Moral Distress and Behavioral Euthanasia in Vet Med | Episode 93 | Reviving Vet Med

Behavioral euthanasia is one of the most emotionally complex and least supported aspects of veterinary medicine. It sits at the intersection of medical ethics, human safety, and the human-animal bond, often leaving veterinary teams grappling with moral injury. In this episode, we’re joined by Valerie Bogie, an animal trainer and Veterinary Social Worker, to discuss how we can better support both the pet owners and the professionals providing the care.

Drawing from her 20 years of experience and her work as the Director of Human Support Services at Insight Animal Behavior Services, Valerie explores how behavior science and social work principles can protect our mental health. We discuss the "Pain Connection", the fact that up to 80% of behavior cases have an underlying medical cause, and how a thorough workup can provide the "why" that alleviates a team’s moral distress. We also dive into the "Person-in-Environment" framework to help mitigate judgment and burnout, and the practicalities of "Emotional CPR" for teams after a heavy case.

Valerie also shares insights into the "invisible labor" clients perform before reaching a crisis point and how a supportive, non-judgmental response from the veterinary team can shape a professional’s own sense of identity. This conversation offers an essential perspective for anyone in veterinary medicine who wants to navigate behavioral loss with more compassion, less shame, and a stronger commitment to team longevity.

Watch the Video Version of this Episode
https://youtu.be/QfHV6bKjEUM

Resources
Connect with Valerie Bogie on social media: www.instagram.com/valerie_bogie, www.facebook.com/valeriebogievsw, www.linkedin.com/in/valerie-bogie/ 

Visit Valerie’s website: https://linktr.ee/valeriebogievsw 

Valerie’s additional resources: https://revivingvetmed.com/wp-content/uploads/2026/05/Behavioral-euthanasia-resources-for-Reviving-Vet-Med-show-notes.pdf 

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Transcript

Dr. Marie Holowaychuk - If you're like most veterinarians, you didn't get into this field for the paperwork. You got into it for the animals, the medicine, and the people who love them. That's why I'm so excited about scribenote. It's AI built specifically for veterinarians who love practicing medicine, not just writing medical records. Scribenote was designed with vets so it actually understands what a real day in a clinic looks like. Their delightful AI Scribe automates your documentation, giving you back hours every single day, and it's effortless to use even if you're not tech savvy. You just work the way you normally do. The first week I tried Scribenote, I actually left on time 3 days in a row, which almost never happens in the ER. Imagine what you could do with that time. More patience, more support for your team, or just getting home on time. Start with a free plan today and see everything Scribenote has to offer. Just head to the Scribenote website to learn. 

Dr. Marie - Welcome to another episode of Reviving Vet Med. We often talk about the clinical side of behavior in veterinary practice.  The drugs, the training protocols and the safety risks. But we don't always talk about what happens to the people standing at the.  Other end of the leash or the veterinary teams caught between their medical ethics and a client's breaking point. My guest today is Valerie Bogie and she spends her career in that exact intersection as both a professional animal trainer. And a veterinary social worker. Valerie has over 20 years of experience navigating the human animal bond in its most stressful moments. She currently serves as the Director of Human Support Services at Insight Animal Behavior Services and is a leader within the International Association of Veterinary Social Work. Valerie is an expert in emotional CPR and strengths based practice. She helps us look at the heavy reality of behavioral euthanasia not just as a clinical outcome, but as a human experience that requires deep empathy and better systems of support. 

Dr. Marie - In this Episode we tackle so many different things including the pain connection in behavior cases and why a healthy debrief is a non negotiable tool for teen longevity.  So let's get into it. Here's my conversation with Valerie Bogie. This is the Reviving Vet Med podcast and I'm your host, Dr. Marie Holowaychuk. My mission is to improve the mental health and wellbeing of veterinary professionals around the world. Hi Valerie, thank you so much for joining me on the podcast today. 

Valerie Bogie - Thank you for having me. I'm very excited to talk about this topic. It's not always the most fun topic to talk about but I think it's something people need to hear. So I really appreciate you bringing me on for this one. 

Dr. Marie - Yeah. Well, it's so important, and I think we're especially lucky today to have you on as our guest because you have this unique vantage point as both an animal trainer and a veterinary social worker. So how has seeing behavior through that scientific lens helped you to hold more empathy for both the humans in the room, especially when they are facing the weight of behavioral euthanasia as well as, of course, the animals as well? 

Valerie - Yeah, I think that knowing how behavior works and being able to train animals, I worked in a lot of zoos, aquariums, you know, I've worked in animal shelters and things like that. But a lot of times I was directly training the animals. And it's interesting, right, because you don't have words. Right. You just have to work on your training skills with these animals. And then working for a vet behaviorist for over five years. 

Dr. Marie - Right. 

Valerie - There's the human element that gets thrown back in there. Really. You're teaching the clients. So I think it is really helpful to have that perspective of teaching animals a little bit more in a vacuum and then kind of zooming out and be like, oh, now I have to actually kind of teach the whole family in this way, because it is a little bit different. And I think when I was going through my master's program in social work, I didn't really know what social work was very much before I started, because I wanted to be a veterinary social worker because I knew that was going to be cool. Because being a veterinary social worker helps you help the people anywhere there's animals and people caring for animals. And so that is veterinary professionals, pet professionals, it's the clients, it's people working in shelter. 

Valerie - So all these different places, and there's so many parallels between animal behavior. We're really just large mammals after all. So I think that was one of the coolest parts, is just like, oh, when we are dealing with animals, let's say that they came in from a bad situation at a shelter and they're super fearful or they're super aggressive, we think, oh, well, they came from a bad place. Oh, they probably had crappy genetics, mothering. We don't even know if they had any mothering. Right. So we know all of those underlying factors that are affecting that animal's behavior, and we cut them some slack. We do not always cut the same slack for the humans in the room.

Valerie - So I think that is really important because it's a lot easier because we have words as humans, we take them for granted, but there's so much that could still be going on underneath the surface when we are trying to help the humans that are bringing their animals to us. I think one of the biggest things that I have learned is that it's all the same. And if someone is upset with you, whether it is a coworker or a client, it's probably not just you. Simon Sinek, who's a really great speaker, has a sentiment he shares, and he says, if it's above a 5 on a 1 to 10 scale of being upset, if it's above a 5, it's not about you. Right. We know that there's some other things going on. 

Valerie - And just like animals can go through trigger stacking where there's just too many things kind of piling up, and then they get into that flight or fight state. We do it too. Right. Especially when we're working with our veterinary professionals that know animal behavior. They know the ins and outs of veterinary medicine. Those little reminders to say, oh, yeah, you know a lot more about the human animal in the room than you're probably giving yourself credit for. 

Dr. Marie - I love that. I've never really thought about it that way. You know, I speak a lot about communication as a keynote and as a coach. And I often will use the analogy of reading the room and reading the nonverbal behaviors of the humans. And we're so good at reading animal body language as veterinary professionals. And sometimes we forget that we can do the same thing for our clients when they're in the room and they're starting to get agitated and they're showing these signs. And of course, many of us are conflict avoidant. So we think, oh, I'm just gonna pretend that I don't see them pacing or huffing or clenching their fists or that their ears are getting red or whatever it might be. So I really love that analogy. 

Dr. Marie - I want to acknowledge the fact that in your line of work there are some really hard circumstances that you have to deal with from time to time. So you work with families who invest a tremendous amount in their animals, emotionally, financially, and so on, and then sadly, they reach the point of euthanasia. And I'm wondering what advice you would give to veterinary teams to better recognize this invisible labor and to validate the client's decision rather than inadvertently adding to guilt, which is, I know that something that often will happen with us as veterinary professionals. 

Valerie - Yes, I really appreciate that question. I actually recently have done some research on the guilt that dogs with Behavior challenges go through. So the quantitative half has been submitted for publishing. The second half we're working on is the qualitative part, because we had three beautiful questions, and one of them was about what do I want the veterinarians and the other pet professionals to know about people that have dogs with behavior challenges? So I feel like we'll be able to write a book just on the answers. And we had over 560 people respond to that online survey. So we have so much great data. And one of the primary things that we’re studying in that survey was guilt. And people always feel like they're not doing enough, always. 

Valerie - And I think one of the other things that is a huge misconception about behavioral euthanasia is that it's a convenience to euthanasia. I do support our clients within Insight Animal Behavior Services, but I also support clients around the world. I have yet to meet a person or a family that has not tried everything within their means to try to help their pets and to try to keep their pet's quality of life and their family's quality of life as best as they could. So I have yet to encounter a behavioral euthanasia that is a convenience euthanasia. So I think that is a huge misconception that I would love to just squash as quickly as we can. I think the other thing that's important to think about is how we talk about behavioral euthanasia. 

Valerie - One of my colleagues, Dr. Lisa Radosta, who is an amazing veterinary behaviorist, also the president of the American College of Veterinary Behavior, did a fantastic podcast with Dr. Andy Roark. And one of the first things she said was, we need to stop calling it behavioral euthanasia. And that just blew my mind. I was like, wait, what? That's just what we call it. But when you break it down, she talks about how when we euthanize for cancer, do we call it a cancer euthanasia? When we euthanize for old age, do we call it an old age euthanasia or a hit by car euthana? Right. So we don't have the qualifier before the word euthanasia, we might say, oh, I had to euthanize because they were old or because the cancer got really bad. Right. 

Valerie - So in a space where euthanasia is already hard enough, and then behavioral euthanasia has more stigma attached to it. Now we're just going to label it as such. It's kind of backwards. I really liked that approach to say, can we just call it euthanasia for behavioral reasons? And again, I know when we're writing things down and, you know, typing things out, clinic wise, put behavioral euthanasia. But I think it's really important how we're talking to the clients about that process and that decision making to really be able to call it just euthanasia. Right. The ability to be able to recognize that the mental health struggles are just as important for our animals as the physical health struggles. And just because they look healthy does not mean that their day to day life is healthy or that the family's, you know, life is healthy. 

Valerie - You know, when you think about how many vet visits an average, you know, healthy animals go to, maybe two for vaccines and blood work per year, that's what, 30 to 60 minutes out of 365 days. You are seeing like horrible at math, but you know, like 0.1, whatever percentage of that animal's life. We never know exactly what the home life looks like for these humans and these animals. I think we just have to kind of give them credit where credit is due and also really try to assume positive intent in those situations where we have to assume that they have tried everything. The good news is that there are surveys that you can give your clients if you are so inclined. So Dr. Mary Beth Spitznagle has been really one of the first ones that started measuring caregiver burden in pet owners. 

Valerie - And so she took a survey that was originally created for humans that were caretaking for a loved one that had dementia. And then she validated that for pet owners. She has since even created her own canine caregiver burden survey. Right. So there's longer versions that are 22 or so questions, there's abbreviated ones. So on our intake forms at our vet behaviorist clinic, we have the CBI that caregiver burden 22 questions, 0 to 4 Likert scale. And that gives us a data point because again, we love data for the animals. We don't always take data on humans. To me, I think it's a great reflective exercise for the client that's reading it, but also gives you a little bit more intel as the providers to say, oh, anything over 17 is above normal pet owner burden and they're over 31 is severe. 

Valerie - And I've worked with clients in the 50s and 60s and so they are at the end of their line. 

Dr. Marie -  Right. 

Valerie - And so you kind of have to have that in perspective where you might come in and say, here's the gold star standard, what I'd love to do. And all these diagnostics and this med trial and this diagnostic test, they might have the money, they might not have the emotional bandwidth. In other cases, they might have the emotional bandwidth, but they don't have the finances. There's also the physical aspect of all of this caretaking, of if we're doing a lot of management and we have gates and crates and maybe it's a big dog that's reactive, unleashed and they pull the owner down. And then also just the amount of time that it takes to train the animal, take them to all these extra appointments and the specialists and things like that. 

Valerie - So I think really reminding ourselves on the veterinary medicine side of things that this is not a snap decision. They've probably been grappling with this for months, if not longer. And the kindest thing you can do is listen. Or if you are nervous about the safety of the family for whatever reason, you can bring it up too. I think so many times that everyone kind of just tiptoes around it, but everyone's thinking the same thing. So I think also to really work on how can I present this, you know, like I see you trying really hard instead of, hey, have you tried training or giving some unsolicited advice? 

Valerie - I guarantee they've tried a thousand trainers already, so let's not say that or be quiet for a minute after they share and kind of unload on you and say that sounds really hard or that sounds really heavy. Even just saying, I trust, you know, the best for your pet and your family. Right. I know it feels weird when you're looking at the dog that's all bouncy and jumpy and looks great in clinic, but when they are left home alone, they injure themselves, they destroy the house, they're potentially going to get kicked out of their apartment because the dog is in such distress, because they have horrible separation anxiety. If we're just looking at the patient in front of us and not taking it into consideration, that entire timeline of the family and the animal, we're kind of doing a disservice in that way. 

Dr. Marie - Wow, Valerie, I mean, there's so many great points there. And what I'm hearing you really emphasize is this empathy piece, right? To just really hear what the person is saying. To start with those open ended questions, you know, tell me what efforts you've taken to manage this or what brings you to the place where you are today. Like those non yes or no questions that really get them to tell their story and then take it in and honor, like you said, with empathy. Wow, that sounds really hard. Or wow, you've really exhausted everything. And you know, I love that sentiment of trusting the pet owner to know what is best for their own animal, whom they are spending 24, 7, 365 with. 

Dr. Marie - And not thinking that just because we are the quote unquote expert in the exam room that we necessarily have all the answers in these unique situations. I also love the reframe of renaming behavioral euthanasia as just euthanasia. And it reminds me a lot of reducing stigma in mental health where we're really careful about our language. And I think there is a lot of stigma in the veterinary profession about behavioral euthanasia and so reframing it as euthanasia, just like every other euthanasia. Just like mental health is health. Right. When people take a medical leave for a mental health reason, we don't say they're taking a mental health leave, we say they're on medical leave. Just like we wouldn't say they're on back pain leave. We don't describe what that is. So I really love that. 

Dr. Marie - And again, as a mental health advocate, I really see a lot of analogies there. So, so glad you brought up those important points. You mentioned briefly this workup that can happen in these situations. Obviously there's the animal behavior training and behavioral modifications and so on. There is also the responsibility of the veterinary team to make sure that there isn't anything medical happening. And I was surprised when you told me that up to 80% of behavior cases have an underlying physical component like chronic pain or GI issues. So if you could remind the listeners, how can a thorough medical workup actually serve as a tool for team wellbeing, maybe providing a definitive why that alleviates that distress associated with euthanizing what otherwise looks like a physically healthy animal. 

Valerie - Yeah, the statistics are just mind boggling, but when you think about it makes complete sense. 

Dr. Marie - Right. 

Valerie - Think about the last time you were under the weather. You're not feeling great, you're 100% physically. Does your behavior change during that time? Absolutely. Right. So what does that do? Right. You're just not at a hundred percent. So that's changing how you're processing the world. And maybe some stressors externally that are coming at you. It also changes how you communicate with those around you. I know my partner might say I'm a little cranky when I don't feel good. So we can understand that for ourselves and for our humans. But we don't always think about that for our pets because we also have to remember they're very stoic. They are programmed as animals in self-preservation mode. So they're not always going to be forthcoming with whatever pain is going on under the surface. 

Valerie - So anything that's undiagnosed or untreated could be directly impacting the behavior challenges you're trying to fix. So if we're leaving those things out, then we're not treating the entire patient. And our practice has seen so many GI issues. It's a huge correlation between GI issues and anxiety with humans and with animals. So getting the correct, you know, whether it's a GI panel or one of the newer, like dysbiosis tests can be really helpful because even as a behavior consultant supporting these people and when someone says their animal is a picky eater, there is just a light bulb that goes off on my head. Right. Because then they go through this, oh, well, the regular diagnostics that their physical was normal, they couldn't find anything and their poop is normal. Right. 

Valerie - So they just go down this laundry list of oh, all of these things are fine. Right. I don't like that word, but it's right. Everything looks okay and everything, it's okay. And so what that does sometimes is then put the kibosh on anything where we might say, as a vet behaviorist practice, can you go get this additional diagnostic test now everything's fine. Well, it's not because your pet still isn't, you know, after trying multiple foods, they're not eating regularly. Right. We've tried to assess if they're, you know, if there's separation challenges or other resource guarding and things like that. We're looking behaviorally like what could be contributing to the eating issue. Right. And so yes, we can jump through all these hoops or we could just do the test and know exactly. Right. To try to pinpoint some of these things. 

Valerie - It's the same thing with arthritis. I think those statistics are one out of every seven dogs over the age of one has arthritis somewhere in their body. Which when I tell people that they're like looking at their one year old dog, like, no. Right. It can be sad. But also, again, if we know about it, then we can treat it. We can make sure that you're feeling as good as they can physically as we are trying to unravel some of the behavior issues. And there's a lot of times, let's say there's a pain med trial that gets inserted somewhere and after that, you know, at least four weeks, six to eight would be wonderful. If we see a decrease in the intensity of the problem behaviors, if we see a decrease in the frequency of the problem behaviors, we know there's pain somewhere. Right. 

Valerie - So I think those things can be really helpful. And I also recognize that when we look at resource wise, there's still about 100 veterinary behaviorists around. That's not a lot. Right. So our Chicago practice has people driving from Michigan, driving from Iowa. Right. Driving from Southern Illinois. Right. So people are driving hours to come in clinic to establish that patient relationship so we can start diagnosing, treating, prescribing directly to them. But again, that takes time, that takes money and things like that. So I think also for any other veterinary professionals, whether it's gp, whether you're emergent, you know, whatever else, there's also vet to vets that both our practice and a lot of others provide. And you can just do it for your own knowledge. 

Valerie - You can also do it attached to a specific patient or client because I think again, if you can increase your awareness of what are the go to medications for X, Y or Z, what are the go to diagnostic tests, when this is how this animal is presenting, you can actually get some of the work done before you even have to refer them out to a vet behaviorist. And again, not everyone can afford or has access to a veterinary behaviorist. So the other side of this coin is there is no way anyone can exhaust all options. So we also can't expect the clients to do that either. Right. So if they come to you and said, well, I've done everything within my power, we have to help them. I've heard so many stories. 

Valerie - And someone had brought in their dangerous dog that was biting their family to be euthanized and they were handed a training pamphlet. They had already come to the decision that this is no longer safe. We love this animal so deeply, but this isn't sustainable. They made the hardest decision that can be made when we have a pet is to euthanize them and say goodbye. They came to the professionals asking for help. The family has said goodbye. They were already maybe feeling a little bit of relief because you have to walk on eggshells every single day when you have a dangerous animal or when you have animals that are fighting and we have to separate and do all of these things, the daily anxiety of trying to manage those situations is huge, that mental load. 

Valerie - And so to go to professionals and say, I need your help, I can't do this anymore. And then to be told, have you tried training? My heart sank when I heard that from a client that was sharing that with me. And then what do they do? So now they bring this dangerous animal back into their house and then now what so now there's another bite. Right. So again, I know it's an emotionally charged situation and everyone wants to do their due diligence and I completely understand there's, you know, the code of ethics and everything for vet medicine, just like there is for social work. One of the reasons I love it so much. But again, I think going back, they are the expert, right? And like you said, like having those open ended questions to say like, okay, yeah, tell me what's going on. 

Valerie - What led you to this decision? Are you ready to do this today? Do you need more time? Right, great questions to get a temperature check on those situations because it's hard. So I think, yeah, just being able to, yes, we can maybe do some of these diagnostic tests, but also it's okay not to. And really, unless we have done every diagnostic test on the planet, how can we confirm it's even just a euthanasia for behavior in the first place? Because if we can't rule out every possible physical issue that could be going on or diagnosis, we can never say with certainty it was a hundred percent euthanasia for behavior. Right. So again, it's like it's a slippery slope. 

Dr. Marie - Right. 

Valerie - As we're diving into it. So I'd love to hear some of your thoughts about that. Like as far as, like on the veterinary professional side, have you encountered cases like that or worked with teams that have kind of got into this situation where we want to help this family, but we feel bad for the animal? Have they tried everything? Like, I would love to hear a little bit more about that. 

Dr. Marie - Well, absolutely. I mean, my scope of practice is primarily emergency and critical care. So certainly in the icu on the critical care side, it's not something that we would typically manage unless there happened to be a dog with significant behavioral issues that found themselves in the icu, which doesn't happen too often, I would say, for whatever reason, probably because folks do really try to avoid having them hospitalized because of course that would be very distressing for everybody. I think the biggest challenge for us in the ER is that we don't have established relationships with pet owners in these situations. And, as you pointed out aptly, it's not to say that they maybe have well established relationships with their GPs either because they might only really be seeing them for those 30 to 60 minutes a year for their wellness checks. 

Dr. Marie - Again, wanting to avoid going into the vet because of the stress and the concern and the potential danger for everybody, and yet doing all of this work behind the scenes. So talking with you about this has really heightened my awareness of how I would approach a case like this coming to the ER. And I've seen it happen in the ER where folks have turned away a client that has come in for euthanasia for behavioral reasons, because they just don't feel comfortable establishing, I guess, appeasing really their moral distress in that situation of feeling like they're maybe euthanizing animal they shouldn't be euthanizing. 

Dr. Marie - And I'm really gonna, you know, refer them to your work and everything that you've shared with me to really emphasize that if a person finds themself in the ER, in an unfamiliar environment, with an unfamiliar veterinary team desperate to relieve what they perceive to be their pet suffering or to put their family out of danger or whatever, I think we have to hold space for that individual and really make a concerted effort to acknowledge what their experience is and to find a way to appease our potential distress in that moment and really hold space for that owner's distress. Because as you said, none of these decisions are made lightly.

Dr. Marie - If you or someone on your team could use a little extra support right now, I invite you to visit revivingvetmed.com you'll find a growing library of free practical resources designed specifically for veterinary professionals. Things like printable handouts, quick self-assessments, blog posts, guided meditations, and more. So whether you're looking for something for yourself, a teammate, or your entire practice, there's something there to help you start meaningful conversations and take small steps toward better wellbeing. Just head to revivingvetmed.com to explore these resources today. 

Dr. Marie - I guess. Valerie, that brings me to one of the questions I want to ask you with your social work lens on. Because I know in social work you look at the person in environment and I feel like this dovetails nicely into this question, which is when a team is frustrated by a client's quote unquote failure to manage a dangerous dog, how can looking at the client's safety, their finances, their home life give that veterinary team perspective to help mitigate the distress and the judgment that they might be feeling in those situations? 

Valerie - Yeah, I usually talk about, right. When we're animal professionals, we are looking at the animal centered approach, right? We are giving dignity and worth to the animal and you know, we're trying to use fear free techniques and doing all these great things for the animal, recognizing that they're unique individuals, right? And that's exactly what a person centered environment really is talking about in the same exact way. So again, that same kind of parallel of we never know what's kind of going on underneath the surface with the humans just as much as the animals. And I think just drawing that parallel there is really helpful. And I think people get confused sometimes or have big feelings about being able to give someone dignity and respect versus agreeing with them. Those are two different things. 

Valerie - You can still respect someone else's perspective that they have a different lived experience than you. You can say that they are a human that is worthy of dignity, but you don't always have to agree with them a hundred percent of the time. So I think that sometimes it is hard for some people where they're like, oh, I gotta tell them what's right or wrong. No, no, they deserve to speak. They deserve to have dignity and respect regardless of if we are agreeing with them 100% or not. I don't agree a hundred percent with anyone. I don't know about you, even my loved ones. Right? There's always something that we see differently and that's okay. And those are people that I know I like. Right? 

Valerie - So then you get into these situations where it is people that you rarely see, you know, just a couple times a year and stuff like that. So again, extending that same courtesy to the human that we are to the animal in that situation is really important. I also think that active participation and care, because again, like you said, you are the veterinary expert in the room. You know what tests you can run, you know what medication you can try, right? Like you are ready. Oh, maybe they need a dental. Maybe there's tooth pain, right? You have all of those things brewing while the client is talking to you because that's how your brain is triaging it, which is fantastic. But I think we can miss the mark if we are just telling the client what we want to do. Right? 

Valerie - It's just again, a little reframing of how we're presenting the information. Here's my concern. Here's some options. How do those sound to you? Or do you want to talk a little bit about your bandwidth? You know, how much time do you have left? How much? Many. Right, like, can we talk about those? You know, the physical aspect of this, the emotional aspect of this, diving into those things rather than tiptoeing around it. Because you're going to get answers faster and you're going to build trust faster with that client if you just go to those things maybe a little bit sooner than later. Because again, they're already thinking about it. 

Valerie - I have yet to be in a vet visit where I'm not thinking about, okay, now they just did this blood draw and I'm not going to say no because I love my animals and I want to do all of the things. But at some point sometimes I have to say, is that necessary? Can that wait for a couple months so I could build my bank account back up to bring them in again or something like that? Right. So I think again, making sure that we are working with the clients and walking alongside them through these decision making processes versus just kind of telling them what we want them to do. Because again, that is going to be a shift for the client. Because again, going back to they know the pet better than you do, right. 

Valerie - The amount of time they spend with them is a lot longer. Even if they don't necessarily have the medical expertise, maybe they don't even have the verbiage to describe some of the body language that they're seeing. But they know who's stressed out in the household, they know what some of those triggers are. Right. So I think about it that way too and again, just knowing that they're a unique individual, right? So maybe earlier in the day you had a couple really hard cases or easy, you know, maybe it was your favorite client or one that kind of rubbed you the wrong way earlier in the day. You have to show up to every client with a clean slate, right? Because every client is a unique individual. 

Valerie - They have their own lived experiences and I think that's something that plays a huge factor in our decision making for our animals. Someone might be delaying their euthanasia for a pet for any reason. Maybe they have some attachment issues that go back to their childhood. Maybe they've had traumatic losses of humans or other animals in their life so they're delaying it. You know, we can dive into this. If there's any domestic issues or violence in the home, they might be delaying leaving that situation cuz they don't want to leave the pet behind, right? So there's just all of these layers that when you're in that room for such a short amount of time, we don't know. So I think just looking at that person to say they are doing their best, they are there, they are at the vet clinic, right. 

Valerie - They made the appointment, they're ready to pay the money, they want to have this conversation with you, they are asking for help and I think just reminding yourself that the person in the room is just as if not more important than the pet because that person is the one that can verbalize these things and they're the ultimate decision maker in those situations. I think just those are some of the reminders I would share about that. I love that. 

Dr. Marie - I mean, what I'm really hearing from you is this. Always being curious. I often say, you know, abc, it's like one of my favorite acronyms to remember. Always be curious. Like in these situations. Again, I go back to my experience in the ICU and sometimes in the ER where we're having these quality of life, end of life discussions and we talk about quality of life in the context of pain and appetite and nausea and comfort in other ways. Well, behavior and the pets mental health or behavior experience is just as much a part of the end of life quality of life conversation, not to mention the human's quality of life. 

Dr. Marie - And so I'm hearing questions in my mind that I often ask to my critically ill patients or other patients coming into the ER, which is, how much more are you willing to do for the sake of getting more time in this situation? What sort of risks are we willing to take if there's young children in the home or if there's elderly folks that might be a little bit more frail and not able to have as much reflexes to protect themselves in the event that there might be a dangerous pet in the home? So, so many great things to think about. And I'm just so grateful for your lens and your perspective in that area. I know that you're also a very strong advocate for utilizing resources in these situations. 

Dr. Marie - Things that bring people together, like peer support groups or other like minded support groups for veterinary professionals who feel like truly, quote, unquote, they're killing a healthy animal and they're experiencing a lot of moral distress. How can connecting with some of these communities change their perspective on what compassionate care really looks like in these behavior cases? 

Valerie - The community aspect, I think in our modern age is something we've lost. Right. Like they talk so many times about the third space. Right? We have work, you have home, and then we're supposed to have this third space. Community centers, libraries, that kind of stuff. Now a lot of that has gone away. And so our opportunities just to connect with other humans are already much more restricted than they used to be. So I think being able to actively seek out some of those opportunities. And you would be surprised how much community you can build in a virtual space. 

Dr. Marie - Right? 

Valerie - Because I think, yes, obviously in person it is great, but with some of the support groups that I lead through Insight, they are open to anyone worldwide. And there are many times I have people in every time zone in the United States, sometimes coming in from other countries as well. And the ability to speak freely to people that have some semblance of understanding of what it's like to live with animals with behavior issues is huge. The gratitude people feel, the ability to not feel so isolated. Right. Like if you don't have anyone in your direct circles that has that experience or has had animals with behavior issues, you might not have anyone to talk to. So being able to show up to a virtual space with strangers and then be able to talk about it can be really therapeutic and helpful. 

Valerie - And I'm not a therapist, so they're not therapy groups, right. They're peer support. And so I'm not. And I think it's important to. I do a lot of like just open sharing, right? People come and click. Yes, I want to join this meeting for a reason. So we do introductions, we let them share whatever they want to share and it's not a space for giving advice and things like that. So I think for the veterinary professionals there are some opportunities for support within the veterinary community. Obviously Namvi, obviously Veterinary Hope foundation also has some group work and things like that because I think those are spaces where you can work with your peers through some of those things. I also offer debriefs and one on one coaching sessions for veterinary professionals as well. There's even Losing Lulu. 

Valerie - So for the first time ever, there was an entire online summit specifically about euthanasia for behavior. It's created by Sue Alexander, an amazing Canadian human who is also from the dog training world. And then, you know, had been supporting others through these decisions for behavioral reasons and had a close friend that had to make the decision. And she has since also had to make some decisions for her own pets. So there is an online Facebook group that anyone can join, even veterinary professionals. So I always have a warning label for anyone that's going to join the Facebook group because there are moderators, but it really is sometimes people just open sharing. They just want to get something off their chest. And so if you're still kind of in a raw state after your loss, maybe hold off on that one for a little bit. 

Valerie - But the website itself has other articles and you know, free webinar and things like that on there too that you can utilize, you know, and then you can kind of decide what is the best for you. I have a support group that is specifically for those that have euthanized for behavior. And then there's also one through Lap of Love. So again we're growing the resource list for these things. I also have created a directory that has veterinary social workers and people that have additional training in the human animal bond. And we're up to over a hundred people internationally on that list. So that can also be a great resource to be able to find someone either as a vet professional or even to add on your resource list. 

Valerie - So when you are having these conversations with people, you have the caregiver burden survey on there, maybe you have some of these resources so they can talk to someone else. There's also. I love that you're talking about the quality of life parameters for the physical side of things. There's also one that was specifically created for behavioral quality of life. Because it's not just eating and drinking as we know it is. Can I get them medical care? Can someone safely come over and give my family medical care if someone in the family is having a medical emergency? And several other things in there. 

Valerie - So I think being able to share some of those supports for the team that's going through these alongside the clients, but then also building up a more robust resource list for the clients because it's not just the Rainbow Bridge poem anymore, we can do better than that. So I think also kind of, you know, maybe having specific resource lists for specific situations to be able to be more supportive to the clients can be helpful as well. 

Dr. Marie - I love this. I mean, you know what I'm hearing is that there's so many more resources than we've ever had to support families that are going through the loss of animals for behavior reasons, which is incredible. And it sounds like for those veterinary professionals that are really struggling, they're feeling this guilt and distress that they were involved in what they perceive to be the euthanasia of a healthy animal, that they can also gain perspective by joining some of these groups or listening or accessing some of the resources that are available to these other pet owners to really broaden their perspective and enhance their empathy around what these families are really going through. Because I think as you've shared like so many things in life, when you haven't actually walked in those footsteps, it can be hard to grasp just how challenging that is. 

Dr. Marie - And so getting a glimpse into the world of some of these families and the anguish that they have experienced trying to navigate the lives of their pets with behavior challenges, I think would be a tremendous gift for them. I know that you do a lot of work and you mentioned it, your one one support offering debriefs and so on. Can you walk us through what that might look like in practice? I know you're an emotional CPR trainer as well, so you teach people how to support others through trauma after a heavy Behavioral case in the clinic, what might a debrief look like? And I know there's varying degrees of debriefs from structured formal 60 to 90 minute debriefs to, you know, a huddle in the practice. 

Dr. Marie - If you were to leave our listeners with, you know, a recommendation for how they can come together as a team after one of those distressing or one of those euthanasias that the team is struggling with, what would you say? 

Valerie - I would say you don't need a veterinary social worker to lead it. So yes, I think just remembering that even as a peer, as an empathetic human that you already are, you can support your team, you can support each other. So and like you said, it could look like a lot of different things. Is it just right after it happens and just give people, you know, 20, 30 minutes to get something off their chest? Is it something that's scheduled which can be supportive sometimes because people know what to expect versus kind of springing something on them. Right. So knowing your team and knowing what will be more supportive versus harmful in those situations I think is really important. 

Valerie - And with emotional CPR we're really focusing on connection which is active listening, which we're not really good at, pre-programmed so we have to learn that skill and that's really listening intentionally and not coming back with questions and oh well then what happened? Or what was that? Or what color shirt were they wearing? Right. Like we're not asking additional questions, we're letting whoever is sharing share what they want to from their story. Especially in these situations. It's already completed, right? We have already said goodbye. Whether it was traumatic for the team because the animal appeared healthy and we don't realize the fear or the anxiety or the reactivity or aggression or maybe the euthanasia just didn't go as planned. That part of it was traumatic as well. 

Valerie - I think just listening and being able to just give someone space to share their story without interruption is huge because again, self-proclaimed fixer over here, that's before I was introduced to emotional cpr. That was me, right? You're telling me this story and I'm like, I'm there, I'm with you. And in my head I'm already like, I got a three step plan that I'm going to help you with. I'm just waiting for my time for you to ask me for help and maybe you never do and then I just share it anyways. And now we're in this unsolicited advice situation and I've broken a little bit of trust. Because now the person that was talking was, oh, I didn't actually want your advice. I just wanted to talk. I think really focusing on that connection aspect of things. The P is for empowerment. 

Valerie - And that can be as simple as, how have we gotten through something hard before as a team? What did we do to support each other? What did we do to support that client? Oh, yeah, I remember we sent them flowers. Oh, oh, I remember we called them, you know, an extra time that week just to check in on them. Oh, I remember. Yeah, we all took a walk outside together at lunch. Right. Something like that. Like, what could we do to build some restoration into that? Because that last piece of ECPR is revitalization. Again, we're not toxic positivity. Everything is sunshine and rainbows. 

Valerie - But feeling a little bit more calm, maybe feeling a little bit better, just because you got to get your feelings out, you were able to process with others that were in that room or in that space with you, I think is really important. So I think my take home messages don't overcomplicate it. Right. In the same way that we're talking about, don't tiptoe around the euthanasia for behavior conversation with the clients. Also, do not tiptoe around the fact that you can see your team is struggling and can we just do a timeout and reconvene and say, how can we help? What can we do to support you? All right, now what do you need? And someone might say, I need an extra break today. Great. Got you. All right. Can I talk to you now, after this next appointment together? Great. 

Valerie - And then someone else might say, can we talk as a team at the end of our shift? Perfect. Right? Boom, boom. Right. Because if we're not asking people what they need, we can't meet those needs. 

Dr. Marie - Right. 

Valerie - So I think, again, in the same way we're trying to give some agency to the clients, we got to give that same agency to our teams as well. 

Dr. Marie - I love that I always say that humans have an innate desire and need to just feel seen and heard. So a debrief really offers that. And so emotional cpr. You mentioned connection, empowerment, and revitalization. So great takeaways to finish off with. I'm going to ask you just one more question that we ask all of our guests on the podcast, Valerie, and that is, what does the phrase reviving veterinary medicine mean to you? 

Valerie - Reviving veterinary medicine is caring for the people as deeply as we care for the animals. That includes caring for the clients that includes caring for each other as professionals and most importantly, yourself. You have to make sure that you're putting yourself in there and taking accountability for your own self-care, but also making sure that you're keeping an eye out on your team, on the clients. Because again, I don't meet many people that say they got into vet medicine for the people, but it's mostly people, right? So I think once you have that recognition and recognize that by caring for the humans, you are providing excellent animal care in all of those situations. And that to me can really elevate and help revive veterinary medicine. 

Dr. Marie - I love that. What a beautiful way to end. And we will link up to all of those resources that you mentioned as well. So we'll direct folks to the show notes to review those. Thank you so much for your time and your wisdom and all of your expertise, Valerie. It's just been a great pleasure speaking with you today. 

Valerie - Yes, thank you so much for having me, Marie. I really appreciate it. 

Dr. Marie - So that's it for this episode of Reviving Vet Med. I'm so grateful to Valerie Bogie for her honesty and for helping us navigate such a heavy yet critical part of our profession. Hearing that up to 80% of behavior cases may have an underlying physical component. Is such an important reminder that our. Diagnostic work isn't just for the patient. It's a tool for our own peace of mind.  If you'd like to learn more about it. Valerie's work or the support groups she facilitates for pet owners and professionals, we've linked her website and resources in the show notes. I also highly recommend following her on LinkedIn for her insights on building sustainable animal focused cultures. If this conversation resonated with you, please share it with a colleague who might be struggling with a difficult case right now.  The more we talk about these invisible burdens, the more we can help support. One another in staying in this profession. For the long haul. A sincere thank you to Valerie for joining me today to Bear Beat Productions for producing this episode, and to you, our listeners, for being part of this community. Until next time, take care of yourself. Bye for now.