Senior Dog & Cat Tips

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.

Summertime Lyme on the Rise

Whether you’re heading to the Lake for a summer vacation or staying closer to home to enjoy the great outdoors, be on the lookout for the increasingly pervasive Black Legged (Deer) tick, purveyor of Lyme disease.

Frequent pet checks will help keep your pet – and your family – safe from Lyme disease, which has increased five-fold in the past decade throughout Michigan and is reaching what the CDC is calling epidemic proportions across America. The CDC estimates 300,000 cases last year, making Lyme the fastest growing vector-borne illness.

While lower Michigan had historically been spared a heavy infestation of Black Legged ticks – theoretically preserved from Illinois population due to Lake Michigan – migration continues from several counties in northern Indiana, which have reported ticks infected with B. burdorferi, the bacteria responsible for Lyme disease.

Black Legged ticks have become established throughout the entirety of the Lake Michigan shoreline in the Lower Peninsula. But tick populations are not staying confined to coastal counties, and are becoming established increasingly to the east in the southern part of the state, including Grand Rapids.

According to the Michigan Veterinary Medical Association, clinical Lyme disease in domestic animals may involve many organ systems. Fever, loss of appetite, depression, lethargy, swelling and pain in one or more joints, kidney disease, heart disease, and nervous system disorders have all been reported.

“An accurate diagnosis can only be made by a veterinarian. A Lyme disease vaccine is available. Consult your veterinarian about the appropriateness of vaccinating your pet and also to discuss recommendations for avoiding ticks,”

– Dr. Laurie Brush, founder of Heaven at Home Pet Hospice.

Last year, the FDA granted Nexgard the right to label the medication for Lyme disease prevention after clinical trials showed that the acaricide killed ticks before the disease could be transmitted, which typically takes 24-48 hours. Pet parents should discuss the risks and benefits of parasiticides with their routine care veterinarians because these types of medications all have the risk of possible side effects.

Other Ticks & Diseases Becoming Prevalent in Michigan

In the last decade, diseases spread by ticks, fleas and mosquitos tripled, according to the CDC. While many research papers point to climate change and milder winters for the rise in vector-borne illnesses, our highly mobile population also plays a role. Despite Michigan’s historical “protection” by the surrounding Great Lakes that slow the rise, the Companion Animal Parasite Council (CAPC) is predicting increase prevalence of diseases carried by ticks in the Great Lakes area in 2019.
Tick populations mate in the summer, increasing to peak populations in Fall.

Nationally, prevalence rates have risen each of the past 5 years and are now up 20% from 2013 levels, according to CAPC. The organization maintains an interactive map of diseases detected across North America:

Tick Types In Michigan:

Ticks to be on the lookout for include:

• American Dog Tick
• Black-legged Tick (Deer)
• Winter Tick
• Woodchuck Tick
• Lone Star Tick

These ticks can carry diseases such as Rocky Mountain Spotted Fever, Ehrlichia canis, and increasingly, Anaplasmosis.

The major vector of RMSF in Michigan is the American Dog tick, D. variabilis. It can also transmit the bacteria that causes Tularemia, and can harbor the Ehrlichiae bacteria.

In this video by the Companion Animal Parasite Council (CAPC), the council explains why the prevalence of the American Dog tick is of such grave concern. Essentially, as a tick that also infects animals in urban areas, it carries great potential to infect not only pets with diseases like Rocky Mountain Spotted Fever, but also another zoonotic disease (which means they can be transmitted to humans) that’s on the rise: Tularemia.

Tick-Borne Diseases:

• Rocky Mountain Spotted Fever Dogs are very susceptible to RMSF. Other small domestic mammals that are allowed outdoors or have contact with infected ticks may also contract this disease. Signs of RMSF include combinations of fever, lack of appetite, arthritis, shortness of breath, coughing, abdominal pain, nervous system disorders and swelling of the face or extremities. Small hemorrhages on the mucous membranes occur in severe cases. Transmission from dogs to humans does not occur, but people should exercise caution when removing ticks from pets, as the fluids from the tick can carry the RMSF organism.
• Ehrlichia canis is the disease in dogs, caused by Ehrlichia canis, and other Ehrlichia species, mimics RMSF.
• Tularemia is a bacterial disease caused by Francisella tularensis and is often referred to as rabbit fever. Tularemia is most commonly found in rabbits and rodents, and it survives by creating tumor-like masses and abscesses in the victim animal’s liver. Tularemia is often self-limiting although some dogs experience short periods of poor appetite, lethargy, and mild fever. Less frequently, dogs may show conjunctivitis, uveitis (inflammation in their eyes), draining abscesses, and enlarged lymph nodes.
• Anaplasmosis, aka dog fever or dog tick fever, is a tick-borne disease that infects a dog’s bloodstream. The most common form of the disease is transmitted by deer tick bites and infects white blood cells. A second type, carried by the brown dog tick, affects the blood-clotting cells known as platelets. This disease can also infect humans and is common throughout the United States. CAPC predicts it will be highly active in the Great Lake States this year.

How to Check Your Dog for Ticks – What AKC Recommends:

1. Inside of Ears – Ticks sit themselves on tall grasses and shrubs, waiting for your dog to walk by, so they can attach themselves to him. With so many crevices and hiding places, the ears make a perfect home for a hungry tick. When checking your dog, make sure to look deep into the ear, because the ticks can get attached and go unnoticed for a long time. If your dog is shaking and scratching at his ear, it’s a sure sign that something is off, and you’ll want to take a look.

2. Between Toes – Since ticks like to hide in places where they won’t be found, crawling in-between your dog’s toes and attaching there is a common occurrence. You can find them in-between the toes or even on the bottom of the foot near the pads.

3. Under the Tail – Ticks like dark, moist areas, so the underside of the tail makes a great home. If your dog has thick fur, you’ll want to make sure to comb through it and search thoroughly. A fine comb will likely catch a tick that’s attached itself under the tail.

4. In the Genital Region – Most dog owners aren’t keen on checking their dog’s genital regions. However, this area is another dark, moist region on the body that attracts ticks.

5. Around Eyelids – Ticks go unnoticed near the eyelids because they’re mistaken for skin tags or eye discharge. Unfortunately, by the time many owners realize there is a tick on their dog’s eyelid, the tick has been attached for quite a while.

6. Under the Collar – Many dogs rarely have their collars taken off. Ticks can become attached underneath your dog’s collar without anyone noticing, usually until the tick is large enough to be seen — which means it’s been there for a while. Remove the collar to do a thorough check for ticks.

How to Safely Remove a Tick

1. Using fine-tipped tweezers, grasp the tick by the head as close to the skin as possible.

2. Then gently, but firmly, pull it straight out. Do not: twist or jerk the tick, apply petroleum jelly, a hot match, or other irritants. This can lead to infection because the tick’s mouth parts may remain embedded, or you may be burned. Use your fingernails and tissue paper if tweezers are not available.

3. Immediately wash the bite area and your hands with soap and water then apply an antiseptic to the bite wound.

• If in doubt of tick identification, place the tick in a small vial containing a damp piece of tissue and submit it to your local health department for examination.

Tips from Tufts University on Reducing Tick Risk:

1. Take care of your yard. Mowing the lawn regularly will make your backyard less attractive to ticks. Be sure to pull tall weeds and to remove leaf litter, particularly from under shrubs and around the perimeter, because that’s where ticks hide. Secure your outdoor trash cans to discourage rodents that carry deer ticks.

2. Use a tick preventive on your pet. Make sure you choose a veterinarian-recommended product that is safe for all the animals in your household.

3. Check your animals for ticks daily. If your pets spend time outside, feel them for bumps, parting their fur so you can see where the coat meets the skin. Pay particular attention to under the legs, around the neck and inside the ears.

4. Talk to your veterinarian about a canine Lyme vaccine. Some research suggests that vaccination appears to work well in preventing infection in dogs not previously exposed to the Lyme bacterium. However, it’s still important to use a tick preventive on your pet.

5. Protect yourself. Use repellent, wear treated clothing, shower after being outside and regularly check yourself for ticks. They can hop from you to your pet.

• Since it can take 24 to 48 hours for an attached tick to transmit an infection to its host, prompt and proper removal is helpful in preventing disease onset.

Fido finds himself in a corner and seems confused. Lately, he’s spent hours staring into space. He doesn’t feel like playing with his human. Other times, he gets stuck behind furniture or acts afraid of people he once greeted joyfully. Sometimes he barks for no reason, and paces at night. And then there were those “accidents” on the living room floor, right after he’d been outside…

Fido’s loyal human thinks these are just symptoms of old age. But Fido knows something’s not right.

These symptoms, among others, could point to Canine Cognitive Dysfunction Syndrome (CCD), a disease similar to Alzheimer’s, where tissue changes in the brain block normal communication between neurons. Both Humans and dogs can develop beta-amyloid plaques on their brains.

As many as 85% of CCD cases are undiagnosed, according to the Washington State University’s Veterinary Teaching Hospital. And while there is no cure, there are things you can do to help.

“The goal is to slow the disease’s progress and improve the quality of life. Treatment may involve medication, an enhanced diet, and management of the environment and behavior,” said Dr. Laurie Brush, founder of Heaven at Home Pet Hospice.

“For example, ensuring play, structured social interaction and exposure to sunlight will help with engagement and regulation of the sleep-wake cycle.”

The first step, she said, is to see your routine care veterinarian to rule out any other medical cause for the symptoms, which might be reversed. But if your pet is diagnosed with CCD, the following tips may help:

• Similar to puppy-proofing, senior-proof you home by making sure there are no spaces where he or she might get trapped. This may include gating off safe areas.
• Use runners to help your dog remember the layout of the home. Dogs with dementia often end up in corners.
• Place food at optimal heights to see.
• Use night lights to minimize night time anxiety
• Engage your dog with games and activity to stimulate his or her brain.
• Even if you need assistive devices, include daily outdoor exercise, sunlight and play sessions.
• Be aware for some dogs, dementia can also cause failure in animal-to-animal communication or increase aggression.

Most importantly, give yourself, and your loyal companion, the most pleasant present moments you can, and enjoy those sunset years.

Need help with a fur-friend suffering from CCD? Contact Us for an appointment.

You might think holiday stress is confined to last-minute-shopping humans, over-burdened hosts or folks with in-laws they secretly refer to as “outlaws.” If the holidays are stressful for you, imagine how your aging pet feels. Your own stress plus the bustle of the holiday season compounds pet stress, and it takes elderly animals longer to bounce back. Follow these tips to help your pets have a stress-free, happy holiday.

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