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.
