Healthy Dogs and Difficult Decisions Runa Hanaghan BVSc
Healthy Dogs and Difficult Decisions Runa Hanaghan BVSc PG Dip SSRM MRCVS Deputy Veterinary Director, Dogs Trust
Healthy Dogs…. Health is “A state of complete physical, mental and social well-being and not merely the absence of disease or infirmity” [WHO] Healthy Dogs “Animal welfare means how an animal is coping with the conditions in which it lives” [OIE] “Dogs Trust never puts a healthy dog to sleep”
…& Difficult Decisions Veterinary and Behaviour issues Complex Veterinary issues Difficult Decisions Lack of Resources We need to develop a holistic approach to these concerns which ensures we maintain their welfare.
How do we achieve this? • Ethics and Welfare must be considered and what this means for the patient eg Not deciding to proceed, just because we can. • Is the procedure or intervention curative? • Ability for the dog to cope (environment and intervention) • Culture eg concerns about amputation or euthanasia
Dogs Trust Resources; Expertise providing solutions Veterinary Teams (at Centres and in Head Office) Behaviour Experts (in our Centres and Head Office) Complex Cases: Team Work Rehoming Experts (at Centre and in Head Office) Veterinary Experts (in general and referral practice)
Dogs Trust Resources; Environment options Single kennel/ Quieter area Stepping Stones Unit Complex Cases: Environment Specialist Training and Rehabilitation (STAR) unit Foster Carer
Case Management • A Framework has been developed to help assess cases for decisions on treatment. • The aim is to help provide a structure for all parties who care for the dog to contribute. • It also helps to set out the expectations for each element that the dog may be dealing with, whether environmental, emotional or physical.
Case Management The impact on Quality of Life – is the process CURATIVE? The TIME FRAME is critical to how likely the dog is going to manage with any of these elements; particularly those which they may find uncomfortable.
Problem List (Behavioural or Medical) • Consider all the problems that a dog may be dealing with. • Age may be a consideration depending on the condition. • Behaviour and how this dog might interact with humans and other dogs may be important for both treatment and rehoming.
Solutions to these problems • The options for treatment, or solution to the problem, can now be considered. • The timeframe to recovery will be important to consider and impact that this might have. • What does ‘recovery’ mean - is it a curative intervention?
Resources; are they available? • Is veterinary care and medicine available? • Can this dog be medicated easily, do they have a feeder that they trust? • If it involves long term intensive treatment, are there enough people to help monitor and manage the case? • Answers to this section might help identify where resources are lacking, allowing us to move forwards strategically as an organisation.
Ability to cope (with the Intervention or Environment) • If a dog would normally live on the streets, will coming in to an intensive situation terrify them? • It is important to consider whether the dog’s temperament is going to enable the full post operative care to proceed uneventfully. • Does this dog have any other options eg foster carers • What might this mean for a dog whose natural environment is living on the streets eg loss of environment?
Planning Framework
Approach to using table The top line corresponds to the circular diagram and includes IMPACT and TIME FRAME
Approach to using table Both Medical and Behavioural aspects need to be considered. This can be expanded to include financial and environmental factors if necessary. We record the decision made. . Milestones and reviews of these cases help to continue the discussion around welfare and set out a change in options or timeline.
Meet Molly • Molly arrived with us from a pound with reduced muscle tone on her left hind. • She was approximately 5 yrs old and a female Springer Spaniel. • This was investigated and she was found to have an old fracture that had healed without repair.
Options for Molly • OUTCOME: It was decided to amputate Molly’s leg • Milestone 1 = Check up 10 days after surgery
Molly • She recovered really well! • She had physiotherapy at our rehoming centre and found her forever home a few weeks after the procedure.
Meet Barney • Barney was a young pup, about 10 weeks old, when he was handed in to us. • He was vaccinated when he arrived as usual for Dogs Trust. • Sadly he developed diarrhoea within 3 days of being with us and we discovered he was positive for Parvovirus.
Options for Barney • OUTCOME: It was decided to continue supportive care and review progress within 5 days. • Sadly after 3 days Barney was not improving, his blood results were deteriorating and he was depressed. • It was decided to Euthanase him at this point to avoid any more suffering
Meet Phoebe, a little 1 yr old dog that came in to us with a very distorted front leg due to trauma when younger. She saw a specialist near the centre who suggested that we progress to surgery to straighten the leg using an unusual technique with 3 -D printing of the scan. We undertook an exercise to consider the options available to her:
Options for Phoebe
Options for Phoebe • OUTCOME: We proceeded with the new technique • Her recovery was uneventful and the result was very good
Phoebe The exercise helped us to consider the options available to her and understand which might be the best option to choose: • The new technique offered superior results • A home was found for her and she undertook the surgery once settled it turned out very successful
In Summary • Welfare is important for every case that we consider • Health is made up of both physical and mental wellbeing • A framework can provide a holistic approach to making decisions • A framework can also help share the decision with others in the team • If resources are not available, the options for a case may be limited • By using a framework then fundraising or lobbying could help improve the resources available eg behaviour experts/medication
Thank you
- Slides: 26