Q&A: Caregiver burden can begin early in pet illness. Are veterinary teams equipped to support clients, and how can veterinary social workers help both parties?

Veterinary teams routinely navigate both the emotional and practical challenges of serious or chronic illness in patients—difficult decisions, long-term care, hard conversations, grieving clients.

According to Caroline Cox, LSW, MSW, a veterinary social worker at Mount Laurel Animal Hospital, and Erika Krick, VMD, DACVIM (Oncology), specialty medical director at the hospital, caregiver burden in pet owners can begin from the very start of the care process. So, what happens when clients need support beyond what the veterinary team is equipped to provide?

At the 2026 Fetch National Harbor Veterinary Conference in Maryland, Cox and Krick co-presented a session on veterinary social work. dvm360 spoke with them following their session about how they work together to support clients and veterinary teams in a way that benefits both parties.

This Q&A has been edited and consolidated from that interview for length and clarity.

dvm360: What is a veterinary social worker, and what role do they play alongside the medical team?

Cox: It’s really a position that was created to address the human needs of veterinary medicine. That’s both from the staff side and the client side.

From the staff side, veterinary medicine is a very high-stress job with a lot of exposure to difficult things, whether that’s client emotions or difficult cases. A veterinary social worker can help with debriefing cases, education on compassion fatigue and how to combat that, and staff well-being in general.

From a client perspective, it can mean addressing the needs of clients if they need help making difficult decisions, coping with an emergency with their pet, or a chronic illness in their pet. It encompasses a lot of things.

It can also look very different hospital to hospital. Some social workers work in very large hospitals or hospitals with multiple locations, so they might not have the capacity to do as much staff work and might focus mostly on clients. Some hospitals want the social worker more for the staff. It depends on the needs of the hospital.

Krick: That was a question we talked about a lot when we were bringing Caroline on. How do we introduce this person to the staff? What should the ratio be of support for the clients versus support for the staff?

It’s worked out really well. Caroline has been very effective, particularly with ER cases and critical cases, when the care team is at a point where they’ve given the client all the medical information and some guidance on the recommendations, but the client still, for whatever reason, isn’t really able to come to a decision or still needs some more support to get there.

That’s where she’s been extremely useful for the team. They can tag her in so that they can keep going with the medical things and focus on the patients while she’s focusing on the people.

Cox: Hopefully, that makes it less stressful for them, too.

dvm360: You talked about oncology care during your session. Where does veterinary social work become especially relevant for clients dealing with caring for pets with cancer?

Krick: I would expand it a little bit to say that there are considerations for people who are managing pets with chronic illnesses, whether that be cancer, kidney disease, or chronic arthritis.

There is a huge amount of caregiver burden that our pet parents can end up finding themselves in, and oftentimes they feel really alone because other people understand if you’re taking care of your mom or your child or your spouse.

People don’t always understand that you can have that same level of caregiver burden when you’re caring for your pet.

For people who are treating their pets with cancer, they may have friends or family members who very strongly feel that they should be doing something different. They might have family members saying, “Why are you letting your pet suffer? Why are you putting them through this? It’s not right to be torturing your pet like this.”

Or they might have family members saying, “Don’t give up on them.”

I think it can be a very isolating experience sometimes for our clients.

Cox: I think, as we talked about during our talk, it’s just validating people and those feelings, and being a staff member whose job it is to work with the clients and not take care of the pets.

I think people then don’t feel bad about talking about their emotions. They’re talking to someone whose job it is to listen.

Krick: There can also be a stigma associated with the word cancer. The word “cancer” is really scary. “Liver disease” is not nearly as scary as “your pet has cancer,” per se.

A lot of people also have friends or family members who have gone through cancer treatment themselves that could color their perceptions. They may be coming in saying, “I watched so-and-so go through this. I don’t want my pet to go through that.”

So there’s a whole other component as well.

dvm360: What might a client say or do that signals they need additional support, particularly when they haven’t directly asked for it?

Cox: A lot of it is in their expression or body language. You can tell when someone is saying, “Yeah, I got it,” but they don’t really have it. They might still have more questions, or you can tell that they’re not really finished talking about something.

Some people are very explicit in saying, “I just don’t know what to do,” which is the easiest scenario, where you can say, “I have someone that can help talk to you.”

Then there’s the client who is kind of stuck. They have all the information, and there’s not really any other question that can be answered, but they still haven’t come to a decision.

Those clients, maybe it’s not what they’re saying, but it’s their lack of moving to the next step or feeling confident or comfortable about a decision. That can clue the team in to, “Hey, we could maybe tap someone else in.”

I would also say any expression of guilt, whether that’s, “I don’t know if I want to be putting them through this,” “I feel bad,” or “I can’t do this.” They might just need another person to validate that they’re doing the best they can for their pet. Someone to say, “We wouldn’t be giving you this option if we thought it was harmful to your pet.”

A lot of times, veterinary social workers get tapped in if a team hears something that worries them, such as, “This pet is all I have,” “I don’t have any other family or friends,” “I don’t know what I’m going to do if I lose them,” or “I can’t lose them.”

Or even more concerning things that really worry veterinary staff, like, “I might die without my pet.”

That’s a really heavy burden for a staff member without training in assessing the severity of that statement to carry around. Being able to tap someone in who has training to go talk to this person and really assess, “What does your support look like at home? We heard you say something that really worried us. Let’s talk about that,” can help get an idea of how they’re actually feeling and how they can be supported.

Then there’s also following up when that pet eventually passes away. I can check in and say, “How are you doing?” and go back to the staff and say, “I checked in with them. They’re doing OK. This is how they’re doing.”

dvm360: What does effective communication between the veterinarian and social worker look like behind the scenes?

Cox: I feel like a lot of times veterinarians want to give me more details than I actually need, which is not a bad thing. But sometimes less information is better because then I can get an actual idea from the client of what they think is going on.

Sometimes I’ll go in with a brief history and say, “Tell me from your perspective what’s going on.” Then I might go back to the veterinarian and say, “X, Y, Z,” and they’re like, “That’s not it at all.”

That can be particularly important when people are really worried and make something a lot worse in their mind than it actually is. I can go back in and say, “I actually talked to the veterinarian. Your pet is stable enough to go home and think about it for a few days. You got some scary news, but they’re not in imminent danger right now or we wouldn’t tell you they could go home.”

For end-of-life care or another big decision, I always like to triple-clarify that the client has made the decision. I never want to go in and make an assumption that they’ve already made a decision if they haven’t. That could be scary, offensive, or make them feel like they’re being pushed toward something.

Krick: On the clinician end, we do tend to look at Caroline as somebody else we need to really explain the case to.

It is helpful to know that she doesn’t really need to know what medication they were on when the disease progressed and everything else. She kind of just needs to know where we are with the client, what options we’ve given, and that sort of thing.

For us, after she’s spoken with them, it’s really helpful to hear what the client’s understanding is. It helps us learn, “OK, I communicated this pretty clearly to the client. We’re on the same page with this. But then there’s this other aspect where we’re not on the same page.”

From a medical standpoint, I may need to go in and clarify that or inquire what other medical questions they have, because she can’t really answer from the medical side. But she can pass along, “This particular point seems to be a sticking point.”

Cox: There can be instances where people feel like the same thing has been explained to them many times, so they might feel embarrassed to ask to hear it again, or they’re just not understanding it.

A veterinarian is obviously always happy to explain it until the client understands it, but I can go back to the veterinarian and say, “They’re just not getting this one thing. Can you maybe say it in a different way or help them out with that?”

dvm360: How can that same support help the veterinary team beyond debriefing a difficult case?

Cox: I think just remembering that the social worker is someone who’s accessible to them, not just in crisis situations. For the oncology team, when you’re very used to working with clients who are dealing with a pet that has cancer, they’re all overwhelmed and stressed. Instead of just tapping the social worker in when it goes over into a crisis, remembering, “Hey, I can actually use the social worker earlier to potentially help me out.”

It might be that you’re really stressed about getting to the next appointment and need someone to talk to the client to help conclude the appointment.

And then, aside from debriefing, recognizing when things have piled up. It might not be one particular case. It could be, “I need to talk about the fact that this is really weighing me down. I’m really particularly stressed out right now.”

An outside perspective can help identify why. Did something change? Is there a change that needs to happen to your schedule? Do you need to talk to your teammates?

If you’re on a team where you feel tired and stressed out, but you’re looking at the person next to you and thinking, “But they’re not,” an outside perspective can help you talk through that.

Krick: I agree. Incorporating a social worker into some of these conversations also gives the veterinary care team a little bit of a break and a reset to focus on the medical aspects of the case.

Sometimes it can be difficult not to let what you assume or know to be going on with the client affect what you’re recommending medically. Having somebody else talk to the client about the client-related things helps you take a minute and say, “OK, they’re talking to them. Let me just reassess what’s going on with this patient. What do I think we need to do medically and how can we work together to make sure that we’re properly explaining that to the client?”

We’re not trying to coerce the client into doing anything, but veterinarians are all bleeding hearts and we want to help. We do tend to take on more than we can, and sometimes we find ourselves mired in this very much people-focused part of the interaction when we don’t really have the skills or the training. We’re not mental health professionals.

Tagging in somebody else can alleviate some of that burden. What if I misunderstood what the client is saying? What if the client is actually at risk and I didn’t grasp it because I’m not trained to do that? Just having somebody else can be really helpful.

Cox: A lot of times when I talk to a client, they express a lot of gratitude for the team that’s been taking care of their pet in a way that maybe the team has, in a way, lost sight of.

If the patient is a pet with chronic illness or cancer, the client might have known the veterinary team for a year. The client might be saying thank you every time, but they might not be explicitly expressing, “The team has been so helpful through all of this. They answer all my questions.”

It’s nice to be able to go and share that with the team and remind them that their work is appreciated—just because the client might not be explicitly saying it every time doesn’t mean that we’re not effectively communicating with them and helping them.

dvm360: For practices without a veterinary social worker, what can they do to build some of this support into their care?

Cox: There are ways to access training from other veterinary social workers. Some veterinary social workers practice in a setting where they come into a practice for a few weeks and contract with the practice.

They can say, “You might not have the capacity to have this person on staff right now, but what are some tools we can give you to recognize when a person might need more help? What resources can you give that person?”

I really think having a bank of resources to give clients, if you don’t have a veterinary social worker on staff, is very helpful. You don’t want it to feel like it’s on the veterinary staff.

Maybe just having some education on what are some concerning phrases or things people might say, when can a person be offered more help, and things like that.

Krick: There are resources for clients, but then there are also resources for the staff.

dvm360: What are the biggest takeaways you hope veterinary teams take from this?

Cox: I think veterinary staff should get a lot of credit for the human interactions they are dealing with because that is, of course, part of the job. But it’s a really hard part of the job.

From a social work perspective, when I came into a veterinary hospital and asked staff how they were feeling about their interactions with clients, I think sometimes veterinary staff don’t give themselves enough credit for the work they do in helping people.

That’s not what they went into the job for, of course, but it’s a really hard part of it that I don’t think people give themselves enough credit for. Not recognizing that can potentially contribute to burnout because if you don’t know what’s weighing you down, it’s hard to combat that.

Krick: It’s fair to consider reaching out to a veterinary social worker or providing resources to the client sooner rather than later.

There was one study we referenced during our talk that showed caregiver burden in pet owners of pets with cancer starts even at the beginning of the process. I would have thought it was, as they went along, the caregiver burden increases. And maybe when we switch to palliative care is really when you have to think about that. But it starts pretty early in the disease process.

So I think reaching out to somebody, or at least having the resources available for the client sooner rather than later, is helpful.

It can just be something that goes along with your handouts: “A lot of people also go through this, and we want to be able to support you. We want to care for your pet, but we also want to offer you, the pet parent, some resources as well.”

I think it’s also a little easier if you’re offering it to anyone who is in a certain situation, so it’s not, “You seem like you’re having a really hard time. Let me give you the social worker thing.”

It can be, “This is a very stressful situation. This is your beloved pet. We know you weren’t expecting this. Sometimes it can be helpful on the person side of things to have some support. So here’s a list of resources if you’re interested.” Something you offer to everybody in a non-judgmental way.

Another thing I would like veterinary teams to know is that veterinary social work is still a relatively newer facet of social work, and partially because of that, it’s also very flexible.

Depending on the practice and the situation, a practice may utilize a social worker 95% of the time for clients and very little for doctors and staff members. Or it may be more of a 50-50 split. Or they may use the social worker for a lot of staff training so the staff is empowered to start handling some of these situations or communicate a little more effectively with the client.

It’s very flexible, and I think it can be very customizable using a veterinary social worker and incorporating them based on what the needs of your practice are.

Caroline Cox, LSW, MSW, is a veterinary social worker at Mount Laurel Animal Hospital in New Jersey. She earned her master of social work from the University of Denver, where she also obtained a certificate in animal-assisted social work. Cox has diverse experience in social work, including roles in emergency medicine, inpatient psychiatric care, child welfare, and reentry services. She is passionate about supporting veterinary professionals and clients in navigating the emotional challenges of animal care.

Erika Krick, VMD, DACVIM (Oncology), is the medical director at Mount Laurel Animal Hospital. She previously served as an assistant professor of oncology at the University of Pennsylvania School of Veterinary Medicine, where she also served as section chief of the Oncology Service. Her clinical specialties include medical oncology and palliative care, and she has authored more than 20 articles and clinical studies.