Last week, I helped a senior large breed dog (15 years old!) and his family. This dog was not eating, barely drinking, couldn’t stand or walk any longer. We were all sitting under a tree in their backyard on a Saturday morning: Henry (not the dog’s real name), Mom, Dad, 2 young sons, and me. As is my routine at all appointments, we sat and talked for a while about their life with Henry and everything he brought to their lives for the past decade and a half. [Read more…]
Yesterday I helped four amazing animals cross over the Rainbow Bridge. They ranged in size from 1 lb (a ferret) to 140 lb (a St. Bernard). Each was a beloved family member. Three had cancer; one had severe arthritis resulting from hip dysplasia and possibly the start of a spinal neurologic disease. Family members of the 3 dogs told me that, among other things, their dogs had been panting heavily even when at rest in the cool house, and they were quite restless. [Read more…]
From time to time, we hear from potential customers that we are too expensive. They say, “My vet will put my dog to sleep and cremate him for $xxx, and you want to charge me double!” People ask us to give them a discount. Sometimes people yell, or they simply hang up on us. Although some days we feel discouraged by this, we have never strayed from the principles that guide our business. [Read more…]
If you’ve ever lived with a senior pet, you know the questioning and worries that go along with assessing your furry friend’s health and well-being. This is the number one thing I help pet owners with every day. At Peaceful Pet Passage, we spend a lot of time talking with our clients about Quality of Life, which is a broad concept of well-being that has subjective and objective components. I’d like to share with you a Quality of Life scale that I’ve found useful. Dr. Alice Villalobos, a veterinary oncologist, developed this scale, also known as the HHHHHMM scale. She is well-known for coining the term “pawspice” and developing a comprehensive hospice program for pets. Patients are scored in each category from 0-10 (with 10 being ideal).
Is your pet panting heavily in the absence of high temperatures and exercise? Is his breathing irregular or with a lot of abdominal effort? When you flip up his lip, do his gums appear pink or pale or even white? Is he restless and having trouble sleeping soundly? Are you currently giving pain medication, and if so, does it still seem to be helping?
Is your pet willing to eat? Does he eat his regular pet food, or do you give him “people” food or special treats? Will your pet eat out of his bowl or only if you offer food by hand? Do you notice he has lost weight?
Is your pet drinking enough water (rule of thumb is 1 cup per 10 lb body weight per day)? Do his gums feel tacky? When you pinch the skin in the scruff of the neck, does it “hang” there or fall right back down?
Are you able to keep your pet clean and brushed, especially after elimination? If your pet is spending a lot of time lying in one place, does he have cushioning to prevent pressure sores from forming? Are there open wounds in the skin that require cleaning?
Does your pet seem happy to see you and spend time with you and your family? Does he play with his toys? Is he depressed, anxious, bored, lonely, or fearful?
Can your pet get up without help? Can he walk without help? Does your pet show interest in going for a walk? Is he limping, stumbling, or having seizures?
more good days than bad
When bad days outnumber good days, quality of life may be too compromised for your friend. Keep a daily journal for your pet so you can objectively assess trends. If your pet is suffering, making a decision for euthanasia is the right thing to do.
Scoring and Acting on the Score
Add up your numbers from each category above. If your total is more than 35 points, quality of life is acceptable, with the caveat that your pet may need supportive care such as pain medication, mobility aids, a change in diet, etc. If the score is less than 35 points, I encourage you to reach out to your veterinary team, who can assess your pet’s condition and make recommendations for supportive care, or in some cases, for euthanasia. As Dr. Villalobos points out on her website, our companion animals are fortunate: society protects them from suffering and grants them a peaceful and painless death.
I hope this Quality of Life scale will help guide you. If you have questions about using it, please reach out in the comments or send me a message.
Something troubling happened during one of my appointments last week. I was called to help a family say goodbye to their 14-year old dog, who was diagnosed with a heart murmur and enlarged heart about a year ago. In spite of using heart medications and improving her diet, her condition worsened. She had been experiencing seizure-like activity (actually I believe she was having something called syncope, which is loss of consciousness due to lack of blood flow to the brain). She had very low energy and stamina and was having frequent accidents in the house. Her family made the difficult decision to euthanize her, based on her poor quality of life. We sat and talked about her, how she loved to go for walks and had an uncanny ability to know when there was chocolate on the table. During this sharing time, I learned that she had received several vaccines only a few months ago at her regular veterinary clinic.
In the days since that appointment, I haven’t been able to stop thinking about the fact that this geriatric dog with a serious heart condition received no less than three vaccines within the past three months. Why was this done? For what medical reason did this dog require vaccination? Was she at great risk of contracting any of these diseases?
The answer is that there was NO medical indication for any of these vaccines. She had a vanishingly small risk of contracting these diseases, because she was not in contact with other dogs. She literally had to be carried into the backyard during the day and wasn’t able to go for walks anymore. Furthermore, she had received repeated injections of these vaccines over her lifetime, meaning with great likelihood that she had immunity. Can I give you incontrovertible evidence that she was immune? No, because I don’t have that data.
My point is that vaccines are not water. When they are injected into a body, a whole series of events takes place in the immune system. There is growing evidence that many types of cardiovascular disease have an inflammatory component, meaning the immune system is ramped up and spitting out chemicals and cells with the goal of solving the problem. When we introduce vaccines into this pro-inflammatory environment, we are 1) taxing an already stressed immune system; 2) diverting the body’s limited resources to respond to foreign particles (all components of a vaccine are foreign); and 3) probably not even getting the expected response out of giving the vaccine in the first place (which is a boosted immunity).
I cannot predict how, or even if, things would have been different for this sweet little dog had she not been given vaccines. I do strongly believe in the adage “above all, do no harm,” which is part of the Hippocratic Oath taken by physicians. We veterinarians don’t have anything quite so eloquent in our oath, which I have included below. I remember clearly reciting this on the day I graduated from veterinary school, with tears in my eyes and thanks in my heart that I had achieved my goal. Given that our oath does include the protection of animal health and welfare, I regret that I even have to write about this topic. My hope in doing so is that I can encourage you to speak up on your pet’s behalf.
The Veterinarian’s Oath
Being admitted to the profession of veterinary medicine, I solemnly swear to use my scientific knowledge and skills for the benefit of society through the protection of animal health and welfare, the prevention and relief of animal suffering, the conservation of animal resources, the promotion of public health, and the advancement of medical knowledge.
I will practice my profession conscientiously, with dignity, and in keeping with the principles of veterinary medical ethics.
I accept as a lifelong obligation the continual improvement of my professional knowledge and competence.
According to my blog calendar, I am supposed to be writing today about skin issues in senior pets. It’s a common problem and an important topic, but I will have to cover it another day. The only thing circling in my brain right now is some very special dogs and cats who went to the Rainbow Bridge since last Friday. I was with them when they left us; in fact I was the instrument in their leave-taking. [Read more…]