Senior Dog & Cat Tips

September is Animal Pain Awareness Month, during which time the International Veterinary Academy of Pain Management educates pet parents on signs of pain in their companion animals. As providers of pet hospice at home, Heaven at Home would like to take this opportunity to help pet parents ensure that their cats and dogs do not suffer needlessly as they age. Our hospice veterinarians are available for Quality of Life telemedicine consultations to help pet parents evaluate pain in their senior pets.

Can you imagine not being able to tell your doctor that you were in pain? Animals suffer from pain just like we do. Pain comes in many forms: surgical pain, arthritis, and cancer, just to name a few. Acute pain is obvious and distressing. Chronic pain can be subtle, and masked as “getting old” or “slowing down.” Age is not a disease, but pain is. There are many options to treat the various causes of pain in animals including pain medications, physical rehabilitation, and acupuncture. In addition, there are many environmental strategies that can help reduce pain, such as slip-proof and padded flooring, altered-height feeding, ramps, and other supports. Contact us if you’d like assistance identifying and managing pain in your aging pet. Here are some of the key signs to watch for:

Common Signs of Pain in Dogs

• Decreased social interaction
• Anxious expression
• Submissive behavior
• Refusal to move
• Whimpering
• Howling
• Growling
• Guarding behavior
• Aggression; biting
• Decreased appetite
• Self-mutilation (chewing)
• Changes in posture

Common Signs of Pain in Cats

• Reduced activity
• Loss of appetite
• Quiet/loss of curiosity
• Changes in urinary/defecation habits
• Hiding
• Hissing or spitting
• Lack of agility/jumping
• Excessive licking/grooming
• Stiff posture/gait
• Guarding behavior
• Stops grooming/matted fur
• Tail flicking
• Weight loss

Download or Share this Poster that illustrates Signs of Pain in Pets

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For many pet owners, the cause of incontinence in their fur family member can be as simple as a highly treatable UTI (urinary tract infection) or the harbinger of serious disease.

“Many pet parents struggle with incontinence issues, especially with senior dogs and cats. But there are a number of simple things that can be done to help manage incontinence,” said Dr. Laurie Brush, founder of Heaven at Home Pet Hospice.

In Younger Dogs & Cats

Uncharacteristic bouts of incontinence in young companion animals can signal a wide range of ailments, from urinary tract infections to hormone imbalances. Sometimes incontinence can be caused by endocrine disorders (such as Cushing’s and Addison’s disease) diabetes, kidney or liver disease, polyps or cancerous growths in the urinary tract or prostate and bladder stones.

“A trip to your routine care veterinarian will help rule out serious disease and give you treatment options, such as antibiotics, phenylpropanolamine or hormone therapy,” Dr. Brush said.

However, in cases caused by advancing age or a life-limiting disease, proactive palliative home care can help keep your pet comfortable.

“Incontinence is often a trigger for pet parents to evaluate the pet’s quality of life. But it doesn’t necessarily have to mean an early close to your pet’s life story,” Brush said.

Home Management

The three key goals to successful home-management is keeping your pet comfortable, reducing the cleanup time required, and ensuring that you are providing veterinary oversight for medical interventions that may improve the situation. There are many medications and supplements that can help, whether provided by a home hospice service or your routine care veterinarian.

For Dogs:

• Use waterless shampoo to keep your pet’s skin clean to avoid urine scald.
• Use absorbent waterproof bedding that’s easy to change and wash, such as medical supply waterproof pee pads.
• Use bloomers or belly-band style diapers with disposable inserts.
• Create a “safe” space where accidents are easy to clean for when you’re away.

Especially For Cats:

• Use flat litter pans that are easy to access or cut out a lower access.
• Consider keeping litter pans on a main floor.
• Ensure good pain management since arthritic pain often prevents use of the litter box.
• Pursue diagnosis for Feline Cognitive Dysfunction or anxiety.

If you’d like more help managing senior pet incontinence,  contact us for a consultation.

Good hydration is key during the “dog days of summer.” Dogs can become seriously ill – or even die – from losing as little as 10-15% of their body’s water. Dogs need at least an ounce of water per pound of weight daily – more if active. Hot weather makes dogs pant more and sweat through their paws.

“Dehydration can promote urinary tract issues, the formation of kidney stones, and organ failure. It can be a veterinary emergency,” said Dr. Laurie Brush, founder of Heaven at Home Pet Hospice. “Senior dogs are at a higher risk.”

Symptoms may include lethargy, weakness, labored breathing, an elevated heart rate, and dry, sticky-feeling gums or sunken eyes.

How Can I Tell If My Dog Is Dehydrated?

Your pet’s mucous membranes should be moist. The easiest way to evaluate this is to check their gums. If they are sticky or dry when you run your finger over their gums, your pet may be mildly dehydrated.

If your pet is ill or has other symptoms, you can check further for dehydration by lifting a pinch of skin at the back of your pet’s neck/shoulder area and letting go. The skin should snap quickly back into place. If your pet is severely dehydrated, the skin may stick together, and form a “tent.” In this case, call your veterinarian immediately.

Improving Hydration

 You might think drinking enough water is a simple biological function but in truth there are a number of things that put dogs off their water:

• Lack of water freshness/dust and debris
• Water bowl is in a high-traffic area
• Water bowl is at an uncomfortable height
• Dog is distracted by play activity and lacks access
• Dog feels unwell or nauseous, or is in too much discomfort to seek water

During hot weather, keep a water bottle nearby and take frequent H20 breaks during play, but note that deep-chested, large-breed dogs should not consume large volumes of water while highly active to avoid bloat, which can be fatal. Use dog fountains to keep water fresh via circulation. Place raised water bowls in multiple convenient locations. For pets with mild dehydration, encourage drinking by mixing in low-salt, low-fat chicken or beef broth, or a small amount of plain Pedialyte. But if your dog is clearly dehydrated, talk to your vet immediately. Hydration is your dog’s best friend in the dog days of summer!

When to Worry About Bloat

One caveat about hydrating your pet is taking care not to give a deep-chested dog copious amounts of water during vigorous play, as we mentioned above. That’s because it’s believed to contribute to bloat, also known as gastric dilatation-volvulus (GDV) complex. Bloat is a medical and surgical emergency that occurs when a dog’s stomach rotates or twists, trapping blood from the hind legs and abdomen from returning to the heart. Blood pools at the back end of the body, reducing the working blood volume and sending the dog into shock.

Dogs with a deep, narrow chest — very tall, rather than wide — suffer the most often from bloat. Great Danes, who have a high height-to-width ratio, are five-to-eight times more likely to bloat than dogs with a low height-to-width ratio. In addition to Great Danes, large- or giant-breed dogs at greatest risk include St. Bernards, Weimaraners, Irish Setters and Gordon Setters, Standard Poodles, and Doberman Pinschers. Males are twice as likely to bloat as females.

Signs of Bloat:

• An enlargement of the dog’s abdomen
• Retching
• Salivation
• Restlessness
• An affected dog will feel pain and might whine if you press on his belly

Without treatment, in only an hour or two, your dog will likely go into shock. The heart rate will rise and the pulse will get weaker, leading to death.

Too Much Hydration?

On the other end of the dehydration spectrum is Water Intoxication, which, while rare, can happen. Does your dog “bite” at the water when swimming? Maybe they can fetch a stick in a pool or lake all day — ingesting water each time they do. Or maybe they love to drink from pressurized water like a sprinkler spigot. But the ingestion of too much water can throw their electrolytes out of balance and cause a life-threatening condition.

Symptoms of water intoxication in dogs include lack of coordination, lethargy, nausea, bloating, vomiting, dilated pupils, glazed eyes, light gum color, and excessive salivation. Advanced symptoms include difficulty breathing, collapsing, loss of consciousness, and seizures.

Because water intoxication in dogs can progress so quickly, time is critical. If your dog exhibits these symptoms, get to a veterinarian immediately to run blood work. A low level of electrolytes will confirm the condition. Treatment for water intoxication includes fluids, to put electrolytes back in the system, and sometimes a diuretic.

Your loyal companion was there for you during lockdown, entertaining you, relieving your stress, photo-bombing your Zoom meetings… Repay that kindness and nourish your connection even if you’re back in the saddle at work.

“What’s important is that you set aside the time to create DAILY opportunities for engagement – not just “weekend warrior” sessions,” says Dr. Laurie Brush, founder of Heaven at Home Pet Hospice.

“Aging pets enjoy routine engagement and need dedicated, age-appropriate exercise and sunshine beyond a simple walk.”

Here are just a few great ways you can “up” your pet’s “game.”

1. Daily Training – Just like an Olympic athlete, dedicated daily training is a must to keep Fido’s cognition firing. Teach old dogs new tricks. Build rewarded commands into daily routines, such as “wait” at meals and “stop/sit/stay/come” during walks or play. Dogs enjoy getting it right.

2. AquaMan’s Best Friend – For arthritic pets, swimming can help keep the muscles moving without stressing the joints. Even wading pools can give your old dog a bit of relief. A trip to a dog pond (eg. Shaggy Pines Dog Park) or the Lake (eg. Kirk Park) or a friendly neighborhood Dog pool (eg. K9 Athletics) offer great opportunities for low impact exercise.

3. Feline Fun – Dog aren’t the only contenders in Senior Olympics. Cats can combat cognitive decline with interactive food dispensing toys and games that trigger the hunter within. Hide treats under egg cartons or get out the flirt pole. High perch climbing equipment and a visually stimulating window (eg. put a bird feeder within view) will help keep Felix feeling spry.

4. Scent-ual Work – Choose a smelly, favorite treat and create a “treat trail” around the yard to get Fido working his or her sniffer. Not only is it an engaging way to deliver goodies (or a meal) – sniffing also relaxes dogs, which may help with separation anxiety.

5. Mighty Kong-Quest – Stuff a Kong with treats such as all-natural peanut butter, bananas, plain yogurt or wet food with kibble and freeze. See if your pet can beat their “Personal Record” for time to Kong-quer! Or leave this engaging treat as a parting gift when you’re away.

They say “old” is a state of mind. Help your pet feel young again with daily attention, movement, and novelty. That’s how you “win” the Senior Pet Olympics!

Are you confused by reports that grain-free and exotic dog food ingredients may be causing an increased number of dogs to die prematurely of “DCM” (dilated cardiomyopathy)? The stakes are high in the $30 billion petfood market where boutique producers are pitted against mounting evidence from the FDA. It’s hard for pet parents to cut through the spin to get the facts.

To make matters worse, nutritional DCM is one of those rare diseases where we have “the cure” before we conclusively know the precise cause, though high proportions of legumes in grain free foods are suspect.

Here are key talking points to discuss with your veterinarian:

DCM is referred to as a “Silent Killer” because often by the time a dog shows outward signs from an enlarged heart, it’s too late to avoid DCM. Reports include sudden collapse of seemingly healthy dogs of all ages and breeds.

Diet-Related DCM is distinct from hereditary DCM because if caught early it can be reversed by a change in food. There have now been many such cases where switching to a major brand with a veterinary nutritionist on staff and, in some cases, taurine supplementation has corrected the issue.

Low levels of taurine do not confirm a diagnosis, and in many cases, levels are normal. While a pre-screening blood test called NT-proBNP can help identify early stages of heart failure, only an echocardiogram can confirm a diagnosis.

Dog food ingredients work together. The bioavailability of certain nutrients changes, sometimes dramatically, depending on the other nutrients and foods in the recipe. This is why a helping of green beans may be harmless, but a food composed predominantly of legumes through ingredient-splitting (listing peas, chick peas, beans separately) could theoretically interfere with absorption of taurine or other nutrients vital to heart health. The quest to identify the cause continues.

The World Small Animal Veterinary Association (WSAVA) and the cardiologists and nutritionists who first uncovered Diet-Related DCM recommend selecting pet foods that have been:

1. formulated by an on-staff Phd Veterinary Nutritionist
2. with product research published in peer-reviewed journals
3. and perform a minimum of live AAFCO feeding trials, with a preference for long-term digestibility research
4. with quality testing of every batch

If you’re feeding your pet grain-free foods, be sure to discuss your options and risk with your veterinarian.

For more information, visit: https://dcmdogfood.com/

Pet parents are faced with tough choices when spring wanderlust strikes. Senior dogs and cats truly require more monitoring with advanced age.

“Many of the concerns of old age such as joint pain, incontinence or a change in behavior/temperament can make a boarding experience more trying,” said Dr. Laurie Brush, founder of Heaven at Home Pet Hospice.

“Sometimes the stress of boarding can cause medical conditions to worsen. But good communication with the caregivers and advanced planning can help keep your pet comfortable,” she said.

In addition to providing documentation of medications, veterinary info, condition details, routines and feeding habits, you will also want to supply an advanced directive that spells out what kind of emergency procedures you authorize in your absence. Ensuring the provision of extra blankets, incontinence products, walking mats and heated bedding will help keep your pet comfortable.

If you choose a licensed boarding facility, ask if there is an area designed for seniors, which is an emerging trend in the industry. Features such as an area located away from main stay and play areas, extra soundproofing, raised beds, extra-bedding, and increased monitoring create an improved experience. For example, Whiskers Pet Spa and Resort has just launched its “Villas” wing this spring, designed to cater to senior pets.

Another option is boarding with an animal hospital that also provides geriatric treatments such as hydrotherapy, acupuncture or cold laser therapy. Grand Rapids is fortunate to have several boarding facilities of this type, such as Cascade Hospital for Animals.

Other pet parents may be more inclined to seek trustworthy “in-home pet care providers” who either offer up their homes for overnight stays or come to your home. Resources available include the “Air BNB” of the pet world, Rover.com, or in-home pet sitting services. Dr. Brush recommends doing due diligence and asking specifically about caregivers’ experience with senior pets, checking references, and asking if the caregiver is bonded and insured. Trial stays will help your fur friend feel comfortable and help determine if the arrangement is the right fit before considering an extended trip.

Whichever type of boarding experience you choose, thoughtful preparation will help take the stress out of spring vacation for both you and your senior pet.

During the holiday rush, owner distraction and plummeting temps can leave your fur-friend feeling bored. And boredom can spell trouble. If you don’t want your pup to redecorate the house, or your senior pet to withdraw, consider pet enrichment tips to make your fur-friend’s season “merry and bright.”

Canine Enrichment

What Is Canine Enrichment?

With an increasing population of senior pets, research has focused on ways to stave off cognitive decline through play and engagement. Evidence now suggests that mentally-engaging activities help reduce the clinical incidence of canine cognitive dysfunction.

“Creating an enriching environment with enriching activities is one of the greatest gifts you can give your senior pet,” says Dr. Laurie Brush, founder of Heaven at Home Pet Hospice.“It vastly improves a senior pet’s quality of life.”

More Than Fun for Fido

In one study, older dogs receiving environmental enrichment plus an antioxidant diet showed the most improved cognitive scores, while environmental enrichment alone improved scores more than the group given the dietary treatment without enrichment. Increased perfusion to brain tissue, decreased bodyweight, upregulation of growth factors and improved synaptic plasticity may all be molecular mechanisms underlying the benefits of enrichment and activity therapies. Providing low-stress and predictable social interactions, play, outlets for other natural behaviors, and sensory-stimulating opportunities all serve to create an enriched environment.

Dogs Love Novelty

Researchers who were trying to uncover why dogs tire of toys have discovered that dogs possess “Neophilia” – the love of new things. (WE could have told them that!) You can make an old toy seem new again by changing its scent, or you can restrict access to toys and offer them in rotation to re-pique your pet’s interest. Otherwise, be sure that Fido’s on Santa’s list if you want to keep him busy throughout the long winter ahead.

Food Puzzles – A Win-Win

“Sniff and Nudge” type toys are engaging for pets of any age. Think Busy Buddy or Westpaw toys where you hide treats for Fido to find. For senior dogs who are experiencing cognitive decline, puppy versions of these toys work well if you make sure you show your pet how to get the treats.

Sensory Exposure

From snuffle mats (shaggy mats in which you hide treats) to jaunts BEYOND your back yard, new smells stimulate the mind of your fur-friend like nothing else can. That’s because the part of a dog’s brain that is devoted to analyzing smells is, proportionally speaking, 40 times greater than ours.

Training & Playing Don’t End in Puppyhood

Spending a few minutes each day on reward-based basic obedience or simple trick training is a great method for mental stimulation and appropriate social interaction, especially in less mobile animals. Likewise, encouraging play even in older animals offers opportunities for engagement. A play partner should support the appropriate level activity and not pester or distress the older animal. Toys can also be a good outlet for older animals but daily rotation, food and owner facilitation may be necessary.

“Dognition” –

For the pup who has everything, Duke University’s Canine Cognition Center has created Dognition.com – a science-based website you can join for assessment tools and monthly enrichment games. Dognition is dedicated to enriching the relationships between dogs and their owners through cognitive science. By tailoring fun, science-based games to subscribers and by offering everyday “citizen scientists” a chance to contribute to research that furthers the study of dog cognition, The Dognition Experience helps owners discover what is extraordinary about their dogs, while contributing to the greater good of all dogs. Annual membership is currently $79; a one-time assessment is $29.

Give your fur-friend a December to Remember with the gift of enrichment!

Feline Enrichment: Kitties Need Enrichment Too!

Similar to dogs, senior cats can also suffer cognitive decline and benefit from enrichment. However, while there is some overlap in strategy, feline enrichment caters to the unique makeup of cats. As a result, activities that cater to visual stimulation, hunting instincts and spatial awareness prevail. Here are some ways to keep your aging kitty engaged:

• Provide safe outdoor time for cats with bungee harnesses or cat-specific fencing. Screened porches or outdoor enclosures do not encourage as much activity as walks or large fenced areas, but will help present new sights and sounds.

• Access to windows, preferably with perches, provides mental stimulation as your cat looks out the window. Regularly move beds and perches. This mimics a changing outdoor environment and encourages cats to explore.

• Ensure there is vertical space for cats both indoors and outdoors to help foster activity and provide safe places in a multicat household. Cats like to be up high, physical condition permitting. Providing access to elevated places makes cats happy. Provide your cat with a carpeted tree or condo, preferably with hiding spots, cat perches and shelves. Single perches with room for only one cat at a time are a good way to help your cat escape from any other household animals.

• Cats will get bored with a toy after a while, so it is important to provide only a few toys at a time on a rotating basis to keep your cat’s interest. Social activities with humans can be the single most effective way to enrich your indoor cat’s environment. Schedule playtime a few times each day, and rotate toys and games you use each time.

Making the decision to euthanize a pet is the hardest thing a pet parent has to do. However, deferring or avoiding the decision can allow a degree of suffering that no one would deliberately wish on their loyal companion. Natural death is rarely humane. But how do you know when the kindest act you can offer is to plan to say goodbye? How do you know when your beloved companion is ready to cross the “Rainbow Bridge”?

Some people have a difficult time with the thought of euthanasia. They might feel like they’re “playing God,” and feel besieged by guilt. It’s important to remember that the illness, disease, or injury is causing the end of life, not you. Here are some of the key questions to ask yourself:

• Has your pet lost his/her quality of life?
• Is your animal suffering?
• Can you maintain your pet’s normal routines?
• Are there behavioral problems that compromise the safety and well-being of your pet or others?
• Are there human limitations (emotional, timing, or financial) that you must consider? While it may be difficult to admit that any of these limitations may be the reason you are considering euthanasia, they are among the most common reasons for euthanasia.
• What do you think your pet wants?  

Quality of Life Assessment Help

Your routine veterinarian, or the Heaven at Home Pet Hospice team, may be able to assist you in assessing the quality of life of your senior pet, but we can’t make the decision for you. Pet parents play a pivotal role in assessing a pet’s quality of life because they are direct observers of the day-to-day signals of their pet’s condition. Your veterinarian team can help you manage aspects of pain, reduce suffering, and make changes that help in daily care.

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Many of Heaven At Home’s clients have found assistance and comfort by using the resources and assessment tools of  Ohio State University’s “Honoring the Bond” program. The 2019 edition of “How Will I Know” addresses making difficult medical treatment decisions, dispells many euthanasia myths, and offers a  comprehensive assessment questionnaire, together with anticipatory grief advice for pet parents, companion animals, and children.

In addition, our team finds this short “Quality of Life” Scorecard below helpful for our clients.

Contact us if you’d like assistance in your assessment, or feel ready to plan a peaceful and compassionate end to your fur friend’s life story.

Knowing when to say goodbye is hard, but with the right support, advice, and planning, it can be a beautiful final gift to give your beloved pet for his or her years of loyal companionship.

Adapted from Villalobos, A.E., Quality of Life Scale Helps Make Final Call, VPN, 09/2004, for Canine and Feline Geriatric Oncology Honoring the Human-Animal Bond, by Blackwell Publishing, Table 10.1, released 2006.

Nine years ago, a mere 30 veterinarians gathered to discuss ways to help bring comfort to aging pets and help pet parents know when it’s time to say goodbye. That was the dawning of the International Association for Animal Hospice and Palliative Care (IAAHPC). Earlier this month, ten times that number gathered in Chicago to learn about trends in the emerging field.

“Research shows that more and more Americans are opting for pet hospice,” said Dr. Laurie Brush, founder of Heaven at Home Pet Hospice and early graduate of the IAAHPC’s new certification program.

“I got involved in home hospice in the early days because I firmly believe in pro-active comfort management and helping pet parents make small changes that can greatly improve a pet’s comfort.”

To celebrate the upcoming National Animal Hospice awareness day November 2nd, we’re sharing some of the elements involved in “Animal Hospice.”

It’s More Than Home Euthanasia Services

Animal hospice and palliative care provide comfort to companion animals as they approach the end of life. Services from the veterinarian team may include treatment for pain and anxiety management plus nutritional management specific to the pet’s condition. The primary goal is to relieve – or avoid – suffering.

The veterinarian team can also help pet parents assess the pet’s quality of life and teach pet parents ways to improve end-of-life care. Good pet hospice care is a team effort.

Things to Consider in Pet Hospice

 Pet parents can manage many aspects of pet hospice themselves, while they will need veterinarian assistance with other aspects. These are the key areas to consider:

• Environmental Assessment: Review mobilizing, feeding area, litter box, bedding, and enrichment.
• Mobility Support: Consider non-slip mats, carpeted stairs, ramps, slings, harnesses, wheel carts.
• Toileting Solutions: Use incontinence pads, diapers/belly bands, and consult vet for stool softener, catheterization.
• Pain management – Monitor pain signals and medication together with vet; use multi-modal approach (alternative therapies & environmental supports.)
• Nutrition: Devise superior diets specific to illness with vet, ask for appetite stimulants if needed.
• Behavior Modification: Discuss medication and strategies for managing anxiety, restlessness, vocalization, sleep disturbance, and cognitive dysfunction.

Together, pet parents and hospice veterinarians can dramatically increase the quality of end-of-life care a pet receives.

Heaven at Home Pet Hospice offers private hospice consultation, but also periodically hosts group workshops and webinars. Contact us for more information.

As part of pet pain awareness month, we published an article earlier this month about identifying and managing pain in members of your fur family. In this second installment, we’ll share a handy infographic to help identify pain in cats and dogs and include the American Animal Hospital Association’s article summarizing its guidelines in layman’s terms.

Pain Management Approach for Senior Companion Animals:

The Heaven at Home team takes a “multimodal” approach to helping manage pain in palliative pets. We are firm supporters of the AAHA/AAFP Pain Management Guidelines for Dogs and Cats, and subscribe to the “Continuum of Care” philosophy inherent in it. This means that pet parents and routine care veterinarians are part of the pain management planning process and that pain management should include anticipation, early intervention and evaluation.

During home visits, one of the team’s veterinarians will evaluate your pet’s condition and assess things that can be changed in the home environment to help your pet stay a part of the family. They will review records from your routine care veterinarian if available, and give you pain assessment guidelines so that you can also monitor and rate your pet’s pain behaviors. Together, we then develop a pain management plan for your pet. The plan may include a number of elements depending on the underlying cause of pain, which could be from arthritis, cancer, or any number of life-limiting illnesses.

From AAHA: 9 Things You Need to Know About AAHA’s Pain Management Guidelines:

Contact the team at Heaven at Home if you need help managing your senior pet’s pain.