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Senior SIT!-izens

Practical guidelines for aging pets

By Steve Dale

We live in a nation filled with aging baby boomers, who also happen to have aging pets. Our companion animals are living longer than ever before. Perhaps there ought to be AARF cards for pets so they can get into movies cheaper. Instead, the American Animal Hospital Association (AAHA) recently released Senior Care Guidelines for veterinarians to treat the aging pet population.

    Dr. Mark Epstein, a private practicing veterinarian in Charlotte, NC chaired the task force that authored the Guidelines. He says that when he began practicing medicine about 20 years ago, even small dogs typically didn’t live more than 12 years and cats rarely made it to their 15^th birthday. Today, due to better nutrition, more frequent vet checks, and advances in medicine, small dogs often enjoy quality life into their middle teens, and many indoor-only cats live into their late teens.
    When an animal can no longer heal, end of life is inevitable. The authors of the Guidelines have taken a bold stance, even challenging their profession by encouraging veterinarians to offer in-home euthanasia. Today, this is a service offered by only a minuscule percentage of vets.
    “There’s no doubt in my mind that euthanasia at home is the most preferred course for many guardians, and it’s a service we feel far more veterinarians should offer,” Epstein says.
The reality is that some veterinarians may not want to leave the confines of their practices to offer euthanasia because they’ll lose time seeing other patients. It’s a matter of economics. Also, at many busy practices, one could argue it’s unfair to turn down a client with a pet who can be healed because the vet’s busy with an in-home euthanasia.
    “This isn’t an easy recommendation to make; after all we’re calling for a fundamental change in the practice of veterinary medicine,” says Dr. Daniel Aja, president of AAHA, and also a contributor to the Guidelines.
“I’m absolutely convinced at-home euthanasias are the right thing,” says Epstein. “Let’s face it, most pets are far more comfortable in their own homes than in our clinic even under the best of circumstances. And these animals aren’t in the best of circumstances; they’re obviously very ill. After visiting our clinic for a lifetime, I think an animal deserves to end his or her life in dignity.”
    Dignity and quality of life are what it’s all about. “As our pets age, pain is inevitable, but suffering isn’t,” says Dr. Peter Hanson, senior director of companion animal pharmaceuticals at Merial in Duluth, GA.
As our pets do live longer, they’re impacted by the same diseases associated with longevity as occur in people, such as cancers and osteoarthritis (although genetics may be associated with both, and environmental factors may be linked to some types of cancers).
    “We can’t prevent all the illnesses associated with old age, but we can prevent chronic pain,” adds Aja, who also has a private practice in Traverse City, MI. The AAHA Guidelines are absolutely clear in their views on pain management. The bottom line is that there’s absolutely no excuse for a dog or cat to be in prolonged pain.
Historically, this stance wasn’t always the case in veterinary medicine. “After 15 years in an emergency practice, I know that pain relief was once considered at best, an afterthought,” says Michael McFarland, director of the sedation and painmanagement at Pfizer Animal Health. He says, “It was thought veterinarians actually shouldn’t relieve the pain—even if they could—because you wouldn’t want the animal to do further damage.” For example, say after leg surgery, you wouldn’t want a dog’s healing to slow or risk a re-injury by letting the dog run.
In fact, science now shows the opposite is true. McFarland explains, “Pain is a significant stressor and has a profound affect on the ability to mount an immune response to heal.”
    “Relieve pain and you’ll promote healing,” Aja says. The Guidelines even suggest adding pain to the list of vital signs, often known as TPR (temperature, pulse, and respiration) which veterinarians are trained to pay most attention.
    Dr. Gary Landsberg, a veterinary behaviorist based in Ontario, Canada is also a Guidelines author. He notes, “Observing any change in behavior in older pets is key. For example, if an older dog is acting just out of it, we typically say, ‘Well, he’s old, and that’s the end of it. But there is likely an underlying reason that probably can be treated. The dog may have the onset of early kidney disease, diabetes, cancer, or perhaps cognitive dysfunction.”
    Cancer and arthritis aren’t the only diseases to impact older pets. Two additional examples are canine or feline cognitive dysfunction syndrome— which is a fancy way of describing a disease that’s much like Alzheimer’s in people. Landsberg says that a change in diet and medication does help many pets to significantly improve their quality of life. Unfortunately, some people just ignore a pet that’s acting differently–assuming there’s nothing that can e done. The good news is that often something can be done.
    Unfortunately, the Task Force Guidelines don’t suggest a cure for old age, and the authors haven’t discovered a fountain of youth. But they do offer suggestions for helping our pets to age gracefully while maintaining their dignity and quality of life. For further details about the AAHA Senior Care
Guidelines, check out, www.HealthyPet.com.
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Editor’s Note: The following Chicagoland facilities offer in-home euthanasia for their patients: Animal Ark, Compassionate Vet, and Dr. Kimberly Curtis.