Jack Russells. They just keep going, don’t they? My little old man is 14 years old now, but no one has informed him of that fact so he still bounces off the walls and has enthusiastic zoomie sessions on a daily basis. He looks so good and is so happy all the time, he must be fine, right?
Not necessarily. Animals are amazing. As long as they have their favourite toys and treats, and their special time with family, they often go months or years without necessarily showing any overt signs of discomfort or illness and we can carry on blissfully unaware of any underlying problems.
This is where general health checks with your vet are so important. As vets, part of our training involves not just understanding the pathology and treatment of various diseases, but also identifying the subtle abnormalities that may otherwise go unnoticed. A dog doesn’t need to be vomiting to show signs of nausea, a cat does not need to be limping to show tiny indications of arthritis.
You may ask: “Where is the value in a health check for an old pet, and what can one expect from the check-up of a pet that seems otherwise happy and healthy? Is it a waste of time and money? Shouldn’t I just let Fluffy go on as he is until his time comes?”
The first and most important thing that your vet will do is a thorough clinical exam and discussion of your pets’ history. This will include listening to the chest, running their hands over your pet’s entire body, examining their mouth, assessing their level of alertness, as well as palpating their abdomen and feeling their limbs. They will ask questions about your pets activity level, appetite, any chronic medication or supplements, changes in behaviour and many other factors that might help us to piece together the puzzle of what your loved one might be experiencing but unable to tell us about in a language that we are familiar with.
Imagine if you did not brush your teeth for 10 years? In some cases, the smell enters the room before the pet does, and this is not something they or we have to live with. Periodontal disease is one of the most common problems we encounter with geriatric patients, and dental treatment is one of the easiest ways we can improve the quality of life and health of our patients. Dental disease not only affects the comfort of our pets, by causing pain or discomfort during eating, but can also have an effect on other organ systems by allowing oral bacteria to travel into the bloodstream and affect the kidneys or heart valves. The procedure can only be done effectively under general anaesthetic, as it requires probing of painful teeth and pockets under the gums, as well as scraping of sensitive areas to clean them. Many elderly pets will require multiple extractions due the advanced state of deterioration of their teeth, and experience a new lease on life once the rotten painful areas of their mouths are treated. If a pet has underlying problems (common in elderly pets), such as heart or kidney disease, this is taken into account, and a specialist anaesthesiologist as well as specialist veterinary dentists and nurses can also be involved if necessary.
Lumps and bumps:
The dreaded C word often causes us to want to ignore that lump on Fluffy’s leg that just keeps getting bigger every year, until it’s too late to do anything about it. Your vet can help to investigate any abnormal lumps that appear so that we can act sooner rather than later if it needs to be removed, or if additional treatment is needed. Benign lumps often keep growing and can affect the function of the area that they are associated with. For example a lump near the armpit can press on the nerves there, or a lump near the anus can cause difficulty with defaecating. If a malignant cancer is identified earlier, we can start treatment sooner and this may impact the overall outcome of the treatment, and if palliative care is being done, we can start helping the pet to feel better and more closely monitor any signs of deterioration from an earlier stage so that they are not suffering in any way.
Weight loss can be due to a variety of different problems and a thorough evaluation by your vet can help direct the hunt for a specific cause. Excessive weight gain is also common in elderly dogs as they become less active, and this can worsen the symptoms of arthritis as well as contribute to a myriad of other health problems including heart disease, diabetes, and pancreatitis.
In many cases the clinical exam is the first piece of the puzzle, and your vet may recommend additional tests to garner more information. A blood panel may help to identify common problems such as kidney or liver disease, and ultrasound can help us to examine the various layers of many of the internal organs, as well as identify if your pet has any internal masses, blockages or areas that may not be functioning properly inside the abdomen.
Arthritis and chronic pain:
Old age usually means achy joints. If I have a sore knee I can take a painkiller and rest it until I feel better, or go to my doctor if it is not improving. Our pets, unfortunately, just learn to live with their discomfort. You may notice Fluffy seems to want to lie in his bed all the time, and takes ages to come when you call him. He might have difficulty getting up the stairs, or standing up after lying down for a while. He might stiffen up or give a little yelp when you lift him into your arms. It might last only a millisecond, and he might be licking you and wagging his tail the entire time all of this is happening, but the pain is still there. He’s just so happy to be with you that he’s allowed himself to forget about it for now. Your vet can help to identify areas of pain and stiffness and recommend various treatment modalities, including species-specific safe anti-inflammatory and pain medication where indicated. (Please note many of the human medications are metabolised differently in various species of animal and can be highly toxic to animals – especially CATS).
What can you do, as a pet owner/family member?
Depending on the specific ailment your pet is experiencing, there are many additional things that can be done to help them and improve their quality of life.
Home adjustments may include sloping ramps to allow arthritic pets easier access to different areas of the house or onto beds and couches. Surfaces can be covered with non-slip mats to allow for better traction and decrease injury by slipping. Pets with decreased vision will often memorise the location of furniture and entrances and may become disoriented if things are moved around. Work gently with pets that become hard of hearing, as they are easily startled, especially when at rest or sleeping. Make sure that pets are prevented from wandering into areas with pools or ditches, as the combination of frail mobility and decreased awareness of their surroundings puts them at risk of falling in and being unable to get back out again, with sometimes tragic consequences.
Decreased activity levels makes elderly pets more prone to having longer nails as they are not wearing them down on a daily basis. Long nails alter the angles of the joints in the feet and limbs and can contribute to pain by keeping those joints at an abnormal angle, or they can grow into the paw pad causing pain and infection. Joint pain can lead to difficulty with self-grooming leading to matted fur and faecal contamination. Regular nail trims and grooming certainly helps with preventing this from occurring.
Physical rehabilitation in the form of a combination of non-weightbearing movement in a hydrotherapy pool, mobility exercises, massage and laser or ultrasound therapy can work wonders on our grey whiskered friends.
Extensive research based on sound scientific principles has gone into the development of various prescription veterinary diets that can help with stress-related bladder inflammation in cats, kidney disease, arthritis, weight gain, thyroid problems and many others.
The hardest question
Decreased hearing ability, as well as sight, combined with a progressive loss of cognitive abilities can lead to severe distress in elderly pets. Add in chronic pain and debilitating disease, and we find ourselves faced with the question of whether our loved one have reached a stage in their life where the bad days outnumber the good. It is the most difficult and heart wrenching dilemma we may have to deal with, and figuring out when to say goodbye is not something you ever have to do alone. Remember that as your vet we are here, to talk you through all the options related to treatment, as well as to listen to difficulties faced as your pet grows older. We can help you by providing advice, support, as well as professional feedback on the realities of any illness your pet may be suffering from. Factors that may be considered when making that final decision is an entire topic of its own that will be covered in a future blog post, but always remember that considering that decision can be one of the bravest and selfless things you can do for your pet.
Article by Dr Zarina Motala of TAH Bellville