Appetite challenges -vs- problems with the act of eating in pets

Eating is an activity of daily living (ADL) that looms large in the work that families & I do together. We track the usual aspects of this activity: the pet’s interest in food, how much they’re eating, when they’re doing so, & what they’re eating. And that gives the pet guardians, the core members of the vet interdisciplinary team (vets, vet techs) & me good information about how well a pet is doing & coping with symptoms & changing needs as they navigate this time, whether they’re senior or geriatric, coping with recovery through injury or illness, or, as is a focus of my practice—when they’re benefiting from the program of care that is animal hospice & palliative care (AHPC).

If a pet is demonstrating a change in appetite, our identifying what’s happening, when, how often, to what degree, & what has or hasn’t worked is par for the course & then relaying that information to the vet team. Routinely submitting quality of well being assessments & written logs to be added to the pet’s medical file can bolster this. From there, the vet can assess & make adjustments to their plan, & then reassess the situation to track improvements, or lack thereof. While I educate the pet guardians on the basics regarding appetite challenges by way of the learning hub, there are many factors that I hone in on as a veterinary interdisciplinary team member, whether I’m stepping in & providing that hands-on care with respite care or overnight stays—or supporting families in person or remotely with AHPC. And it’s not uncommon when a new-to-me family expresses that their pet struggles with appetite, or what’s seen as an appetite issue -vs- a problem eating—two very different things. At times, there isn’t a meaningful level of symptom management on board (pain, nausea, anxiousness top the list), & so next steps are to work with the vet to get that sorted out, because those are the priority. But if that’s been done & the vet has implemented strategies to bolster the comfort care plan, & there isn’t enough meaningful change—all is not lost.

There are other features of how the pet moves through the activity that can differ from what I commonly hear pet guardians & vet teams focus on, like medical causes: perhaps the effects of disease processes like chronic kidney dysfunction or cancer, that they’re dehydrated or nauseous, there’s a bad tooth/teeth, an appetite stimulant is needed or they have cognitive dysfunction. And it’s not to say that these aren’t part of the equation. They can be & often are. But another set of facts can also be true even after a vet exam, blood work & other tests indicate that things like subcutaneous fluids & other supportive care would help sort the situation. 

When those strategies don’t move the needle, it can be posited that things have reached the ‘end of the line’ or the pet has entered the stage where their body is signaling that food is no longer needed & the dying process has begun. But I submit that more curiosity is in order. As an experienced Certified Animal Hospice Practitioner, I’m never comfortable landing on the notion that a pet has reached that pivotal point unless symptom management has been adequately assessed & addressed, if it can, along with other things.

And so, in addition to the usual suspects that we associate with fueling appetite issues, I also observe the other possibility: the pet is having trouble with the act of eating. That is, how long it is taking the pet to finish a portion of food, & how they physically manage the activity. For example:

• Can they stand long enough to do so?
• Do they seem comfortable & focused?
• Are they struggling/working harder than seems sensible to do such a simple task?
• Do they seem frustrated?
• Are they making more of a mess of their feeding station than I’d expect?
• Are they able to prehend their food, or is their food just getting pushed the food around the bowl & the pet can’t get ahold of it?

Sometimes I find that yes: a pet is having difficulty standing long enough or remaining comfortable during the activity, & they might be working really hard to manage such a simple & important activity of daily living. They can become frustrated for those or other reasons, like they can’t actually pick up (prehend) their food or because their feeding dishes or feeding station no longer fit for their current abilities. 

And so, the pet gives up. 

Imagine, not being able to get through a meal because you can’t get the food into your mouth for various reasons, but you still have a normal sense of hunger & enjoyment of food. We don’t want that for anyone.

And so as I observe & assess a pet for all of this, I ponder these questions, keeping in mind that one or more can be true,

& then trialing key things known to be helpful:

• Is their feeding station in a location that is accessible & physically/emotionally comfortable for them? (Cats can feel like they’ll be ambushed by other cats in the household, & any pet may simply have a preference for one area over another due to physical or emotional needs.) 

• Are they feeling confident in their ability to walk up to the feeding station & eat? That is, are they slipping or losing their footing? (Yoga mats & rugs at & around the feeding station are the heroes here, as are booties for dogs. Also, ensuring a dog’s better grip by trimming the fur that grows too long on their paws is good.) 

• Is the height of the feeding station adequate to allow them to perform the activity? Do they need to reach down too far, or do range of motion limitations or physical discomfort & pain limit them? (Making or purchasing a raised feeder appropriate for their height & physical ability is helpful.)

• The size & shape of the dish can matter—perhaps it’s too deep or concave (My observations are that when a more shallow dish, like a pie plate is used, this helps improve things dramatically. Flat silicone mats can be much easier, too.)

• The material of the bowl can be extra slick, like stainless steel, causing some foods to slide away from the pet’s mouth when they try to grab it, especially if the bowl is too concave. (Swapping out a stainless steel dish or bowl for ceramic or even silicone can help.)

• The food’s texture, while appetizing to the pet, may not be manageable for them to lap up or pick up with their mouth—I see this frequently with fresh or fresh/frozen diets, whether they’re prescription or homemade. (I love that giving dog food a go round in my handy personal smoothie blender makes a big difference, here. A few blitzes with a little water to produce a smoother texture, like a gruel, is all that’s needed in some cases. With cats, when feeding canned, pâté can be easier for them, especially if it’s mounded up.)

More: 

Changes in swallowing can be present, primarily in dogs, & so having that assessed by the vet first is key. In these cases, to make it less challenging for the pet, it’s often suggested that soaking their kibble in warm water until softened before feeding can prevent any dry food from crumbling & accidentally making its way into the airway, or switching to canned, homemade or fresh/frozen. Feeding the pet at a 45° angle helps, too. 

I do notice that for some dogs, it can be time to retire the slow feeder dishes, since they can be especially frustrating. It’s likely they’re not inhaling food like they once had, so you’re probably safe in making the switch to a regular bowl, dish or mat. 

When trying to figure out any change in a pet’s eating patterns, it’s vital to discern the differences between changes in appetite -vs- having trouble performing the act of eating. Doing so promotes better well being for the pet, & the pet guardian’s sense of mastery of caregiving. I want the families I’m working with—all families—to look back on this time with the perspective that they pursued everything that made sense for their pet, because that significantly reduces the feelings of ‘…did we miss anything—were decisions made too soon or without enough context?’.

With over 20 years of experience in pet care and the past 12 of those focused on animal hospice, Lorrie Shaw is a Certified Animal Hospice Practitioner, Certified Hospice and Palliative Care Advocate and Certified Fear Free Professional. She is CXO of Telos Companion Animal Services, LLC. She can be found at lorrieshaw.com.

Anger & rage after a pet’s death: it’s expected

 Hey you. Yes, you.

The one who’s grieving after your pet has died. Especially when trauma was a feature of the pet’s death or when a diagnosis was sudden, swift & explained, or not. 

This is for you. 

Anger is a common feature of your grieving process. But you knew that already. But you might not be able to hone on why you feel so angered, pissed off. You might have some inkling, but the anger feels wrong or incompatible with the sadness, anguish & the fogginess that’s taken over your brain & body right now.  

Let me assure you that your anger is natural. Expected. Why? When an accident, someone’s negligence or a diagnosis that swoops in unannounced & departs like a clattering whisper has been a catalyst in your pet’s death, it’s accompanied by a sense of injustice & it feels terribly unfair.

When these scenarios unfold, I often hear, ‘It’s not fair’ or ‘I did everything ‘right’: I did the regular vet visits & got the bloodwork done as was in line with their life stage. I made sure they were on preventatives, I brushed their teeth & we sorted how to get nail trims done at home using cooperative care. WHAT THE FUCK? How could this happen??’ 

If this is you, the truth is, you didn’t do anything wrong. You didn’t miss anything. Some diagnoses are brutally swift & quiet. Accidents happen. Other people are negligent. You did not have control over things. In fact, the anger you’re feeling stems from the sense of the death being unjust & unfair—which is accurate. And your autonomy has been stolen from you. 

The only control is in how you respond. So be angry or full of rage. It’s ok. And giving yourself the outlet to discharge this valid emotion is critical.

And I’m going to offer ideas on opportunities to do that in a controlled, safe & constructive way. 

•rage rooms: as the name implies, it’s a room to let your anger & rage fly—in a safe way. Essentially, you pay to use an interior space to satisfyingly destroy things like dishes & other breakables, in a controlled environment. 

•axe throwing: giving your frustration & rage some oxygen is totally doable when you engage in throwing axes at a target. 

•visiting your local recycling center: the least costly of the three, by taking your recyclables to your nearest depot, it’s a good option to give your anger an outlet. On several occasions, I’ve witnessed local residents giving their clear & colored glass recycling a shattering, noisy thump against the confines of the recycling dumpster, & to great effect. No one is going to question you, nor do you need to reserve an appointment. 

Whatever your jam, giving one of these options a healthy outlet with its safe space, the promise of physical activity & feeling like you’ve properly given the anger & rage that accompanies the sadness after a pet’s death someplace to go. 

With over 20 years of experience in pet care and the past 12 of those focused on animal hospice, Lorrie Shaw is a Certified Animal Hospice Practitioner, Certified Hospice and Palliative Care Advocate and Certified Fear Free Professional. She is CXO of Telos Companion Animal Services, LLC. She can be found at lorrieshaw.com.

One simple trick can improve comfort in seriously ill or terminal pets in minutes

After many years of hands-on work in animal hospice and palliative care, keeping pets comfortable who are in their final years-to-days is my jam. I’ve had the good fortune of discovering and learning many things along the way and helping families near or far. 

But I’m going to show you that you have the ability to provide an enhanced level of comfort for your own pet right now. 

Pets who are feeling unwell—especially those who are experiencing pain or nausea—really have a tough time. This includes those with liver disease, or late-stage cancer, and especially those with airway issues like Geriatric Onset Laryngeal Paralysis & Polyneuropathy (GOLPP) and primary or secondary lung masses. They experience trouble staying cool or more accurately, feeling cool. And in pets with airway issues, they can’t breathe and pant as efficiently and that can contribute to them working even harder to breathe, and as importantly, anxiety. This isn’t good for any patient, nor their caregivers and so mitigating that is a priority. 

A simple strategy to address that in warm, humid weather—and even in winter—is having a fan blowing to create air flow and a sense of being able to breathe with less effort. It’s recommended that allowing the fan to blow on them at a rate they appreciate is best, though, for some pets, just having it blowing in the room is quite helpful. 

But did you know why fans are helpful in caring for pets with certain diagnoses, like GOLPP? 

The moving air, when it’s directed at the face of dogs with the diagnoses I spoke about, triggers the upper airway cold receptors on the trigeminal nerve. 

It’s an easy way to provide physical comfort and reduce anxiety in these doggos. This is very helpful in comforting terminal patients, animal or human. 

As a Certified Animal Hospice Practitioner, I need to have a solid plan, and be ready to pivot on a dime when necessary. Being a planner and ‘what if’-er, I invested in a Venty Fan awhile back due to its portability and no-kidding—over two day run time on battery alone. (It runs on a plug, too.) With power outages becoming more common, being in a lurch with no power and a dog who is struggling to stay comfortable is not an option. Along with other strategies to keep pets in fragile health cool, this gives me a lot of peace of mind. It also has a built-in night light, it oscillates and telescopes for maximum benefit. This fan packs up small and is totally portable, a real win/win since my work largely involves my providing overnight stays and full hands on care to pets who are in delicate health in their own homes. 

With over 20 years of experience in pet care and the past 10 of those focused on animal hospice, Lorrie Shaw is a Certified Animal Hospice Practitioner, Certified Hospice and Palliative Care Advocate and Certified Fear Free Professional. She is CXO of Telos Companion Animal Services, LLC. She can be found at lorrieshaw.com.

Co-sleeping with geriatric dogs made safer with this inexpensive product

There are countless ways the human-animal bond can be strengthened, but one that lots of pet guardians really love is co-sleeping. As a pet ages, though, many wonder whether it’s feasible due to some age related problems like incontinence, and as importantly, the pet’s safety: plenty of my families have expressed they’re understandably concerned after their dog has fallen out of bed. 

Since the bulk of my practice is devoted to palliative and hospice care support offering overnight stays, I can attest to my families’ concerns about an aging dog’s changing ability to judge the edge of the bed, especially at night. 

Some pet guardians decide that doing away with the frame of the bed makes most sense since it lowers the height of the bed considerably, while others have gone in a different direction to keep things safe while not changing their cherished routine. The video below highlights one budget-friendly way that’s done. 

With over 20 years of experience in pet care and the past 10 of those focused on animal hospice, Lorrie Shaw is a Certified Animal Hospice Practitioner, Certified Hospice and Palliative Care Advocate and Certified Fear Free Professional. She is CXO of Telos Companion Animal Services, LLC. She can be found at lorrieshaw.com.

Waning appetite in a pet’s final months requires monitoring—and perspective

Many guardians discover as they tend to pets in their final months, their appetite just isn’t the same as it once was. It’s not a happy observation.

It’s important to understand that pets aren’t giving up or being willful about their desire to eat: it’s something that can emerge with that time of life. Disease processes can affect a pet’s appetite, along with medications and changes in physiology can impact how food tastes to them. Pain of all sources most definitely plays a role, in fact it’s the most common reason behind appetite challenges, with anxiousness following closely.

Pets who’ve entered the period that leads up to animal hospice supported natural death—usually three months prior, give or take—most certainly see a decrease in food intake, along with other signals, and that’s expected and interpreted differently. While that is a topic for another time, what I will be focusing in on here is that messy, grey area in those final months when families really struggle since death isn’t imminent, and sustaining life looks different for the pet. 

When assisting pet guardians who are in my concierge animal hospice & palliative care program with quality of well being (QWB) assessments, getting granular about appetite challenges is a priority. Being curious about any changes in the household and other stressors, whether or not they’re able to stay on track with their medications that are designed to address pain are my starting points. And then it’s always critical to ensure that we have perspective: that is, differentiate between dysrexia, hyporexia and anorexia. Honing in on that can tell us a lot about what’s going on, and what direction we need to go with hurdling that before getting in touch with the vet. In most cases, the family and I are able to pin down what’s going on and get the situation sorted.

Of course, there are times that the veterinarian needs to intervene to medically suss out what might be behind the change in appetite. There are times they determine the pet is eating plenty given their lower activity levels, it’s just way less than what they needed when they were younger, more healthy and active. And perhaps they just can’t eat as much due to various reasons.

Regardless of the shift, it’s always a great idea to ensure that the amount of food that a pet is eating—or will eat—is on par with their caloric needs (and nutritional requirements). The truth is, brands and recipes vary in their caloric and nutritional composition, no matter if it’s kibble, canned, fresh frozen, homemade and other types, measure for measure. And that fact highlights a valuable consideration that I learned years ago in my animal hospice training, and it has reduced the stress for many of my families: quantity doesn’t necessarily need to be the thing that should be considered with one food over another. A hard concept, no doubt, given that a certain amount of food feels reliable and telling that things are on track. And that's the kind of thing pet guardians need in this stage of their pet’s life. 

For guardians struggling to get their pet to eat what they deem to be a meaningful amount of food and they’re laser-focused on that, instead, they should consult with their veterinary team and have them evaluate the pet’s caloric and nutritional requirements against the specific diet or diets they are eating. From there, they can calculate factors like the number of calories (sometimes referred to as kilocalories, or kcals) that the pet needs to be at their best. It’s not that uncommon that a family discovers that the pet needs fewer of those than they expected. And with that, they can relax a little, have expectations of themselves that are more realistic, and have mealtimes less stressful for both guardian and their beloved pet. 

And, the veterinary team can even suggest solid alternative diets that are suitable no matter the changing needs, should a pivot be necessary. 

With over 20 years of experience in pet care and the past 10 of those focused on animal hospice, Lorrie Shaw is a Certified Animal Hospice Practitioner, Certified Hospice and Palliative Care Advocate and Certified Fear Free Professional. She is CXO of Telos Companion Animal Services, LLC. She can be found at lorrieshaw.com.