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Abstract The landscape of veterinary medicine in the United States has undergone significant change in the past several decades. Specific to large animal medicine is the increasing demand for veterinary care of patients that have been rescued, including formerly farmed animals now residing in sanctuary. We initiated this exploratory study in response to internal reports of ethical conflicts related to this changing demand at a high-volume, large animal veterinary teaching hospital in the Mid-Atlantic region of the USA. Specifically, we wanted to explore the extent to which these ethical conflicts contributed to psychological stressors among patient care team members. All 130 individuals who responded to our anonymous survey reported having had moral or ethical concerns with at least one patient scenario. A large majority, 87%, reported having had ethical or moral concerns about the care of rescued or sanctuary patients, and 55% reported that providing care to these patients is more stressful than caring for patients from non-rescue or sanctuary backgrounds. Our experiences as members of the hospital’s Ethics Consultation Service suggest that these stressors are a function of shifting norms in the rights of formerly farmed and working animals combined with a stark lack of hospice and palliative care options for large animals. Following a single-site exploratory study of this kind, further research is needed to examine whether this issue exists at other similar institutions and in the field at large. Also needed are (1) guidelines for hospice and palliative care for large animals, (2) a veterinary-specific measure of moral distress that accounts for sanctuary and rescue work in large animal medicine, and (3) sustained dialogue with owners of farm animal sanctuaries.