|Things we learned in caring for an elderly and disabled dog|
When the photo at right was taken, Drew was about 14-1/2 years old, and had just had a spinal operation to repair a herniated disk which had ruptured downward just behind her shoulders and had disabled her ability to walk altogether. When the emergency animal hospital told us what had happened, we asked "what do we do?" They said that probably it was time to say goodbye. We asked if there were any procedure that could help her, and they told us about this operation, but said it was very expensive, and she might not survive it. And we wouldn't learn for six months if it would improve her chances of ever walking again, even if she did survive it. However, they said, unless they did this operation, she would have to be put down because her spinal cord was still under severe compression by the herniated disk.
They were quite astonished when we didn't agree she should be euthanized. Apparently nearly everybody throws in the towel at this point. We don't know about other dogs, but a Long Haired German Shepherd is as much a person as we are, and our view is "if we wouldn't do it to Uncle Henry, we won't do it to Drew". We said we understood she might not survive the operation, but she certainly wouldn't survive being put down, and if she had a chance we wanted to give it to her, even if we had to borrow money to do it.
So, they operated. Afterwards, they seemed surprised at how well she came through it. She still couldn't walk with her back legs and we understood that would be the case. But her health was still pretty good, despite her diagnosis the previous summer of Degenerative Neuropathy, which is sort of a canine version of Muscular Dystrophy; it's genetic and ongoing. She couldn't wait to come home, and as you can see in the photo, she was very happy to be back with us.
We enrolled her in physical therapy with a top therapist who found her spirit inspiring and helped her move her legs in water therapy. This would have done her much good had it continued, but her therapist, Dr. Carol Helfer, rest her soul, died in her sleep a few weeks later, and no other canine therapist locally had an opening for her, which ended her water therapy. We do recommend such therapy if you can find a good therapist with an opening for your dog, however.
We tried acupuncture, and saw some improvement, but apparently not as much as the acupuncturists in the clinic we were recommended to had expected, apparently, and in late spring of 2014 they booked us for an appointment, had us bring Drew in as usual, and then announced they wouldn't treat her anymore and we should put her down. They offered to do it. Astounded that they would have sprung this on us only after having us bring in Drew for the appointment they themselves had made, we took her back home and that ended the acupuncture. The top "people acupuncturist" in our city said those vets had acted unbelievably unprofessionally, and apologized for the profession. But there were no other animal acupuncturists within a reasonable range that we could locate, and that ended the acupuncture, which we really wish we could have continued.
Finally, we were referred to a new animal masseuse, who we are proud to recommend to anyone in our Portland, Oregon, area -- Kim Schwartzenberger
-- who was a Godsend in Drew's final months. Drew by now was spending most of her time lying on the mattress we set up for her in our livng room, and we had finally realized she needed something more to prevent sores and deterioration from this. We had bought a 3-inch-thick Memory Foam mattress topper at Costco -- twin-bed size, and we cut it in half, and put one half of it on top of her regular mattress. She was sleeping far better as a result, but Kim found she was getting stiff as well as weak in her legs from disuse, and the massage was very helpful in addressing this.
Earlier in the year, Drew was still able to walk on her front legs, and we held up her back end with the "Help 'Em Up Harness" described in the "Final Chapter
" page of this website for short walks for exercise and to relieve herself. We also took her to her water bowl and food bowl in the kitchen thils way. But the degenerative neuropathy continued to weaken her, and by late spring she was wobbly on her front legs and could no longer hold herself up that way. We could hold her up with the absolutely invaluable "Help 'Em Up Harness" for transport and other needed movement -- she wore it all the time -- but she was unwilling to eat or drink from her bowls if she was not holding herself
So, we began to hydrate her with Lactate of Ringers, intradermally. Our vet provided the bags of Ringers and needles, and taught us how to use them to hydrate her. She needed at least a bag a day, split between morning and evening, and somtimes she needed another half bag. If she got diarrhea and lost fluids that way, she needed even more, and got it. By the way, even if a dog is fully hydrated this way, we found he or she still needs some water in the gut for its proper operation, plus they can still get thirsty while being fully hydrated inter-dermally. So we advise having a large plastic syringe full of filtered water handy to give water by mouth whenever the dog is willing to take it.
As for her excremental functions, she had always strongly avoided "doing her business" in the house, even as a puppy, but when it became impossible to take her outside for this, we stocked up on "puppy pads" (an excellent and inexpensive type is sold at Costco), and she lay on these on her bed.
Nonetheless, she wouldn't urinate there if she could help it, so we would move her to puppy pads on the floor in front of her bed at least three times a day and "express her". This involves squeezing the bladder to force out the urine. Our vet showed us how to do this, and yours can too. The thing is, for Drew, it always required really hard pressure -- until the day around the time of her 15th birthday party when, stupid dumb idiots that we were, it FINALLY occurred to us to explain
to her what we were doing, and ask for her help!
Bingo. From that moment on she stopped fighting us on the expressing, and expressing her became much easier for us as well as her.
As for bowel movements -- she didn't like doing that in bed, but did when she had to -- on her bed, on those puppy pads. We did nothing but praise her when she did, and because of the pads, cleanup was easy.
And, going back a bit, when she stopped eating from her bowl, we got cans of Science Diet dog food and would give her the contents of a whole can, bite by bite, on a fork for a daily meal, sometimes -- and other times would give her things she really liked, to vary her diet. She enjoyed a cheeseburger, with bun, cut up like a pizza and fed on a fork -- and we made egg scrambles for her, with cheese and chopped sandwich meat and seasonings -- and fed her those from a fork too.
When a dog is lying on her side and must eat that way, the ability to eat from a fork is providential, and we were lucky Drew had shown that skill early on, and that we had encouraged it for years (as the photos on page one of this site and elsewhere readily attest). Someday your dog may need this skill too, for a reason like this, and we suggest you develop it now! Your dog will probably love being personally fed by you from a fork, so you and your dog will likely enjoy it if you try it.
Drew, like all dogs, had a higher body temperature than people do, and didn't enjoy the hot summer. In our living room she had proximity to an air conditioner, and we kept it on throughout the hot season for her comfort, and to keep her cheerful. Since she was basically immobile and helpless without us, we made sure she was never alone. One of us would sleep half the night on the sofa near her, and the other of us would sleep there the other half of the night. Eric was fortunate being able to work at home, so for the year 2014 he moved down from his upstairs office and worked on the living room sofa. On the occasional days when both of us had to be gone at the same time, either our animal masseuse, Kim Schwartzenberger, or our friend Mike Sullivan would come and sit with Drew. She was never alone, and her annoyance at her immobility was considerably tempered by the fact she was getting more love and personal attention than she'd ever had before.
In late September of 2014, two months after her 15th birthday party, Drew suffered a stroke. This is not unusual in older dogs (or people, too) -- although dogs recover from strokes much better than people do. We realized this had happened to her because we recognized the symptoms from our first dog, who had a series of strokes over the last few years of her life, but who recovered pretty well from all of them. The most noticeable symptom for this is rapid jiggling eye movement, and the tendency of the eyes to roll upward.
Drew did recover somewhat from her stroke, but not before -- a few days after the stroke -- she went blind. That lasted about five days, and then she began to see things in front of her eyes again. The worst point had past, and after another week or two the jiggling eyeballs gradually stopped. There was one symptom that did not improve, though -- and that was that she was having difficulty eating. Her tongue worked fine, but she had trouble opening and closing her mouth precisely as she wanted to, and in particular, chewing properly.
Since she was eating sideways, things would now fall out of her mouth as she tried to eat them. We had to hold up her front end enough to get her mouth fairly level for her to be able to eat, and only really soft food would work, so that ended anything crunchy or chewy, and even the canned dog food. All we could give her after she regained her ability to eat at all (for a week and a half after the stroke she could only eat liquid foods in a big plastic syringe, and that weakened her). All she could eat now was the scrambled egg dishes we had been preparing, and we put more cheese in them not only to hold them together and make them more tasty, as before, but now also to make them solid enough that they wouldn't disintegrate into fragments when she tried to get them down. And they went down mostly unchewed.
It was during this period, in her last two months, when digestion became a bit erratic for her. We mixed Prozyme powder from the vet into her eggs to give her additional digestive enzymes, but she became increasingly constipated, with bouts of diarrhea in between. We had to turn to the use of enemas to get things going, and we can tell you that the animal enemas are not as effective or comfortable for the patient as the ones sold over the counter for people. A vet confirmed that for us, and recommended we go with the human enemas.
They were very helpful, but because we used them only when she had not eliminated in a week, there was the possibility of an explosive emission, so we bought a large roll of painter's plastic at our hardware store and laid out a protected area to contain any such problem. It was not the explosive problem that the vet had feared, but we can tell you there were a few times we were very glad for the plastic protected area we had constructed!
Drew began to fail in the last week of her life, and we knew the end was near, but we were determined to let her finish her life as we hope to end ours -- on our own terms -- and indeed it did happen that way. She passed very quietly and peacefully in her sleep while we were sleeping near her in the living room.
The vets had been suggesting putting her down for nearly a year, but she had the will and stamina to prove them wrong again and again. (Her bloodwork was absolutely perfect -- three pages of numbers, all in the "normal" range, as late as September.) By knowing and listening to her, rather than the well-meaning vets, we had one extra priceless year with our girl. We suggest you use your own judgement, and gauge your own patience and ability to assist a geriatric dog, before you take well-meant advice to call an early end to the life of your friend and companion.
We have put this page together to give some assistance in dealing with an elderly and geriatric dog -- and in particular to show that it can be done (some vets doubt it, because apparently many pet owners cannot be bothered) -- and to share some of the things we learned. We should tell you that half a week after her spinal operation, when she seemed to be doing so well, Drew went into a deep decline, got limp, could not even hold up her head -- and we rushed her back to the pet emergency hospital, where the topnotch vets we had been working with sighed, "we were afraid of this. Failure to thrive. You should put her down." We responded, we are not going to agree to that until we find out WHAT THE PROBLEM IS!
So they did tests, and discovered that Drew was simply dehydrated! She needed more fluids! So they kept her for a couple of days while reinfusing her with Ringer's Lactate, and she went home robust once again.
With the best of intentions, good vets will be pessimistic about the elderly dog. Insist on finding answers before making decisions! One of the reasons vets are this way is that they so seldom see an elderly dog with infirmities and setbacks that ever have the chance to survive them!! Dogs can surprise them with their resilience and will to live as a result.
Before we finish, we would like most earnestly to reinforce something that we thought was so important, we put it on the bottom of the home page of this website when Drew was still only age eight. We refer you to it for the detail, but the combination of 500 to 600 mg each of Alpha Lipoic Acid and Acetyl L-Carnitine works wonders not only for older people but older dogs.
Every dog gets weaker in the back legs as he or she ages (as people do too). Since Eric had discovered this as a result of the article we have posted on the bottom of page 1 of this site, and had been taking this combo twice a day since about 2001 with outstanding results, when Drew began to show signs of weakness in her back legs at age seven, we bought her a ramp to get into cars with, and then started her on this combo once a day. This combo worked so well we never actually used the ramp! Drew fairly quickly regained the ability to jump into cars and go up stairs, and play her Whippy Ball game with energy, and did not start to show some weakness again until she was thirteen. She was on this regimen daily from age eight to the end of her life and it gave us five more years with our girl.
Of course, Drew turned out to have Degenerative Neuropathy, but all dogs develop back leg weakness anyway so this regimen should be followed for all aging dogs (and people). Her neurological vet, when making his diagnosis in mid-2014, said that the only thing he had heard of that could retard this congenital disease was Acetyl L-Carnitine! Well, she had taken it for years and inadvertently we had given her exactly the right thing -- but even without that condition, she would have needed this combo. We want you to understand how important this is for all aging dogs (and people).
And, you will probably find dogs hate taking this combination! We started with less than a full described dose for Drew, and that was enough for a while, but it did have to increase to the full dose eventually. But don't bother trying to hide it in things your dog likes because once they discover what's in them, they stop eating those things that they like. It's a terrible thing to do -- to turn them off their favorite foods.
In the end we found the only way to dose it is to open the mouth, drop the capsules in, then hold the mouth closed until they swallow. It does get down that way, and does not sour them on their food. They don't like the procedure, but Drew seemed to understand we did it benevolently, and did not hold it against us, and indeed got used to it. But because it can upset their tummies a bit, dogs, like people, should take the combo either after a meal or they should eat something after the dose to prevent stomach upset. (We also got our vet to prescribe the antinausea drug Compazine, or its generic equivalent, to give with the dose, and that helped too.)
We may have overlooked something we learned that we should have put on this page, and if so we will add it later. This page is intended to be a resource for those with elderly dogs facing issues.
But we also invite you, if we have not touched on something you are confronting, to e-mail us and see if we can help. You can always reach us, c/o Drew, rest her soul: firstname.lastname@example.org