Want advice on feeding your infirm pet? Skip the armchair experts, go to the professionals

Food is one of those most important topics that is discussed in the focus of my work, and it’s not surprising. 

I use it as a positive reinforcement tool when I’m performing care duties for a pet, and I teach families how they can, too. It’s used as part of enrichment strategies that are appropriate to a pet’s telos, physical ability and emotional needs. 

Food is sustenance. 

It brings joy to families when they’re feeding their pet and it’s well-received, since it signals that the pet is feeling good about things and that they are doing at least reasonably well. 

Pets need food to survive, at least until they are approaching the stage of animal hospice-supported natural death, where food becomes more of a burden than a support, but that is a topic best reserved for a post all on its own.

I’m often asked about what I think in terms of what food or foods are best for a pet. As a seasoned Certified Animal Hospice Practitioner (CAHP), I am qualified to speak to whether it not specific foods are safe for a pet (think foods and ingredients that are inherently toxic, or those that can trigger GI symptoms, like those that are high in fat). It’s also totally fine that I make safe suggestions on strategies that can help a pet be more willing to eat or hurdle an off day when an appetite is flagging to see if that’s helpful, before having to have the vet weigh in. This is actually good to do, since if it doesn’t help, the vet can use that data to decide what next steps should be. 

The truth is, beyond that, I’m not the person to ask about what food or foods or are best for a pet. That’s not my lane. My professional training isn’t in veterinary nutrition, animal nutrition, or Traditional Veterinary Chinese Medicine (TVCM), where food is a focus of adequately supporting the patient. And those are the professionals whose lane that is. Yes, I get it: it’s not a popular point of view, and in fact my position is in conflict with many people who tout themselves as experts. 

When a family expresses a hearty interest in supporting their pet’s well-being with food, I’m fully on board with that. Food is one of the cornerstones of supporting health. And when a pet is experiencing a health challenge, or age-related decline and even the journey through hospice, food can be a tool in the box to help them feel and do their best. In fact, its not unusual for a family-of-record to relay that they aren’t comfortable with a vet’s recommendation for a prescription diet when it becomes necessary, even though they can appreciate that those options are there. Or, they want to feed a fresh, homemade diet or even a raw diet, though they aren’t getting the support they’d like from the vet team to do that. The position of the clinician is understandable, and so I always open my response with that. There are many caveats to going homemade or raw, though by searching internet, you’d not know that—there’s lots of unqualified support for pursuing it anyway. And, families need to understand the problems that they might face in doing so without an expert reviewing their pet’s individualized needs. 

Because it’s required that the primary or hospice vet be in the loop, I have happily referred families to the real professionals: veterinarians boarded in nutrition, veterinarians certified in TVCM, veterinarians with additional education and interest in assisting families with therapeutic diets and animal nutritionists (these professionals typically have MS or PhD level degrees). These professionals are able to, after reviewing a pet’s medical records, make their assessment and design a nutritional plan that is appropriate and safe for the pet’s needs. From homemade diets, fresh frozen and dehydrated options that are commercially available—and even raw—families can be matched with options that all involved can feel good about. 

I’m also very excited to report that if families ask their primary or hospice veterinarian, who might not be that comfortable making recommendations for these options, they’re usually happy to liaise with online resources like balance.it and Pet Diets—companies spearheaded and powered by veterinarians whose specialty is nutrition and designing individualized meal plans. 

If you’ve an interest in feeding your pet in a way that is aligned with your values and wishes and that serves your pet best, you deserve to have the best support possible to help make that happen—and that doesn’t come from armchair experts. 

With over 20 years of experience in pet care and the past 9 of those focused on animal hospice, Lorrie Shaw is a Certified Animal Hospice Practitioner and Certified Fear Free Professional. She is CXO of Telos Companion Animal Services, LLC and can be found at lorrieshaw.com.

Looking for a canine enrichment option that won’t be a foreign body risk but is still fun? Help is here

Canine enrichment is a topic I bring up not only during consultations, but throughout the pet’s lives that I’m tending. It’s vital in keeping dog’s happy, with its ability to stimulate the brain, engage the body and at times, use problem solving skills. It’s also a stress reliever. Enrichment can take many forms, can be employed at any age, and I’m deeply appreciating the notion that so many pet product companies have come up with novel designs for pets, especially dogs. 

Some of them have been designed for those who are power chewers—you know, those dogs who will routinely destroy and swallow commercially available toys. Sadly, a percentage of those dogs have or will land in an veterinary emergency hospital after ingesting a chunk of said toy and developing an obstruction. And so, families have no other option but to skip offering traditional toys, but what fun is that for them or the dog? 

I’ve stumbled on a workable and safe solution that any dog—no matter the telos, size or age—can safely enjoy, thanks to my brain going down a rabbit hole whilst working with an avian charge this past week. We professional often use fruits and vegetables to hollow out and stuff to create foraging opportunities for exotic birds, and I thought, ‘why not use this idea for dogs’? 

‘Tis the season for apples here in Michigan, and they can be used to craft a safe, inexpensive and healthy opportunity for dogs to have a chew party, when they might otherwise have to forgo that pleasure. I explain more in the video below. For more ideas on safe options for dogs, click here. 

With over 20 years of experience in pet care and the past 8 of those focused on animal hospice, Lorrie Shaw is a Certified Animal Hospice Practitioner and Certified Fear Free Professional. She is CXO of Telos Companion Animal Services, LLC and can be found at lorrieshaw.com.

Has ‘work-from-home’ influenced how we view and tend pet loss and grief?

A commonly-asked question is, how does one respond to people who say, Grieving over a pet? I mean, it’s just a dog… you can get another one?

I won’t go too far into the weeds with how comments like these lack sensitivity. I can say from my years in companioning families through their pet’s journey through hospice and end-of-life that most of the time, it’s hard for other people to be sensitive to situations they’re not familiar with, or find too emotionally-grueling to navigate. And so, the comments that land like a lead weight during an already brittle time erode what emotional and physical resources those grieving have left. 

 

We know that when people have space held for them to move through their grief, they can fare well. It’s when that disfranchised grief is minimized, ignored or is used to shame is when problems begin. And those responses—stressors in themselves—from others add to the trauma and emotional toil that is experienced. 

 

We find this is especially prevalent in one’s work life, a space that many of us occupy more than our home lives. And so it’s easy to see how impactful walking that tightrope can be both for the one that’s suffered a loss as well as their workmates. 

 

In my years of companioning those who’ve lost a pet and need extra support, I’ve advised that avoiding people who aren’t behaving as supportively as they’d like to be is a good option. The problem with that is it’s more of an ‘ugly coping’ tool, as George Bonanno calls it. Coping ugly can take shape in various ways, and consist of strategies/behaviors that we might otherwise deem unhealthy to help us cope with grief or trauma. In this case, it’s having to suck it up and sit with the offhanded comments or the platitudes that come out of another person’s mouth. It’s fine, now and then, and it's also an emotionally draining front line strategy. 

 

The additional advice I offer is that it’s perfectly fine to respond clearly and thoughtfully, with one’s boundaries fully intact: 

 

This is a very difficult time for me to navigate. I’m not sure you’re aware of it because maybe this uncharted territory for you. But your comments are unhelpful, so I’d appreciate your saying instead ‘I don’t understand any of this though I can see it’s affecting you tremendously’, and leave it at that, or at the least not remark on what’s happening at all.”

 

I have to say, though, I’ve had a thought getting traction in my head: I’ve been wondering if the increased opportunity of work-from-home in the past couple of years helped us be more aware and empathetic to others when it comes to grief? Seeing our co-workers’ pets on Zoom meetings over and over, does it make us more aware of how profoundly their deaths affect their guardians? 

 

I think so.

 

And though it’s fair to say that we’ve all gotten more savvy with Zoom in the way of being able to navigate the platform and others like it and tweaking our backgrounds and such, seeing those we interact with during our work time in their home environment albeit on the screen probably caused a lot more of us to ‘see people close up’, so to speak. More human, more who they are. Having some of that curtain pulled back, the one that normally obscures our home lives also means seeing family pets on the screen. 

 

More than one pet guardian has relayed how comical their colleagues thought it was that their dog barked upon hearing another Zoom participant’s dog bark in the background. Or, during a virtual meeting with a co-worker who they find frustrating, a client noted that upon seeing an adorable feline mug suddenly pop up on the screen, they were reminded that while challenging for them to deal with, they “are still that cat’s dad! It helped me remember that he might find me frustrating, too and he really seems to love his cat.”

 

I’ve also heard echoes of sentiments like, “…after Sammy died, all of my co-workers seemed to be genuinely clued in to how hard it was for me in those first days” or “one of my team members had been off for a few days, and they hadn’t known Eddie died…they piped up just before their last meeting of the day ended asking ‘…where’s your cat? He’s camera-shy, today!’ They’d no idea about Eddie, and understandably, were taken aback. They were so affected by the news.”

 

It’s clear that to some degree, those emotional barriers that were the norm previously are giving way. Plenty of us noted during the beginning of the pandemic that virtual meetings of every type made things feel artificial, less-connected. And as time went on, that eased into realizing that using Zoom and other platforms, for some at least, fostered a different environment. One where, because people had to pay closer attention to the other parties on their screen, they’ve also been able to view them with a new lens. What seems to have unfolded is an environment that’s more human, accepting, and naturally creates more space for others, especially with something that we all share—loss and grief—is concerned.

 

And so, will that momentum in being more sensitive to others during times when they’re experiencing a high emotional load because of their pet’s illnesses, decline or death continue to move in the right direction? I certainly hope so. But more importantly, I do think that will help make issues surrounding grief and loss less taboo and better equip our culture to understand how to support others who need it.

With over 20 years of experience in pet care and the past 8 of those focused on animal hospice, Lorrie Shaw is a Certified Animal Hospice Practitioner and Certified Fear Free Professional. She is CXO of Telos Companion Animal Services, LLC and can be found at lorrieshaw.com.

 

Want to enhance your pet's overall quality of life in the fourth life stage, as well as your own? Capitalize on their youth

Pets are living healthier lives, thanks to the advances in veterinary medicine and better understanding of their needs, both behavioral and emotional. Healthier also means longer, and that has implications that families might not have expected with their current generation of pets: challenges surrounding age-related decline. Having seen many families through what is now their third generation of pets, and walked with them through their pet’s fourth life stages, there have been so many advances in medication and complementary therapies to enhance comfort — which in turn supports mobility — along with tools in helping that go more smoothly.

All pets experience age-related decline. And I’m going to focus on talking about one area that invariably comes to the forefront: how dogs and cats are able to manage changing mobility and independence with the use of products and tools. 

With cats, we know they have certain spots in the house that they really love to hang out in, and they’re usually not floor-level: up on their human’s bed, on a favorite piece of furniture or other spot that’s elevated. The increasing weakness, especially in the rear limbs due to decreased muscle mass and painful osteoarthritis that our feline friends develop often result in not finding them in the places we expect to. Helping them make that transition from jumping up aplomb as we’ve been accustomed to seeing for so many years, to getting a little help to do so independently is as easy as pulling a chair or ottoman next to the desirable area, or investing in a set of portable stairs.

Litter boxes can be another frustration for geriatric kitties, and so getting a vessel that is low enough for their less-able legs and sometimes bigger cabooses to maneuver into and out of, can keep everyone happier. I recommend a few ideas for my families, including a box designed for senior and geriatric cats. For cats with really troublesome mobility, some families find using a boot tray or lid from Rubbermaid-style storage container lined with a disposable pee pad to be ideal, or simply using pee pads on their own.

For dogs, though they’re typically not hopping up on the counter like their feline counterparts, things can be a bit more complex, and that’s for a few reasons. We’re so accustomed to our canine pals simply hopping into the vehicle with relative ease and accompanying us on outings for so long, that its easy to see how we might take that ability for granted as the years go by. Dogs also need to get outside to do their business, and outdoor entries involving stairs can begin to be troublesome to navigate. We start to notice, much like with our feline friends, that dogs do things like hop up on favorite pieces of furniture with less frequency. And as time goes by, some dogs, especially medium and large breeds, need a bit of help getting up and walking about due to hind limb weakness, which has various causes, and the effects of osteoarthritis.

Portable stairs, just as with cats, can be incredibly helpful for dogs in aiding them to get up on furniture, like their human’s bed. Portable ramps, with their durability and sturdiness, can be a boon for getting in and out of a vehicle and with varying designs can be an option to accommodate getting from ground level to a porch or deck and inside so much easier. Some of my families, who are very handy with carpentry, have designed their own for a custom look and grade that have fit in well with their dog's needs without being obtrusive. Ramps are made for indoor use as well. Harnesses designed for mobility-challenged dogs of all sizes (my favorite is the Help ‘Em Up Harness) are probably the most used items in my lending library of tools and products that I have on hand for families-of-record whose pets are in my Animal Hospice Palliative Care program. 

And we can't call it a day there.

These items are all helpful in making the lives of companion animals easier and more manageable, every bit as much as for all of their caregivers. But they’re only so if the pet is willing to use them, and as with anything else, we need their cooperation and consent to make that happen. 

Pets, just like us, are really good with having a sense of predictability in their day to day. It’s one of the ways they’re able to adapt to subtle changes and those that are not so. And the novelty of these newly-introduced products can often throw things off for them significantly, even though they’re designed to help. I’ve had many a family whose pet is already experiencing markedly-reduced mobility by the time we connect report that the harness, ramp or other product I’ve dropped off is met with not just reluctance, but flat out refusal by the pet – usually a dog. Sometimes we can use positive reinforcement to grease those wheels, but in a lot of cases, there’s no movement. And that’s hard to see happen, because that one tool can make all the difference in a pet being able to negotiate getting outside and back in with the help of a ramp, or a human being able to assist their dog up 3-4 stairs more safely without worry of injuring themselves in the process. And when the pet isn’t able to let it happen, sometimes there are no other options and families need to make different and hard decisions about what makes most sense for their pet’s care options going forward. 

Can this be hurdled? Yes.

My advice to every family, is that while their pets are younger, healthier and emotionally more resilient to novelty is to plan ahead – far sooner than they think they’ll ever need to. Do it now. Sitting down and deeply considering a pet’s habits, their size, and their abilities is a start, as well as considering what the floor plan where they are living is like. How about access points to the outdoors and hardscape – do they pose any foreseeable challenges? I encourage families do this every time they move. 

Getting some insight from a professional can help tremendously. It’s not uncommon for me to identify possible issues early on, and make recommendations since I’m someone that has the luxury of seeing how a pet does inside and outside the home for myself. Now, the same is true for housecall vets and their teams, but brick-and-mortar vets, since they don’t have the opportunity to see things firsthand, they can be caught rather flat footed if they’re asked for advice. However, they can also give as good of guidance if you snap some footage of the pet’s home living environment with your mobile phone and give them a virtual tour. 

Doing all of this early in their life, and then re-assessing as time goes on, can help you identify possible trouble spots and ease your pet into using these tools and products while they’re at their absolute best stage of accepting them. In fact, it tends to be a fun, positive experience, if not neutral. This is especially helpful with a cat’s litterbox arrangements, since they tend to be fussy about that sort of thing. 

Onboarding these strategies sooner also has a hidden side benefit: caregivers will be in a mindset where having implemented their use will be far less of an emotional beacon that a pet is declining and instead, to reframe, they’re simply changing and adapting as needed. I’ll note that families who do this experience less anxiety about navigating their companion animal’s fourth life stage, and they are able to better focus on meaningful shared experiences with their furry friends since they don’t see the ramps, harnesses and other tools as reminders of their pet’s inability, rather a transition that results in maintaining their independence and happiness.

As we know, that ability to adapt – for both the pet and the humans – is an asset as a pet ages and promotes resilience and helps maintain the human-animal bond.

With over 20 years of experience in pet care and the past 8 of those focused on animal hospice, Lorrie Shaw is a Certified Animal Hospice Practitioner and Certified Fear Free Professional. She is CXO of Telos Companion Animal Services, LLC and can be found at lorrieshaw.com.

Imagining your life after a pet’s death during their decline can seem like a betrayal. It’s actually a healthy tool.

“Are you just waiting for her to die?”

That was a question that two people—one who I’m closely tied to—asked me when I spoke about plans I was sketching together to travel to a place I’d never been. It was 2015. Puerto Rico had been on my mind. And as a late-bloomer when it had come to traveling, much less doing so alone, it had become an essential mental well-being tool. It also, ironically, helped to squash paralyzing social anxiety that had plagued me into adulthood. 

I’d not traveled in the final few months of Gretchen’s life. And as a sole human in the household, I was her main caregiver. 

Gretchen was my nearly 16 year-old St. Bernard/shepherd mix. I’m quite certain in imagining the gasp (16!) that invariably escaped from your lips that I need not go into too much detail about how heavy the caregiving was for a geriatric, large breed dog with advanced osteoarthritis, a touch of renal disease and had been recently treated for hemorrhagic gastroenteritis. Gretchen was never the same after the latter and in fact that was the diagnosis that became the tipping point of a steeper decline over three months: a touchy GI tract, stress impacted her gut more easily and many of her favorite things to eat were now off limits. 

We’d been traversing ever-so-gently into this phase of our life together (I was also caring for my geriatric cat, Silver, who had his own share of issues, but I digress). And with the help of a mental health professional specializing the needs of humans immersed in a life circumstance such as this, a plan was crafted. A plan which supported me in navigating the process of being a caregiver to pets with ever-increasing needs, and the expected anticipatory grief, the frustration, the decision-making, the unknown, re-framing/re-imagining my relationships with both Gretchen and Silver—and preparing for life after both of them died. Especially Gretchen, I won’t lie. Heart dog, soul dog… whatever you want to coin it as, she was it. My ride or die being. I never saw her as my child. She was a dog, and I felt I needed to honor that. Gretchen was at that point more like my smart, sassy, independent-minded elderly aunt who never married and needed tending in her dotage. She loathed being fussed over, like someone else I know. 

Anyway, I knew it’d be hard. I’d have a very new life. I knew I’d be a different person. I’d have a different identity: I’d not be a dog guardian anymore. And I wasn’t sure what any of that would look like or feel like, because I’d spent over a third of my life living in that identity that would be unwillingly stripped from me. Yes, it scared me a little. But I was more afraid of how things would unfold if I didn’t give a lot of thought to what life would be like after. Because going from a life where your pets are naturally the first thing you think of in the morning and the last before your feet lift off the floor and into bed, to having their needs increase so much to the point that being away from home for four hours is a big deal, that’s a lot. And then when you’re aware, even though it feels unfathomable, that all of that will, in a blink of an eye—vanish. And you’ll not need to think about heavy caregiving, or medication refills or ‘what will they be willing to eat today?’, or anything else. And your instinct is that your life will develop a natural sense of emptiness when all that comes with loving and caring for a pet edging toward their end-of-life comes to a physical end. 

And then it does. And for how long, that depends. And it’s not unusual for that to ebb and flow. 

Back to the question I was asked. 

‘Are you just waiting for her to die?’

I bristled at it. And then I softened. Because if nothing else, I had no mental bandwidth to get curious about what they meant. Nor to help either person feel comfortable with how I was navigating through a brutal time. 

Because most of the time, that’s what those who are expressing things like that need. Or because it’s weird for them to hold two ideas in their hands at a time—that one can be fully engaged in the heavy caregiving and anticipatory grief while realistically looking to a future where their pet will be gone and not coming back—because they seem completely incompatible. Or because they feel like acknowledging the fact that life will go on is a kind of a betrayal of the love one has for their pet.  

I could also see how easy it is for others to mistake a healthy coping tool for rushing through a period of life that’s full of unpleasantness and gut wrenching changes while full of love all at once. Or stuffing it down so it doesn’t need to be felt because it’s too hard. 

So, was I just waiting for Gretchen to die? No. Of course not.

I couldn’t stop her dying from happening, I could not save her despite the advances in vet medicine. Nor was her dying going to be a failure on my part or anyone else’s, or of vet medicine. But what I could do, was control how I reacted and coped with the process, and the outcome. And I knew I’d not be moving on, but moving forward. I was envisioning what life would look life after she died and planning for it. I was taking care of myself, and my mental health. 

I was accepting the inevitable. And that I would never not grieve Gretchen. 

So, I responded with that. And then, I guess, they understood. 

That looking ahead and giving the reality of what life would be like some much-needed space to stretch its legs came naturally to me. That, along with my having good instincts about how I might respond to things along the way given my history, how I used my existing coping tools, and how to adjust and gain additional healthy strategies as needed. Planning the trips I was going to take after experiencing two deaths in what would be a short 10-month span was an integral part of that. As I later discovered in my professional training in Grief Companioning and animal hospice, that looking ahead is a tool that is used in working with guardian caregivers when we are supporting them in navigating through a tender-but-brutal time. 

It’s perfectly normal and natural if your thoughts move into a direction of thinking ahead to a time when you’ll have far less to think about, to manage, with a pet who is in decline. You don’t love them any less, you’re not betraying them, and you are still the very best guardian caregiver you’re able to be because you’re taking care of yourself. 

And yes, Puerto Rico was amazing.

With over 20 years of experience in pet care and the past 8 of those focused on animal hospice, Lorrie Shaw is a Certified Animal Hospice Practitioner and Certified Fear Free Professional. She is CXO of Telos Companion Animal Services, LLC and can be found at lorrieshaw.com.

A pet’s dental health makes an impact on their final months of life

 February is Pet Dental Health month. I’ll skip the usual ‘you should get your pet’s teeth and oral health tended to’ without adding context. 

Since I specialize in caring for pets in their final years, months, days and hours, I’ve had the honor of observing a lot of pets in these stages of life. I see the health challenges and complications they are faced with and need tending.

But more on that in a minute. 

Though it’s uncommon for a pet in their final months of life to undergo dental exams and cleanings, they certainly benefit from having them regularly throughout their lives. We know that maintaining overall oral health—including regular exams, X-rays and cleanings addressing any periodontal disease, and any extractions or root canals that need doing—boosts a pet’s health at younger stages. And that sets the stage for helping a pet manage at a time when they’re less resilient, experience more pain-related issues, and need to be handled and interacted with more often: their final months of life. (Think assistance with mobility and administering medication.)

When the inside of a pet’s mouth is in good shape at a time when so many other things can be more difficult to manage because of age-related decline or a life-limiting illness, that’s a nearly-invisible asset.

Why? 

Senior and geriatric pets most often experience multiple diagnoses and changes that need managing. 

• Cognitive changes impact how a companion animal experiences the world, and this includes behavioral changes like irritability, being withdrawn, and an unwillingness to be interacted with or touched. 
• Pets can develop anxiety at this stage of life, or if it’s present, can be exacerbated by all of the things previously mentioned, including increased pain and discomfort. 
• Pain is a ball of wax that needs to be addressed on its own merit, and it’s often nuanced and complex at this stage. Osteoarthritis, diagnoses like chronic gastrointestinal issues and two grossly underrated and under-diagnosed sources of pain—eye pain and mouth pain—can impact a pet significantly. 

Discomfort and pain in the mouth contribute negatively to all of the above, and then some. In my experience, if a pet is experiencing either, they’re more likely to have a waning appetite, and far less likely to accept much-needed medication. Not eating well and not having pain and other symptoms managed with medication invite at the least a viscous cycle of pain that increases and often becomes more complicated, which can trigger inappetence, as well as nausea, and then back around.

The complicated mouth bacteria that develops with a pet’s poor dental health goes further. In dogs, chafed skin from wearing a harness designed to help with mobility issues, and callouses/pressure sores that often develop on bony protrusions are more easily infected due in part to a pet transferring the bacteria in their saliva to those areas by licking (or in some cases, if they drool a lot). I’ve seen cases where the wounds were hard to heal, needed culturing and long courses of oral antibiotics and topical treatments to try and get them under control were necessary. Need I say much about how dangerous accidental cat bites are can be when a pet is aged and they have sharp, brittle teeth? These interactions happen, and the bite need not be that deep. 

I could go on, really. I see time and time again that being proactive with a companion animal’s health early makes the biggest difference in how well their palliative, hospice and end-of-life journey unfolds. And consistent, preventative dental care is just one tool. In fact, I feel like a big piece of the pie. It’s easy to overlook it, I know. It seems expensive to pursue, and many families worry about anesthesia (yes, it’s necessary though quite safe, hence the pre-procedure bloodwork and exam) and a lot to go though in preparing before and a little aftercare. And yet, the returns on that up front investment are far greater, especially when it comes to a lower-stress, less-expensive and more manageable final months with a beloved pet where the human-animal bond is kept intact. 

With over 20 years of experience in pet care, Lorrie Shaw is an Animal Hospice Palliative Care Practitioner, Certified Fear Free Professional–pet sitter and owner of Telos Companion Animal Services, LLC. She can be found at lorrieshaw.com.