What Should I Ask My Veterinarian About My Aging Dog?

A dear friend posted a question in a Facebook group and I thought I'd put some thought into it. The question was simple but because of COVID19, there were some added complications - 

I knew she was getting older, but all of a sudden she’s old. We have a 6 week follow up appointment at the vets tomorrow morning to make sure she’s still a healthy old, but I want to make sure I’m asking all of the right questions. Which is made harder when all of the questions have to be asked over the phone because COVID means Dad sits in the car while she has her exam. So what questions did you ask your Vet when your dog got older?
It brought out several voices who wanted to offer guidance. The thread was exactly why I created the group: Kind, helpful people coming together to answer someone's question with compassion and data.

Also, they come for the distractions.

Y'all, what is EVEN up with her arms and legs?

But today, we talk about aging dogs and what to ask in the age of COVID19. 

What to ask if you can't go into the hospital?

The hardest part of COVID19 is that many pet owners cannot go into the building. They either have to wait in the car in the parking lot or go home to wait for a phone call. I would absolutely advise that everyone who has big questions or bigger decisions make a list before the visit. Start a few days early and everyone in the family writes down their questions on the same sheet of paper, the same shared to-do app, whatever can funnel every thought into the same space. 

Then, if you have a veterinarian who is taking emails, send them screenshots or pictures of the list. This can help streamline the process for everyone and make sure all the questions get answered. If not, give them a hard copy of the list so they can work on the answers in the phone call to you from your car.

The biggest concerns for aging dogs are of course related to comfort. Common issues revolve around arthritis (pain after running. stiff getting up, soreness, etc), loss of hearing, sight or smell, and an increased need to go to the bathroom are a few of the biggies. 

The list of issues and concerns might be longer if a dog has other underlying conditions, injuries, or complications, of course, and that's where the list comes in super handy. If a dog seems to forget who a person is, or is "forgetful", acting different, or in the case of my friend, "woke up suddenly older", then absolutely a trip to the vet is a good call. 

Pain Management (or, why your vet hears 'Can I Give My Dog CBD' a thousand times a day):

You all know I think it's super important that we all stay in our lane, but with CBD, it's the question that every dog trainer, veterinarian, groomer, dog walker, everyone in the pet industry has heard or has been asked to weigh in on - and not in the same way an NSAID would. Why is that? Well, for starters, CBD is reported (anecdotally) to help with most issues under the Canid sun but it also hasn't been tested or studied in trials. 

Remember earlier this year when our President suggested sunlight and disinfectant as cures for COVID19? There is a reason it's irresponsible to put things out there that aren't founded. 

flu shot GIF
“You see it gets in the lungs and it does a tremendous number [on the] lungs, so it would be interesting to check that...We’re going to have to use medical doctors, but it seems interesting to me.” -D.Trump, definitely not a doctor.

Arguably, not a president.

Dogs are known to suffer from a placebo effect, so if someone is using CBD for just one of the reasons people decide to use CBD oil - 

  • Pain
  • Cancer
  • Vision Loss
  • Anxiety
  • Depression
  • Epilepsy
  • IBS
  • Cardiac Benefits
  • Anti-nausea
  • Appetite stimulation
  • ...and More! 
- it could work? Maybe? And the number of people on the Internet who get upset who are convinced their veterinarians won't talk to them about this potential lifesaving alternative is so incredibly disheartening. 

See, vetrinarians in some states are allowed to discuss CBD as an option while other states ban the discussion from the jump (veterinarians can lose their license if they discuss it with patients). 

What I will say about CBD is the same as what my favorite medical podcast, SAWBONES, has to say about cure-alls. 

Cure-alls cure nothing

The SAWBONES episode on wine as medicine is so good and so funny. And, demonstrates the phenomenon of cure-alls perfectly.

Candy Cure GIF by zoefannet 

...At least,  on paper. There were some studies in the works before the COVID disruption (my new band name), and of course, tons of anecdotal data (though, remember placebo effects!) 

It's important to note that of my client base (again, all anecdotal!) those who have used CBD for anxiety still have had to use traditional pharmaceuticals to help with significant anxiety-related concerns (separation anxiety, fireworks, and noise phobia, living with kids, etc). If the anxiety is bad enough to warrant medical help, it can be really hard to get the medication correct even with a medical degree as every dog's health is totally different. 

I've spoken about Sadie's need for behavior modification medication that she needed as she aged - her inability to cope with noises, with changes in routine, with other dogs all got worse as she got older. A friend had a dog who presented exactly the same as she did - and yet, the medication that worked for Sadie did not work for that other dog. The medication that worked for the other dog did nothing to help poor Sadie. And we had the guidance of medical professionals and behavior specialists!

I can't speak to the pain side of things as I am not a veterinarian so I am not dispensing medical advice. However, if thought there was something out there that would help my dog and even if the placebo effect seemed to help my dog, great! But, I would try proven medication first (anti-inflammatories that have been trialed and tested, anxiety medication that would work NOW) and if I still felt like my dog needed additional comfort, either the medication dosage would need to be tweaked, or maybe I'd try something else that would help him, but I would never use it as his only medication as it's not trialed or tested, and not as a first resort. If my dog was in pain, I'd want to stop that pain, ASAP. 

TLDR: That's not to say I wouldn't ever consider using CBD, but I wouldn't consider it first. I'm not anti-CBD, and I could see cases where I might personally choose it for my dog, but I'm just not endorsing it until I see the receipts and for now, given the state of the country, I'm going to defer to the experts.  :) 

anything expert sevenredlines GIF

As another poster suggested on the thread: 

I would really look to address pain and maintain. Dogs are usually very stoic, so I would suspect some discomfort. Also, aim to figure out how much and which activities are best as in movement every day-but not running-adding in swimming if she will and really look to make her as happy and comfortable as possible.

Veterinarians are the experts here - and of course, they are going to give you the best advice they can. They aren't holding back, they aren't in bed with the "Anti-Dog-Pot-Lobby" -  and I promise they aren't being assholes by not suggesting this as a viable option. They are trying to be responsible and do what is going to help your dog, right now.  Given there are lots of variables with dosing, acquisition, placebo, strain, all of it - the responsible thing is to not advise for it until there is proof CBD can help for the thing a particular owner would be asking for it, and it probably won't help with everything on the ever-growing list of what the Internet says CBD, in theory, can fix. 

Sensory Loss

Since our dogs can't talk with us or to us about the aging process, we have to look at behavior changes. Anytime there is a sudden change in behavior, it's important to get thee to the vet, stat. In part because sudden changes can indicate an entire grocery list of issues - not least of all is sensory loss. Loss of hearing, sight, and yes, even smell, can all relate to behavior changes. 

Some dogs who lose vision might not be able to perceive someone/something coming in fast (like off-leash dogs or a tennis ball), those who lose registers of hearing might not be able to hear footsteps or cars pulling into the driveway (therefore surprising the dog when someone just magically walks through the door!), and still others might not be able to find treats hidden around the home. Any changes in behavior should absolutely be checked by a veterinarian, but in aging dogs, sensory loss should be a big part of the discussion. 

Other Suggestions

Some of the other suggestions were incredibly helpful and I wanted to put them here, too. Talking to your primary veterinarian about home visits so your dog doesn't have to get in or out of the car (or stand on a slippery floor at an animal hospital), alternative therapies like chiropractic and water therapy for dogs (water therapy near our apartment has helped so many of my clients aging dogs!) and of course examining trouble spots for older dogs can be a game-changer. 

  • Slippery floors can hurt aching, aging joints. Putting rug runners or bath mats in high-traffic areas to help an aging dog get from point A to point B without having to work so hard on linoleum, wood, or tile floors can really make a huge difference. 
  • Nosework and scenting games can keep a dog active and engaged mentally like crossword puzzles and chess do for humans. Keeping hides in a comfortable place for an aging dog is important - so an older greyhound looking at nose height might be more comfortable than leaning down like a grown giraffe for a floor hide, and alternatively, a 13-year-old dachshund looking up really high might be painful, so be mindful of the hides. 
  • Take it slow. The same walk you used to do in 25 minutes might take much longer or the distance might need to be shortened. Now more than ever it's important to go at your dog's pace and help them out. 
  • Doggie Massage - my friend and colleague, Amy Campbell, is a certified canine massage therapist. I can speak personally to the benefits of this craft. As Sadie was aging, Amy was studying to earn her certification. Every treatment, Sadie came out of it like a new puppy for several days. It was clear she felt better, much more limber, and was able to relax - something she was not able to do often as a high-drive Border collie in a city with a baby in the house. I've heard the same with acupuncture and chiropractic treatments for dogs. And yes, I know I might come off as a hypocrite as I wasn't endorsing CBD, but these treatments have certifications, a foundation in canine anatomy and physiology, and can help without adding unregulated chemicals to a dog's body that might counteract existing medication a dog might be taking.
  • Physical Therapy can be an absolute game-changer for older dogs, too! It's movement, strength, flexibility, and I'd argue, a connection to people.  
  • Appropriate exercise
dogs jumprope GIF
Not this

All in all, it can be eye-opening to see a dog getting older. For me, staring down the barrel of time for my beloved dog, Sadie, was hard. I feel like I was grieving her eventual departure from this mortal coil since she turned 8 - that's a long time to be looking for the exit with your friend. Every choice was, "is this good for her? Is this the right call?" 

And if you're thinking, "Is this the right call?" then the answer is almost always, yes. I believe fully that even if it's the wrong call, if you're thinking that question then you have the best intentions at heart, and your canine partner-in-crime (CPC?) is lucky to have you as their guardian. 

deon cole dogs GIF by Angie Tribeca
CPCs for Lyfe.

Books and Resources? 

Books can offer some help, as can podcasts and just talking with other people who are going through this, too, but unlike puppyhood, the resources are much fewer.

Good Old Dog: Expert Advice for Keeping Your Aging Dog Happy ...
"Good Old Dog" by Nicolas Dodman, DVM
Nicolas Dodman's book on aging is a great perspective from a veterinarian and compassionate human. And, if listening to a discussion instead of reading a book is more your vibe, there is the conversation he has here on NPR about the book. 

The AVMA is a great resource, too, specifically on aging animals. 

Hannah Brannigan's podcast, "Drinking from the Toilet," (great name!) explores the aging dog with trainer, canine massage therapist and all-around awesome dog lady, Lori Stevens. 

Age is but a number

And with that number, different issues pop up. It's part of the dog-owning journey and given that in comparison to puppyhood, there are SO few books about this part of the dog-owning process, I think it's important to talk about openly. Puppies are easy to love - even when they are peeing on your floor. Older dogs, maybe not so much. 

Puppies are exciting because there is so much potential.
But with older dogs, there is history, habits (good and bad), and a foundation of love. 

Of the two, it's harder to write about history because it's often so personal. We all tell our stories and our dog's stories with a very anecdotal slant, a personal slant, looking down the tunnel of inevitability - this ride will end. Our co-pilots are statistically more likely to cross the rainbow bridge before we do, and that feels so unfair. 

Yet, it's the way it goes - but just because they can't catch a ball, or chase a rabbit with the same pep, they can totally rock a sofa cushion, watch Netflix, and be what we always think of them as: 

st bernard dog GIF

Our best friends. 


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