In this month’s post, Dr Felicity talks about some of the tough decisions that can come up when caring for senior pets.
One of the most important jobs I do as a vet is looking after senior pets. These are often animals who have loved us unconditionally and to whom owners have become very attached. They are part of our families. We watch our puppies and kittens turn into beautiful dogs and cats that become constants in our lives.
Then one day we realise they are getting old. Grey muzzles. Grey feet. A little bit slower. Sleeping more. Tolerating less. And we start seeing permanent, age-related health problems. Suddenly we are weighing up the pros of this and the cons of that. There’s the process of diagnosis, the cost and the medications that must be given at home. It gets stressful.
I have an old dog. I have had her for over 15 years. She has nine lives at least. She’s a typical English Staffordshire and she’s indestructible. She had a post-operative spay complication at six months old and I was told to be prepared for the worst. She survived impalement on a stick when a stranger in the park thought it would be a good idea to throw one for her. The stick injury in her throat led to a suspected mycobacterial tissue infection which eventually required extensive specialist surgery to cure. She’s had severe pneumonia and spent three days in an oxygen chamber. She’s survived snail bait poisoning. She’s been hit by a car twice, the first time causing severe bleeding into the lungs and the second time causing a broken leg and severe abrasions with spectacular scarring. All this happened in her first four years. Amazingly, she recovered every time.
Fast forward 11 years and my vibrant pal has changed a lot. She used to think she was a person, in fact she was my person and came with me everywhere. We’d have conversations and she would sit on my lap whenever she could. She now has dementia and doesn’t respond to me in the same way anymore. I remember the first time I called her and she actually ran away from me instead of barrelling towards my open arms. It was then that I knew something in her was changing.
She still enjoys hanging out with the other dogs, hopping in her kiddie pool and eating but she doesn’t like to be handled. She still gets excited when people visit, she just has no idea who anyone is! She is quite deaf, has been on permanent medication for arthritis for two years and has also developed valvular insufficiency in her heart so requires medication every 12 hours. We also now put drops in one of her eyes 2-3 times per day to prevent the spread of some sort of growth on her cornea. She really doesn’t like being given tablets or eyedrops so it can be a trick to actually get it done before she realises what’s happening and runs off under the house.
As pets get older, owners struggle more and more with decision-making when it comes to health care. I know that we are at our limit with our dog for treatments because we feel she would be unable to cope with further prodding or interference. For many owners, the decision to treat various ailments can be financial (our dog’s medication costs $200 per month) and some dogs simply cannot be given tablets or eye drops or whatever no matter what and the stress to achieve this daily is not worth the benefit.
So how do you know? How do you make decisions about managing your old pet who has developed a permanent condition? Quality of life is the key. Pets should not be in pain. Pets should feel well enough to eat. Pets should be able to get up unaided. Pets should be able to interact with their environment in a meaningful way.
If there is a treatment available that will improve your pet’s quality of life then you have to ensure that the administration of the treatment does not cause undue stress. If treatment is unavailable or unaffordable then it always comes back to quality of life. Vets counsel owners on this all the time and it is one of the most important jobs we do. It’s important to know your options and fix things that can be fixed, but it’s just as important to know when enough is enough, and when to let go.