Conditions and Diseases of Senior Dogs

Also known as "hypoadrenocorticism" -- caused by insufficient secretion of glucocorticoids (cortisol) and mineralocorticoids (aldosterone) by the adrenal glands. From the UC Davis Book of Dogs: "The cause of the disease is unknownwebmd, although immune-mediated destruction of the adrenal gland is suspected in most cases. The loss of adrenal gland function is usually a gradual process, first leading to a partial deficiency syndrome with relatively mild clinical signs often occurring only during periods of stress (e.g., boarding, travel, after surgery). As destruction of the adrenal glands progresses, hormone secretion becomes inadequate even under non-stressful conditions, and a true metabolic crisis without any obvious inciting event then ensues."

 

Appetite Problems

Appetite loss can be a sign of underlying health problems. Check with your vet if your dog's appetite is depressed. Once the vet has checked your dog and given the okay to stimulate her appetite, you can try these tips:

Aside from a totally home-prepared diet, which most dogs seem to adore, you may perk up your dog's appetite simply by warming food up to room temperature or slightly more -- causing the aromas to become more apparent to your older dog's olfactory senses. You may also try topping commercial fare with such goodies as: sliced or grated cheese, canned gourmet cat food, chicken or beef broth or gravy, or canned tuna with its liquid. Cream of Wheat or Wheatina add both flavor and a new, interesting texture (along with B-vitamins that can stimulate appetite).

When changing or making additions to your dog's normal fare, introduce the new foods in small quantities very gradually to avoid gastro-intestinal upset.

Dogs who have lost some of their teeth can still have the crunchy biscuits they love if you put them into a food processor and grind them into small particles or powder.

A product called STAT is a liquid with a flavor that dogs find appealing. It provides total nutritional support. Just a couple of tablespoons a day can ensure your dog will get all the necessary vitamins and minerals needed for survival. According to the label, it is, "A concentrated high-calorie liquid diet for animals. Stat is formulated to contain maximum nutritive value in a minimum amount of liquid volume." A clear advantage to the product is that you can use a syringe to get it into your dog's mouth. 

Other dog-food manufacturers have special foods meant for dogs with inappetance. Consult your vet for a recommendation.

Arthritis

Arthritis is a disease in which joint cartilage deteriorates. The result is that surfaces that are supposed to glide over each other become rough, and lubrication within the joint is decreased. Movement is more difficult and often painful. The signs of arthritis in a dog are: difficulty in walking, such as limping or a stiff, slow, or ungainly gait; difficulty in getting up from a seated or lying position; difficulty climbing stairs; a creaking, crackling, or "ratcheting" sound in the joints; an overall decrease in mobility; an unwillingness to move; dragging the back legs so that the tops of the nails scrape the floor. Dogs who are experiencing the pain of arthritis also may become "snappish" if they are touched in the wrong place or made to move when they're not ready. They experience arthritis pain just as humans do.

You can help your dog's arthritis in the following ways:

(1) give him a reasonable amount of controlled exercise -- that is, the kind of exercise that does not overtax joints, but that helps maintain overall mobility and flexibility
(2) control your dog's weight
(3) get an early diagnosis and recommended therapy -- which means taking your dog to the vet for a definitive diagnosis and recommendations on exercise program, nutrition, physical therapy, and pain medication.

Mobility aids for helping dogs with arthritis and joint problems are discussed under the heading "Mobility Aids" further on in these notes.  Hydrotherapy is another possibility; resources are noted under "Physical and Hydro-therapies" in these notes.

TherapiesWhen dealing with a dog's arthritis, pain relief is a major goal, since there is no cure for the condition.  Another reason that pain relief is such an important objective is that, with less pain, a dog will be more mobile, which will help maintain muscle mass to support the affected joints.   Pain relief is most often  achieved through conventional pharmaceuticals, although alternative therapies such as nutraceuticals and acupuncture may also be effective. There is no conclusive proof of such effectiveness, but there is enough anecdotal evidence showing that nutraceuticals, such as glucosamine, may work to improve the functioning of the joints and, in so doing, also relieve pain. Because of the side effects associated with some drugs, many people choose to have their veterinarians treat their arthritic dogs with alternative therapies. Glucosamine and chondroitin, for example, have no known side effects.

It's possible that if your dog is not helped by one substance, he may be helped by another. If, for example, glucosamine and chondroitin do not seem to work, your vet may want you to try MSM. Similarly, if one non-steroidal anti-inflammatory drug does not work, another might. Note also that your dog may experience side effects from one type of NSAID but not from another.

Always seek your veterinarian's advice when administering any medication or supplement to your dog. None of the information on the srdogs website is intended as a substitute for your veterinarian's advice, nor is it intended as a recommendation of any specific therapy for your dog.  As a double check, always request a "Client Information Sheet" when your veterinarian prescribes medication or vaccinations of any kind for your dog.  Such information can be instrumental in ensuring that (1) you can review your preferences for the type of medication or vaccination being prescribed after considering potential side effects; and (2)  should your dog experience serious side effects, you can discontinue the medication before it does any harm.

Non-Steroidal Anti-Inflammatory Drugs (NSAIDs)

This website has a page on Rimadyl and other non-steroidal anti-inflammatory drugs (NSAIDs) used to relieve pain and the symptoms of arthritis in dogs. Although these drugs are extremely effective with many dogs, side effects can be serious. If you would like to learn more, visit the Rimadyl pages on this site.

NSAIDs vary in the form of administration but generally have the same side effects -- e.g., diarrhea or vomiting, excessive urination, lack of appetite, lethargy, behavioral changes, etc.  Of course, you would discontinue the medication immediately should these symptoms appear. Remember, also, to ask your veterinarian how to determine the lowest possible dosage that provides relief, which will thereby lower the risk of toxicity..

 

Glucosamine and Chondroitin Sulfate (Glycosaminoglycans or "GAGs")

Glucosamine alone and glucosamine and chondroitin sulfate in combination are widely recognized among "nutraceuticals" as those that have the most consistently-demonstrated beneficial effects in the symptomatic relief of arthritis -- in both humans and dogs. This class of substance, known as "glycosaminoglycans" or "GAGs," appears to enable the body to repair damaged cartilage, which, in turn, decreases the pain of osteoarthritis. 

According to sources such as Jane Brody, formerly the health columnist for the New York Times, supplements alone are not the total answer; " . . . exercises that foster aerobic conditioning, muscular strength and flexibility and a diet that counters overweight . . ." must be part of the equation.

You will encounter many brand names for nutritional supplements containing glucosamine and chondroitin; the important thing to know is how many milligrams of these substances are included. Many products are advertised as being more effective because they contain additional ingredients such as Vitamin C or garlic or yucca; however, the only substances that have demonstrated effectiveness are glucosamine and chondroitin, so that is what you should look for.

N.B.: People and animals with diabetes should NOT take glucosamine.

Pain Relievers to Avoid!!

Ibuprofen (Advil and Motrin) can cause serious problems in dogs; there is no safe dosage. Acaetaminophen (Tylenol) is not an anti-inflammatory, and can also have toxic effects on the liver. Dogs are more sensitive than humans to drugs that are toxic to the liver, and Tylenol is known to have toxic effects in humans. Don't use Tylenol for relief of arthritis pain in dogs.

Alternative Medicine

Acupuncture is gaining acceptance in the veterinary medical community as an effective alternative therapy for relieving the pain of arthritis and to increase joint mobility. 

Homeopathy, chiropractic, and holistic healing are not as well accepted or given as much credibility as acupuncture. Anecdotally, however, there is support for them. 

CBD Oil -- The latest entry in the field of alternative medicine for dogs is a substance derived from  hemp.  The AKC site states the following:

"While there’s no definitive scientific data on using CBD to treat dogs, there’s anecdotal evidence from dog owners suggesting it can treat pain, especially neuropathic pain, as well as helping to control seizures.

"According to Dr. Klein, CBD is also used because of its anti-inflammatory properties, cardiac benefits, anti-nausea effects, appetite stimulation, anti-anxiety impact, and for possible anti-cancer benefits, although there’s no conclusive data on this use.

"The AKC Canine Health Foundation (CHF) is currently sponsoring a study, through the Colorado State University’s College of Veterinary Medicine and Biomedical Sciences, that will evaluate the use of CBD in treatment-resistant epileptic dogs. The CHF hopes that this will be the first study to gain scientific data on the use of CBD in dogs with this condition."

Bloat

Bloat is a life-threatening condition caused by a dog's ingesting food too rapidly or exercising too vigorously after eating. Feeding your dog -- especially your senior dog -- two or three small meals in the course of a day is far preferable to one large meal in many ways -- including its being a means of avoiding bloat. Have your dog rest a couple of hours after a meal before engaging in strenuous exercise. Any time your dog has not eaten for a prolonged period -- a day or more -- offer small portions of food over several hours instead of a large meal.

 Body Odor 

In an aging dog, body odor can originate in the malfunction of internal organs. If a dog's thyroid function is impaired, for example, this may cause a "yeasty" odor. Odor may also be caused by an ear or mouth infection or a skin condition. In addition, a very important factor can be quality of diet. If complete and careful bathing of your dog does not eliminate bad odor, see your veterinarian and discuss the various possible causes, including the kind of food you are feeding your dog.

Cancer

Traditional medicine, such as surgery, chemotherapy and radiation, are commonly used for dogs with cancer. Dogs do not seem to suffer the side effects of chemotherapy in the same way that humans do; the side effects do not seem to be as severe or as prolonged. The initial chemotherapy session may cause the dog to become ill due to the shedding of malignant tumor cells. However, subsequent sessions are usually tolerated extremely well.

If your dog has cancer, it is wise to explore various treatment modalities. Consult your vet to determine if traditional medicine or alternative medicine or a combination of both may be appropriate for your dog.

Endless Love is an E-mail list for people who have pets with cancer. Founded by Vicki Roudonis, it is a place to share the good times and the bad, ask questions, and share information. It's open to anyone who has a pet with cancer.

Cognitive Dysfunction Syndrome/Senility/Dementia/Old Age Syndrome

Early signs of canine cognitive dysfunction syndrome: pacing, crying, barking without apparent reason, loss of appetite, repeated attempts to get into small spaces, getting stuck in small spaces, diminishing interaction with family members, lack of recognition of family members, turning away from previously "favorite" family members, loss of house-training, sudden fascination with mirrors and staring into them, appearing hypnotized, appearing "lost." In the initial stages, the dog will have good days and bad days. Not all vets recognize the condition, attributing the symptoms to "old age." However, old age is not treatable and cognitive dysfunction syndrome can be.

Anipryl is a drug that can help a dog with cognitive dysfunction, although it does not help all dogs. It takes between 4 and 8 weeks to work. It is an expensive drug under its brand name, but there is a generic equivalent to the human form of the drug (Eldepryl): selegiline hydrochloride. Check with your vet to see if the generic form is acceptable. It is cheaper and can be purchased at any pharmacy with a prescription.

Congestive Heart Failure

Congestive heart failure often involves an increase in the left side of the heart because there is a "leak" in the heart valve, causing blood to flow back from the right to the left side, which then makes the left side work harder and become overdeveloped. In congestive heart disease, fluid accumulates in the lungs, which causes coughing and wheezing. A dog's breathing is very labored and coughing is common when congestive heart failure is present.

Medications that help with the condition are diuretics, vasodilators (which decrease resistance in the blood vessels), angiotensin-converting enzyme inhibitors, and sometimes digoxin. The drug Lasix is commonly used. However, Lasix is extremely hard on the kidneys. A blood test to determine kidney function is done prior to administering Lasix and during the course of treatment.

Cushing's Disease

Cushing's Disease (Syndrome) is a common hormonal disease in older dogs. It is an overproduction of the hormone "cortisol" by the adrenal glands. Signs of the condition are: increased drinking and urinating, an enormous appetite, excessive panting, bloated abdomen, weakness, and lethargy. Hair loss and changes in the skin, scaling of the skin, delayed healing of wounds, and hematomas may also be noticeable.

Surgery and medicines are available to treat Cushing's. More information at:  Cushing's Disease

Deafness

Some encouraging words and advice on deafness in a dog: "I don't believe dogs spend any time pondering the mysteries of life, dwelling on such questions as 'How come no one talks to me anymore?' They instead react to whatever stimuli are present in their lives. Remember that if your dog can't hear well, you won't want to charge up behind her and surprise her. And don't step over a sleeping deaf dog; she might awaken with a start and leap to her feet, causing you to trip." (From Jenny Daniel, contributor to srdogs.com)

Recommendations from others: Tone of voice is important. Many dogs with hearing loss can hear deep or low tones but not the higher-pitched sounds. They can also "hear" (feel) vibrations, so walking firmly across the floor will give a deaf dog warning that someone is approaching.

Challenges and Rewards of Living with a Deaf Dog

"Living with a Deaf Dog" by Susan Cope

Degenerative Spinal Myelopathy

Degenerative Myelopathy Online Resources: https://www.handicappedpets.com/blog/understanding-degenerative-myelopathy-dm/

Degenerative Myelopathy Help and Advice --  Spanna's Site

http://www.mzjf.com/ -- a support group for the owners of GSD's who have the condition

Diabetes

Diabetes web page: http://www.petdiabetes.com/

You may want to look into participating in a message board. People really like the message board format, where messages and replies can be read in sequence over a prolonged period. On the Canine Diabetes Message Board, anyone can post messages.

A simple blood test and urinalysis done by your veterinarian are the best ways to diagnose diabetes. Symptoms to watch for are excessive thirst and urination. However, these are sometimes missed, and, in some cases, the first sign that is noticed is that the dog has begun to bump into things....which indicates a loss of eyesight due to the effects of the uncontrolled diabetic condition. Such sight loss can happen very quickly, but, if you take your dog to the vet semi-annually, as recommended, and have the appropriate lab work done, you are likely to catch the problem before it gets out of hand.

Eye Conditions

Please see:

18 Helpful Tips for Caring for a Blind Dog

Information about cataracts: dogstop website

If your dog has been diagnosed with heart disease, one of the medications your veterinarian may recommend is "Enacard." There are some known side effects of the drug, however, as in the following reports:

"My dog was put on Enacard and Lasix. He started having bouts of a little tremor followed by collapse. These bouts lasted a matter of seconds and would occur 8 to 10 times a day. He was fully awake and aware during them. The vet finally withdrew the drug, and the episodes stopped. He is now taking Lasix and Coenzyme Q10. He seems to be doing well. He weighs 14 pounds and was on 1 mg of Enacard a day. The vet said it was unusual for Enacard to have that effect; however, since these episodes have subsided, he does believe that Enacard was the cause." (There have been reports that Coenzyme Q10 is helpful for cardiomyopathies, and that it also seems to boost the immune system.)

"Enacard was prescribed for my 7-pound, 13-year-old toy poodle with a heart murmur at a dosage of 1.0mg daily. He took the drug for eight weeks; the side effects were frightening. He became confused and fatigued, had no appetite and none of his usual desire for play and exercise. My children were home for the holidays and were alarmed at how 'old' our dog had become in a few short weeks. Then I realized it might be the drug. Two days after withdrawing the drug, our dog is practically back to normal. Please be advised of the side effects of this potent drug. Always consider that with every drug there is a side effect and sometimes it may outweigh the benefits of the drug itself. Your pet cannot tell you what's wrong; you must be alert to signs of change and distress while the drug is being administered."

Hip Dysplasia

Although hip dysplasia is a congenital condition, it may not become apparent until later in a dog's life, when the condition becomes worse and inevitably leads to arthritis. Hip replacement surgery is generally recommended only in the case of younger dogs, and it is very successful. With older dogs, however, the most common course of therapy addresses the arthritis associated with the condition.

For devices that can help with mobility visit the Handicapped Pets site.

Hypothyroidism

As dogs age, one of the more common problems they experience is thyroid dysfunction. In hypothyroidism, the thyroid gland does not produce enough hormone to properly regulate the many bodily functions affected by it. You can become familiar with the signs of hypothyroidism and learn more about its diagnosis and treatment by visiting the following websites:

http://www.thyroid-info.com/articles/dog-hypo.htm

http://www.canine-epilepsy-guardian-angels.com/Thyroid.htm

Controlling hypothyroidism is not difficult. Once it's been properly diagnosed and your veterinarian has determined the proper level of medication needed to replace insufficient hormone, your dog will "bounce" back beautifully. Here is what one visitor to the srdogs site reported:

"My 13-year-old Beagle suffered from hypothyroidism for several years before I discovered this affliction. She would sleep 22 hours a day, her coat felt like a bristle brush, her tail was starting to look like a stick from the hair coming off it, and her paw pads were very rough and scaly. She was also overweight, even though I moderated her food intake. After taking the drug Soloxine, I saw a marked change in her within two weeks. She is such a different hound now! Her fur and paw pads are very soft again and her colours are brighter, including some spots which have reappeared in the white areas. Her tail hair has grown back and looks like a Beagle tail now. She has lost over five pounds and has gotten her proper 'figure' back. Although she has arthritis, she is much more alert and gets around a bit faster and does not sleep as much."

Incontinence

Older dogs, like older people, sometimes have an incontinence problem. For dogs, as for older people, incontinence can be a very manageable condition -- with the proper diagnosis of the cause, the right medication, if indicated, and the appropriate environmental support.

People (and some vets) have said that when a dog is incontinent, he or she is "embarrassed" and "feels bad" about it. This is is not a reason to euthanize a dog. "Embarrassment" and "feeling bad" might occur at first, but, for a much longer period than you might think, incontinence problems can be effectively managed, and a dog can enjoy a happy, high-quality life. We like to quote this reminiscence from a contributor: "It just seemed to slip out in her sleep -- not every night, but most. We kept a clean pad or rug under her and cleaned it up in the morning. I never minded. We always had the rest of the day to spend happily together. She was such a good, sweet dog."

What causes incontinence?

As a female dog ages, one of the most common causes of urinary incontinence is the decline in estrogen levels in the body. This can lead to a loss of muscle tone and possibly mucosal thickness in the bladder, which does often lead to incontinence.

There are several medicines that can be used to control urinary incontinence, but, before your vet can determine that one of them might work, other possible causes of the incontinence need to be ruled out. A bladder or urinary tract infection is one possible cause to be investigated.

There are also a number of neurologic causes of incontinence. Diseases like diabetes, hyperadrenocorticism, and kidney failure can all cause an increase in drinking and urine production, which can show up as incontinence in a dog that previously did not have problems with urine retention. It is also important to rule out bladder stones. In older male dogs, bladder stones are a fairly common cause of incontinence.

Of course, there may not be any underlying problem with urinary incontinence. As one contributor to the Senior-L e-mail list noted, her vet said she simply had ". . . an old dog who sleeps VERY soundly and whose sphincter muscle is wearing out."

How is urinary incontinence treated?

Depending on the cause of the incontinence, your vet, in almost all cases, can prescribe treatment to help control it. The first medicine of choice is usually phenylpropanolamine (PPA), given two or three times a day. If your dog has been diagnosed with "urethral sphincter incompetence," there is a 75 to 90% chance that PPA will work. PPA is sold over the counter as Propagest, Dexatrim, and Sudafed. One known side effect is restlessness. PPA may also affect the heart, and therefore should not be used for a dog with a diagnosed heart condition. Also keep in mind that, while "Dexatrim" and "Sudafed" are over-the-counter drugs, you should check with your vet before giving either to your dog for an incontinence problem. PPA is cheaper in its generic form than by brand name at the vet's office.

Spayed female dogs with urinary incontinence are sometimes treated with synthetic estrogen. Testosterone may work for male dogs. The most serious potential side effect of hormone therapy is bone marrow suppression, although it is quite rare. It may also be linked to breast cancer and obesity.

Imipramine, which is an anti-depressant, is sometimes used in conjuction with other medications to control urinary incontinence.

Alternative remedies include Thuja and Causticum (specifically for spayed females), which have been reported anecdotally to yield good results. Corn silk extract has also been favorably mentioned. Reportedly, a couple of drops of corn silk at every feeding act as an anti-inflammatory, helping the bladder to work more efficiently.

What about bowel incontinence?

There are many possible causes of bowel incontinence. Usually it requires an extensive medical work-up to diagnose the cause (or causes). Your vet will need to test for such things as neurological or musculoskeletal problems, disc disease, spinal tumors, other forms of cancer, etc., in order to advise the proper treatment and give a prognosis.

If bowel incontinence is only occasional, and particularly if it's the kind that "slips out" accidentally when your dog is asleep, you may simply need to manage the problem with the right equipment. This is assuming that your vet has ruled out a condition that requires other treatment.

In cases where a dog's incontinence is related to senility or "old age syndrome," the drug Anipryl can help the dog to sleep and eat better, and to have better control over elimination.

Managing Incontinence

If your vet has done everything medically possible, and your dog is still incontinent at times, you can manage well with the right "set up." Some of us with incontinent old dogs have completely redone our homes with linoleum. You don't need to go to that extreme, however. You can, for example, use the big, thick "doggie pads" or "puppy training pads" that have a cotton backing, absorb lots of water, and are totally washable (most pet supply stores have these). An old, washable mattress pad folded several times for absorbency can also serve the purpose. (When washing pads, use bleach to sanitize.) One senior owner we know puts on her dog a 4-inch-wide cloth band with a sanitary napkin attached to it. An elasticized "sport sock" can be used to hold a pad in place over a male dog's penis. Change it often, though, to prevent urine burn on the skin. Infant-sized diapers may also work.

Keep your dog's rear-end fur trimmed short and, after a bout with incontinence, rinse the fur (you can use a fine-mist spray bottle with warm water) and dry well. You want to keep the skin from being continually moist.

Never withhold water from your dog, no matter how much you think it affects her incontinence. Water is essential to your dog's health, and withholding it can cause or exacerbate kidney problems.

For bowel incontinence, in addition to a protective "set up," you may want to try changing feeding times so that your dog has finished digesting the last meal of the day before going out for a last walk.

For clean-up, use a product such that eliminates stains and odors from any surfaces that were not protected by pads or washable bedding.

Foam rubber mattresses with plastic covers and a washable, artificial sheepskin topper are useful. You can wash the sheepskin toppers daily.

If your dog likes to sleep on your bed, but incontinence is an issue, here's a suggestion from a website visitor: "I put the underpads on the bed and then put a blanket over them (for my dog's comfort and to keep the pads in place). Then, if she had an accident, I had only one blanket to wash. Her final days with me were full of quality time and fond memories. I now also use underpads around my litter boxes, since we have an older male cat (18 years old) with some arthritis. He gets in the litter box, but his butt isn't always as low as it should be. If it weren't for those pads, we might have to euthanize him prematurely. Cat urine can ruin a floor; but what a poor reason to lose a faithful pet!"

One of the best tips, from an E-mail to the Senior-L list posted by MillyWilly@AOL.COM: "Things got so much better for us when we just accepted the situation, cleaned up after her, and acted like it was no big deal. Her housemate, Wolfie -- the nine year old rescue -- takes his cue from us and just acts like the piddle isn't there (he doesn't even sniff it any more and we're eternally grateful that he doesn't feel he has to mark her spots inside like he does outside). Milly has been so much happier since we accepted the situation. I hadn't realized how embarrassed she really had been."

Inflammatory Bowel Disease

Inflammatory bowel disease occurs in middle-aged and older dogs. It is a reaction that the stomach or intestines have to chronic irritation. Vomiting and diarrhea may both be present, and, if the condition goes untreated, the dog will have a poor appetite and lose weight.

To treat inflammatory bowel disease, ideally your vet should diagnose the underlying disease that is causing the chronic irritation. If diagnosis is not feasible, however, a change in diet can be prescribed. If that is not successful, corticosteroids and other drugs can be tried.

Kidney Disease

Kidney disease need not result in kidney failure if it is treated. Dietary treatment is the most common therapy. Traditionally, control of protein intake is the basis of kidney diets. However, recent research on restricted protein diets shows that they may put a dog in danger of protein deficiency.  More information at the Drake Center site.

Laryngeal Paralysis

Laryngeal paralysis is common in older, large-breed dogs, although it can occur with any breed and any size dog. The initial symptom may be a change in the sound of the dog's bark. Other symptoms are labored breathing and panting when exercising -- even mildly -- or when excited. The condition can progress to severe and terrifying episodes in which the dog becomes so oxygen-deprived that the gums turn blue (a condition called cyanosis). A dog can die during such an episode. If you notice any of these symptoms or suspect your dog has laryngeal paralysis, remove your dog's collar and use a harness instead (the pressure of a collar can irritate the laryngeal nerve). Keep your dog calm and resting until you can get to your vet.

Liver Disease

Lack of appetite is the most common first sign of liver disease. Inflammation of the liver (hepatitis) most often develops in dogs at around ages 6 to 8.

The UC Davis Book of Dogs states: "The liver is able to heal if the patient is provided with a diet that supports an optimal return to normal function. The liver cannot heal if the patient does not eat; thus, it is important to ensure an adequate food intake. The diet must be based on protein from milk and/or soybean; healing is impaired when the protein source is meat. The diet should be prepared by the person feeding the dog; no commercially prepared foods are acceptable. In general, the diet is formulated with cottage cheese and or tofu (as a source of protein), a source of starch such as boiled rice, a source of fat (animal fat is acceptable and is more palatable than vegetable fat), and a vitamin-mineral mixture to balance the diet. It is important to ensure that adequate vitamin C and zinc are added. In some cases the diet shold be low in copper because of copper's accumulation and toxicity in some forms of liver disease. Since vitamin A can be toxic to the liver, any amount added to the diet should be minimal. Vitamin E is protective to the diseased liver and be added in greater than usual quantities."

Alternative therapies for liver disease: Milk thistle has been identified as the chief liver herb. Balch and Balch in "Prescription for Nutritional Healing" (1997, Avery Publishing Group, Garden City Park, New York) write: "It contains some of the most potent liver-protecting substances known. Prevents free radical damage by acting as an antioxidant, protecting the liver. Also stimulates the production of new liver cells and prevents formation of damaging leukotrienes."

Lumps, Bumps, Swellings

In general, it's a great idea to be putting your hands on your dog on a daily basis -- checking around the body for anything that feels different.  Studies have shown that petting and paying attention to a dog is great for humans in maintaining a healthy blood pressure.  The other advantage is that it affords you an opportunity to notice any lumps, bumps, or swellings that develop on your dog.  Many lumps will be lipomas -- fatty tumors that are not malignant and that won't necessarily need treatment, just observation on your and your veterinarian's part.  Other lumps, bumps, or swellings can be problematic, so it's best to have them checked out immediately.

Pain

In keeping with their instinct to survive, most dogs tend to avoid showing any sign of pain or weakness. As our dogs age or become debilitated with illness, we want to be sure they do not suffer undue pain. Since they will try to hide pain, we need to know what to look for beyond any obvious symptoms. Here are some possible signs:

Limping
Scratching
Favoring
Licking an area
Unusual mouth movements
Turning the head to look at an area frequently
Roaming in circles
Pacing
Erratic movements
Uncharacteristic aggression -- snapping at people or other dogs
Reluctance to get up or lie down
Reluctance to climb stairs or climb into a car
Panting for no apparent reason
An odd look to the eye or face
Trembling
Seeming inability to curl up comfortably
Becoming quieter than usual and wanting to be close
Unusual tail position
Unusual tension in the face and throughout the body
Awkwardness/stiffness of movement
Lack of appetite/refusal to eat
Withdrawal and passivity, even in situations that would normally evoke fear or avoidance
Choosing remote places to lie or sleep in, away from all activity

If your dog is clearly in pain, you must take him to the vet as soon as possible. However, even if you have only a suspicion that your dog may be in pain, you should have your vet examine him.

Always consult your veterinarian about the medication to give your dog for pain. And ALWAYS, ALWAYS, ALWAYS request a Client Information Sheet that describes the intent of the medication, prescribed dosage, and side effects.

Not recommended for pain: Ibuprofen (Advil and Motrin) can cause serious problems in dogs; there is no safe dosage. Acaetaminophen (Tylenol) can have toxic effects on the liver. Dogs are more sensitive than humans to drugs that are toxic to the liver, and Tylenol is known to have toxic effects in humans.

Seizures
Good information on seizures in older dogs at:Senior Dog Revolution

Skin Conditions

Itchy skin is not a condition that is exclusive to older dogs, but it tends to occur more frequently as skin ages and becomes drier and less resistant to environmental irritants. Be sure to check your dog's environment for fleas and other pests. Check out the Dermatology page on the University of Illinois website.

Stroke

Many dogs recover completely from a stroke. There will be a major difference in a dog's recovery if immediate medical attention is obtained. If you suspect your dog has had a stroke, take him to the vet right away.

Reports from people with older dogs who have had strokes:

Still Running after a Stroke: "I was with my dog when the stroke happened and rushed her to my vet. My vet administered a strong anti-inflammatory. It was amazing; by the end of the day, she had a complete recovery. Getting help quickly in the event of a stroke seems to be important. Now when I run her, I make sure my car is nearby in case she has another stroke. She brings great joy to our family, and we hope to have her as long as we can."

The first report on "Gator": "I'm desperately looking for information on whether (or how much) a dog's quality of life can improve after a stroke. My11-1/2 year old Rottweiler, Gator, who is my heart, apparently had a stroke on Monday. His symptoms were mild on Monday; it actually appeared as if he had a virus. Then the symptoms became worse yesterday. He's disoriented, confused, stumbles into walls, etc. If I don't guide him, he walks in circles. I took him to the vet, expecting to say goodbye. The vet prescribed Dexamethazone. She said she has seen dogs improve after a stroke and told me to give it two weeks. Gator had a very bad time of it last night. He is an intelligent dog; he knows something is wrong, so he is very anxious. I'm wondering if I did him a disservice."

The follow-up, some days later: "Gator is doing so well, I don't think one could tell he had a stroke! He just looks like an old gent with a touch of weakness in the rear."

It is extremely important that you give your dog as much support as possible during recovery from a stroke. Be sure that she eats and gets enough water. Pet her and massage her, gently and patiently. Keep her near you. Help her to go outside when she needs to. Your physical contact, presence, and attention will keep her focused on returning to normal behavior patterns following a stroke.

Urinary Tract Infections

According to the UC Davis Book of Dogs, "Bacterial infection of the urinary tract is the most common infectious disease of dogs. At least 10% of all dogs seen by veterinarians for any reason have a urinary tract infection in addition to the problem for which they were presented."

It is important to properly treat a urinary tract infection, not only for the sake of a dog's comfort, but also because untreated infections can lead to kidney failure or a chronic, recurrent infection.

Antibiotic therapy is the normal treatment for urinary tract infections. Some strains of bacteria are resistant to specific antibiotics, making it necessary in some cases to try several before the right one is found.

Vestibular Syndrome

In older dogs, a sudden loss of balance and coordination, circling, rolling, abnormal eye movements, uncontrollable tilting or turning of the head (sometimes resulting in vomiting) are indications of vestibular syndrome. Usually these signs disappear after a short time (about a week) without treatment. Prednisone can be used to alleviate the symptoms while the dog is recovering. Also suggested are rest and quiet during recovery, and if the dog needs to be lifted, keep his paws in contact with the ground and his eyes on the horizon.

An excellent suggestion from a website visitor (Parkosew@gateway.net): "I wanted to share with your readers a suggestion to aid the mobility of a dog with idiopathic vestibular syndrome. My dog is currently recovering from this distressing syndome, and the vet tech at the pet emergency clinic suggested something that has made our lives a lot easier. She told me to get a seat-belt-type harness found at most pet stores. This fits under the chest and has a nylon loop centered over the top of the dog's back, making it very easy to support and stabilize the dog during stair climbing or walking. The long loop makes the harness easy to hold onto and eliminates excessive bending."

The website of the Encyclopedia of Canine Veterinary Medical Information has additional information on vestibular syndrome.

---