Older pets have special needs

Our older pets may have special needs…

Changes are to be expected in our pets as they age, but many are reversible if recognized early enough.

1. Recognize the signs

  • Difficulty jumping.
  • Increased stiffness or limping.
  • Overgrown claws in cats.
  • Loss of house-training.
  • Increased thirst.
  • Increased urination.
  • Changes in activity level, up or down.
  • Excessive panting.
  • Circling or repetitive movements.
  • Confusion or disorientation.
  • Excessive barking or yowling.
  • Less interaction with the family.
  • Decreased responsiveness.
  • Tremors or shaking.
  • Skin and hair coat changes.
  • Changes in sleeping patterns.
  • Less enthusiastic greeting behavior.
  • Altered appetite.
  • Weight change, up or down.
  • Rear end weakness.
  • Diarrhea or vomiting.
  • Bad breath, trouble eating, or sensitive mouth.
  1. Determine if a major disease is responsible. 
  • Start with a physical examination and discuss the diagnostic options with the veterinarian.
  • Run indicated tests: urinalysis, complete blood count, blood chemistry profile, stool check.
  • Imaging: radiographs (X-rays), ultrasound, CATScan, MRI.
  • Refer to veterinary specialist: ophthalmologist (eye doctor), cardiologist (heart doctor), oncologist (cancer specialist),etc.
  1. Evaluate treatment options. 
  • Every patient is unique.
  • Every household has its own standards of care based upon personal experience, intuition, finances, and outside demands on time and energy.
  • Just because care is available, does not mean it has to be provided.
  • Tailor the right care for each pet.
  1. Manage the impact of these findings on the family. 
  • We all deal with illness differently.
  • Pets need not be a source of conflict.
  • These discussions of care can

    be a starting point for discussing care of the human family members.
  • Consider euthanasia (a good death) as a possible option, if needed, for the sake of the pet or the family.

I have personal experience with older pets, and the choices we face if we are fortunate enough to have long-lived pets. 

  • My mother’s cat is eighteen.  Mystic has hyperthyroidism that caused weight and muscle loss, yowling, diarrhea, increased urination, and an increased appetite, while he maintained his energy.  My mother did

    not feel surgery or radioactive iodine were options for him.  She did give medical management with Tapazole® a chance.  He is doing well.  Close monitoring was needed to find the correct dose.  She is happy.  The cat is happy.  My brother who is allergic to cats is being patient.
  • Sugar suffered with severe arthritis of the elbows and flea allergy and cancer. I waited to spay her until she was two years old, since I thought I would breed her, so she developed mammary (breast) cancer.  She survived her mastectomy.  She did not live long enough to benefit from Frontline® to kill the fleas so quickly they would not get a chance to bite her or from Rimadyl® for her arthritis.  I had told myself if she were ever too stiff to enjoy swamping, I might have to make a tough decision.  That day never came. .  She passed away in the swamp, swimming after my canoe, at the age of twelve.
  • China dealt with cancer.  I did what I could with surgery and prednisone here, but I did not choose to refer her to the specialists, because her cancer was likely to respond poorly to chemotherapy or radiation.  The travel to Tufts would have been exhausting, and the separation from her brother would have diminished her quality of life.  Even a vet considers the costs of care compared to the benefits.  She died without assistance with her brother, Josh at her side, at the age of eleven.  (More on Josh to come.  Keep reading.)
  • McKeever’s increased thirst had indicated sugar diabetes, which I managed with twice-a-day insulin injections for several years.  He developed cataracts secondary to the diabetes, and went blind.  He lived long enough to be deaf.  He used his nose.  He gave up water retrieving gracefully a year before he died.  His hips were excellent until the end, but nerve deterioration brought him down at nearly fifteen.  I actively ended his life as my final gift to a great companion.

Deafness

A loss of hearing would seem easy to recognize, but some dogs, like my dog Josh, are extremely good at adapting.  In retrospect, the signs were there, if I had put the pieces together.  He had learned to watch my other dogs, so that when I called them, he would come.  The only times he did not come was when he could not see them.  But since dogs sometimes dawdle for good smells, and the joy of it, I did not realize he could not hear until the horse came noisily off the manure pile, and Josh did not get up and move.  The horse was sure he would hear, and get up and move, Josh was stepped on and had his leg broken.  Look further down for more on Josh’s story.

Most dogs lose hearing near the end of life.  They do not tolerate hearing aids well, so these devices are saved for specialty dogs with unique work requirements.  Early retraining with blinking of lights and hand signals helps the most.  Early deafness may be reversible in a few cases in younger dogs.  I can help you and your dog adapt.

Vision loss

Since dogs use their noses and memories, we may not realize the loss of vision until we move the couch, or change our routine.  I had a blind dog Abigail, that functioned as well as a sighted dog in the deep woods, since she used her other senses so well. Dogs see badly enough to begin with, that some vision loss may not affect function.  I can help you help a dog adapt if treatment can not restore vision.  Euthanasia (a good death) is not the only option for most dogs, unless they are so fearful that they are aggressive.

Blindness in older dogs can occur from several causes.

  • Cataracts are an opacity (loss of clearness) of the lens such that the light can not get into the retina (the film-like part of the eye that connects to the brain).  Although some cloudiness of the eye is normal in dogs over 7 years of age, (lenticular sclerosis), it does not affect vision.  Surgery can help many dogs with cataracts.  Evaluation will require referral to a Veterinary Ophthalmologist.
  • Glaucoma is a sudden rise in pressure in the eye that in dogs usually rapidly damages the optic nerve, causing permanent blindness.  Immediate treatment can help.  Signs include may include:

Pain.

Light sensitivity.

Pawing at the eye.

A dilated (big pupil).

A cloudy cornea (the surface of the eye that is usually clear).

Redness of the blood vessels in the white of the eye.

Enlargement of the eyeball over time in an eye that is blind.

Abigail lost her vision to glaucoma.  One eye lost the vision quickly.  The other gradually became blind.  Eye problems are unfortunately common in breeds like Cocker Spaniels.  One eye bulged.  Treatment options have improved in the last thirty years, so vision can be saved, not just the eye, in cases detected early.

  • Retinopathy refers to several diseases that affect the film-like light-detecting part of the eye.  The Veterinary Ophthalmologist is needed to determine the exact disease process. 
  • Dry eye is a lack of tear production that causes mucous build-up.  Since the surface of the eye loses nutrition as it dries, it may get pigmented (brown) or have blood vessels grow across.  Early treatment with Optimmune®, a prescription medication, may stop the loss of tear production in dogs and restore vision or save the eye.
  • Others to numerous to name.

Cognitive Dysfunction Syndrome (CDS)

The name of a brain disorder in older dogs similar to Alzheimer’s Disease in people, though the disease process in the brain is different.  Treatment can be effective in dogs.  Research is ongoing for cats.

Diagnostic Aid for CDS in dogs

  • Disorientation:

  • Wanders aimlessly.
  • Appears lost or confused in the house or yard.
  • Gets “stuck” in corners, under the bed, or behind the furniture.
  • Stares into space or at walls.
  • Has difficulty finding the door.
  • May stand on the hinge side instead of the part that can open.
  • Stands at the wrong door to go outside.
  • Does not recognize familiar people.
  • Does not respond to verbal cues or name.
  • Appears to forget reason for going outdoors.

Interaction with Family Members:

  • Seeks less attention.
  • Less likely to stand or lie down to be pet and walks away.
  • Less enthusiasm upon greeting.
  • No longer greets owners (once the dog is aware the owner has arrived).

Sleep and Activity:

  • Sleeps more (overall) in 24 –hour day.
  • Sleeps less at night.
  • Decrease in (purposeful) activity in a 24-hour day.
  • Increase in aimless activity (wanders, paces) in a 24 –hour day.

Housetraining:

  • Urinates indoors.
  • Defecates indoors.
  • Urinates or defecates indoors in view of the owners.
  • Urinates or defecates indoors soon after being outside.
  • Signals less to go outside.
  • Through the summer of 2000, Pfizer Animal Health is offering a 30-day free trial of the drug Anipryl®, so a person can try the medication with minimal risk to see if it is worth treating an individual dog.  A veterinarian is needed to discuss the risks for each case, versus the likely benefits.

Arthritis

Winning the battle against osteoarthritis

Osteoarthritis-

I am sure if you have an older dog in your household, you know what I am talking about. The stiffness when rising, lagging behind on walks, limping when the weather is crummy, and the difficulty climbing stairs. These are all clinical signs of osteoarthritis and until now there was little we could do to make our pets more comfortable.  We now have a new technology called NSAIDS. These are known as non-steroidal anti-inflammatories. A few of the commonly known NSAIDS are Rimadyl and Etogesic. Both of which seem to be the “miracle” drugs for treating osteoarthritis. We now have the technology to help take away some of that pain which plagues the older generation of pets. Right now at the Pomfret Small Animal Clinic we are running a promotion with Pfizer Animal Health in which we give you a free 7 day trial of Rimadyl if your pet is suffering from osteoarthritis and has never tried it. This is a golden opportunity you cannot pass up if your friend has been suffering. You may be amazed at the difference that can be made by giving a pill twice a day. Rimadyl is not right for all pets and if you are considering using this trial offer, you need to keep in touch with Dr. Norris and her staff to let us know how your pet is doing. We care very much for your pet’s well being and want to make the quality of life the best possible. If you are short on time, or have a hectic schedule, you can try Etogesic- a once a day NSAID. We cannot cure osteoarthritits but we can try to make those that suffer with it as comfortable as possible. So please stop by and ask us about Rimadyl or Etogesic. The staff here is eager to answer your questions. You can also visit www.rimadyl.com to find out more about what Rimadyl can do for your aging pet.

Weight changes

Weight gain is a major contributing factor to arthritis, by wearing down the joints.  At a meeting I attended, one of the veterinarians that runs an emergency practice speculated that such clinics would be obsolete if people managed the overweight pet.  He may have been exaggerating.  But we can control our pet’s weight.

  • Food does not equal love.  Attention equals love.  We often start only paying attention when food is involved, especially if we are busy.  Just because my dog looks at me while I give your dog a pill at the Clinic, I do not give him a pill.  Nor do I feed him just because he looks at me.  I do make sure when spend time together: cuddling; walking; doing chores; and sharing hobbies like boating.  Patients that have lost the weight come in happy with happy owners, as “in love” as ever.  We think they beg for food when they really beg to be part of our pack.
  • Lower calorie options are readily available.  Josh is kept at a good weight with Waltham Calorie Control Food for Dogs® now because the Hill's R/D® became boring during his convalescence, though he had eaten it successfully for years.
  • Lower calorie treats are plentiful.  Peanut shells, baby carrots, and fruit can work.  Even dog food in a bowl on the counter will be enticing if you fuss over it.  If the dog is not hungry enough to eat dog food, then it was not asking for food, just attention.
  • Have them work for food.  A polar bear in a zoo was treated successfully for obsessively swimming in the pool all day.  The veterinary behaviorist had the keepers hide his food.  First he looked for the buckets in his enclosure.  Then he chipped out the fish, frozen in the bottom.  Breaking treats into quarters, and giving it twice as often, with the pet doing work, cuts calories.  Less food can take longer to eat in a slow-release toy such as a Kong® or Buster Cube®.  The Dobermans here at the Clinic like their dinner in plastic bottles that they roll around.  Less food takes longer to eat and is more fun.

Weight loss can signal disease, like it did for McKeever and Mystic.  Some pets just need the calories in a different form.  Purina® has designed special diets for the thin, older pet.

As my blue tick coonhound, Blue, thinned to skin and bones last fall, he had no body fat to keep him warm.  His weakened muscles worked even less well in the cold.  I bought him a polar fleece jacket of many colors, and fitted it with an extra panel to accommodate his deep chest.  The horses could not their eyes off him.  He enjoyed our walks until the first cold blast of the New Year, when he walked up the hill, lay down, and never ate or walked again.  I assisted his departure from this world.  There remains debate as to where his spirit would reside now.  When he was good, he was very, very good.  He saved dogs’ lives as a blood donor dog here at the Clinic.  But I have always joked that he is the kind that would not have smoked until the day the Surgeon General’s Warning appeared on the back of the package.  There is a new commercial with a hound like him driving into a pond after being warned not to.  Maybe Blue is in Hollywood.

Josh’s new adventure…

“This is even more embarrassing than wearing a coat…”

Josh was my black and white pitbull. After his sister, China’s, death, Josh had slept with Blue for companionship.  After Blue’s death, he slept alone.  He got his company from the other dogs on our walks and helping with barn chores.  He had been given more than his fair share of burdens already.  At the age of six, while I hurried into the back door of the Clinic to care for a hospitalized patient, he stepped into the road to look at Holstein heifers (young female cattle) across the street and was hit.  It took a year, three surgeries, and a patient spirit to recover.  His injuries included: 

A diaphragmatic hernia, which is a tear of the breathing muscle which allowed his guts to enter his chest.  It was repaired surgically at Rowley Memorial, the MASPCA Hospital in Springfield, Massachusetts, while I cared for my patients at the Clinic.

A broken socket (acetabulum) on the left hip that could not be plated in time (within five days) due to the chest trauma to allow smooth joint function.  The orthopedists tried, but instead removed the ball of the hip in a femoral head ostectomy.  The muscles then held the joint in place without pain.  The leg is shorter.

Torn cruciate and lateral-collateral ligaments in the right stifle (knee).  I repaired those, but his leg remained extended, and became arthritic.

Nerve damage to the ankle so it was hard for him to place his right foot without training him by rewarding the correct placing with a “good dog”.  At first, touching it down was enough.  Then a step.  And finally three steps.

A shattered pelvis that compromised his pelvic canal, so the higher fiber foods helped him to defecate normally.

Why did I wait to install the Invisible Fence!?! 

For more information see:   http://www.caninefence.com

Deafness prevented Josh from hearing the horse.  He, the horse, and I watched helplessly as the horse stepped on his stiff right hind leg and broke it.  I debated repair options.  Older bones (by now Josh’s bones are twelve) heal more slowly.  He has some lumps in his skin that may represent cancer, but at too many sites to remove.  He does not want to be away from the group. 

I tried conservative management.  It may have been a mistake at his age, but I gave it a chance.  I was superstitious about surgery because the cancer might spread to the bone as part of healing.  I still can not decide if I sensed this as a veterinarian, or a pessimist.  I finally removed the leg, which left him the left hind with no ball to bear his weight.  He had a hard time getting around.  I ordered the cart, so I could get firsthand experience with it.

At first Josh found it silly.  I had to adjust it carefully.  Within a week he was galloping along like on horse with a cart on a cross-country marathon, careening down steep banks, and even testing if it floated.  (It does not, but he was so fast, he tested the theory himself without my help, while I found a stick for the others.)

He now navigates both ways, because it helped him get back his strength.  Sitting is impossible in the cart.  Standing is easier in the cart.  He has even learned how to hang up his wheels and pull himself out of the cart at will.

Like you, I will never know if all of my decisions for his care were the best ones.  But I do know the outcome has been a success.  He is freed from the arthritic leg.  He is back with the group faster than surgery would allow, since his activity would have been restricted for at least six weeks post-operatively.  The cancer has no place special to spread, and is stable for now.  He is even swimming, and can get into the canoe with me if the other dogs and I are going too fast, with the stiff leg out of the way.  He even sleeps with the Dobermans at night, after the feeding time, when I do late patient checks, and their food is gone.

His care has required money, time, patience, and will on his and my part.  His strength of spirit and courage amaze me.  He will even go to the scene of the injury, though he does keep a closer eye on the horses, which takes some effort.  They can not take their eyes off him in the cart.  They were first filled with fear, and now with wonder.  Weren’t we all…

For more information on carts and their uses see:

http://www.k9carts.com



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