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A Guide for Owners of Aging Pets

Our aging companions now, more than ever, need more attention to their health and well being. While age is not a disease, with aging can come disease and many pets who suffer from chronic conditions can experience a rapid progression of health problems. Adequate hydration and nutritional intake are essential along with mental stimulation and controlled but regular exercise.

How to prolong your aging pet's quality of life

Ensuring balanced nutrition, adequate water intake (hydration) and regular, positive interaction will go a long way to ensuring a great quality of life.

Nutrition and hydration should be maximized. There is plenty of research to suggest that feeding for life stages can produce better physical and mental health in aging pets. Diets targeting older animals often are bolstered with antioxidants and essential fatty acid. They are often easier to digest and may include pre and probiotics. It may be best to stick to more limited ingredient diets designed to feed senior pets. Water should be changed daily and both food and water should be offered in stainless steel bowls which are easiest to sanitize. The bowls may need to be elevated to assist older animals with neck pain or muscle weakness.

Regular controlled exercise is good to promote blood flow, maintain muscle tone and assist with balance. Even pets with osteoarthritis will benefit from regular controlled exercise. Walks can be shorter but more frequent – let your dog tell you how far they can go. Older cats can be encouraged to move about more by placing favorite treats throughout their environment – encouraging activity (hunting activity is an ancient instinct for cats).

Mental stimulation is very important and many older pets enjoy the social interaction with play and attention. Being with them on their bathroom breaks, even in the backyard, can be reassuring to them as they lose confidence with their senses and function.

Finally, regular visits to your veterinarian can ensure that we are not missing quality-of-life markers. Checking body weight is important and loss in weight can reflect muscle loss and even dehydration. For chronic medical conditions, it is appropriate to check some lab data to ensure that we are not harming organs with medications and also to determine whether the medications are effective. In some instances, based on liver and kidney function, it may be more appropriate to adjust the dosage of medications to prevent damage.

Is your pet near end of life?

There are times when end-of-life care is clearly appropriate, and other times where this is uncertain. Either way, the decision is understandably difficult for all involved. Here are some points to consider when coming to terms with this decision:
 
  •  Does my pet have a chronic medical condition for which medical therapy is failing?
  • Can I provide the patient care required at home to keep my pet comfortable?
  • Can my pet perform basic functions such as getting up to potty or eat/drink?
  • Does my pet have a condition in which pain cannot be safely treated?
 
Unless there has been discussion during prior visits about the possible need for end-of-life care, it is best to set an appointment with us to address any concerns. We offer a consult appointment where pet owners can come in to the clinic for an appointment without bringing their pet. A consultation fee is charged for this visit. Some people have found this to be very helpful and free form the distraction of having to load and unload their pets from the car. In some cases, True Care can provide some reasonable options if there is uncertainty about performing euthanasia. For some cases, the doctors may recommend end-of-life care based on their evaluation and experience (especially in cases where there is a terminal condition for which few to no options exist).
 
In many cases, it is often best to have a conversation with us about the needs of your pet and whether we can all agree that end-of-life care is a reasonable decision for their sake.

What to expect for end of life care

Providing end-of-life care (humane euthanasia) is one of the most difficult things for pet owners and veterinary teams to experience. We are here to assist with arriving at this decision and to counsel whenever we feel it may not be appropriate. True Care has provided a guide to end-of-life care which we will expect you to read and understand. The veterinarians wish to be certain that the time has actually come and end-of-life care is appropriate

Please never be afraid or nervous to ask us any questions about the end-of-life process. It’s something we all have to go through.

End-of-life (EOL) care is an especially difficult time for you the pet owner and the staff and doctors at TCVH. Unless emergency circumstances dictate, all EOL appointments are scheduled through a doctor. For an EOL visit to proceed the following must apply and we will confirm with you at the time of scheduling whether you are familiar with the requirements and are prepared:

  • You must be a client at TCVH (if not, a medical exam fee will be assessed at the time) – we are legally required to establish a veterinarian-client-patient relationship to perform any veterinary care on your pet – this involves generating a basic medical record and performing a routine examination.
  • Your pet must have a medical or surgical diagnosis (if not, there must be obvious signs that the pet is in distress/pain – this will be OUR determination based on an objective assessment).
    • At minimum, there must be clinical evidence of a terminal/painful/untreatable condition on physical exam and the patient should be showing the appropriate clinical evidence of this.
    • If your pet is bright and alert and not showing these signs we will NOT proceed with EOL care – in these cases, we should perform basic testing to determine whether there is a treatable condition or evidence of end-organ disease, etc.
    • We will euthanize an animal who cannot be cared for due to a debilitating condition and for which the owner cannot provide basic and adequate supportive care at home (such as large dogs that are painful and immobile).
  • All fees for EOL care are payable at the date and time of the service.
  • EOL appointments are typically scheduled at the end of day to assure some privacy.
  • We will NOT euthanize an animal because they are old.
  • We will NOT euthanize any animal because they have become an inconvenience – if this is determined then you will be referred to one of numerous rescue agencies, house call services or the SPCA should you wish to pursue end-of-life care.
    • Examples of inconvenience are house soiling, “picky” appetite or being restless.
    • These pets are family and they need care and attention.
    • Convenience euthanasia is not ethical.
    • We will NOT euthanize an animal because you are moving and cannot take them with you – you will be referred to numerous rescue agencies or the SPCA (unless they satisfy the above criteria).
  • We will NOT perform more than one scheduled EOL care on any given day.

For witness euthanasia, we will explain the entire process and what you can expect. This process has often been referred to as “putting an animal to sleep” which is technically correct. An intravenous catheter is placed so that we can get a smooth administration without the use of needles. We administer an overdose of an anesthetic like medication. Your pet will enter a profound sleep state (complete loss of consciousness). This is quickly followed by loss of heartbeat and finally breathing stops. We will listen to ensure that all vitals signs have ended.

Most pet owners witness euthanasia while a few do not feel it is right for them. There is no right or wrong regarding this. Whichever you decide is the right choice.

There are several important things that you can do to ensure this most difficult visit goes as smoothly as it possibly can. If your pet is a dog, please make sure they have had a chance to relieve themselves as they may be very uncomfortable if not. Bring a blanket or large towel with you so that they may lay on something familiar (you may elect to have them go with this item or take it home with you). If you are bringing children with you, please prepare them for the visit and ensure that they are not too noisy as this can stress the pet.

Please decide about after-care prior to the visit if possible (see below). Save a swatch of fur if desired. There are kits at hobby and craft stores with which you can make clay paw impressions (we recommend Crayola soft modeling clay – we have a limited ability to make these if requested).

  • Upon arrival you will be escorted into a private room.
  • Our staff will confirm we are performing end-of-life and will handle the paperwork and charges prior to EOL being performed.
    • If you wish, you may have a discussion with the doctor regarding end-of-life and whether it is appropriate at that moment – we will give you our honest assessment (which in some cases may be a recommendation to euthanize).
  • We will have your pet brought back to treatment (with some exceptions) and place an intravenous catheter – this is more comfortable than using needles – you may not be present for this as we have to focus whenever performing medical procedures.
  • We will return your pet to you when the catheter is placed and you may spend time prior to proceeding – you may hold them in your arms or on your lap if desired.
  • Once your pet has passed, we will notify you and you may spend some additional time as needed.

Witnessing end-of-life is not for everyone and if you elect not to witness it does not mean you do not love your pet any less – it is important to do what you feel is right for you. Occasionally, we have clients who do not witness but remain at the clinic until we confirm that their pet has passed – we will act as their family during the process with the same level of care that we ourselves go through when we euthanize our own pets.

There are several ways to handle your pets’ remains.

The remains can be cremated and either returned to you or scattered. You can arrange to have a private burial (including burial of ashes) with a local pet cemetery. In New York, it is now legal for you to have your pet’s ashes join you! Communal burial involves placing their remains in the ground with other pets with no marker. Burials are performed on private property for privacy.

Some owners prefer to take their pet’s remains home with them. Most towns frown on burials so we recommend you contact them first. Home burial must be done properly so as to prevent wild animals from potentially disturbing resting sites.

Some stories have occasionally made the rounds about what happens after you leave your pet’s remains at the vet clinic or emergency clinic. We can assure you that we/they do not perform procedures on your pets remains, however, you can sign a permission release giving a veterinarian permission to use the remains to perform and perfect a procedure which could be used to help a living animal. Also, you can elect to have a necropsy (equivalent of an autopsy) performed in an attempt to determine a possible reason for needing end-of-life care. This can even involve submitting tissue and fluid samples for outside study. Full results and reports would then be shared with you. Remains are handled with the utmost respect.

If you feel that EOL is not appropriate at TCVH based on the above information you have some options:

  • We can recommend numerous rescue agencies.
  • Home euthanasia = Lap of Love
  • Home euthanasia = Paws in your Heart
  • These services will come to your home and help arrange after-care for your pet.
  • SPCA: (they do not allow witness EOL care).
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