What Factors Influence Client Decision-Making and Clinical Outcomes for Dogs with Non-Traumatic Hemoabdomen?

CHF Grant 02923-E: 2021 Clinician-Scientist Fellowship; Skylar Sylvester, DVM; Cornell University

Publication:
Menard, J. V., Sylvester, S. R., & Lopez, D. J. (2023). Assessing major influences on decision-making and outcome for dogs presenting emergently with nontraumatic hemoabdomen. Journal of the American Veterinary Medical Association, 261(7), 980–988. https://doi.org/10.2460/javma.23.01.0014

What can we learn?
Nontraumatic hemoabdomen is a common, life-threatening emergency in veterinary medicine. It presents emotional and financial challenges for owners forced to decide whether or not to pursue surgical treatment in the face of unknown pathology and prognosis. Understanding the factors that influence this decision can facilitate more effective veterinarian-client discussions in this difficult situation.

Surveys were completed by 132 owners of dogs that presented to Cornell University Hospital for Animals with non-traumatic hemoabdomen between 2015 and 2022.

• Owners reported that the most important factors influencing their decision-making were quality of life, followed by risk of cancer, and then time remaining with their pet.

• Median survival time was higher for dogs that underwent surgery compared to those treated with only palliative care. However, that survival benefit was lost when considering only cases of malignancy.

• Quality of life scores and owner satisfaction were higher in cases treated with surgery compared to those treated with palliative care or euthanasia.

Conclusion:
When treating nontraumatic hemoabdomen, it is important to prioritize surgical treatment for clients who value quality of life and survival time the most. To make informed decisions, preoperative staging is crucial as clients also consider the risk of cancer to be an important factor in their decision-making. Preoperative staging can also help identify metastasis and malignancy, which negate the survival benefit of surgical treatment.

Standardization of these challenging discussions to include treatment options and potential outcomes can effectively and efficiently guide the treatment of patients with this common presentation.