Managing Special Needs & Chronic Conditions in Dogs
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by Peri Norman
As the baby boomers are aging, tips on maintaining our health and maximizing our quality of life are frequent topics of discussion. We know that better medical care and nutrition have contributed to a longer life span than we had just a couple of generations ago. The same is true for our pets. Much of what is recommended to help us enjoy the best possible health in our golden years is also applicable to our dogs.
Advances in care and feeding are only useful if you put them into practice. For our dogs, that involves regular veterinary check-ups. Observe your dog carefully and pay attention to any recent changes in appetite, thirst and toilet habits. Changes in activity level should also be noted. A thorough grooming on a regular basis can help us to stay in touch with what is normal for our dog. Decreasing activity levels, small bumps and lumps on the skin and other changes consistent with aging can be very gradual, so regular veterinary visits can help us sort out “simple” aging from chronic problems that might be less onerous with some medical therapy or management.
Many people find it helpful to make a list of questions before a doctor’s appointment. This is also a very useful thing to do before a vet appointment. Writing out a list of questions and concerns helps us to crystallize our thoughts and not forget anything. I like to make two copies of the list; one for my use and one for the staff to include in the dog’s chart, so that your veterinarian also has a written copy to refer to.
If you have given your dog appropriate veterinary care throughout its life and fed a good quality food, your dog may be well into later years before any chronic problems surface. Sometimes, for a variety of reasons beyond our control, young dogs can also face illness requiring extensive care and management. One thing that I find is a tremendous help in caring for a pet with a chronic illness is a log sheet. One of my dogs was hospitalized at 10 months of age with life-challenging gastrointestinal disease. At my request, the clinic gave me a copy of the daily log sheet that was attached to her kennel to keep track of all aspects of necessary care and medications. I modeled my log sheets after the clinic version and keep them in chronological order in a green file folder. It serves not only as a reminder for food and meds, but also gives me a place to notate any unusual occurrences like vomiting, loose stools or increased temperature. I take the green folder with me to veterinary appointments so that I can refer back to my notes about changes in food and medication as well as symptoms.
Having a dog with a chronic condition that requires a lot of medication has led me to consider that all my dogs should be taught to take a pill without protest. In my right hand, I hold the pill(s) between my thumb and forefinger and between the heel of my hand and my ring finger and pinky, I hide a small, high-value treat. With my dog on my left side or slightly in front of me, I gently grasp the muzzle and slip my thumb on one side and my forefinger on the other right behind the upper canines with just enough pressure to get the dog to open its mouth. I quickly drop the pills into the back of mouth and then with a little twist of my right wrist present the yummy treat. Every dog I have tried this with immediately swallows the pill while reaching for the treat. Coupled with enthusiastic praise and cheering, this method has worked well to encourage my dogs to take their pills happily.
I use a similar method for topical flea prevention application. Take all the wrapping off the flea prevention vial. I show the dog the treat and the medication. Then I place the treat on the kitchen counter and ask the dog to “stand and wait” using the same words I would use in the show ring. In the beginning, you may have to encourage the dog with a hand under the neck and reminders to stand and wait, or enlist someone to gently hold their head and scratch their ears (while not blocking the view of the very important treat on the counter), but with quick work on your part followed by praise and receipt of the treat they have been watching, these procedures will also become comfortable and relaxed. With some dogs who are particularly amenable to handling, I have been able to use this method to give injections as well.
One of the hardest things about having a chronically ill pet can be the cost of veterinary care and medications. It is important to have your dog treated by a competent and caring veterinarian. Take the time to shop for a general vet that you are comfortable with. While a general vet can be a jack of all trades, a good one knows their limitations and will recommend a board certified specialist if that is appropriate for your dog. If you are uncomfortable with any aspect of diagnosis or treatment, do not hesitate to ask for a referral to a specialist. An ethical veterinarian will be relieved to have another opinion on a complicated case. In addition to years of extra training, a specialist has the advantage of having seen significantly more cases of disease processes that fall within their specialty. It can sound counter-intuitive, but because the specialist has seen more cases, it can sometimes be less expensive to go to a specialist sooner. Their depth of experience can help by narrowing down the set of useful tests, as opposed to endless fishing expeditions. Questions you might ask before doing invasive and/or expensive testing are:
1. What are the possible diagnoses that fit my dog’s symptoms?
2. How are the suggested tests going to help us eliminate some possibilities and/or include others?
3. How will ruling particular diseases in or out affect our treatment plan?
As with humans, another important aspect of health care for our pets is being knowledgeable about the medications/supplements that we are giving our dogs. Very few medications have no possible side effects. When your vet prescribes something new for your dog, ask the following questions:
1. What changes should I see when this medication takes effect? What is a normal timeline for visible improvements?
2. Is there any cause for concern about drug interactions between this new medication and any current medications or supplements?
3. What are the possible side effects? How might I see those appear in my pet and within what time period?
4. How often have you prescribed this medication and have you had any pets in your practice exhibit serious side effects?
Lastly, do not hesitate to ask about the expense involved with various therapies and medications and possible less expensive alternatives. When my girl with GI disease was diagnosed, a prescription was called into Costco for her cyclosporine. It was $250 per month and not always available so sometimes I had to pay more at the drug store. My general veterinarian did a search for me and found a compounding pharmacy that produces her cyclosporine in a liquid emulsion for $130 per month, a significant savings. Every day meds like famotidine (Pepcid) can almost always be purchased at the drug store for significantly less than buying them from your veterinary office. Certainly long-term use warrants a full investigation of all the options.
Many sources recommend that you need to be your own advocate with regard to your health care. Be persistent about getting the care you need and don’t let a medical professional blow you off and not thoroughly answer all your questions and concerns. That is doubly true for your dog. They cannot advocate for themselves and rely on us, their loving and responsible owners, to make sure they get the care and treatments they need to live a long and comfortable life.
Sample Log Sheet Date and Time
BEFORE BREAKFAST
1 ten mg famotidine
BREAKFAST
1 ½ cups of kibble
Therapeutic dose of probiotics
AFTER BREAKFAST
1 capsule Prazosin
½ capsule prioxicam
500 mg amoxicillin
LUNCH
1 ½ cups of kibble
BEFORE DINNER
1 ten mg famotidine
DINNER
1 ½ cups of kibble
Therapeutic dose of probiotics
AFTER DINNER
½ capsule prioxicam
500 mg amoxicillin
NOTES:
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Posted by ralbee
on Nov 13 2015. Filed under Current Articles, Editorial, Featured.
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