Consider the case of a 17-year-old domestic shorthair cat with chronic kidney disease (CKD) hospitalized for diuresis and supportive care. After 3 days on intravenous fluids, antiemetics, and appetite stimulants, the kidney values are unchanged. The pet has not eaten in over a week and spends most of its day in lateral recumbency, only lifting its head occasionally when the owner visits. Despite the cat’s condition and grave prognosis, the owner wants to continue hospitalization and is considering placement of a feeding tube to provide nutrition.
Cases like this are distressing for all involved—the patient, the pet owner, the veterinarian, and the veterinary team members who are cage-side providing care in futile situations. In a profession with continued technological advances in diagnostic and treatment options for our patients, we may not find ourselves asking the question of whether we can do something, but whether we should.
But are cases of futile care actually common in veterinary medicine? A recent study in the Journal of the American Veterinary Medical Association sought to answer this question.1 Nathan Peterson, DVM, DACVECC, associate clinical professor at Cornell University and one of the study’s authors, shared his surprise in the results. “It was a problem I knew I was experiencing,” he says. “We went into [the study] thinking it was a more isolated problem.” Instead, the survey found that 99% of veterinarian respondents—the majority of whom were board-certified specialists—believe that futile care occurs in veterinary medicine, and 85% stated they had experienced a case of futile care within the previous year.1
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