Expanding Our Hearts: Grief and Kindness within Veterinary Medicine

anticipatory grief grief guest blogger mollyrose dumm veterinary teams and practices Feb 21, 2024
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Expanding Our Hearts: Grief and Kindness within Veterinary Medicine

By Mollyrose Dumm, CAHP
Guest Blogger & Veterinary Client Liaison

I have spent 10 years in veterinary medicine, and 6+ years (professionally) in rescue and rehabilitation of both people and animals before that in a maximum-security prison setting. I have seen grief and pain in many of its forms and have seen the light that animals bring to the darkest of places. I have said goodbye to my own pets, including the very recent loss of my soul dog who lived to be 16 this past fall.

Veterinary medicine thrives within a capitalist framework in the United States. Although there are nonprofit arms and assistance groups, veterinary clinics primarily operate as for-profit businesses. Profits earned by privately owned, non-corporate offices are reinvested to ensure a reasonable salary for their staff and to grow their businesses to better serve their patients. Even the staff (read: not owners) at corporate-owned clinics work towards similar goals. In my decade+ of experience in veterinary medicine, not one among them found their way into veterinary medicine for the money. We all share a common goal: we love animals and hate to see them suffer.

As human medicine advances, so does veterinary medicine. From CT scans, MRIs, radiation oncology, blood transfusions, and orthopedic surgical fracture repairs, to specific laboratory tests and the availability of various medications and specialties, the options for care have vastly expanded. As the value of our beloved pets soars to the status of family members, our desires to have these family members treated with the best medicine available increase—just as we would for our human children, siblings, and parents.

We have agreed as a society that it’s immoral to let a child suffer because their family cannot afford the price of healthcare and so we treat them no matter what (and then in the US send their family into bankruptcy after the fact… but that discussion is for another day). Because veterinary medicine exists as a business in most societies, even those with universal healthcare for humans, money must be part of the conversation. This leads to two implications - both of which are untrue. The first is that veterinary workers care more about money than they do the lives of animals. The second is that pets aren’t family.

What does this have to do with grief in pet ownership, you might wonder? The connection is profound. Most of us adopt or buy our pets assuming that we will outlive them. This means, in some ways, our grief process begins on day one. Our anticipatory grief starts with the realization that we'll likely witness the end of our pets' lives. While one’s expectation of how much time they will have with their pet will depend on a variety of factors, even the most out-of-touch person knows that their pets will not live forever.

Your veterinary team doesn't think this means you shouldn't grieve. We understand that saying goodbye is heart-wrenching. We don’t think this means the news will be easy. We don’t even think this means you should, on some level, “be ready” even when you have time to plan a wonderful goodbye. Saying goodbye is awful. And when humans feel awful, we often want someone or something to blame. 

Sometimes owners start to blame themselves, the “if only” reaction. “If only I had noticed he was drinking more water,” “If only I didn’t have to travel for work so much, I would have had more time with her.” This is a very normal reaction. 

But too often owners blame the person in front of them, the veterinary staff. They aren’t actually mad at these employees. From experience, it’s usually a combination of a lot of complicated feelings - injured pride or embarrassment about finances or a lack of understanding of the science, but mostly I think it’s our good old friend grief (particularly anticipatory grief).

Grief can indeed pack a punch, bringing about a myriad of emotions like fear, anger, sadness, guilt, loneliness, and isolation. It can also cause physiological symptoms such as chest pain and trouble sleeping. This is where mental health education in veterinary medicine becomes crucial. Understanding the stress responses in our bodies and how to regulate them can make a significant difference.

Our brain starts to shift as our prefrontal cortex functioning (judgment, managing emotional reactions, and ability to adapt to change) decreases and our amygdala processing (fight/flight/freeze/fawn reaction, where we connect emotions to memories, and where our aggressive behavior is activated) goes into hyperdrive. So, our attachment center that tells us “DANGER” is ready to go, while our ability to control our emotional reaction to said danger is just kind of clumping along.

So here you are, a client receiving the news that your pet has a terminal diagnosis, and your brain is telling you to survive and preparing you to do so – your vision becomes focused, blood rushes to your heart and to your larger muscles, and you start breathing faster. It’s harder to hear. Physiologically speaking, game on.

Here is where my plea for compassionate veterinary care and self-awareness comes in. It focuses on the central idea of mental health education. For consumers of veterinary medicine, learning about stress responses in their bodies and how to regulate them is vital. There are wonderful resources online about grief in pet ownership as well as the ever-growing field of Animal Hospice and Palliative Care within veterinary medicine.

In an ideal world, our clients would understand that we grieve the loss of their pets along with them, and accusations that we prioritize profit over happy outcomes are hurtful and caustic to providers working in an industry that ranks among the highest in suicide rates. 

To my fellow vet med colleagues: educating all your staff about anticipatory grief is imperative. Though I was knowledgeable enough to recognize some of where our clients' sometimes venomous comments were coming from, it was not until I went through my Animal Hospice and Palliative Care Practitioner training that I took a deep dive into grief theories and my eyes really opened wide. 

The anticipatory grief experienced by all our clients must be supported from as early as possible. If you are a practice manager or technician lead or even the CEO of a clinic, I cannot recommend educating ALL your staff (not just the doctors) about anticipatory grief, at the very least. If you are not in a position of leadership within your clinic but recognize the value of this type of education, bring it to your supervisor as an idea. Do research on your own and offer to lead a conversation about it during a staff meeting. The effect this can have on your client care is, in my eyes, immeasurable.

A pet owner’s anticipatory grief journey starts long before their pet is euthanized—possibly even years before—and must be supported as early as possible. It has been noted that “[a] lack of adequate support during this time of pre-death grieving can have a lasting effect on the overall long-term bereavement journey of a caregiver after their loved one dies.”[1] The grief starts when they notice their once athletic dog slowing down on walks and taking longer naps. It starts when their once plump and fluffy cat starts to feel angular, bony, and scragglier. When their meow or their bark changes. The first time they hear a vet say, “This one kidney value is a little off, let’s keep an eye on that.” When they start to limp. 

Understanding anticipatory grief and how grief manifests in the body can help us better serve our clients by building stronger trust, thereby increasing their compliance in care, their empathy with our experience, and the bond they have with their pets.

If both sides of this relationship can educate ourselves about our own and each other’s experiences, we can move through our individual and shared grief experiences with kindness and empathy.



Photo of Mollyrose hugging her beloved dog with mountain and lake backdrop

Photo: Mollyrose Dumm and her beloved heart dog, Izzy. Photo credit: Marie Wulfram Photography

Meet Mollyrose, guest blogger

I learned through my studies with Animal Hospice Group that my interest and devotion to developing an End of Life Program within my current clinic was both part of my anticipatory grief of losing my heart dog as well as the start to building my legacy project for her.

Mollyrose is a Veterinary Client Liaison in Seattle, Washington, and a Certified Animal Hospice Practitioner (CAHP, AHG Graduate).

[1] D’Antonio, Jocelyn PhD, RN, Caregiver Grief and Anticipatory Mourning, Journal of Hospice and Palliative Nursing

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