Grief, Loss, and End-of-Life Considerations

Grief, loss, and end-of-life considerations are among the most emotionally complex aspects of veterinary practice. While veterinary medicine is often associated with disease prevention, diagnosis, and treatment, it also encompasses helping animals and their caregivers navigate the final stages of life with dignity, compassion, and informed decision-making. End-of-life care is therefore not solely a medical process—it is also an ethical, emotional, and relational experience that affects animals, their caregivers, and the veterinary team.

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The human–animal bond shapes how families experience illness, aging, and death in companion animals. For many people, pets are family members deeply integrated into daily routines, emotional well-being, and social relationships. Consequently, serious illness and the loss of a companion animal often evoke grief responses comparable to those experienced after the death of a close human family member. Research increasingly recognizes companion animal bereavement as a legitimate form of grief deserving empathy, validation, and professional support (Cleary et al., 2021; Barnard-Nguyen et al., 2016).

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Veterinary professionals occupy a unique position within this process. They guide families through difficult conversations, explain changing health conditions, facilitate shared decision-making, perform humane euthanasia when appropriate, and often witness profound emotional responses from caregivers. At the same time, repeated exposure to patient death and client grief can place considerable emotional demands on veterinarians, veterinary nurses, technicians, and other members of the healthcare team (Dow et al., 2019; Bergamini et al., 2023).

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Modern veterinary literature increasingly frames end-of-life care as a continuum rather than a single event. Instead of focusing exclusively on euthanasia, contemporary approaches emphasize patient comfort, quality of life, caregiver communication, ethical reflection, palliative care, bereavement support, and the well-being of veterinary professionals themselves (Bishop et al., 2016; Costa et al., 2026).

This Major Pillar introduces the scientific foundations of grief, loss, and end-of-life considerations in veterinary practice while connecting readers to more detailed educational resources within the CountryVetMom Veterinary Knowledge System.

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What This Major Pillar Covers

Grief, loss, and end-of-life considerations encompass multiple interconnected topics that influence veterinary care before, during, and after an animal's death. These topics extend beyond the clinical management of terminal illness to include communication, ethics, emotional well-being, and family-centered care.

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This pillar provides an evidence-based overview of:

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• The nature of pet loss grief and the emotional impact of companion animal death.

• How end-of-life decisions are made collaboratively between veterinary teams and caregivers.

• The role of bereavement support before and after an animal's death.

• The importance of compassionate communication throughout the end-of-life journey.

• Current scientific understanding of veterinary hospice, palliative care, and quality-of-life discussions.

• The emotional impact of repeated exposure to death on veterinary professionals.

• Emerging research priorities in veterinary grief, palliative medicine, and One Health.

Rather than offering individualized medical advice, this page explains the concepts, research, and professional principles that shape contemporary veterinary end-of-life care.

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Why This Area Matters

Every animal eventually reaches the end of life. Whether this occurs because of advanced age, chronic illness, cancer, injury, or progressive disease, families are often required to make emotionally significant decisions while coping with uncertainty and grief.

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Research consistently shows that the quality of communication between veterinary professionals and caregivers strongly influences how owners remember their pet's final days. Caregivers who perceive communication as compassionate, informative, and collaborative generally report greater satisfaction and less decisional regret than those who experience rushed or crisis-driven conversations (Kogan & Cooney, 2026; Shaw & Lagoni, 2007).

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This area also matters because veterinary professionals experience the emotional consequences of end-of-life care alongside their clients. Performing euthanasia, supporting grieving families, managing ethical dilemmas, and caring for terminally ill animals require substantial emotional labor. Studies have associated these repeated experiences with compassion fatigue, emotional distress, burnout, and other occupational wellbeing challenges, highlighting the importance of supportive workplaces and professional education (Dow et al., 2019; Bergamini et al., 2023).

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Growing evidence further suggests that end-of-life care should be viewed as an ongoing process rather than a single clinical appointment. Discussions about quality of life, caregiver expectations, palliative care options, and emotional preparedness often begin well before euthanasia is considered, allowing families additional time to understand their pet's changing needs (Lam et al., 2023; Bishop et al., 2016).

Collectively, these findings demonstrate that grief and end-of-life care represent essential components of compassionate veterinary medicine and the broader human–animal relationship.

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How This Major Pillar Relates to Mental Health & Human–Animal Interaction Overview

Grief and end-of-life experiences illustrate one of the most profound expressions of the human–animal bond. The emotional relationships people form with companion animals shape caregiving decisions throughout life, especially as illness progresses and difficult choices arise.

Within the Mental Health & Human–Animal Interaction Overview, grief represents an important intersection between veterinary medicine, psychology, ethics, communication, and family wellbeing. Decisions surrounding terminal illness affect not only the animal's comfort but also caregiver emotions, family dynamics, perceptions of quality of life, and long-term bereavement experiences.

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This Major Pillar builds upon the broader Mental Health & Human–Animal Interaction system by exploring how:

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• emotional attachment shapes end-of-life experiences;

• communication influences caregiver wellbeing;

• veterinary professionals support informed decision-making;

• bereavement affects individuals and families differently;

• veterinary teams experience cumulative emotional impacts from repeated patient loss.

For readers seeking broader context, visit our comprehensive parent guide on Mental Health & Human–Animal Interaction Overview.

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Key Concepts Within This Pillar

Several interconnected concepts form the foundation of modern veterinary end-of-life care.

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Human–animal bond

The emotional relationship between people and companion animals influences caregiving behaviors, treatment decisions, grief experiences, and perceptions of quality of life.

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Pet loss grief

Grief following the death of a companion animal is increasingly recognized as a legitimate bereavement experience that may involve sadness, guilt, loneliness, anger, or relief depending on individual circumstances (Cleary et al., 2021).

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Anticipatory grief

Many caregivers begin grieving before death occurs as they witness progressive illness, declining mobility, or worsening quality of life.

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Quality of life assessment

Quality-of-life discussions help families and veterinary teams evaluate an animal's well-being throughout serious illness and support informed conversations about future care (Bishop et al., 2016).

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Shared decision-making

Veterinary professionals increasingly emphasize collaborative discussions that combine medical expertise with caregiver values and preferences rather than relying solely on clinician-directed recommendations (Janke et al., 2021; Kogan & Cooney, 2026).

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Palliative and hospice care

Veterinary palliative care focuses on maintaining comfort and quality of life during advanced disease, while hospice approaches emphasize ongoing support for animals and caregivers approaching the end of life (Lam et al., 2023; Goldberg, 2016).

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Bereavement support

Support following the death of a companion animal acknowledges the emotional impact of loss and recognizes that grief experiences differ substantially among individuals and families.

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Veterinary team wellbeing

Repeated involvement in euthanasia, hospice care, and client grief can influence the mental wellbeing of veterinary professionals, making workplace support and professional education important areas of ongoing research (Dow et al., 2019; Bergamini et al., 2023).

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Pet Loss Grief

Pet loss grief refers to the emotional response experienced after the death of a companion animal. Although grief is a universal human experience, the loss of a pet has historically received less social recognition than other forms of bereavement. Contemporary research increasingly challenges this perception, recognizing companion animal loss as a meaningful life event that can significantly affect emotional wellbeing, daily routines, and family relationships (Cleary et al., 2021).

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The strength of the human–animal bond plays an important role in shaping grief experiences. Companion animals often provide emotional support, companionship, routine, and a sense of family belonging. Consequently, losing a pet may produce sadness, loneliness, guilt, anger, relief after prolonged illness, or a combination of emotions that evolve over time. Researchers emphasize that these responses vary considerably between individuals and should not be viewed as following a single predictable pattern (Morris, 2012; Cleary et al., 2021).

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Grief frequently begins before death occurs. Anticipatory grief may develop while caregivers witness progressive disease, declining mobility, cognitive changes, or reduced quality of life. During this period, families often feel uncertain as they balance hope, concern, and preparation for eventual loss. Veterinary communication during these stages has been associated with better understanding of disease progression and improved preparedness for future decisions (Lam et al., 2023; Bishop et al., 2016).

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Research has also identified factors associated with greater risk for intense bereavement. Owners facing unexpected death, euthanasia-related uncertainty, limited social support, or particularly strong emotional attachment may experience greater grief intensity than others. Recognizing these factors helps veterinary professionals better understand grieving families' diverse experiences without assuming all caregivers respond similarly (Barnard-Nguyen et al., 2016).

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Communication remains central throughout the grieving process. Studies suggest that empathetic conversations, clear explanations, and opportunities for shared decision-making are associated with reduced guilt, anger, and decisional regret after a pet's death (Testoni et al., 2019; Kogan & Cooney, 2026). Rather than being limited to the moment of euthanasia, compassionate communication often begins earlier in the course of illness and continues after death through bereavement acknowledgment and follow-up support.

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Veterinary literature increasingly emphasizes that grief should be viewed as a normal response to the loss of a meaningful relationship rather than a sign of emotional weakness. Families differ in how they express mourning, remember their animals, and adapt to life after loss. Respecting these differences reflects the broader goal of compassionate, family-centered veterinary care.

Read our detailed article on Pet Loss Grief to explore emotional responses and coping mechanisms. 

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End-of-Life Decision Making

End-of-life decision-making is one of the most complex aspects of veterinary medicine because it requires balancing animal welfare, medical knowledge, ethical considerations, caregiver values, and emotional well-being. Unlike many clinical decisions that focus primarily on diagnosis and treatment, end-of-life decisions often involve uncertainty, changing circumstances, and deeply personal beliefs about quality of life and compassionate care. Contemporary veterinary literature increasingly describes this process as a collaborative journey rather than a single event, emphasizing communication, shared understanding, and ongoing assessment throughout advanced illness (Bishop et al., 2016; Shaw & Lagoni, 2007).

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Understanding End-of-Life Decision Making

Serious illness, progressive chronic disease, advanced age, or severe injury may eventually lead families and veterinary professionals to consider how best to support an animal nearing the end of life. These situations rarely have one universally "correct" answer. Instead, multiple factors shape decisions, including the animal's condition, expected disease progression, caregiver observations, family goals, available support, and ethical responsibilities toward the animal's welfare.

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Rather than viewing euthanasia as the only endpoint of discussion, modern veterinary medicine increasingly recognizes end-of-life care as a continuum that includes quality-of-life assessments, palliative care, hospice principles, caregiver education, and advance planning before a final decision becomes necessary (Lam et al., 2023; Goldberg, 2016).

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This broader perspective allows conversations to evolve over time rather than occur only during moments of crisis.

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The Importance of Shared Decision-Making

Shared decision-making has become a central principle of contemporary veterinary practice. Rather than placing full responsibility on either the veterinarian or the caregiver, shared decision-making encourages collaborative conversations that integrate medical expertise with the caregiver's knowledge of the animal, personal values, emotional readiness, and practical circumstances.

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Research suggests that this collaborative approach is associated with more positive caregiver experiences during and after a pet's end-of-life journey. In particular, communication quality appears to strongly influence caregiver satisfaction and later reflections on the decisions made. A large caregiver survey found that higher-quality veterinary communication was associated with greater satisfaction and substantially lower decisional regret, with each increase in communication quality linked to markedly lower odds of experiencing greater regret (Kogan & Cooney, 2026).

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Shared decision-making also supports transparency. Veterinary professionals explain medical findings, prognosis, and quality-of-life considerations while caregivers contribute observations about their pet's daily activities, comfort, behavior, and emotional well-being. Together, these perspectives help create decisions that are informed, compassionate, and centered on the individual animal.

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The Role of Communication

Communication consistently emerges as one of the strongest themes within veterinary end-of-life research. Studies indicate that caregivers often remember conversations with their veterinary team as vividly as they remember the clinical events themselves.

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Best-practice guidance emphasizes that compassionate communication is not simply an interpersonal skill but an ethical responsibility within veterinary medicine (Shaw & Lagoni, 2007). Clear explanations, opportunities to ask questions, and honest discussions about uncertainty help caregivers better understand changing circumstances while reducing confusion and emotional distress.

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Timing also matters. Research summarized in the Consensus review suggests that conversations initiated earlier in the course of illness are more frequently perceived as appropriately timed than discussions that begin only during an emergency or rapidly deteriorating situation (Kogan & Cooney, 2026). Earlier communication gives families more time to understand disease progression, prepare emotionally, and plan for the future.

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Effective communication therefore extends across the entire continuum of care—from diagnosis through palliative management, end-of-life discussions, euthanasia when appropriate, and bereavement support after death.

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Quality-of-Life Assessment

Quality of life is central to veterinary end-of-life care. Rather than relying on a single observation or clinical measurement, quality-of-life assessments consider multiple aspects of an animal's overall well-being, including comfort, function, mobility, appetite, social interaction, and enjoyment of normal daily activities.

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The 2016 AAHA/IAAHPC End-of-Life Care Guidelines emphasize ongoing assessment of patient comfort and individualized care planning—often utilizing validated clinical framework tools such as the HHHHHMM Scale or health-related quality-of-life (HRQL) instruments—rather than focusing solely on disease progression (Bishop et al., 2016). These assessments help structure conversations between caregivers and veterinary teams while recognizing that quality of life is dynamic and may change over time.

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Importantly, quality-of-life discussions are not limited to determining whether euthanasia should occur. They also help families understand how illness affects their pet, identify meaningful changes, and evaluate how care goals may evolve as disease progresses.

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Hospice and Palliative Care

Veterinary hospice and palliative care have become increasingly important components of end-of-life medicine. Although the terms are sometimes used interchangeably, both emphasize maintaining comfort, minimizing suffering, and supporting both animals and caregivers during advanced illness.

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Current literature notes that palliative care is sometimes overlooked when discussions focus exclusively on the timing of euthanasia. Instead, researchers advocate broader conversations that include caregiver expectations, patient comfort, quality-of-life monitoring, and collaborative care planning throughout the disease process (Lam et al., 2023).

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When families need more time to prepare emotionally, or when uncertainty remains about disease progression, palliative approaches may offer opportunities to continue supporting the animal's welfare while discussions continue. Observational research has described situations in which palliative care serves as an important bridge during delayed or disputed euthanasia decisions while maintaining attention to animal comfort (Gray & Radford, 2022).

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The scientific literature increasingly frames palliative medicine as an integral component of comprehensive end-of-life care rather than a separate alternative to euthanasia.

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Ethical Dimensions of Decision Making

Ethical considerations are woven throughout veterinary end-of-life practice. Veterinarians have responsibilities toward both animal welfare and caregiver support, and these responsibilities may occasionally create emotionally challenging situations.

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Recent scholarship highlights the diversity of decision-making approaches observed in clinical practice. Depending on the circumstances, veterinarians may facilitate fully shared decision-making, provide stronger clinical guidance, or encounter situations where responsibility for difficult choices shifts between caregivers and the veterinary team (Cameron et al., 2025).

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Ethical discussions also encompass broader questions regarding humane endings, quality of life, caregiver autonomy, and professional responsibilities. Rather than offering rigid rules, veterinary ethics generally encourages individualized evaluation of each situation while maintaining compassion, transparency, and respect for both animal welfare and family circumstances (Cooney & Kipperman, 2023; Knesl et al., 2017).

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Decision-Making Is a Process

One of the strongest messages emerging from contemporary research is that end-of-life decision-making should be understood as a process rather than a single conversation.

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As illnesses progress, caregivers often revisit questions about quality of life, changing goals, emotional readiness, and future expectations. These discussions evolve alongside the animal's condition and the family's understanding of what lies ahead.

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Evidence summarized by Consensus indicates that veterinary end-of-life care works best when empathetic communication, collaborative decision-making, and individualized planning occur together rather than as isolated events. While research continues to explore the most effective communication strategies and educational models, the existing literature consistently supports relationship-centered care as a defining feature of high-quality veterinary end-of-life practice (Bishop et al., 2016; Kogan & Cooney, 2026).

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By recognizing end-of-life decision-making as an ongoing partnership, veterinary teams can better support both animal welfare and the emotional wellbeing of the families entrusted with their care.

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Read our detailed article on End-of-Life Decision Making to explore collaborative frameworks and quality-of-life evaluations. 

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Bereavement Support

Bereavement support is an important component of veterinary end-of-life care that extends beyond the death of a companion animal. Although the clinical responsibilities associated with terminal illness conclude when an animal dies, the emotional experience of caregivers often continues long afterward. Contemporary veterinary literature increasingly recognizes that compassionate care includes acknowledging grief, supporting healthy communication, and understanding that every family's bereavement experience is unique.

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Research consistently describes bereavement support as an extension of the veterinary–client relationship, not an optional addition to clinical care. Families frequently remember not only the medical care their pet received but also how they were treated before, during, and after the end-of-life process. Compassionate communication, empathy, and respectful follow-up shape caregivers' overall experience and may influence long-term perceptions of both the veterinary team and the difficult decisions made (Cooney et al., 2020; Matte et al., 2020).

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Understanding Bereavement After Pet Loss

Bereavement refers to the period of adjustment following the death of a loved one. In veterinary medicine, this process encompasses the emotional, psychological, and social responses experienced after the loss of a companion animal.

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For many individuals, companion animals provide companionship, emotional security, routine, and a sense of family identity. Their absence may therefore affect multiple aspects of daily life, including household routines, family interactions, and emotional well-being. Research has shown that grief after losing a companion animal is a genuine form of bereavement and shares many characteristics with grief following human loss, although it is sometimes less socially recognized or validated (Cleary et al., 2021; Testoni et al., 2019).

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Importantly, grief is highly individual. Emotional responses differ according to the strength of the human–animal bond, the circumstances surrounding death, previous experiences with loss, family dynamics, cultural beliefs, and personal coping styles. Some caregivers experience profound sadness, while others describe guilt, relief after prolonged illness, uncertainty, gratitude, or a mixture of emotions that change over time (Morris, 2012).

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Rather than following a predictable sequence, bereavement is increasingly understood as a dynamic and individualized process.

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The Role of Veterinary Professionals

Veterinary professionals occupy a distinctive position during companion animal bereavement. Unlike many other healthcare relationships, veterinary teams often know both the animal and the family over many years, creating continuity that extends into the final stages of life.

Research indicates that caregivers frequently value clear information, empathy, and opportunities to ask questions before, during, and after end-of-life care. These interactions build trust, understanding, and emotional support during a particularly vulnerable period (Cooney et al., 2020; James, 2024).

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Compassionate communication also helps caregivers better understand what occurred during their pet's final illness. Studies suggest that empathetic discussions and shared decision-making are associated with lower levels of guilt, anger, and decisional regret after euthanasia, reinforcing communication as a core professional competency rather than solely an interpersonal skill (Testoni et al., 2019; Kogan & Cooney, 2026).

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Veterinary literature therefore increasingly frames bereavement support as part of relationship-centered care that continues beyond the final clinical appointment.

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Communication Beyond the Final Appointment

Supportive communication does not necessarily end when an animal dies. Research exploring caregiver experiences has found that many owners value acknowledgment of their loss, respectful follow-up, and clear information regarding after-death arrangements and memorial options (Cooney et al., 2020).

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These interactions recognize that bereavement continues after clinical care has concluded. They also reinforce the human–animal bond by acknowledging the companion animal's significance within the family.

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Studies examining veterinary communication consistently identify empathy, active listening, honesty, and respect as central characteristics of positive end-of-life experiences. Conversely, rushed conversations, insufficient information, or poorly timed discussions may contribute to greater emotional distress and uncertainty during bereavement (Shaw & Lagoni, 2007; Kuijk et al., 2023).

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As veterinary medicine increasingly adopts family-centered approaches, communication before, during, and after companion animal death is an important part of comprehensive end-of-life care.

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Veterinary Team Wellbeing and Bereavement

Bereavement affects veterinary professionals and caregivers. Veterinarians, veterinary nurses, technicians, and support staff routinely witness grief, facilitate difficult conversations, and participate in euthanasia procedures throughout their careers.

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This repeated emotional exposure represents a form of emotional labor that has received increasing research attention. Studies have associated end-of-life work with compassion fatigue, psychological distress, burnout, and moral stress, particularly among professionals who frequently assist families during euthanasia and hospice care (Dow et al., 2019; Bergamini et al., 2023).

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The Consensus evidence summary highlights the significance of this issue. In one study, nearly half of participating veterinarians reported high or very high compassion fatigue, while another survey found that 91% of Brazilian veterinarians had received no formal grief training during veterinary school. Those who had received grief-related education reported being less emotionally affected by patient bereavement (Dow et al., 2019; Bergamini et al., 2023).

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These findings suggest that bereavement support should be considered not only for clients but also within veterinary workplaces.

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Team-Based Support

Research increasingly recognizes the protective role of supportive professional environments. Collegial relationships, clearly defined team responsibilities, and opportunities for mutual support appear to reduce some of the emotional burden associated with repeated end-of-life care (Cameron et al., 2025; Bergamini et al., 2023).

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Because end-of-life care involves multiple members of the veterinary team, clinicians, veterinary nurses, technicians, reception staff, and others who support families also share these emotional experiences. Effective teamwork contributes not only to coordinated patient care but also to healthier workplace cultures that recognize the emotional realities of veterinary practice.

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Growing educational initiatives also emphasize communication skills, grief literacy, and end-of-life education as professional competencies that benefit both caregivers and veterinary teams (Corrigan et al., 2025).

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Emerging Directions in Bereavement Support

Although veterinary bereavement has become an increasingly active area of research, important evidence gaps remain. Much of the current literature consists of qualitative studies, cross-sectional surveys, expert guidance, and consensus recommendations rather than randomized controlled trials evaluating specific support interventions.

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The Consensus review identified bereavement support as one of the clearest areas requiring additional research. Long-term studies following caregiver adjustment after pet loss remain limited, and relatively little evidence exists regarding which educational or support programs most effectively reduce grief intensity, decisional regret, or compassion fatigue among veterinary professionals. Researchers have likewise called for greater attention to workplace wellbeing, curricular training, and sustainable support systems for veterinary teams (Matte et al., 2019; Dow et al., 2019; Springer & Dürnberger, 2026).

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Another emerging area involves broader One Health perspectives that examine environmental considerations, after-care practices, and the interconnected wellbeing of animals, people, and veterinary professionals. While these topics are beginning to appear within the literature, current evidence remains comparatively sparse and represents an important direction for future investigation (Costa et al., 2026).

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Overall, the strongest scientific consensus is that bereavement support is most effective when viewed as part of a compassionate continuum of care. Veterinary end-of-life practice extends beyond clinical procedures to include empathetic communication, collaborative relationships, acknowledgment of grief, and attention to the wellbeing of both caregivers and veterinary professionals.

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Read our detailed article on Bereavement Support to learn more about post-loss care and family resources. 

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Current Research Themes

Research on grief, loss, and end-of-life considerations in veterinary practice has expanded considerably over the past two decades. While earlier literature focused primarily on humane euthanasia and ethical decision-making, contemporary research increasingly examines communication, caregiver experiences, veterinary team wellbeing, hospice and palliative care, and broader One Health perspectives. Despite this progress, the scientific evidence remains uneven, with many recommendations supported by expert consensus, observational studies, and qualitative research rather than randomized clinical trials.

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Communication as the Foundation of End-of-Life Care

The strongest and most consistent body of evidence centers on communication between veterinary professionals and caregivers. Across multiple studies, compassionate, timely, and collaborative communication is associated with improved caregiver experiences, including greater satisfaction with care and lower levels of guilt, anger, and decisional regret following a companion animal's death (Kogan & Cooney, 2026; Testoni et al., 2019; Shaw & Lagoni, 2007).

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Rather than viewing communication as an isolated conversation during euthanasia, current evidence supports ongoing dialogue throughout the progression of serious illness. Earlier discussions about prognosis, quality of life, and future planning appear more beneficial than conversations initiated only during medical crises. This shift reflects an increasing emphasis on relationship-centered veterinary care that integrates medical expertise with caregiver values and emotional preparedness.

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Growing Interest in Palliative and Hospice Care

Another major research theme involves the evolution of veterinary hospice and palliative medicine. Contemporary literature increasingly describes end-of-life care as a continuum focused on maintaining patient comfort, minimizing suffering, and supporting caregivers throughout advanced illness instead of concentrating exclusively on euthanasia decisions (Lam et al., 2023; Goldberg, 2016).

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Researchers note that palliative care discussions are sometimes underrepresented when attention focuses primarily on determining euthanasia timing. As a result, current guidelines encourage individualized care planning that considers quality of life, caregiver goals, and ongoing communication throughout disease progression (Bishop et al., 2016).

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Although professional interest continues to grow, veterinary palliative medicine still needs higher-quality interventional research to evaluate specific care models and long-term outcomes.

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Veterinary Team Wellbeing

The wellbeing of veterinary professionals has emerged as another prominent area of investigation. End-of-life care requires veterinarians, veterinary nurses, technicians, and support staff to repeatedly engage with grief, ethical dilemmas, emotional conversations, and euthanasia procedures. This cumulative emotional labor has been associated with compassion fatigue, burnout, moral distress, and other occupational wellbeing challenges (Dow et al., 2019; Bergamini et al., 2023).

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Research also highlights the potential value of workplace culture in mitigating emotional burden. Collegial support, clearly defined professional roles, and education related to grief and communication appear to contribute to healthier team environments and improved resilience during end-of-life care (Cameron et al., 2025; Bergamini et al., 2023).

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These findings have encouraged greater attention to veterinary wellbeing as an integral component of compassionate patient care rather than a separate occupational issue.

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Evidence Gaps and Future Directions

Despite growing scientific interest, important evidence gaps remain.

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The Consensus evidence summary identified relatively limited randomized controlled trial data across communication, bereavement support, and veterinary wellbeing. Most current recommendations are derived from qualitative research, cross-sectional surveys, expert opinion, and clinical guidelines rather than controlled intervention studies.

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Several areas warrant additional investigation:

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• Long-term caregiver bereavement trajectories following companion animal loss.

• Educational interventions that improve communication skills and reduce decisional regret.

• Strategies to reduce compassion fatigue and support veterinary mental wellbeing.

• Evaluation of hospice and palliative care models across different clinical settings.

• One Health perspectives addressing environmental sustainability, after-care practices, and broader societal impacts of companion animal end-of-life care (Costa et al., 2026).

Overall, current evidence strongly supports compassionate communication, shared decision-making, and team support as foundational principles of veterinary end-of-life care. However, researchers continue to call for stronger interventional evidence to determine the most effective approaches for implementing these principles consistently across veterinary practice.

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Frequently Asked Questions

What does grief, loss, and end-of-life care mean in veterinary practice?

Grief, loss, and end-of-life care encompass the clinical, ethical, emotional, and communication-related aspects of caring for animals approaching the end of life. The field includes quality-of-life discussions, palliative care, hospice principles, euthanasia decision-making, caregiver communication, bereavement support, and attention to veterinary team well-being.

Why is communication so important during a pet's end of life?

Research consistently identifies communication as one of the strongest factors influencing caregiver experiences. Compassionate, clear, and collaborative communication is associated with greater satisfaction, improved understanding, and lower guilt and decisional regret after companion animal loss (Kogan & Cooney, 2026; Testoni et al., 2019).

What is shared decision-making in veterinary medicine?

Shared decision-making is a collaborative approach in which veterinary professionals contribute medical expertise while caregivers share their observations, values, goals, and preferences. Together, these perspectives inform individualized decisions that prioritize animal welfare and compassionate care.

Is end-of-life care limited to euthanasia?

No. Contemporary veterinary literature describes end-of-life care as a continuum that includes quality-of-life assessment, palliative care, hospice principles, communication, caregiver education, and bereavement support in addition to humane euthanasia when appropriate (Bishop et al., 2016; Lam et al., 2023).

What is anticipatory grief?

Anticipatory grief refers to emotional responses that occur before an animal dies, often while caregivers observe progressive illness or declining quality of life. Families may experience sadness, uncertainty, worry, or emotional preparation during this period.

Why is veterinary team wellbeing included in end-of-life care?

Veterinary professionals regularly support grieving families while managing emotionally demanding clinical situations. Research indicates that repeated exposure to euthanasia, hospice care, and client grief may contribute to compassion fatigue, emotional distress, and burnout, making workplace support an important component of comprehensive veterinary care (Dow et al., 2019; Bergamini et al., 2023).

What are the biggest research gaps in veterinary end-of-life care?

Current evidence highlights several priorities, including stronger intervention studies evaluating communication training, bereavement support programs, hospice and palliative care models, long-term caregiver outcomes, veterinary team wellbeing initiatives, and One Health approaches to after-care and sustainability.

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Explore Related Topics

Continue exploring the Mental Health & Human–Animal Interaction Veterinary Knowledge System:

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• Mental Health & Human–Animal Interaction Overview

• Pet Loss Grief

• End-of-Life Decision Making

• Bereavement Support 

Together, these resources provide a comprehensive introduction to the scientific, ethical, and emotional dimensions of grief, companion animal loss, end-of-life care, and the human–animal bond. They also establish the foundation for understanding how compassionate communication, shared decision-making, palliative care, and veterinary team well-being contribute to high-quality veterinary practice.