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.

Free mindfulness and insomnia apps can help pet guardians manage stressful caregiving by bolstering well being

If you’re a caregiver of an unwell or aging pet, or a pet with complicated behavior challenges, and you’re finding you need to bolster your proverbial toolbox to tend to your own well being, you’re not alone. Everyone’s situation is different, and caring for oneself isn’t a one-size-fits-all endeavor. My mantra: you do you, just do it consistently. We know from the research that pet guardians who prioritize their own well being set themselves and their special needs pets up for a less bumpy ride throughout their journey together. 

It’s never lost on me, as a Certified Animal Hospice Practitioner, that pet guardians have trouble accessing resources that could be useful, either because of financial constraints or geography. Mental health and well being apps like Headspace and Calm designed to help with mindfulness and insomnia are often in vigorous rotation with some pet guardians that I’m companioning, and to great effect, though they rightfully carry a fee to use them. 

Two options crafted by researchers at the US Department of Veterans Affairs is available at no charge to Veterans, Service members—and anyone else who wants to equip their wellness toolbox. 

Mindfulness Coach, available for iOS and Android users, is a mindfulness app that can boost a critical aspect of navigating a turbulent period: self awareness. Having self awareness allows us to successfully manage the stress response cycle and steer through periods of heightened stress, and having a tangible tool can help with that. Download the free mobile app by clicking here. 

Insomnia is a common feature of heavy duty caregiving: many pet guardians report that instead of feeling tired enough to sleep at night after the daily duties, worry, physical exertion and sometimes frenetic pace that builds as time passes, rather, they are feeling wound up. That’s another impact of these stressors on the body and mind. Insomnia Coach, also available to Android and iOS users, is based on Cognitive Behavioral Therapy for Insomnia (CBT-I). Your free download awaits you here. 

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.

Orally disintegrating tablets can be a game-changer in administering medication in some pets

Several weeks ago, I highlighted the topic of vestibular disease in dogs after a diagnosis with one of my charges. And while it’s not a life-limiting diagnosis, the accompanying symptoms can most definitely diminish a pet’s overall well-being and ability to cope until it resolves. That takes a goodly amount of patience, environmental management and supportive care to get there. The supportive care part is par for the course with most diagnoses, and how that’s carried out can take a bit of creativity. 

The source of the vestibular issues with the pet referenced previously took a little time to sort out, which isn’t unusual with some diagnoses. And so, symptoms that initially got better for them but then intensified by week’s end found the family back at their primary vet clinic to get things under control. 

After the vet’s assessment of a middle ear infection, they discussed what would be indicated to provide that supportive care that was critical for the pet’s comfort. And as the vet team was getting things in order, the family texted me to help generate any questions they should have for the vet team as a final plan was put together. 

One of the biggest concerns that I had was that the family might not be as prepared as they needed to be going home given that this was all unfolding on a Friday afternoon. And, going headlong into a weekend with a dog who was already assessed to be mildly dehydrated due reduced water intake because of the inability to keep their head up long enough to drink, let alone the nausea they were experiencing, I could easily envision a very complicated situation needlessly unfold. I made some suggestions for the family to run past the vet if they’d not put them in the treatment plan in an effort to avoid any hurdles over the weekend. One concern was top of mind. This dog had been nauseous all week due to the vestibular problems. And while anti-nausea (anti-emetic) medication was sent home earlier in the week in tablet form, I knew that actually administering a capsule or pill correctly, even a tiny one, would be a real challenge for a dizzy, nauseous, dehydrated dog with a decreased appetite and a worried guardian. And so I urged the family to ask about an option that could be used to be equally effective but easier to administer.

Gratefully, the vet consented to the client’s request—anti-nausea medication prescribed as orally disintegrating tablets—to be used as a backup plan should they be needed. 

Though orally disintegrating tablets, or OTDs, aren’t available as an option for every medication, they are for some very critical ones in human medicine and veterinary medicine. And as the name suggests, they are designed to dissolve in the mouth and do not need to be swallowed. That’s a boon for hard to medicate pets—including cats—and as a Certified Animal Hospice Practitioner and Certified Fear Free Professional, I love the option for pets who are receiving chemotherapy or are on hospice. Expect to have medications that have been prescribed as an ODT to be more costly and filled either through a regular pharmacy and some veterinary compounding pharmacies. 

I’m happy to report that the doggo in question made it through that weekend with little issue and has had a smooth recovery, which is the goal. And I enthusiastically encourage each of my families to advocate for themselves and their pets (and I happy do that for them as well) if they’re not feeling confident about being able to be concordant with a treatment or comfort care plan that their vet has put together and tell them that. Most often, vets are happy to figure out a plan b or in this case, make a minor adjustment that made all the difference. The biggest hurdle for families often is actually administering medication, but these days, there are more options than ever to make those interactions easier, safer and as importantly, they preserve the human-animal bond in the process. 

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 and Certified Fear Free Professional. She is CXO of Telos Companion Animal Services, LLC and can be found at lorrieshaw.com.

Unsteady as she goes: canine idiopathic vestibular disease

It’s not unusual for me to get a text or phone call any hour of the day from families-of-record if their pet is presenting with symptoms that are concerning, or behavior is at all unlike them. (Because we know that a change in behavior is in itself a symptom, right? Of course!) My families know they can get in touch anytime in these situations, and though I can’t diagnose their pet, I can definitely assess the situation and give good guidance on next steps and what to expect if and when their primary vet or an emergency vet needs to be involved. And if I’m able, I’m happy to come by to assess what’s happening and offer support. 

And this weekend, one of those calls came in. 

A very unnerved guardian detailed what they’d just witnessed in their very active and happy senior dog with a sound medical history: sudden onset of stumbling about/staggering/lack of coordination (ataxia), vomiting once, and a little confused. Definitely alarming, was my initial thought, though with my professional training to assess, experience and employing the principle of Occam’s Razor—the simplest explanation is usually the best one—I had a solid basis to work from. Also, I don’t panic. That’s unhelpful. 

The possibility of a stroke crossed my mind, or them having come into contact with a toxin. Other things too, but all of that was far less likely than what I felt was probably going on. 

Upon arriving just a few minutes later to assess things, I could see what the guardian was talking about. Though improved, and possessing otherwise normal vital signs, the pooch was still mildly unable to reliably coordinate their movements, and a little drooly (indicating nausea). They also had a telltale symptom that rounded out what I was expecting to see: though their pupils were equal in size, their eyeballs were moving back and forth like ping pong balls, a symptom called nystagmus. 

“I feel pretty confident based on what you’ve told me about what the past few days have looked like—rather ordinary— and what I see, is that they are experiencing an issue with their vestibular system,” I explained. 

“I’ve seen this before in senior dogs. Though it’s typically idiopathic, not life-threatening and resolves in a short time, I can’t say for sure that’s the case. A vet would need to do a proper assessment, diagnostics and history to rule out other possibilities.” 

The guardian agreed with my advisement to have them assessed immediately as a precaution, and so off to a local emergency veterinary hospital we went. (And of course, said pooch was 90% improved, by this point!) With otherwise normal vital signs assessed, the verdict from the veterinary team a short time later was what I’d expected: canine idiopathic vestibular disease.

Sometimes referred to as Old Dog Vestibular Disease (wince with me here) since it’s more common in senior and geriatric dogs, canine idiopathic vestibular disease is a diagnosis that can feel understandably scary upon its swift onset and presentation. No one likes seeing their pet wobbly, vomiting, sometimes struggling to stand. Stemming from an issue in the middle ear rather than the brain, it’s not known why it happens. 

The good news is that it tends to resolve quickly without intervention aside from any necessary supportive care, usually within weeks with no lingering problems. Below are things that are very helpful in managing the symptoms:

• Maintaining a safe environment indoors, especially blocking off access to stairs, is essential of course, as is close supervision outdoors. Consider nightlights for the overnight hours to help the pet navigate with more ease.

• Providing easy access to resources of food, water and places to rest/sleep. 

• For pets that are having difficulty in relieving themselves due to the wobbliness, I find that having them wear a harness is super-helpful. That way, you can help stabilize them as they are trying to urinate or defecate.

• If a pet is finding it too difficult to hold a position long enough to urinate or defecate even with assistance, they may develop issues with keeping themselves clean. It’s sensible to tend to their hygiene needs regularly and be watchful for urine scalding, matting and soiling. All of these impact the integrity of their skin and their overall well-being. 

• Supportive care, like medication to assuage nausea can be helpful for those pets that need it. Your veterinarian will likely send this home with you as a precaution. If your pet is having a hard time being upright long enough to drink water, consult your veterinarian straightaway so that they can decide on a plan to assist with hydration. 

At last check in this afternoon, I’m happy to report that said pooch is in fine form, and their guardian, relieved. 

For more on canine idiopathic vestibular disease and other vestibular disorders, click here. 

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.

Dog booties are helpful for senior and geriatric dogs in every season, but which ones are best?

Dog booties are used to protect a pet’s paws from the elements, mostly in winter. The products used to melt ice can wreak havoc on the pads, as well as the skin between, and for some dogs, the cold is just too much. Booties are ubiquitous in my day-to-day as a professional specializing in caring for senior and geriatric pets and those who are receiving animal hospice and palliative care. Aside from the reasons above, they’re used to protect the top and bottom of an an aging dog’s paws when degenerative myleopathy is present, or when they need more grip on bare surfaces, like when mobility is becoming less stable. 

There are lots of brands and styles, but few really measure up to the outstanding protection, affordability and usefulness that the Pawz brand does. My lending library gets lots of donations from families-of-record that I’ve worked with as a Certified Animal Hospice Practitioner, and there’s an abundance of various other brands in it for good reason: they just don’t work as well as they need to. They won’t stay on, they’re too clunky and pose a risk of tripping, or they’re just hard to use. 

Pawz, on the other hand, they stay put. Their simplistic design is why they work—they look exactly like a balloon—but it’s also a double-edged sword: they’re notoriously hard to get on. The small opening lends a snug, secure fit, but trying to open one up whilst fitting a dog’s paw inside is like wresting a boa constrictor. 

The tutorial below details how even those caregiver guardians who need to hurdle that obstable, can, with an unexpected tool. 

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.

Observing sedation as a side effect of a pet’s pain medication—or is it something else?

There are a few things that pet guardians rate as important when addressing the needs of their aging or terminally ill pet: they don’t want them to suffer, they want them to eat and they don’t want to see them zorked out and sedated on pain medication. And as a Certified Animal Hospice Practitioner, when I’m supporting families as we are discussing pain management with their pet’s veterinarian, the side effects are top of mind for them. (Some medications are sedating, at least temporarily though in many cases the sedation can be a big help, but I digress.)

Those concerns about sleepiness are valid. And when a family gets on board with adequate pain management, I can tell you it’s not a moment too soon. 

The pet does in fact typically sleep more, but it’s easy to focus so much on how drowsy a pet seems as a side effect of meds and not take into account that maybe, for the first time in a long time, the pet has attained a level of comfort because of the medications doing their intended job and assuaging the chronic pain that’s plagued them. The intended effects of those meds that allow them to sleep so long and deep and well because they’re finally comfortable, when that comfort has been fleeting for far too long. Fleeting, because of chronic pain that is very much a diagnosis all on its own that’s been discounted, and has impeded good sleep. 

Pets in later stages of life require lots of sleep and rest. It’s crucial to their well-being. 

Pain medications that a vet wants to prescribe are not an enemy. They are a blessing and prescribed appropriate to a pet’s changing needs, are an essential consideration of a palliative care plan—an ally.

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.