This past October, Dr. Brooks was invited to make a presentation at the monthly meeting of the West Los Angeles Obedience Training Club, a local group of dog owners. The topic she covered was on the Care of Senior Canines. Dr. Brooks delivered a multimedia presentation consisting of graphics and animation accompanying her speech. Here is an approximation of her complete presentation, with each “slide” (or computer screen) followed by the text of her comments for that graphic.

Although the Los Angeles Obedience Training Club members had the opportunity to ask questions following the presentation, anyone reading this who who may also have questions will have to be content with asking them via eMail, by clicking the “send eMail” link in the frame at the bottom of the page.

SLIDE ONE:

Thank  you for attending tonight’s presentation. The topic will be the special needs and care of the geriatric dog with a special focus on what the pet owner should watch for at home.  The speaker is Dr. Wendy C. Brooks, owner of the Mar Vista Animal Medical Center. She has been in practice for 12 years, and has been a board certified specialist in canine and feline practice  since 1995. She also answers questions on-line on the Questions for Vets boards at www.vin.com/petcare (formerly the Pet Care Forum of American On-line).

SLIDE TWO:

We all want to live long lives full of companionship, activity, and happiness with good health and freedom from discomfort. We want the same thing for our loved ones including our dogs.

SLIDE THREE:

In order to guide a dog into his golden years with the kind of quality life we hope for, an owner must pay special attention to early warning signs (which we will review later).

SLIDE  FOUR:

Also important is a good relationship with your veterinarian.  Older pets are at higher risk for assorted medical conditions that may not be obvious to you.  While a younger adult animal can be evaluated annually and do just fine, many experts are recommending that the geriatric pet see the vet twice a year for evaluation. This evaluation is likely to include blood testing, blood pressure measurement, and possibly radiographs.  Obviously, this is more expensive than the general annual check up younger animals get and one should plan accordingly. 

SLIDE FIVE:

So how do we know when our pet is “geriatric” and all this extra vigilence is needed? Well, if your dog looks like this one, it is pretty clear that he is a geriatric dog BUT a lot of dogs run and play like puppies well into their geriatric years. There is no clear marker or clinical sign that identifies a dog as “geriatric.” So how do we know? What do we use as criteria?

SLIDE SIX:

We have  all seen this formula. The problem with it is that every year in dog’s life (or a person’s for that matter) represents an equivalent period of time. A dog’s first year is worth more like 15 years. Later years are worth more like five (Otherwise a fifteen year old dog would be at an age comparable to that of a 105 year old person and I am sure we know many more 15 year old dogs than we know 105 year old  people.) And what about the fact  that smaller breed dogs tend to live longer than the larger breeds? Let’s look at another formula.

SLIDE SEVEN:

The Senior Care Program sponsored by Pfizer Animal Health and the Iams  company is designed to promote awareness of the special needs of senior  pets.

SLIDE EIGHT:

They have chosen to draw a magic line at age seven. This is a conservative figure but still does not differentiate between different breeds.

SLIDE NINE:

Let’s look at some human definitions. These are the definitions used by the World Health Organization to define age in people.  The implication for us is that we are defining our turning point as the equivalent of age 60.

SLIDE TEN:

This is one of my favorite tables for determining a dog’s equivalent human age.  As you can see, different size dogs reach “60” at different ages.  Now we know there is no way to make this completely objective but if we have to grab on to an age and say that from this point forward the dog will require the extra attention needed for senior care, then this guideline chart seems to make the most sense.

SLIDE ELEVEN:

So what special care should the owner of a senior dog be considering? Diet is one of the most obvious considerations yet one of the most controversial.  What are the special nutritional needs of the geriatric dog? It turns out that there is tremendous disagreement among nutritionists.  The nutritionists at Select Care (the prescription diet division of Nature’s Recipe) felt that there ARE NO special nutritional needs of geriatric dogs and the Senior Vet’s Choice diet manufactured by this company has been  completely phased out. 

One might think that reduction in protein would be a characteristic of a senior dog food but in fact, a study looking at two year old beagles versus 13 year old beagles found that the senior dogs needed at least 50% more dietary protein. The nutritionists at Purina and their prescription division (the “CNM” line) have taken this study to heart and their senior foods are higher in protein than their maintenance diets. (This is especially important to realize as many pets in kidney failure who really do need a low protein diet are frequently fed “senior” foods if they reject their prescription diets.  Apparently this is not appropriate.)

Another nutritional concept that has entered the diet market is the supplementation of diets with what are called “nutriceuticals.” A nutriceutical is a dietary supplement that can be used as a medication.  The FDA does not regulate nutriceuticals thus they may be marketed without proof of effectiveness and without studies determining optimal dosage.  Some common nutriceuticals that are often added to senior foods include glucosamine (a strengthener of arthritic joints), omega 3 fatty acids (which have anti-inflammatory properties), and extra vitamin C and E (which are anti-oxidants and may have cancer prevention properties.)  It is not known whether or not the amounts contained supplemented foods are efficacious but one should be familiar with these terms as they are frequently proudly displayed on pet food labels.

SLIDE TWELVE:

An especially important early warning sign of disease which every pet owner should be familiar with is excessive water consumption.

SLIDE THIRTEEN:

Excessive water consumption can indicate diabetes mellitus, adrenal hormone imbalance (Cushing’s disease), urinary tract infection, diabetes insipidus, uterine infection/pyometra or medication side effects.  Any animal for whom excessive water consumption is noted needs an evaluation and lab testing.

SLIDE FOURTEEN:

How much is too much? A  normal dog should drink about one cup of water for every 10 lbs of body weight daily. Excessive water consumption is defined as one cup of water for every 4 lbs of body weight daily (or 2 and a half cups for every 10 lbs of body weight daily). Obviously if there are multiple pets drinking from the same water bowl, measurement of water consumption is impossible. As a general rule if you notice your pet drinking frequently, it should probably be checked out.

SLIDE FIFTEEN:

Another important concept in senior pet care is oral care. Many people never look in their pet’s mouth. It is  very important to be comfortable regularly looking at your pet’s teeth and gums. This picture shows a tooth that is in serious need of cleaning. Tartar (the yellow mineralized deposits on the teeth) consists of bacteria, food, and minerals and every time your pet chews bacteria seed the circulation and can deposit and set up infection who knows where.  Periodontal disease is painful as well and needs to be addressed.

SLIDE SIXTEEN:

Many owners of senior pets are fearful of dentistry as general anesthesia is required. While general anesthesia must be respected, it is important to realize advances in recent years (in monitoring equipment as well as anesthetic agents). With proper monitoring and pre-anesthetic evaluation much of the risk can be effectively addressed. One should not allow a pet’s mouth to deteriorate into a sewer for fear of general anesthesia.

SLIDE SEVENTEEN:

We could not find a good graphic for this concept but it is still very important. With all the petting and contact we lavish upon our dogs, it is easy to find lumps in the skin. All lumps bear checking out so be sure to mark the lump prior to your vet visit with a pen or by trimming the hair locally. Don’t be one of those people who can’t find the lump once they get to the vet’s office.

With few exceptions, there is no way to identify a lump without some kind of sampling (either biopsy or aspiration of cells with a needle). Some lumps can be removed with just a local anesthetic.  Be sure to have any lumps you find evaluated by your vet.

SLIDE EIGHTEEN:

This graphic shows a radiograph of normal hips as compared to a radiograph of hips showing hip dysplasia. The dysplastic hips show bone spurring, flattening of the ball and socket, and generally classical arthritis findings.  Arthritis/Degenerative Joint Disease is common in older dogs. No one’s joints are perfect and after years of walking on imperfect joints, painful changes occur. The dog will tend to be less active due to the pain. Less activity leads to atrophy of muscle. Less muscle means less support for the abnormal joints which promotes further arthritis. If this vicious cycle is allowed to continue unchecked, the dog will become extremely weak, stiff,  and possibly even unable to walk.  Sadly, we often see these animals for the first time, not when they first start getting stiff, but when they can barely walk and are presented for euthanasia.

SLIDE NINETEEN:

While this condition is ultimately progressive, it is very  helpful  to begin addressing it when it is just starting. Anti-inflammatory medications, joint strengthening supplements, and physical therapy can help slow the progression of what can be a crippling disaster especially for a large breed dog.

SLIDE TWENTY:

Behavior changes may come in age and it is important not to simply write them off as “senility.” A syndrome called “canine cognitive dysfunction syndrome” is characterized by reduced interest in social interaction, house-breaking problems, sleep disturbances (either sleeping more or waking in the  night), apparent confusion or any combination thereof.

SLIDE TWENTY-ONE:

A medication called Anipryl has been approved for this syndrome and Pfizer Animal Health has a program whereby the first month of medication is free so that an owner can see if it makes a significant difference to the pet at no charge. For more information, see  www.anipryl.com.

SLIDE TWENTY-TWO:

Again, senior pets require more than average surveillance for disease. Expect an evaluation to include blood testing and/or further testing to uncover latent problems before they become untreatable.

SLIDE TWENTY-THREE:

Which brings us to the topic that no one really wants to talk about: Euthanasia. Still, this would not be a complete presentation without discussion of this topic.

SLIDE TWENTY-FOUR:

Everyone who owns a senior pet has these thoughts in the back of their head. The decision for euthanasia is never easy and everyone hopes they will not have go through making it. It is also a personal decision based on what you think your pet would want. Still, it is helpful to have some guidelines to assist in this decision process when the question of “how will I know when it is time?” finally comes up.

SLIDE TWENTY-FIVE:

Appetite and enjoyment of food are important parts of a quality life.

SLIDE TWENTY-SIX:

Enjoyment of company and companionship are also important.

SLIDE TWENTY-SEVEN:

Pets are housebroken at a very early age and are generally humilated by loss of voluntary elimination function. Continence and cleanliness are important in life quality.

SLIDE TWENTY-EIGHT:

Freedom from discomfort is also obviously important in life quality.

In general, these four criteria can be assessed by the pet owner. If any of these four areas seem significantly deficient, then it is time to consider that the pet’s life quality is diminished enough to warrant euthanasia.

The next step should be a consultation with the veterinarian; if possible try not to make this decision prior to the consultation.  Every veterinarian has several tales of pets brought in for euthanasia who turned out to have a simple problem addressed easily and inexpensively. Alternatively, there may be a new treatment available that could be worth trying.  If the euthanasia decision has already been made in your mind, you are probably not going to want to try treatments, especially given the possibility of treatment failure and having to re-undergo what is an emotionally difficult decision-making process. 

If you are nearing a euthanasia decision, please enlist the assistance of your veterinarian. Get all the facts and options about your pet’s condition.

SLIDE TWENTY-NINE:

The loss of a beloved pet is never easy no matter what the circumstances are.  It is the price we pay for loving members of a species who can only be with us for a fraction of our lives.  Still, the bond created and love brought into the world makes it more than worthwhile and we wouldn’t give up a day of the companionship shared with our dogs even knowing that it must one day come to an end.  We will always love them and they will always love us.

And this completes our presentation.