Tuesday, March 26, 2013

Caring for the Senior Pet and End-of-Life Issues

About six weeks ago, my 16-year old Akita, Tomo, passed away.  While his health and mobility had gradually deteriorated the prior 2-3 months and I knew 16 was ancient for such a large breed dog, I was still taken by surprise when I woke up to find him barely conscious.  He passed away 20 minutes later. Dealing with an aging pet entails a whole set of issues that can sometimes be overwhelming both physically and emotionally.  Moreover, when a pet dies at home, there are issues an owner needs to address that are normally taken care of by the staff at the veterinarian’s office.  Based on my experiences during the last 6-8 months of Tomo’s life, this month’s blog will address the needs of aging pets and the end-of-life issues that every pet owner will likely face.

Health, Medical and Behavioral Issues

One of the harnesses I used to help Tomo stand up

Mobility Issues: Taking care of an aging pet can be challenging.  They may have mobility issues from arthritis or illness and they may need special accommodations to help them get around.  Arthritis and spinal degeneration may also manifest itself as incontinence or soiling in the house. If you have a large dog like my 90 pound Akita, you may have to physically lift your dog to help him get around. There are special mobility aids that assist both you and your dog including: special harnesses, steps, ramps  or other lifting devices. See my article reviewing some common mobility aids.

Pain Management: An ill or arthritic pet may also be in pain. Signs that your pet may be in pain include: decreased appetite or changes in appetite, difficulty getting up, favoring a particular part of the body, decreased activity, excessive panting, hiding, being less sociable, agitation and whimpering or yelping.  It is also not unusual for dogs to become aggressive and defend their personal space when they are in pain. It is important to speak with your veterinarian about pain management options to make sure that your pet is as comfortable as possible.  

Dementia (Canine Cognitive Dysfunction): Aging dogs can also get dementia (termed Canine Cognitive Dysfunction or CCD) much in the same way that humans can.  Often the signs are subtle and people mistake them for something else.  Symptoms include:  confusion or disorientation, getting “lost” inside the house, pacing (especially at night), barking for no apparent reason, failure to recognize family members, getting stuck in corners, increased anxiousness and eliminating inside the house. Keeping  furniture in the same place can help with disorientation. Medication may be prescribed by your vet to lessen the severity of the symptoms.  However, there is no cure for CCD. 

Increased Anxiety:  Many aging pets can experience increased anxiety or agitation whether it be from CCD, loss of hearing/sight or pain.  Anxiety aids such as a Thundershirt or DAP (dog appeasing pheromone) can help calm a dog.  My dog started exhibiting occasional bouts of separation anxiety and I used a Thundershirt in combination with ambient music to keep him calm.  Many of these anti-anxiety aids are discussed in this article

Incontinence:  As mentioned above, your pet may become incontinent due to a physical disability or due to CCD.  If an aging pet becomes incontinent, it is important to have your vet first rule out a medical problem such as diabetes, kidney disease, spay incontinence or bladder infection.  Encouraging your dog to eliminate outside more times a day can help lessen the number of accidents in the house and in some cases your vet may prescribe medication to address this issue. In some cases, doggie diapers may be needed.

Deafness and Blindness:  Many aging pets eventually become blind or lose their hearing.  In the case of blindness, it is important not to move furniture around so that your dog will have an easier time navigating.  For blind dogs you can make your presence known by shuffling your feet or calling your dog’s name to prevent your dog from getting startled (and perhaps reacting defensively).  In my case, my dog starting going deaf so it was important for me to make sure he could see me before I used my hand signals to ask him to do something like sit, come, wait or lie down.  In addition, I would clap my hands to get his attention because he seemed to be able to still hear higher pitch sounds.  Inside the house, I would tap the floor or simply get up and stand in front of him to get his attention because deaf dogs can easily startle as well. Here are some resources for owners of deaf or blind dogs:

Deaf Dog Education Action Fund:  http://www.deafdogs.org/training/

Blind Dogs.Net:  http://www.blinddogs.net/ 

Reaction from other pets – It is not uncommon for other resident dogs to pick on an ill or aging housemate.  It is important to keep a watchful eye on their interactions and intervene if you see bullying behavior.  You may also need to set up management practices (separate feeding areas, crating, gating etc) to keep the senior dog from being harassed.  In serious cases, contact a certified dog trainer or behaviorist to help you with this issue (see my article on selecting a dog trainer).

Euthanasia/Hospice Care

There may come a time when you need to assess the quality of your pet’s life.  In my case, my dog had good days and bad days and I was constantly monitoring the number and severity of the bad days.  Although in his case, I did not have to make this decision, I have had to make this decision with other pets and it is important to be aware the condition of your pet and whether it is getting progressively worse.  Some of the issues I monitored were:  

Appetite - amount of food eaten and whether meals were missed;

Pain - whether my pet was in chronic pain and how it was affecting day to day activities and mobility;

Interactions - is my pet interacting with members of the household (human or animal) or being withdrawn?  What is the nature and quality of the interactions? Is my pet hiding or spending a lot of time alone? 

It is best to discuss these issues with your veterinarian who, other than you, can assess the physical condition of your pet.  Your veterinarian will be able to advise you on hospice care or whether euthanasia is the best option for your pet. 

These services often take place at the veterinarian’s office but there are also mobile vets who can come to your home.  This may be a less stressful option for you and your pet.  In my case, since I had such a large dog who had mobility issues, I had the number of a local mobile vet on my refrigerator door in case I needed their services.

When your pet dies at Home

It is less common for a dog to pass away suddenly or unexpectedly at home.  In my own experience, when a pet was euthanized, as had been the case for my previous pets, the veterinarian’s office took care of all the arrangements after the procedure and I did not have to worry about what to do with my pet.  However, if your pet dies at home, you will have to make these decisions and contact the appropriate facility. 

Pet Mortuaries and Crematoriums – you will need to find a local mortuary or crematorium that caters to pets.  They will come and pick up your pet and deal with the remains based on your instructions.  You essentially have two options: cremation or burial.

Burial -  Many cities prohibit the burial of animals in a resident’s back yard.  For example, in the City of Los Angeles,  “no person shall bury an animal or fowl in the City except in an established cemetery.”  Therefore, if  you want to bury your pet, you must contact one of the pet cemeteries in the city.  Burial at one of these facilities is the most expensive option.  Here are 2 cemeteries in Los Angeles:

LA Pet Memorial Park - www.lapetcemetery.com

Cremation:  A less expensive option is cremation.  In addition, cremation gives you more options as to how you would like to deal your pet’s remains.  Most mortuaries or crematoria will do individual or mass cremations (the latter being less expensive).  If you would like your pet’s ashes returned to you, then an individual cremation would be necessary.  Often the ashes are placed in an urn or box and some companies provide a plaster cast of your dog’s footprint.  Individual cremation is the option I chose for my pets.  Here are two facilities that I have used:

Royal Pet Mortuary (Culver City) - http://petmortuary.com/

Guardian Animal Aftercare (Sun Valley) - http://www.guardianaftercare.com/

City Removal – many cities, including Los Angeles, will pick up your pet free of charge.  However, your pet's remains will not be returned to you.  Your city’s animal control department can provide more information.  In Los Angeles, the Bureau of Sanitation (not Animal Services) provides this service. 

Other Pets

The other pets in your home may experience varying levels of behavioral changes after the loss of your pet.  Some pets may act withdrawn or reclusive, others may not react differently at all.  One issue that I had to address since my dog passed away at home was whether the other animals should approach him after he passed away. It was an issue I never had considered before and a cursory search on the internet did not have a definitive answer.  After discussing it with the mortuary (because they could not get to me for several hours), I decided to let my other pets approach Tomo if they chose to.  My cat and Shiba Inu did approach him while my other Akita avoided the room he was in altogether and she appeared distressed prior to and after his death.    

Although this is completely anecdotal, my Shiba and cat did not exhibit any significant behavioral changes.  My Akita, who spent a lot of time playing with Tomo, became very reclusive and spent a lot of time sleeping in her crate.  She did not want to interact with anyone the weeks following Tomo’s death.  In addition, she did not want to spend any time in the yard.  This lasted for about 2-3 weeks.  In the meantime, I tried to maintain her regular walk schedule and arranged for play dates with my dad’s dog to keep her active and engaged.  After a few weeks she started coming out of her shell and within the last few weeks she is almost back to normal. But every dog will be different and it is best to maintain your dog's usual routine and provide enough attention but at the same time not go overboard and force your dog to interact with you if he/she chooses to rest or sleep.  Sometimes, people feel like they have to keep them occupied every minute of the day but sometimes our pets, like people, need time to themselves.  

My other dog spent a lot of time in her crate after Tomo died.


It is normal to grieve in the weeks and months following your pet’s death and you will likely go through a range of emotions from sadness to guilt and depression.  Sometimes it is helpful to commemorate your pet in some special way, especially if you have children.   In my case, I spread some of my dog’s ashes in a grotto at a favorite hiking trail. 

A favorite place where we hung out

Fortunately, there are many resources available to help pet owners cope with their loss.  Here are some resources that you may find helpful:

ASPCA Pet Loss Hotlinehttp://www.aspca.org/pet-care/pet-loss/

Tufts Pet Loss Support Hotlinehttp://www.tufts.edu/vet/petloss/

Association for Pet Loss and Bereavementhttp://aplb.org/index.php

Pet Loss.comhttp://www.petloss.com/

Tomo in his much younger days
at a favorite hiking trail

Los Angeles Dog Trainer:  http://www.pawsitivefeedback.com