or clients who travel regionally should be aware of evolving advisories.

Although the immediate risk to the US remains low, the West Bengal cases reinforce the importance of routine zoonotic surveillance, strict biosecurity, and travel history screening for animals and clients. The WHO recommends clinicians ask about recent human or animal travel to affected regions when evaluating unexplained febrile encephalitis or severe respiratory disease, follow standard personal protective equipment and laboratory biosafety procedures when handling suspect specimens, and promptly notify state public health and veterinary authorities of any suspicious clusters. Reinforce client guidance on food and animal handling hygiene to reduce bat-to-human exposure risk, and engage with One Health partners to ensure rapid information sharing and coordinated response.

Speaking on the release of the updated American Animal Hospital Association (AAHA) One Health Guidelines in September 2025, Brian Sick, MD, MHA, FACP, FNAP, cochair of the AAHA One Health Guidelines, said, “The highest quality care—for individuals, families, communities, and our shared environments—depends on true interprofessional collaboration. Yet, despite this widely accepted principle, one of the most enduring gaps exists between human and veterinary medicine.”

Nipah virus update: West Bengal, India. World Health Organization. January 29, 2026. Accessed January 29, 2026. 

https://www.who.int/southeastasia/news/detail/29-01-2026-nipah-virus-updatewb

Bukhari M, Guarascio F, Sadam R. Pakistan becomes latest Asian country to introduce checks for deadly Nipah virus. Reuters. January 29, 2026. Accessed January 29, 2026. 

https://www.reuters.com/business/healthcare-pharmaceuticals/pakistan-becomes-latest-asian-country-introduce-checks-deadly-nipah-virus-2026-01-29/

Saaliq S. India says it has contained Nipah virus outbreak as some Asian countries ramp up health screenings. AP News. January 28, 2026. Accessed January 29, 2026. 

https://apnews.com/article/india-nipah-virus-outbreak-contained-asia-166df6c637780b99ede380bf4ddccfcc

Shankar P. Why is India’s Nipah virus outbreak spooking the world? Al Jazeera. January 29, 2026. Accessed January 29, 2026. 

https://www.aljazeera.com/news/2026/1/29/why-is-indias-nipah-virus-outbreak-spooking-the-world

McCafferty C. AAHA announces new One Health guidelines. 

. September 2, 2025. Accessed January 29, 2026. 

https://www.dvm360.com/view/aaha-announces-new-one-health-guidelines

Two laboratory-confirmed Nipah virus infections in nurses in West Bengal prompted targeted public health action and regional travel screenings while the WHO assesses national and global risk as low.