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Ask the Vet: How do I know when it’s time to say goodbye?

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Ask the Vet: How do I know when it’s time to say goodbye?

Chris Simmons and his dog Griff.

Special promotional content provided by Simmons Veterinary Clinic. 

For those that missed this segment last month, I’m a veterinarian and owner of Simmons Veterinary Clinic, a recent business school graduate, and a fellow Decaturite. Given the emerging and escalating Great Veterinary Shortage, some pet parents are finding it harder than ever to ask questions, let alone get answers from their veterinarian. While I certainly can’t replace that relationship, I’ll do my best to address some of your questions, ranging from the most pressing to the silly.

On to the questions. 

Q: We adopted three cat brothers 16 years ago. Obviously, they are aging. One died earlier this year after a brief period of weight loss and digestive problems. He was not in pain. Nearly $1,000 in vet bills offered no solutions. He died naturally after continuing to weaken, again with no apparent pain. A second cat seems to follow with similar symptoms. When should we seek aid in dying if there is no pain, and he is peaceful? — Jeanne L.

Dr. Chris: Jeanne, I am so glad you asked this question, as this process can be both challenging and heart-breaking. Frankly, we do not give this topic enough appreciation. And often that leaves pet parents feeling confused, pressured, and heavy with guilt. 

Before I answer your question, I’d like to point out some things. First, these assessments are not formulaic. There just isn’t one single approach that applies to each pet.

Second, “pain” in animals is inherently subjective and can be super subtle, particularly in cats. Most pet parents can identify the obvious signs of pain: loud “yowling,” the inability to move, or dramatic sensitivity to touch. But what about a subtle, low-pitch groan when lying or standing? Or the inability to jump onto the bed? Or stiffness when walking about? These also usually indicate pain. The difference is that they develop slowly over time and can be easy to miss.

So, when should you talk to a veterinarian? The short answer is as soon as you are able. Veterinarians can be most helpful at the beginning stages because we can help rule out “fixable” problems and counsel you on what to expect during the end-of-life process. 

Rule out “fixable” problems: Your pet’s quality of life may be suffering from a medical issue that can be addressed! For example, an older cat who is losing weight and/or has digestive problems may have Hyperthyroidism or Inflammatory Bowel Disease. Both of these diagnoses offer an excellent chance to a terrific quality of life with a simple workup and the addition of a medication or diet change.

What to expect: Not all medical problems can (or should) be addressed. But it can be immensely helpful to talk to a veterinarian about what to expect during the end-of-life process. We can help coach you how to assess your pet’s physical and emotional quality of life. And we can provide clarity by outlining the benefits of the peaceful transition we can provide through humane euthanasia. It’s not easy on anybody involved. Nor should it be. But we are uniquely equipped to comfort you through this process. 

And if you don’t want to stress your pet by going to the veterinary clinic, there are wonderful mobile veterinary services that specialize in hospice and end-of-life care and guidance. Lap of Love is one such organization here in Atlanta, but there are a number of alternatives as well. If nothing else, I’d strongly consider giving one of them a call for a consultation. 

I’ll leave my answer there, but there is so much more to say on this topic. So, please feel free to email me if you are struggling or would like some guidance 🙂

Q: I am overwhelmed by all the commercials and posts about dog food. Fresh, raw, kibble, versus whatever else… I feel guilty all the time for giving my dog kibble, pedigree wet food, and pumpkin. What is the best general food? – Hiraeth S.

Q: Am I causing my dog to have a shortened life span by feeding Purina or pedigree vs something else? — Tiffany E.

Ah, the age-old existential dog food question! Thanks for asking this, Hiraeth and Tiffany because this topic is definitely on the minds of many pet parents. 

The marketing surrounding dog food has really blown up in the last decade or so. There are an overwhelming number of options out there! And the discourse on their efficacy and impact on pet health can be polarizing and dramatic. 

My advice is this: 1) Avoid any/all raw food and grain-free diets; 2) Stick with a science-backed and reputable brand; and 3) Don’t sweat this choice too much.

Why no raw food? There are a couple of big reasons. First, raw food diets pose the same gastrointestinal pathogen risks to dogs as they do to humans. Salmonellosis, for example, is a possibility. Feeding a processed or cooked diet essentially eliminates that risk and provides the same benefits. Second, that risk can be extended to you or your family because those pathogens can linger in an animal’s mouth. So, it’s only a matter of time before they end up on you (unless your pup somehow doesn’t give you any doggie kisses 🙃). 

Why no grain-free? Back in 2018/2019, the FDA warned about a link between grain-free diets and a potentially fatal heart condition (canine dilated cardiomyopathy). In particular, this was found in diets with a “high proportion of peas, lentils, and other legume seeds.” And there’s no known benefit of removing grains. So, there’s no need to take this risk!

Why stick with a science-backed brand? They can point to some research backing their product. That’s all. Nothing too complicated here! My favorite brand is Royal Canin because they make diets specific for certain dog breeds and their prescription diets work great. For those wanting a fancier, home-cooked style brand, I’d look at Farmer’s Dog since their recipes are backed by board-certified veterinary nutritionists. 

Why not sweat the diet choice too much? Well, it often doesn’t make that big of an impact. Is it an important component of your pup’s health? Yes! Is it dangerous to feed any particular type of diet? Not really! I already mentioned raw food and grain-free diets, but I should add that there are many dogs on those diets that are doing great. And food allergies can occur, but are exceptionally rare. So, be intentional in choosing a diet, but don’t let it weigh on your soul!

TL;DR: Diet is an important part of your pet’s health, and you should avoid certain types (raw, grain-free). But, nutrition is a complex science with fairly limited research. And it’s generally not that big of a deal, so don’t beat yourself up over it 🙂

Q: What’s the deal with Canine Flu? — Jackie H.

Hey Jackie! Canine Influenza Virus (CIV) is a highly contagious virus similar to the human “flu” that many of us have experienced. There are two primary types that can infect dogs (H3N8 and H3N2). Neither appears to infect humans (thank goodness 😅).

Symptoms typically include fever, coughing, sneezing, runny nose, watery eyes, lethargy, and loss of appetite. But fortunately, many show no signs at all, and nearly all recover within a week or two. That said, the puppies, elderly doggos, and immunocompromised (those receiving chemotherapy) are at a much higher risk for severe illness, notably pneumonia which would likely require intensive care at a veterinary hospital. 

So, what should we do about it? Well, if your pup is high risk or a social butterfly that frequents the dog park, daycare, or the groomer, then the best thing you can do is get them vaccinated with a “bivalent” CIV vaccine as it is safe and dramatically reduces the chance of severe illness. 

Want even more info? Consider reading this helpful FAQ from the Washington Post.

Rapid Fire Q&A time! 

Q: Seasonal allergy solutions? My pups are sneezing just as much as I am from all this pollen! — Michelle H.

Though it doesn’t work great for itchy skin in pets, Zyrtec (Cetirizine) is a great option for reducing inhalant allergies! Please contact your veterinarian for dosing instructions. You can also look into adding a HEPA Air Purifier to your home, such as this one

Q: How much experience do most vets have with more exotic animals (lizards, etc)? Is it worth taking them to a regular, non-exotic vet? — Lauren E. 

So glad you asked this! Bluntly speaking, most veterinarians receive very little, if any, training in exotic animals. So, I recommend seeking out veterinary hospitals that advertise that they specialize in exotic animals, such as For Pet’s Sake

That’s all for today! Keep the questions coming! And please check out simmons.vet for more information about Simmons Veterinary Clinic 🙂

— Dr. Chris