Abstract Background : Advances in veterinary medicine have extended companion animal lifespans, shifting end-of-life (EOL) care toward longer periods of caregiving. Although euthanasia remains the most common EOL pathway, caregivers’ experiences are shaped not only by clinical factors but also by the timing, content, and quality of veterinary communication. Objectives : This study examined (1) predictors of caregiver satisfaction with EOL care and veterinary team support, and caregiver burden; (2) associations among perceived pet quality of life, EOL pathway, and prior EOL experiences on decision timing; and (3) the relationship between veterinary communication quality and decisional regret. Methods : A cross-sectional, anonymous online survey was completed by US dog and cat owners/caregivers (N = 802) who had participated in EOL decision-making for a pet within the prior 2 years. Measures assessed demographics; religious, spiritual, and cultural beliefs; prior EOL experiences; primary veterinary team type; hospice enrollment; EOL pathway and alignment with expectations; EOL conversation timing, frequency, duration, and content; access to quality-of-life tools; caregiver confidence and perceived pet quality of life; veterinary team support; caregiver burden; satisfaction with EOL care and veterinary team support; decisional regret; post-loss relationship outcomes; and pet acquisition following loss. Analyses included descriptive statistics, chi-square tests, general linear models, and ordinal logistic regression. Results : Most pets died via euthanasia (94.4%), most commonly through in-home euthanasia without hospice support (47.8%). Earlier EOL conversations were rated as appropriately timed by 86–100% of caregivers, compared to 78.4% of those whose first conversation occurred during a crisis. Higher-quality veterinary communication was significantly associated with greater satisfaction ( p < 0.001) and lower decisional regret ( p < 0.001). Communication quality was not significantly associated with caregiver burden; burden was instead associated with rushed ( p = 0.024) or drawn-out decisions ( p = 0.003), and euthanasia at home without hospice support ( p < 0.001). Caregivers who perceived better pet quality of life near death reported longer decision windows ( p < 0.001). Conclusions : Veterinary communication quality, more than EOL pathway, demographic characteristics, or prior EOL experience, was found to be a primary determinant of satisfaction and decisional regret, with each one-unit increase in communication quality associated with a 44% reduction in the odds of reporting greater decisional regret. These results suggest that EOL communication training encompassing proactive initiation, emotional validation, and shared decision making should be established as a core veterinary clinical competency, embedded longitudinally across veterinary curricula, and treated with the same rigor as technical clinical skills.
Kogan et al. (Wed,) studied this question.