From an original article from Harmony Holistic Veterinary care by Delia Macdonald D.VM of Prescott, AZ
Being old doesn’t mean you should hurt all the time. Being old shouldn't imply that you can't get up or move in relative comfort. Being old doesn’t mean loose stool or periodic episodes of vomiting. We would be very concerned if we saw these symptoms in a young animal! Why do we ignore them in an old one?
As a veterinarian, it is my job to help educate owners to best support their geriatric pet friends. To this end, I'd like to share three lessons I've learned: pain is not normal, attitude matters, and food matters. I'll finish up with my takeaways for elderly pet care.
Pain is not normal.
This doesn’t mean that a pet should be “put down” if they limp once in a while. It just means that age should not equate to pain.
I have a beautiful patient who can illustrate this concept. Anna is a gorgeous 14.5-year-old Golden Retriever. Her people, Rita and Bill, got her from a rescue organization when Anna was about eight years old. Anna came to me a few months ago because she was unable to stand without help.
She also walked with a significant limp, caused by osteoarthritis in her right elbow and left wrist area. Anna had a weeping sore on her back and many little wart-like growths as well. Bill was concerned that Anna appeared “shut down” and wasn’t interacting with people as much as she used to.
Anna was eating well. She was happy. She could get from point A to point B without too much help. Shouldn't this be "good enough" for a 14-year-old Golden? My answer is no.
Treating Anna was somewhat of a challenge. She needed very gentle handling and acupuncture. Using too many needles or leaving them in for too long can “drain” qi or energy from the system of older patients. She enjoyed gentle massage and manipulation, which I did to bring blood flow and ease range of motion into joints before treatment. Anna also enjoyed and responded well to cold/therapeutic laser treatment over the tight muscles of her back, hips and pectorals.
The acupuncture technique I used with Anna focused on treating her “Wei” syndrome. (In acupuncture parlance, this means a "wilting" condition.) Anna did not have enough Qi (energy or strength) to bear her weight. In treating Wei Syndrome, it is critical that your veterinary acupuncturist is judicious and careful when using electro-acupuncture.
Interestingly, needles should be left in for a shorter amount of time in old or weak patients. I mention this because Anna had previously received treatments that appeared to worsen her condition and give her more pain. If you notice this in your pet, be sure to communicate with your veterinary acupuncturist so that they can adjust their treatments accordingly.
Lastly, I had to address what appeared to be a skin infection associated with one of her wart-like lesions. The infection was deep enough that a mild antibiotic was warranted.
With this plan in place, Anna started to come for bi-monthly treatments. Bill and Rita noticed an immediate change in Anna's demeanor. People in Anna's life reported that she was "brighter” and “more engaged.” Anna also started moving with a greater range of motion and a lot more comfort. Her forelimb limp has subsided tremendously, and she is now able to get up without assistance 75% of the time! (Up from 0% just a few short weeks ago.)
Anna did so well that Bill and I decided to decrease her treatment intervals to once a month. She is holding treatments well and has recently started acting “more silly.” I have noticed it here in the clinic, too—she’s joyful, her ears are perky, and she eagerly looks for her treat at the end of a session.
While Anna was happy and appeared content before treatment, neither Bill nor I had realized just how shut down she was becoming. Life should be joyful. Your old dog shouldn't sleep all the time. If they are, consider having a workup that would incorporate pain management, dietary therapy, and a thorough dental examination (old dogs are prone to dental disease that can be painful and make it difficult to eat). Finally, something I recommend for all of my elderly patients and their owners is a "plan" for quality-of-life assessment.
Many old dogs become stoic and easily “hide” their pain from the people in their life. Because our pets are so involved in our day-to-day life, the aging process can happen slowly, and we don't always notice the little things. A bi-annual examination with your veterinarian can help catch these problems promptly and institute measures to provide greater comfort and quality-of-life.
In 2010, the American Animal Hospital Association (AAHA) redefined the basic physical examination to include diet. “Nutritional screening is part of routine history taking and physical exam of every animal."
So here are my "takeaways" for dogs of any age, but essential for the older kiddos:
• Multi-modal pain therapy. This means a combination of acupuncture, laser and physical therapy, massage, and light exercise.
• Supplementation, including veterinary hemp products, arnica, and high-quality joint supplements.
• Consider Adequan, PRP (or platelet-rich plasma injections) IRAP (Interleukin-1 Receptor Antagonist Protein injections) and the emerging medicine of testosterone/hormone therapy (where appropriate).
• Traditional western medications such as NSAIDs, Gabapentin and opioids.
• Routine bloodwork and bi-annual health checks. We want to catch “problems” early and treat accordingly.
• Talk with your veterinarian about titer testing rather than routine vaccinations. In my opinion, we WAY over-vaccinate our veterinary patients, which can be detrimental to their health over the long term.
• High-quality nutrition. As we tell all of our clients at Harmony Vet care, “Food is therapy.”
• Quality-of-life assessment. Having a plan in place to measure and account for the toll of aging process is extremely helpful. It gives our clients tremendous peace of mind as owners, and tailored guidelines and milestones for me as their healthcare provider.
Lastly, be gentle with yourself. So many of my clients feel regret for their past pet care—things they could have done "better" or "sooner."
Celebrate your pet’s silly, old-age antics. Share your ham sandwich with them. Love them up. Their time with us is sometimes too short, but it is dear, and filled with the wonders of unconditional love.
Feeding any dog (but especially a geriatric one) a high-quality diet is of the utmost importance. And here is the kicker—vets get precious little information on diet and nutrition.
During my four years of veterinary training, I received one 45-minute lecture on small animal nutrition. This class was courtesy of a large veterinary "prescription" diet retailer. This same company then gave me four years of free dog food. Not the best way to receive non-biased information!
Working with a veterinarian trained to conduct a thorough nutritional assessment of your pet friend can make a tremendous difference to their health and overall quality of life.