Author: Dr. Becky Schoenberg

Today marks the one-year anniversary of Autumn Care & Crossings’ first patient, and my first official step on the path of being a hospice veterinarian.  While I had studied and planned and worked towards this in preparation, it was on this day last year that I formally became a hospice practitioner, and started stepping into people’s homes and lives to help them and their beloved pets in the final phases of their bond.

And I have learned so much in this year.  From my colleagues and the conferences I’ve attended, from the accountants and business folk who have helped me navigate the maze of small business ownership, and most importantly, from those very clients and patients.  I have learned more and nuanced details about targeted pain management and breakthrough pain and natural versus palliated death versus euthanasia.  I have learned how to reconcile Quickbooks and when not to trust Google maps.

I’ve learned to always keep treats and a spare pack of tissues in my bag, and that on a sunny day the dog park is an excellent place to finish a hospice call.  I’ve learned to never underestimate a child’s understanding or an adult’s devotion, when traditional medicine had always taught me to trust in the opposite balance.  I’ve learned that family is not defined by blood or by species, but by love – and that love comes in more shapes and manifestations than I had ever dreamed possible.  And I’ve learned that sometimes saying goodbye is the greatest and bravest act of love that a person can make.

It’s hard to write in a blog here when I sincerely don’t have words for how grateful I am to everyone who has been part of this year.  To my colleagues who shared their knowledge and experience with me; to the friends who helped make this practice real; to my patient and loving spouse who met the question of, ‘can I throw my career, our lives, and our home into chaos and turmoil for the sake of trying this?’ with more grace and support than I had any right to ask for, and most of all to the clients who invited me into their homes to be part of their pet’s care team.  Thank you all, more than you could ever know.

As a mark of that gratitude, and in celebration of the families and pets that I’ve been lucky enough to come to know over the past year, I’m starting what will hopefully become an annual tradition.  Autumn Care & Crossings will be making a donation to the MSPCA in honor of each pet in our care that has passed away over this past year.  It is my hope to celebrate each life passed by helping another animal become someone else’s beloved pet, and find a forever home as loving and caring as the ones my patients have been blessed to know.

Because I can’t say it enough times, thank you all again for being part of this amazing experience with me.  I look forward to many more years of laughter, tears, and learning as I help guide my patients and clients on their journey through this chapter of life.

At some point in our relationship, almost every client that I’ve worked with – in both traditional practice and hospice practice – has asked me how to know when it’s time to euthanize their pet.  It’s a hard question – we want to have as much time as possible with them, but we also don’t want to allow them to suffer, and it’s natural to worry about making that difficult decision either too soon or too late.

I wish I had an easy answer here.  I wish there were an equation that we as doctors were trusted with – multiply the pet’s age by their weight, divide it by some numerical value assigned to their diagnosis, subtract a point for each day they don’t eat, and when you get to zero a timer sounds and you know.  Or, if not that, that there was some concrete point or incident that I could tell everyone to look for.  Unfortunately, that’s not the case.

Every pet is unique, and every person’s relationship with their pet is unique, and so the point of decision is going to be different for each family.  Some people want to be absolutely certain that they avoid any possibility of pain or suffering for their pet, and want to say goodbye sooner – and that’s okay.  Some people want to know that they’ve exhausted every possible treatment, and given their pet every possible moment of life – and that’s okay too.  And on top of that, every pet finds joy and happiness in different aspects of life, and so their quality of life is going to be affected by different things.

Quality of life is, ultimately, the most important factor in deciding when it’s time to help your pet pass.  And, as I said, it’s a very individual thing.   A 90-pound labrador retriever that’s used to being able to run and climb mountains with his family is going to be much more severely affected by joint disease and poor mobility than, say, a teacup chihuahua who’s used to being carried and cuddled for most of his interactions with his family.  On the other hand, that chihuahua (or an aloof kitty) is likely to be more negatively impacted by a need to take multiple medicines two or three times a day than the lab who will eat anything hidden in cream cheese or cold cuts.

One of the most important things that your veterinarian can help you do, as your pets age or confront chronic or terminal illness, is help teach you how to recognize their quality of life.  This is a deep collaboration between you, your pet, and the doctor – while they can talk you through what signs to watch for on the medical front, you know your pet’s personality.  You live with them every day, watch them, and know their favorite toys, treats, napping places, and things to do.  And it’s important to discuss these with your vet, and form a plan to pay attention to them and track them.

If your pet is seriously ill, your vet may suggest tracking their quality of life.  While there is no absolute equation, as I mentioned, there are factors that we can quantify and ways to track whether those details are getting better or worse.  If you’re having a hard time making a decision about whether your pet is suffering, having a way to look back over the past days or weeks and see objectively whether and how their condition is progressing can be a valuable aid.

There’s no way to make this decision an easy or painless one.  But by talking to your vet about quality of life, and paying attention to what your pet loves most, we can help you face this challenge with a little more confidence.

Loss and death are always difficult, whether we’re the ones facing the loss of a beloved friend, pet, or family member ourselves or whether we’re trying to support someone we love through that process.  Every person approaches loss and grief with their own history, worries, and combination of emotions, and just like there’s no one right or wrong way to grieve, there’s no one right or wrong thing to say or do to support someone through grief.  There are, however, some things that can be generally helpful in most situations, and some that may seem helpful but can actually make things worse.

So – what should you NOT do to help someone you love through the loss of a pet?

*Don’t suggest that they get another pet.  While for some people getting a new pet may be part of their grieving and healing process, this isn’t true for everyone – and more importantly, the time to bring a new pet into the family (if they choose to do so) is different for everyone.  What may seem like a practical solution to you can come across as suggesting that pets are interchangeable and replaceable, which can seem dismissive of the pain and loss the person is feeling.

*On that same note, don’t try to reassure them by telling them it was ‘just an animal’ and that it could have been worse, by comparing it to other losses.  There’s no universal scale of loss or grief, and everyone is allowed to feel their own pain.  One person’s loss of a pet may be as traumatic to them as another person’s loss of a human.  Grief is not a contest or a zero-sum game.

*On the other hand, do not tell them “I know exactly how you feel.”  Even if you’ve been through a similar loss yourself, even if you feel that you have a deep understanding of their emotional state and want to be supportive, no two people experience grief and loss the same way.  Their emotional response is theirs and unique, just like yours was and is.  Don’t dismiss their feelings by suggesting that they’re the same as yours.

What CAN you do to be helpful?

*Listen.  This is the most important thing that a supporter and friend can do.  Let the person know that you are present, that you care, and that you’re able to be an ear and a shoulder for them.  If they want to talk, listen without judging or trying to problem-solve.  If they need reassurance, give it to them without straying into personal anecdotes of your own.  If they need quiet company, be present without pressuring them to behave in any particular way.

*Validate their feelings.  Let them know that it’s okay to grieve, and that you understand that their loss is significant to them.  While ‘I know how you feel’ is an unhelpful response, ‘I can’t imagine how difficult this must be for you’ or ‘I can only imagine how you must feel’ are open-ended, supportive statements that let your friend know that you empathize with their loss without second-guessing or hijacking their experience.

*Ask what they need or want.  What’s helpful to one person may not be helpful to someone else, and we run into the biggest problems when we assume that what we would want in a given situation would also then be best for another person in a similar situation.  Asking instead of assuming lets you give the most useful aid.  It also makes sure that the help you’re giving is focused on the grieving individual, rather than yourself.  Often in situations of caregiving we want to help in ways that will make us (the caregivers) feel better, but the most important focus should be on the person suffering the loss.  While we are hurting too, and are allowed to seek our own aid, the help we offer should be focused on those we’re helping rather than on ourselves.

*If the grieving individual isn’t able to focus enough to give you a specific answer to what they need or want, ask about specific ways you can help, but offer them as choices.  (“Would it help if I came over to keep you company?  Do you need someone to run errands for you?  Do you want me to return Smudge’s medicines to the vet so you don’t have to go back to that office so soon?”)  – and be prepared to accept whatever answer they give.  This empowers them to have some say in the help they receive while taking the burden of coming up with ways to be helpful off of their shoulders.

*Most of all, be patient.  Grieving takes time, and sometimes – as much as we want to help – there’s nothing we can do except be present, let the people we care about take the time they need to heal, and let them know that we’ll still be there, still care, and still be part of their life when they’re ready to engage with us again.

*Take care of yourself.  Even if you didn’t suffer the loss personally, having a friend or family member grieving the loss of a loved one (human or pet) can be stressful, challenging, and bring up memories of our own losses.  Make sure that you’re getting the rest and support you need – you can’t be a good caretaker and supporter if you’re not also taking care of yourself.

*If you’re concerned that your friend or family member is in danger, reach out to a professional.  Whether that’s a grief counselor, a religious leader, or a suicide hotline, if you’re seriously concerned that someone may be at risk of self-harm or falling into clinical depression or suicidal tendencies, don’t try to tackle that alone.  Encourage them to seek professional help, or if need be, reach out to a professional yourself.

Grief is something we all have to face at some point, both our own and that of our friends and loved ones – hopefully this can help make navigating that path a little easier.

While the holiday season is meant to be a time of joy and celebration, for those of us who are dealing with a loss – either recent or historical – this time of year can be especially challenging in many ways.  The pressures and expectations of society and of friends and family, even if they’re well-intended or completely unintentional, can add stress and pain to a situation already heavy with memory and pain, and it’s incredibly important, in the middle of these challenges, to take care of ourselves and be aware of our own emotional health.

People facing loss and grief during the holidays are often drawn in two completely contradictory directions.  There’s pressure from society and our culture to celebrate, rejoice, and generally be filled with a spirit of love and good cheer that may not feel appropriate to someone mourning a recent loss or facing an imminent loss.  This may be even more acutely felt by those who have lost pets, as often many people may not regard that loss as being as valid or emotionally challenging as the loss of a human family member, or may pressure them to get a new pet as a holiday gift.

At the same time, at the other end of the spectrum, people facing loss can also be pressured to show their mourning in ways that outsiders feel appropriate – to grieve publicly and to abstain from any displays of happiness or celebration.  They may be told that it’s inappropriate to celebrate under these circumstances, or they may feel guilty for being happy when propriety tells them they should still be sad – it can feel like a betrayal of the individual lost to find happiness so soon after, or so close to their passing.

There is no right or wrong way to feel.  There is no one true way to grieve, and whatever you are feeling around your pet’s loss (or any other loss you may be facing) is right for *you.*  While it’s important to find support from the people you love and who love you, it’s also important to set boundaries, and to make it clear to them that your emotional path is your own, just as theirs is.  If it feels appropriate to grieve, to abstain from celebration, and to be present with your sorrow, then do so.  If it feels right to celebrate – to share tales of joy from a life together, to rejoice in the loved ones still present, to give your happiness as a gift to the world that gave you such a loving companion for as long as it was able, then do so.

You do not owe anyone either your sorrow or your happiness.  Not society, not your family, not the loved one who has passed on.  You have gifted them with your time, your energy, and so many other things, but your grief and your process through loss are yours to travel in your own way, at your own pace.

That doesn’t mean you need to walk it alone, though.  As I said, please reach out.  In this dark, chill, challenging time we can all feel lonely, especially if a beloved companion has passed or is facing terminal illness.  Please take advantage of the resources in your area.  Friends, family, veterinary staff, religious support groups, pet loss hotlines or online communities – whatever support you need to make it through this period.  Help is here.

Best wishes for hope, healing, happiness, and a bright new year.

One of the most common questions I get, when I talk about hospice and end-of-life care, is how a person can discuss their choices regarding their pet’s care with other people who don’t understand or agree with the decisions they’ve made.  This is a challenging problem, in both directions – there will always be people who don’t understand a decision to invest time and money in a pet, and people who don’t understand a decision against aggressive care.

More and more, it’s actually becoming easier to discuss these decisions.  Our culture is coming to recognize the important roles that animals can play in our lives, and the strength of the bond between people and their pets.  From workplaces offering pet insurance to companies making greeting cards and thank-you cards for and from pets to the prevalence of pet-friendly hotels and vacation facilities, pets are being recognized as part of the family unit.  Still, that doesn’t protect us from the questioning and judgment of people who don’t – or can’t – understand the decisions and choices we make, or who accidentally hurt us with well-intentioned but ultimately hurtful advice.

(And for those of you who are friends or family to people facing pet loss, it can be hard to know what to say or how to help them.  That’s another complicated topic, that deserves its own post in the future.)

So – what do you say to someone who tells you that ‘it’s just a cat,’ or asks why you’re putting so much time and energy into what they perceive as a replaceable thing?  Or to someone who feels that your decision to stop chemotherapy or avoid surgery is giving up too early?

I wish I knew the way to answer this, in such a way that would lead to universal understanding and compassion.  Unfortunately, the best solution I’ve found is to politely establish your emotional boundaries, and redirect the conversation.  When it comes to issues around end-of-life care, grief, and loss, we all have so many emotions and so much personal history invested in these subjects that it can be impossible to change people’s minds – the best path I’ve found is not to try to create converts, but just to clarify one’s own position.

What do you say, then, to do that?  I’ve found that something along the lines of this can work:

“I appreciate your opinion, and respect you as a [friend/cousin/coworker] – but the human-animal bond is different for everyone, and this path I’ve chosen is the one I feel that best honors my bond with my pet.”

If they want to learn more, feel free to explain, or share some resources with them – some people have just never encountered the concept of hospice for pets before, or are unaware of the choices available when it comes to pain management and end-of-life care.  But if they persist in pushing their point of view, and don’t respect your decisions, it’s also okay to let them know that what they’re saying is hurtful.

Most people honestly want to help – sometimes you can deflect their well-intended words by giving them another way to help instead.  An offer such as “I understand that you mean well, but this is a very difficult time for me, and right now your words are making things more difficult.  If you want to help, what I really need from you right now is….”  And let them know what could be most helpful for you – whether that’s a hug, quiet acceptance, reassurance, a ride to the pharmacy, or anything else that may either ease your stress and emotional burden or help you face your current challenges.

The most important thing you can do, overall, when faced with challenges like this is seek out people who *do* understand.  Find a pet loss support group, either local to you or online.  Talk to your veterinarian or their staff.  And, ultimately, if you’re feeling overwhelmed or having trouble coping with either loss or the burden of caring for a chronically or terminally ill pet, talk to a grief counselor.  Regardless of what anyone else says, your feelings and your choices are valid – and you deserve to have the support of people who understand that.

Pain.  It’s such a small word for such a large and complicated condition. Our culture surrounds us with so many different messages about pain, especially chronic pain, that it can be difficult to form a clear opinion about how to handle this condition, both in ourselves and in the pets that we love and care for.  How many times have we all heard these statements, or ones like them?

‘No pain, no gain.’

‘Pain is weakness leaving the body.’

‘A little pain never killed anyone.’

‘Just push through the pain.’

‘If it doesn’t hurt you’re not doing it right.’

These – and so many other philosophies – put forth the idea that pain is some kind of badge of honor.  That hurting is somehow proof that you’re working hard, or at the very least that pain in and of itself is harmless, minor, and not a problem that anyone should act on.  That, by treating pain, you’re admitting weakness.  And sadly, nothing could be further than the truth.

Pain is a disease in and of itself.  Pain causes physical damage to the body and permanent changes to the nervous system.  It slows healing.  And, in animals, it is one of the leading causes of death – as our pets reach a point where pain impacts their mobility so severely that they can’t stand or walk anymore, or diminishes their quality of life until they lose all interest in food and interaction, and the people who love and care for them choose to help them pass rather than either watch them suffer or face nursing care challenges that are beyond their capacity to manage.

It is true that some pain serves a purpose – but this is not true in most cases that we treat in medicine.  Ultimately, there are two kinds of pain: adaptive and maladaptive.

Adaptive pain is useful pain.  It is short, immediate, and serves the purpose of warning us that something damaging to our physical body is occurring, and that we need to act to correct that.  When you put your hand on a hot stove, and feel pain, you know to remove your hand before further damage occurs.  This is a normal function of our nervous system, and a way to protect ourselves.

Maladaptive pain is a very different thing – this is pain that serves no protective or helpful purpose.  This can be pain that continues after tissue heals, or pain that exists out of proportion to the stimulus causing that response.  Almost all chronic pain is maladaptive pain, and it can be very difficult to treat.

The problem is that these two forms of pain exist in a spectrum.  In particular, adaptive pain that is left untreated can and will progress to maladaptive pain.  When pain is untreated, there can be permanent physical changes in the neurological system.  Nerve pathways that help decrease or stop pain sensations cease to function, and other pathways that detect and transmit pain become more sensitive.  Other nerves not involved in the initial pain process are recruited and brought into the sensation and transmission of pain.   Once these changes occur, they cannot be undone.  Once chronic maladaptive pain exists, the best we can do is manage it.

There are several tools in our arsenal to manage chronic pain; I’ve talked about some of them in this blog before.  Chronic pain, if recognized and addressed, can be minimized and our pets’ quality of life can be maintained.  But the earlier in the course of a painful experience that we start treatment, and the more thorough that treatment is, the better the chance of preventing its progression to chronic maladaptive pain.  Treating pain early, and completely, is one of the most important tools we have in maintaining quality of life.

Pain is a disease.  We need to recognize it and treat it, just like any other.  Please, don’t let your pets – or yourselves – stay in pain.  Your bodies and your comfort are too valuable to suffer needlessly like that.

When I asked for suggestions of what folks would find it useful for me to talk about here, one of the more common requests I got was for an explanation on how to give medicine to your pet.  Unfortunately, that’s not something I can easily describe in text-only, and it’s not a one-size-fits-all description.  Every pet is different, as is every person trying to treat them, and the best suggestion I can make is to ask your vet to demonstrate how give *this* medication to *that* animal – whether it’s pills, eye drops, insulin injections, or hairball paste.

But I did realize that there is one aspect of medicating (or treating in general) that I can talk about here, and that is how to find a medication form that works for you, your pet, and your lifestyle.  One of the most common problems I see – not just in hospice but in veterinary medicine in general – is people giving up on treating their pet because they feel it is difficult or impossible to give them medicine.  People get frustrated, pets go without treatment, and everybody suffers, because people don’t know that other options are available.  And if there’s one lesson I’d love to teach everyone reading this, it’s just that:

There are *ALMOST ALWAYS* more options available.

Not 100% of the time – some conditions demand to be treated only one way.  But in nearly every situation there are multiple options for getting medication into your pet, and your vet can work with you to find the one that works best.

So, how do you find the best way to treat your pet?  There are a lot of facets and steps:

1. Have confidence in yourself.

Yes, there are a lot of jokes out there about how to pill a cat, and yes, in general giving medicine is a skill.  But if you’re reading this, you’ve already mastered a whole lot of much more difficult and complicated skills.  I have confidence in you, and you can learn to do this.  It just takes time and practice.

2. Talk to your veterinarian.

As I said above, ask them to demonstrate how to give the medication.  Any considerate veterinarian should be able to either show you how to give a medication or have one of their nurses or technicians teach you.  If once isn’t enough, it’s okay to ask for another appointment when the next dose is due, for them to help walk you through it again.  We all went through this same learning curve, so we understand how challenging it can be at first.

3. Follow up with your veterinarian.

If you’re having trouble medicating, don’t just give up, or assume that this just isn’t going to work.  Let your vet know what’s going on.  They can’t help you, or suggest alternatives, if they don’t know there’s a problem in the first place.  On the other hand, if everything is going well, let them know too so they can note what types of treatment your pet tolerates for future reference.

Let’s say, though, that your pet is particularly challenging, and just won’t tolerate pills.  That’s not the automatic end of the road.  There are other ways to get medication – even oral meds – into your pet.

Compounding is an amazing tool for veterinary medicine.  It means getting medication custom-made for your pet.  This is very helpful in the case of super-small (or super-large) animals, because it means that we don’t have to worry about giving your 5-pound cat 1/16 of a tablet of something, or your Great Dane 5 pills three times a day.  It also means that, for pets who don’t want to take a pill, we can find something a little more palatable.

Compounded meds can be made up in a few forms:

-Chewable treats:  These are just what they sound like – chewy little treats that have medicine mixed into them.   They can be made up in several flavors, so let your vet know what kind of treats your pet tends to prefer.

-Flavored liquid: This is similar to other liquid medications, but instead of tasting like chalk or bubblegum, it can be made in flavors that are more appealing to pets.  (This is particularly common for cats, who may not always be as motivated to take flavored treats.)

-Unflavored capsules: For medications that taste very bitter, and whose flavor can’t be easily masked by chewables or liquid, we can hide the flavor by putting it into a capsule.  You still have to give this medication like you would a pill, but without the bitter taste, many animals take it a lot more easily.

-Transdermal:  Some (but not all!) medications can be made into a topical formula that is applied to the inner surface of your pet’s ear.  Be careful when requesting transdermal medications; not every drug can be absorbed through this route, so have your veterinarian double-check before requesting any specific medication be made in this formula.  Some pharmacies will compound any medication in any formula, regardless of efficacy, so having this option available doesn’t guarantee it will still work in every case, but for the situations where it does work, it can be a literal life-saver.

There are some things to keep in mind about compounding.  It’s not something your veterinarian can do at their own hospital (unless your veterinarian has a specialized compounding pharmacy on their premises), so they will need to call your prescription into an outside pharmacy.  Compounding takes time, so you’ll need to keep track of how much medicine you have on hand, and request your refills at least a few days before you run out of medicine.  And because the compounding requires special equipment and takes more hands-on time from the pharmacist, it is more expensive than just buying pills from your vet or a standard pharmacy.

However, if this is the best way to get medicine into your pet that will keep them alive or maintain their quality of life, it can be absolutely worth it.  And, most importantly, it’s free to ask.

And compounding medication isn’t the only alternative out there.  In some situations, medicine can also be given by injection, either at your vet’s office or, in some cases, with training at home.  Also, depending on where you live, you may be able to contact a traveling vet tech or skilled pet sitter to help medicate your pet.

Ultimately, the most important detail is that the first thing we try is almost never the only option.  Sometimes it takes trying a few different routes and techniques before we find the best way to treat a particular pet, to help maintain both their health and their positive relationship with their family.  Talk to your vet, let them know if you’re having trouble, and ask them to work with you to find the best way to treat your pet and their condition.  Together, we’ll find something that works.

In his amazing book “A Dirty Job,” Christopher Moore describes hospice workers as “benevolent Valkyries, midwives of the final light.”  Since I’ve transitioned to practicing hospice medicine, this is a description that resonates with me more than ever.  My practice involves many facets of pet care, including (and often focusing on) end-of-life care, mostly because that’s the one part of home veterinary care that people are most familiar with, but even when it comes to planning for euthanasia, there’s a place for hospice medicine.  In some ways, preparing for and easing the path to death is at the core of what we do.

Many people have both the desire to have their pet pass peacefully at home and the foresight to reach out to a veterinarian that provides in-home euthanasia when their pet is first given a terminal or incurable diagnosis – but most of them don’t realize that having a visit with, and establishing a relationship with a hospice veterinarian can help make preparing for that inevitable final visit much smoother and easier.

All too often, I’ve had clients approach me by phone or email to discuss their concerns about their pet’s condition and their hopes for a home death, but decline any house calls before then, only to wind up in a crisis situation where they have to take their critically ill pet to an emergency facility instead of having the peaceful home passage they envisioned.

There are many reasons people may not choose to have their ailing pet evaluated by a hospice veterinarian.  Often they feel like there’s nothing we can do, medically, to treat the animal.  In other situations, they’re afraid to confront the severity and permanence of their pet’s diagnosis until they have no other choice.  And lastly, they may feel that they’ve already done everything necessary by ascertaining that home euthanasia is an option, and checking on prices and procedures.

When you’re hoping for, or planning on, having a pet pass at home, it can help immensely to make an appointment with a hospice veterinarian as early in the course of events as possible.  Medicine is only a small part of what we do – much of our practice involves education, support, and planning.

We can help you get a deeper and more thorough understanding of your pet’s diagnosis, and teach you ways to recognize their levels of comfort and quality of life.  We can help provide a tentative timeline – while no doctor can see the future, we can at least help come up with an idea of how quickly symptoms are likely to progress, and when intervention may be necessary.  We can help you plan their passing, show you what signs to watch for to know when the right time has come, hopefully without ending up in an emergency situation, and we can help you find both the emotional and educational support that a caregiver needs.

Even in situations where we can’t prescribe medicine to treat an animal, hospice caregivers can help both people and their pets in their journey before, during, and after death.  Medicine is not limited to diagnoses and prescriptions, and support is not limited to the patients themselves.  We are here for everyone involved – let us help.

Working in hospice, palliative, and geriatric care, one of the most common challenges I see – and most emotionally traumatic – is that of pain and declining mobility in aging animals.  This is especially common in large-breed dogs, though it can happen in almost all species and breeds, and it can be one of the most difficult problems for owners to face.  When a beloved pet is still eating and alert and engaged with the family, but can no longer move around or handle getting into and out of the house, the possibility of having to euthanize an otherwise happy animal can be heartbreaking.  Likewise, it is difficult beyond words to watch a creature we love experience pain and loss of mobility, and not know what we can do to help them.

Luckily, as our pets live longer, veterinary medicine also learns new ways to help these creatures in their golden years.  There are a lot of new and emerging options to manage our elderly pets’ comfort and help them continue moving around and taking part in normal life activities, even as they face problems like arthritis, neurological disease, or muscle loss.

Pain management is always at the core of any such treatment plan, of course, and can take many forms.  Anti-inflammatory medications, additional oral pain medication, nutritional supplements, massage, and laser therapy are all tools in our arsenal for combating pain and discomfort in pets.  But sometimes even when an animal’s pain is well controlled, they still need help moving around.  Stiff joints don’t bend as far, weak legs can’t jump as high, and aging nerves aren’t as good at reminding our pets where their feet are at all times.

One of the most helpful tools for dogs with mobility problems is a support harness.  These are tools that allow a person to help the animal to stand up, add stability and support to their hind end, and assist with weight-bearing in difficult postures like climbing stairs or going to the bathroom.  In a pinch, a folded blanket or towel can serve a similar purpose, but for long-term use a harness made specifically for this purpose is more comfortable for the pet, less likely to lead to back injuries for the person doing the lifting, and provides better support.

Most aging dogs have more trouble with their hind end, so I recommend harnesses that have a handle either near the mid-back or two handles, one in front and one closer to the hips.  You may want to try on a few models to make sure you find one that fits and is comfortable for your pet.  In particular, for male dogs, you may want to make sure that any chest piece rests close enough to the body that it doesn’t become soiled during urination.

Ramps can also make a big difference in quality of life.  Whether it’s helping a small dog or cat get up to the sofa or a larger pet climb into a car or in and out of the house, ramps are easier to navigate than stairs.  Many pet supply stores sell such ramps, and for larger pets, ramps made for human use can work as well.

Inside the house, many older animals still have trouble standing and rising, especially on slippery surfaces.  For day-to-day situations where a harness may not be needed but some assistance would still be helpful, yoga mats are an excellent aid.  They’re fairly inexpensive, easily cleaned, can be moved to wherever a pet wants to wander, and provide a non-slippery surface that gives weak or stiff legs extra traction and make rising and walking easier.  Toe grips can also be very helpful – these are little plastic grips that you can slip over a dog’s toenails to help prevent skidding and slipping as they walk around.

Finally, for animals with extremely limited mobility or paralysis, there are carts that can be made to fit an individual pet to allow them to move around with the strength of their remaining functioning limbs.  While this may seem extreme, many pets can adapt quite well to a cart, and can have an excellent quality of life with the help of such a device.

As always, talk to your veterinarian to help determine what techniques and assistance devices would be most helpful to your pet, to help keep them active and comfortable for as long as possible.  With a little thought, TLC, and environmental modification, we can help keep your older pets active and mobile for a long time!