Drs. Laurie and Amy Attending the IAAHPC in Arizona

October 4th, 2018 by Heaven At Home Staff

Dr. Laurie Brush and Dr. Amy Hoss attend the IAAHPC conference in Tempe Arizona

Dr. Laurie Brush and Dr. Amy Hoss are headed for Arizona to attend the 8th annual IAAHPC conference in Tempe Arizona on Oct. 5th. The International Association of Animal Hospice and Palliative Care promotes comfort care that addresses the physical, psychological, and social needs of animals with chronic and/or life-limiting disease. The organization educates professionals and advances research in the field of animal hospice and palliative care. Read the rest of this entry »

Heaven at Home Featured on eightWest

October 3rd, 2018 by Heaven At Home Staff

Special thanks to the team at eightWest for featuring the services of Heaven at Home Pet Hospice! If you missed the show, click on the photo below to watch the video on the eightWest website! Hami, a gorgeous 12-year-old collie with arthritis, stole the show. In this segment, Dr. Laurie Brush discusses ways to help arthritic animals be more comfortable in their sunset years with things like mats, helper-harnesses, and more. If you have a pet who can’t get around like they used to, Contact Us to request an appointment.

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The Conundrum of Feeding Your Senior Pet

September 18th, 2018 by Heaven At Home Staff

SrPetillus_580x300Many pet parents are confounded by conflicting advice on pet food in general, whether it’s commercial, grain-free, biologically appropriate and/or raw. This confusion can be compounded as your pet ages and is faced with medical conditions that require special consideration when it comes to diet. Many diseases that are common in older dogs and cats may be nutrient-sensitive, meaning that diet can play an important role in the management of the condition. As a general rule, dogs and cats 7 years of age or older are at risk of age-related diseases, though specific breed size, genetics, and physical condition influence the aging process.

Dr. Laurie Brush, founder of Heaven at Home Pet Hospice, says senior pet nutrition can be a complicated issue but that conscientious pet parents can help their senior pets enormously by dialing in their pet’s diet to prevent obesity.

“It’s important to work with your routine care veterinarian and adjust your feeding approach as your pet ages,” she said.

“Obesity aggravates many conditions, such as arthritis and diabetes, and accelerates the aging process.  At the same time, if your pet is underfed or receives inadequate protein, waning muscle mass may reduce the effectiveness of your pet’s immune system. It can be a tricky balance,” she said.

In the course of the home visits that Dr. Brush and her staff make to provide palliative care for senior and terminally ill pets, she sees the product of both ends of the spectrum: overweight pets who suffer ailments and mobility issues exacerbated by overfeeding, and pets who’ve lost interest in the foods they once loved.

“Every senior pet can benefit from extra attention to nutrition,” she says. “It can make a real difference in the quality of life a senior pet enjoys.”

Understanding Energy Needs in Senior Pets

Just like humans, companion animals have individual and specific Resting and Maintenance Energy Requirements (RERs and MERs) that vary based on genetic potential, health status, and whether the animal is intact or neutered. RERs refers to the metabolic resting state; MERs refers to maintenance and is dependent on activity level. Research suggests that MERs decrease with age in dogs just as it does in humans. In one study of English Setters, Miniature Schnauzers and German Shepherds, the MERs of 11-year-old dogs were approximately 25% less than 3-year-old dogs.

Among the veterinarian community, it’s generally accepted that senior dogs require approximately 20% fewer calories than their younger peers due to this reduction in energy requirement coupled with lessened activity. To reduce weight in an overweight dog or cat, vets use a formula to calculate 80% of the calories required for RER.

On the other hand, some senior pets can suffer malnutrition and weight loss that aggravates their conditions. Veterinarians may prescribe appetite stimulants to improve nutritional intake. In this case, it is also helpful for pet parents to familiarize themselves with energy requirements to help ensure their senior pet is receiving adequate nutrition.

(See: How to Count Calories for Your Senior Pet)

The case of cats is more complex when it comes to senior energy needs. Short-term research suggested that aging cats did not experience the same kind of reduction in energy requirement, but long-term studies indicated a reduction of approximately 3% per year through age 11. From ages 12-15, however, the energy requirement per pound of weight actually increased in cats.


The Importance of Caloric Makeup –

Research on Protein

One belief that has long circulated in the pet food world is that senior dogs and cats need a low-protein diet to protect against kidney disease. The belief originated from  rodent research performed in the 1940s that has since been disproved. Instead, numerous research studies have confirmed that protein does not adversely affect the kidneys in either healthy older dogs or cats.

In fact, research by veterinarian nutritionist Dr. Delmar Finco, among others, suggests that the need for dietary protein may actually increase in senior pets by as much as 50%.  His research also showed that higher protein diets were associated with greater life spans.

One study comparing protein requirement in 2-year-old Beagles versus 13-year-old Beagles found that the senior dogs needed at least 50% more dietary protein.

Research also suggests that L-carnitine, a vitamin-like compound made from amino acids found in red meats, fish, chicken and dairy products, may help the body use fat for energy.

“High-quality protein with good amino acids should make up a healthy portion of a senior pet’s daily caloric intake, at least 25%. A pet parent’s veterinarian is the best resource for help ensuring this is the case,” Dr. Brush said.

Watch Fat Intake, Take Care with Carbohydrates

“Fewer of the pet’s calories should be from fat because fat leads to inflammation, which can be problematic for arthritic pets.” Dr. Brush said.

Carbohydrate percentage in pet food has been in the spotlight in recent years, with many consumers trending toward grain-free options. While Dr. Brush has heard anecdotal evidence from clients who’ve elected grain-free options, she cautions pet parents to fully discuss the implications with their veterinarians. Recently, the FDA launched an investigation into unusual cases of DCM – dilated cardiomyopathy – in pets who were fed boutique, grain-free foods high in legumes like lentils and peas. The current (and early) theory is that the legumes may interfere with the production of  the vital amino acid, L-taurine. Some manufacturers have responded by supplementing taurine, which is essential to pet metabolic health, but there are still many unknowns.

“In general, it’s best to ensure that the high-quality protein is coming from meat, not protein-dense carbohydrates,” she said.

Other Nutrient Considerations:

Apart from avoiding high-fat foods and ensuring at least 25% of calories are coming from good protein sources, there are a number of supplements that are reasonably time-tested to improve health in aging companion animals, such as Fish Oil and Glucosamine. However, all supplements are not created equal, and are not tested by the FDA. Pet parents should discuss supplements and brands with their veterinarian, and consider using supplements formulated for veterinary use.

• Fish Oil – 1,000 mg twice daily for dogs < 50 lbs, 2,000 mg daily for dogs > 50 lbs.

• Glucosamine – Many veterinarians recommend approximately 500 mg of Glucosamine and 400 mg of Chondroitin per 25 pounds. For oral Glucosamine for dogs, a typical dose may be: Dogs 5-20 pounds: 250-500 mg. Dogs 20-45 pounds: 500 mg.

• Prescription Cat & Dog Food – Most veterinary clinics supply special formulations for pets with specific health conditions. For example, pets with renal (kidney) disease should avoid foods high in phosphorus and calcium, which can exacerbate their illness.If your pet does not find one particular brand of prescription pet food palatable, there are multiple others that can be tried. Work with your veterinarian to find a food that they like and that will make them feel better.


Senior Feeding Problems

Depending on the age-related disease or condition of your pet, you may find that Fido has lost interest in food, has trouble chewing, or difficulty with digestion. Here are some things pet parents can do to make feeding more palatable to their senior pets.

  • Warm food slightly – it releases the aroma and heightens interest
  • Supplement with soft foods for pets that have difficulty chewing
  • Dental disease can sometimes be ameliorated with antibiotics if your pet is not healthy enough to undergo anesthesia for a dental procedure
  • Elevate the food and water dishes to make it easier for your pet to access them
  • Hand-feeding may work with some dogs
  • Adding low-sodium broth to food can make it more palatable

Feeding your senior pet an ideal diet for his or her age and condition can be complex, but help is available. Heaven at Home Pet Hospice can work with your routine care veterinarian or a veterinary nutritionist to help you manage your senior pet’s nutrition and give your fur baby the highest quality of life possible for his or her final chapter.


Tips & Tools to Count Calories for Your Senior Pet

September 18th, 2018 by Heaven At Home Staff

TipsnTools_580x300A pet parent who wants to optimize their aging pet’s health by preventing weight-gain but maintaining a healthy weight has two avenues to success – controlling the inputs and measuring the output. In other words, “Read, Feed and Weigh.”

In this guide, we’ll help you gather some tools to figure out how much food your fur-baby needs to stay fit, from calories calculators and activity trackers to the Body Conditioning chart that helps you assess your pet’s score.

Calorie Calculators

To get a rough idea of calories required by your pet, you can use this embedded calculator from Plato Pet Foods, which is based on Ohio State University Veterinary Medical Center data. However, you can also consult with your routine care veterinarian for breed-specific and diet-specific advice. See our companion article about Feeding Your Senior Pet.

Online Pet Tracking for Weight & Calories Consumed

SampleScreenHealthTrakOne tool pet parents may find helpful is a new Pet Calorie tracker developed by PetSci in the UK. HealthTrak (https://petsci.co.uk/healthtrak/) is a (beta) online system that allows you to track the caloric intake of your pet against the ideal weight sought for your pet’s breed. If your current brand of food is not in the database, it’s easy to add it by looking up the nutrient profile online or on the bag. By tracking calories and weighing your pet weekly either at your veterinarian’s office or at home, you will be able to tell how well you’re doing with a general balance between MERs (Maintenance Energy Requirements) needed and Calories consumed.

Fitness Trackers for Pets – Show Calories Expended

Fitbark_illusAnother new device can give you further insight as to your pet’s caloric expenditure based on activity level. FitBark (https://www.fitbark.com/) is one of a few new Fit-bit style canine trackers that has a nice app interface that will show you Fido’s activity level, sleep quality, and approximate calories expended each day. The lightweight device is attached to your pet’s collar and shows results on your mobile phone. The data can be shared with your vet.

But you don’t have to go high-tech to get the job done. Reading the label for true calories per cup and then feeding according to weight management charts available from your vet or online will help you manage your pet’s weight.

Online Resources include:

Body Scoring – How to Tell If Your Pet is Obese

Dog+Body+Condition+ScoreA Body Scoring Chart (BCS) is your vet’s “go-to” chart for identifying obesity in dogs and cats. Charts are graded on either a five-point or nine-point scale, and are available for both dogs and cats.

A BCS is based on four criteria: how easily felt the ribs are, how obvious the waist and abdominal tuck is, how much excess fat is beneath the skin and how much muscle mass is present. For a dog to score in the healthy range, the ribs should be easy to feel (but not see) and a defined waist, or “abdominal tuck,” should be evident when your dog is viewed from the top and side respectively. Depending on the thickness of your dog’s coat, you might have to feel for a defined waist or tuck if it is not readily visible.

 Download a PDF of a full body condition scoring chart here from the American Animal Hospital Association that includes BOTH Dogs and Cats and shows BOTH styles of scoring points with the illustration: https://www.aaha.org/public_documents/professional/guidelines/weightmgmt_bodyconditionscoring.pdf

The Science Behind Calculating Energy Requirements

If you’re interested in the formula vets use to calculate Resting Energy Requirements or RER, it’s this:  The animal’s body weight in kilograms raised to the ¾ power by 70.

For example, a 10kg (22lb) adult neutered dog of healthy weight needs RER = 70(10kg)3/4 ≈ 400 Calories/day. The RER is then multiplied by factors to estimate the pet’s total daily energy needs. Eg. Active, working dogs require 2.0 – 5.0 the RER; puppies 4 mos. to adult require 2.0 the RER, and inactive/obese-prone dogs require 1.2-1.4. Senior dogs typically need 1.2-1.4 RER, and cats approximately 1.5.

Ways to Observe National Pet Memorial Day

September 7th, 2018 by Heaven At Home Staff


Heaven at Home Pet Hospice treasures the memory of the pets our vets have helped pass peacefully. On Sunday, September 9th, we’ll join you in spirit remembering your fur-baby. Please feel free to observe National Pet Memorial Day on Sunday by sharing the story of the pet you’d like to remember on our blog’s In Memoriam section, or on our Facebook page, using the hashtag #NationalPetMemorialDay.

Ways to Observe National Pet Memorial Day

Keep both past and present pets in your mind. One popular tradition on this National Day is to plant a tree or a shrub as a living memorial. Other families make a special place in their homes, yards, or workplaces to honor their pet who has passed.

Summon up your memories of your companions to help you keep your animal’s love and presence in your heart. You can think of what was special about your fur-baby, and reminisce with family members or others who knew your friend. Look over old snapshots. Talk about the funny or silly (or annoying!) habits your pet had. Reflection will help you express and work through your grief.

Help with Grief

The West Michigan Pet Loss Support Group meets the second Tuesday of each month from 6:30 – 8 p.m. at Heaven at Home, 1530 Monroe Ave. NW, Grand Rapids MI. All are welcome. Please RSVP with Group Facilitator Ginny Mikita at 616.460.0373 by noon on the day the group meets.

Canine Influenza & Senior Dogs – What You Need to Know

August 14th, 2018 by Heaven At Home Staff

Fotolia_87230374_SMedia reports of an oubreak of Canine Influenza H3N2 in West Michigan this summer have many pet parents wondering whether they should vaccinate their senior fur babies. As of this week, 13 cases of Canine Influenza have been reported in Ottawa County and 3 in Kent, with a total of 98 cases in Michigan.

Dogs do not have a natural immunity to H3N2, a relatively new strain that infected 1,000 dogs in Illinois in 2015 and since has spread throughout North America. According to Dr. Laurie Brush, founder of Heaven at Home Pet Hospice, vaccinations should always be evaluated on a case-by-case basis.

“Pets with complicated medical histories can be more vulnerable to Canine Influenza, which can, in a weakened immune system, develop into pneumonia,” she said. “But it’s important to remember that the CIV vaccine doesn’t prevent infection; it reduces viral shedding and may lessen the severity and duration of symptoms.”

“Generally, the CIV is considered safe, with few known reactions or contraindications,” Dr. Brush said. “But it’s better to evaluate both the risk and the animal’s condition before assuming it should be given.”

Side effects of the vaccine are generally similar to other vaccine reactions: lethargy, low-grade fever, a lump at the site of injection, hives, and itching. In very rare cases, severe reactions can occur. The newst versions of the CI vaccine innoculates against both strains of Canine Influenza, with two shots required two-to-three weeks apart.

“Social” dogs, those with exposure to others through grooming, boarding, classes, and dog parks, may benefit most from the vaccination, as it also helps reduce the contagion level.

Dogs that contract the H3N2 strain of influenza remain contagious and should be isolated for at least 21 days. About 25% of dogs who contract H3N2 are asymptomatic.

So pet parents whose dogs have medical complications should exercise caution in spending time where there are a number of fellow canines. Many dog daycare facilities and classes are currently requiring that participating pooches have the CIV. Whiskers Resort & Pet Spa and the associated Whiskers University training classes, for example, requested that all pet parents have their member dogs vaccinated by August 10th.

“The best way to reduce the risk for your senior pet is to avoid exposure to locations densely populated by dogs, and to exercise good hygiene after handling other dogs,” Dr. Brush said.

If you feel your dog is showing symptoms of Canine Influenza, your routine care vet may ask that you do not come into the waiting room but may make arrangments to see your dog in another area or in your vehicle. Alternately, Heaven at Home Pet Hospice can assist with an at-home evaluation, and in coordination with your routine care vet, arrange for a vaccination if deemed appropriate.

“While it’s important not to panic, it is a good idea to be familiar with symptoms and to keep an eye on your fur baby with a mind toward minimizing risk,” Dr. Brush said.

 Canine Influenza Primer:

Canine Influenza Facts

  • Strains are H3N8 and H3N2 – West Michigan has recently seen the H3N2 variant, which has a longer contagious period
  • H3N8 was first identified in America in 2004 at a greyhound race track in Florida
  • H2N2 was first identified in Asia in 2006 but infected more than 1,000 dogs in Illinois in 2015. It is believed to have originated in avians and may be transmitted to felines.
  • The flu is transmitted by respiratory secretions (coughing, sneezing and barking).
  • According to the CDC, the virus, is not known to be contagious to humans.
  • However, the virus can live on clothing for 24 hours; human hands for 12 hours; and on surfaces for up to 48 hours. It can, therefore, be transmitted to your pet by humans who’ve handled infected dogs. Emerging reports suggest it may be transmitted to felines as well. (CDC)


  • Symptoms show 2-3 days after exposure and include:
  • Moist, soft cough or dry hacking cough
  • Discharge from eyes and nose
  • Sneezing
  • Lethargy
  • Loss of appetite and fever (as high as 104-106)
  • Duration 21-28 days


  • Dogs with weaker immune systems and complicated medical histories can present with pneumonia
  • This is a secondary infection caused by the illness. It only occurs in severe cases. Dogs that develop pneumonia may need to be hospitalized. These dogs are usually very young, elderly, or immune-compromised. Dogs suffering from the more severe form may have an increased respiratory rate as well.


  • Fluids to maintain hydration
  • Anti-inflammatory medications
  • Antibiotics for secondary bacterial infection

Risk Factors: “Social Dogs”

  • Boarding
  • Grooming
  • Daycare
  • Dog Parks
  • Classes

If you need help at-home help with a senior pet you believe has contracted Canine Influenza, or to determine if your pet would benefit from vaccination, contact us.

Senior Feline Health Issues

July 25th, 2018 by Heaven At Home Staff


As our kittys age, physical and mental changes occur just as they do with people. Their metabolism may change, they sleep more deeply and may not be able to jump as high as they once did when they were younger. This being said, cats should be seen more often than once a year (recommendation is every 6 months) as they begin to age, usually around the age of 7 years of age.
It is always easier to treat a disease if caught early on and cats often do a great job at hiding some of these changes. They may often be subtle changes that we chalk up to slowing down due to age but these changes could also be due to a medical issue.

Signs to watch for as our feline friends age:

  • Not grooming themselves or a greasy hair coat
  • Bald patches
  • Decreased or increased appetite or thirst
  • Weight loss
  • Eating and drinking more but still losing weight
  • Blood in the urine
  • Unable to urinate (especially male cats)
  • Unable to defecate
  • Any changes in litter box habits
  • Coughing or difficulty breathing
  • Has a lump
  • Not wanting to play (if they are generally playful)
  • Not wanting to be petted (if this is something they typically enjoy)

    Changes in Senses: Vision, hearing and taste may affect our senior cats. You may not even notice these slow, subtle changes as cats tend to easily compensate for them early on.
    Any time the cat’s sense of taste and smell have altered, food may not be as appetizing as it once was. If your kitty is not eating, try warming up canned food a tiny bit to see if the smell and taste are more appealing.

    Behavioral changes: Cats often mellow with age and spend more time sunbathing and lounging on our laps. They tend to be less curious. If your cat is normally cranky and that personality changes, this warrants concern. Same goes for a cat that is generally very sweet then suddenly becomes more cranky. The elderly felines do not handle stress well so if you are thinking about adding a kitten, this may not be the best idea. Senility can also affect cats though it is not as common as it is for dogs. Things you may notice, if they forget how to use the litter box, forget where the box is, or walk around disoriented you should check with your veterinarian about health concerns.

    Most common health issues we see in cats are related to kidney and thyroid issues. The most common thyroid problem in older cats is hyperthyroidism (an overproduction of thyroid hormone). If left untreated, heart and liver problems will occur causing the cat to become more sick. There are treatment options available; Radiotherapy, surgery, medication and most recently available, and iodine-restricted dietary management. Check with your veterinarian for the best option for your feline companion as each case varies.

    Urinary issues also affect our senior felines. Sometimes chronic (slow and long term) or acute (rapid onset and urgent). Treatments vary depending on specific case.

    Bad breath, tartar and gum inflammation may be a sign of tooth damage, periodontal disease, oral cancers or ulcers and even systemic health issues in our feline friends. Your veterinarian will discuss any concerns noted on physical exam.

    We know this is hard to believe, but Hypertension (high blood pressure) is fairly common in our senior cats. Many diseases can be associated with hypertension.

    Arthritis can affect our senior felines just like people. They may require assistance getting up onto surfaces or even into their litter boxes. Stairs can become problematic as our feline friends age, so take where their litter box is located into consideration. You may also need to get creative in the type of litter box you have, sometimes these arthritic kids have a hard time getting into a box that has high sides for them to step over. A paint tray or cookie sheet offer easier entry.

    Diet and keeping our cats at a normal weight is important. Overweight felines generally have a shorter lifespan than those that are at a normal weight. As with humans, extra weight can cause other health concerns as well. Today’s feline life expectancy is approximately 20 years. Enjoy this special time with your kitty and pay special attention to any subtle changes.

  • In Memoriam of Boo

    July 21st, 2018 by Heaven At Home Staff

    Boo TuttleBoo’s Story:
    July 9 was one of the hardest and saddest days of our lives as we had to say goodbye to Boo. He left us and made his journey across the rainbow bridge. He was a month shy of his 11th birthday. There are no words to thank Dr. Brush from Heaven at Home who came to our house and allowed us to honor, grieve and come to a place where we could lovingly let Boo go. Boo transitioned to the next part of his journey in the comfort of his home, surrounded by everyone who loved him.
    It is difficult to find the words to describe the sorrow you feel. It literally tears your heart out. The only comfort we can take from this, is that he is no longer suffering.

    Our house is not the same without him. I could list 1000’s of things that we will miss about Boo because he was such a huge part of our family. He made each and every one of us a better person. He had so many quirks that would make you smile. He lived each day to the fullest with such joy and enthusiasm. He was such a character!

    I truly believe pets come into our lives to help us become the best version of ourselves. Boo you did your job well! You will be missed more than words can say. Thank you for all of the wonderful memories we will hold them dear to our hearts. We were so blessed to have you be a part of our lives for almost 11 years. It was truly a gift! We will love you always and forever.

    Dr. Brush and the staff was wonderful. Nobody wants to say goodbye to their beloved pets but Heaven at Home allows you to do this in the comfort of your own home. Dr. Brush allowed us time to honor, love, say our goodbyes to Boo and grieve as a family. We all felt a sense of peace in our hearts. Thank you Heaven at Home.

    In Memoriam of Leemore

    June 25th, 2018 by Heaven At Home Staff


    Our sweet, handsome boy passed peacefully at home last night with the help of Dr. Brush. He was a Bernese Mountain Dog who would have been 14 years old September 11. He was given to me after I was divorced and I credit him for saving my life after the divorce and helping me to learn to live and love again. I remarried 4 years later to a wonderful man who became the best daddy to him I could have ever hoped for. Leemore loved life so much, especially his people. He was my best friend, my shadow and my caretaker and I was the same to him. As a Registered Dietitian, I of course have always made his food for him and I feel that helped this Bernese Mountain Dog to live to a ripe old age. His love for eating chicken was almost parallel to that of his love for me. When he was a puppy, I asked him to please live for a very long time and in return I promised him I would never let him suffer. We both made good on our promises to each other. I will forever be so grateful that there is an angel like Dr. Brush who helped us give Leemore the goodbye he deserved in his own home lying with us. We will spread some of his ashes in some of his favorite places: Kelleys Island, Ohio; Manitou Beach Michigan @ Round Lake; up north in our woods where some of him will rest and some I will keep for myself close to my heart.
    I love you so so much Leemy my sweet boy, wait for me on the other side.

    Thank You for what you do, it meant the world to us to say goodbye to our dog in our own home and Dr. Brush you were so comforting. I can’t thank you enough! You are an angel!

    In Memoriam of Shia

    May 23rd, 2018 by Heaven At Home Staff

    Shia’s Story:

    Shia was born in May of 2003. Mom and Dad found her at a Puppy Half Way House in Greenville. Her and her sister came out and Shia be-lined for mom and dad while her sister went straight for the food. It really is true that they choose you. It was meant to be. She even fake puked and they got her cheaper, although looking back with what we know now, they would have paid any amount of money for her. After begging mom and dad for years about getting a dog, we finally got her in July of 2003, much to our surprise from coming back from a camping trip with our cousins. Tears of joy were shed. Shia was a Whippet/Lab mix. She was a very fast water dog who was lucky enough to live most of her life on Lime Lake. Her hobbies included racing other dogs and kids, swimming, boating, bon fires, playing bean bags and going bye bye. She was the best friend any one could ever ask for. On Tuesday, May 22, 2018, The Wheeler family said good-bye to their life-long friend, Shia (Shy Shy, Sheeba, Big Ox) of 15 years. She passed peacefully at home with all of her loved ones by her side. Her beautiful soul will be deeply loved and missed, always.

    Wait for us at the Rainbow Bridge where there is always warmth and sunshine which was your favorite. I can picture you in my head running full speed again like you used to, grass flying up behind you. If love could have saved you, you would have lived forever.
    We love you, Shy Shy!

    Mommy, Daddy, Rach & Bran

    Compassionate home care for your companions!
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