Let’s get started on the causes of arthritis.
But before we get started about the causes, one of the things I’d like to say is with all the modern medications that are available; there’s almost no pet that ever needs to be euthanized because of arthritis or arthritic pain or bone pain. And that’s a little bit different to the way it was, even as short as five years ago, but there are so many modern things available.
The causes and the causes of arthritis fall into three broad categories;
‘trauma’ or environment.
For example, hip dysplasia, 40% of all cases or causes of hip dysplasia 40% of the cause is genetic; it’s the genes, it’s what you’re born with.
Little dogs don’t tend to have very much genetic predisposition; the large and giant breeds do.
Nutrition can be in utero nutrition while they’re in the womb and then nutrition in the first, say six months of their lives and unfortunately, not all dog foods are made equal, and some are made a lot less equal than others, and we don’t have enough time to go into it here. But essentially, the more you pay for dog food, the better quality you get, and if you feed a large and giant breed dog on a cheaper quality dog food, you are opening yourself or your pet up to more of the nutritional causes of joint disease or arthritis.
I could spend half a day going through this topic tonight, so I’m really trying to condense it down.
And then the third predisposing cause is trauma or environment. For example, if you have a working kelpie who jumps in and out of the back of the ute 50, 60, 70 times a day, that dog is a lot more likely to become affected with arthritis than a pug who lies on the couch all day.
If you have a dog that has a major accident and dislocates an elbow or a hip or something else, then there’s a lot more chance of that dog is going to develop arthritis in that joint and obviously other joints, because if this elbow is affected, then that dog will offload this elbow and load onto the other three legs and that’s a lot more likely to predispose to arthritis, going forward.
Now let’s talk about diagnosis, and this is unbelievably difficult.
We’ll break this up into dogs and cats, and both dogs and cats are incredibly excellent at hiding pain.
I have an example today of a pet that came in today, and this pet fell down last night or this morning and was really sore in one of the front legs; and I admitted that dog and took x-rays of both his elbows and they were horrible, severe arthritis in both elbows.
I’ve known that dog forever since I’ve been at HVH, three and a half years now, and we’ve done lots of work on him for other bits and pieces and at no stage during this three and a half year that I’ve known him has he shown signs of arthritis or pain in his elbows, but his elbows on x-ray are quite terrible.
The good news is that there are lots of things we can do for him.
But he has arthritis in both elbows, which means that he can’t limp on either elbow because they’re both equally sore.
When he fell last night or this morning, his right elbow became a lot sorer, and so he started to limp on that leg, and so it became obvious.
And he’s 13 now, and this arthritis in his elbow, according to the x-rays, has been going on for probably four or five years, but he’s been hiding it really, really, really well, and because it’s been equally in both elbows, he hasn’t shown lameness in either leg.
Take home – dogs are great at hiding pain!!
Let’s talk about cats.
When cats are in pain, they will hide more; they’ll decrease their levels of activity, dogs may pant more.
Think about it this way – a million years ago, dog or cat in the wild, if you showed signs of weakness or pain, then you were someone else’s lunch.
So you had to show pain but not show obvious pain.
That involved hiding, carrying a limb, decreasing your levels of activity, panting, which allowed you to dissipate the pain but not show it.
For example, a normal cat can jump two meters up or down… if you’ve got a washing machine dryer combination, the average cat up until quite late in life can jump up and down that stack of washer dryers quite easily.
What you’ll notice in the cat with arthritis- what you may not notice in a cat with arthritis – is the cat will jump from the double story down to say a little ledge and then onto the ground.
You’ll see a cat not jumping as well, and it’ll be really hard for you to notice unless you really know what to look for.
And the other thing is that when the cat jumps down, a normal cat will jump down and then move away, whereas the cat with arthritis in its elbows or anywhere else will jump down, pause to gather him or herself for a couple of milliseconds and then move away.
Simply a decrease in activity levels or the tiny changes we’ve described above can show you that a cat has arthritis.
Let’s move on to the dog.
Once again, panting, hiding, sleeping more, being not as active, not socializing as well, all those things are signs of arthritis.
And then the question becomes, is my dog simply aging or is my dog arthritic?
The same question applies to cats.
Cats are really covert at hiding pain. Dogs, not so much, but still to some degree.
It’s really hard to say aging or arthritis.
Tail down, offloading the sore leg – these are classic giveaways.
If you’ve got a dog and you’re watching that dog from behind, that dog may be offloading on the sore leg. Standing off the sore leg, and it’s really hard to notice unless you’re actually watching for it.
A dog with hip arthritis, for example, before that dog lies down, may spin three or four or five times before he or she finally plonks down, and when getting up, it may be an exaggerated effort loading more onto the front legs; all very, very, very subtle.
Slow to get down, slow to settle, slow to rise, turning around a lot, and that can go all the way through the overt pain.
Overt pain may be limping excessively, vocalizing; it may be even something as challenging as being cranky, snarky or even biting or mouthing, and that is totally abnormal behaviour.
It can be really hard to notice pain in our pets.
I had someone in not too long ago, and this dog had arthritis, and we treated the dog with a product called Zydax, which I’ll talk about later on. And what this gentleman noticed – what he hadn’t noticed, but what he noticed once we had treated the dog was, the dog once again started to follow him around the house and follow him around the backyard.
Whereas what he hadn’t noticed was, previously before we treated the dog, the dog had laid in the lounge room in the house and watched the owner as the owner walked around and did things but hadn’t followed the owner around.
And when we treated him, the dog once again followed the owner around.
But the owner had never noticed that the dog had stopped following him until he started re-following him if that sort of makes sense.
So it could be really, really, really subtle.
Let’s talk about treatment.
As I said a minute ago, there’s almost no patient now that needs to be euthanized for arthritic pain because there are so many treatment options, treatment modalities available and let’s divide things into two basic classes to start with;
- that’s disease-modifying agents and then
- the second one is pain relief.
Disease-modifying agents actually fix the joint, fix arthritis, improve the joint function and therefore improve the pain.
They don’t; they do not pain killers, they don’t improve the pain by being pain killers, but they improve the joint function and therefore, the pain decreases.
Let’s go to the product that I had up a minute ago, and the one I’m holding up now is a product called Zydax; it’s a fourth-generation product.
The previous generations were called Cartrophen Synovan and Pentosan.
This is a newer version. It’s made from the bark of a tree in Scandinavia, and I was involved in the studies of the first one, Cartrophen when it came out in 1987, and we actually injected dogs with this product and then x-rayed the dogs over a period of six months, and we actually saw the x-ray changes regress or improve.
One injection a week for four weeks, no side effects at all and what I tell clients it does is a grease and oil change on a damaged joint.
If you’ve got a damaged joint, the synovial fluid, the fluid inside the joint becomes either too thick or too thin; this normalizes the joint fluid.
The synovial membrane, the membrane around the outside of the joint, becomes inflamed; this takes the inflammation out of that synovial membrane, and the last thing is, the bone above – so the bone is very springy at a microscopic level; it’s like the innerspring mattress of a bed, and when a joint becomes arthritic, the bone above and below that joint becomes filled with blood clots and becomes much stiffer and no longer springy, and this product dissolves those blood clots and re-springs the mattress.
It’s one injection a week for four weeks, and it’s repeated twice a year.
Now – there are many variations.
Some vets will give a course of four twice a year as I do; others will give a course of four once a year and an injection at the six months mark; other vets will give an injection every month for 12 months, etc.
There are many, many, many, many varied forms; it’s brilliant.
Good evening, good evening and welcome to the final part of our series on arthritis and where we finished off last week was talking about the different modalities or treatment options for arthritis.
How many pets get arthritis?
But before I want to do that, the one thing I realized that I hadn’t talked about in the previous section was what percentage of pets suffer from arthritis?
Arthritis in cats
There is a recent study that came out about three weeks ago that absolutely shocked me. The section that shocked me was the section on cats.
The studies show that something like 80% of cats over 10 years of age suffers from some form of arthritis.
We see a lot of cats coming into the practice, and very few people mention their cat being incapacitated. And when I examine those cats, similarly, very few cats are incapacitated or show pain. But when we x-ray them, we see significant arthritic changes in their joints.
And we find some that clinically have sore elbows or hips or whatever; we put them on medication they improve out of sight.
That just goes to back up what we were talking about last week, in which it was, in which I said how great cats are at hiding arthritis. 80% of cats over 10, 11, 12 years of age have arthritis.
If you’ve got an elderly cat, it’s almost guaranteed that cat has arthritis.
Arthritis in dogs
The numbers in dogs aren’t as strong, but they’re certainly up there as well.
10-year-old dogs and older, at least 50 to 60% have arthritis somewhere that can benefit from treatment.
And speaking about treatment, we started talking about the two different big picture treatment options last time, and one was;
disease-modifying agents and the other one was
I talked about disease-modifying agents. The one I started talking about was Zydax.
This is one injection a week for four weeks, and you use a 4-week course twice a year.
It’s very inexpensive. There are a number of ways to use it, and I mentioned that to some degree last week.
There are no side effects, fantastic treatment. I think most vets have actually used this on themselves. I certainly know I’m one of that group, and it works very well for dogs as a four-part injection, as I said with no side effects, and the simplest way to describe how it works is to think of it this way;
- it does grease and oil changes on the joints by normalising the joint fluid
- it takes the inflammation out of the joint capsule, and
- it improves the blood supply above and below the joint. By doing so, it re-springs the bone, the mattress above and below the joint.
This is a disease-modifying agent that works really well.
There is a lot of other disease-modifying agents about which there isn’t a great deal of science, or there’s not a great deal of science behind it.
I had knee replacements four or five years ago now, and I talked to my orthopedic surgeon about the ‘classic treatments’ which most of know about, and they include glucosamine, chondroitin, green lip sea mussel, fish oil, celery, rosehip, etc. all those sorts of things and he said to me, “In people, the jury is really out. Take them by all means, and if they work, fantastic. If they don’t work, that’s what we’d expect.”
It’s exactly the same in dogs.
The things that we commonly use in pets are the same as those I’ve just listed for humans.
I’ll mention this product here. Paw Osteo Advanced.
Paw produces a number of different products, this, in my opinion, is their best one, and this has glucosamine, chondroitin and green lip sea muscle and a couple of other products that I’ll mention in a minute.
The first three products, chondroitin, glucosamine and green lips sea mussel, are the essential building blocks of cartilage, and if your dog’s cartilage is missing these ingredients, then this can be a really good solution. And similar products can be a really good source of supply and helping those joints improve.
With things like the green lip sea mussel and the other sea mussel type products, the kelp type products, what’s really super, super, super, super important is how they’re processed. They must be processed in a particular way in order for them to be of any benefit.
And many products are not processed in such a way, and therefore the ingredients may be listed on the label of the product, but because of incorrect processing, they DO NOT WORK!!
In the PAW Osteo Advanced product, we know that the green lip sea mussel is harvested and produced in a certain way that it is super, super, super effective, and it works.
Antinol is another one that works really well because it has been harvested and produced in a certain way to make it really useful.
But most of the other green lip sea mussel products and products of that type aren’t produced in the correct way, so that they’re actually not very useful.
What I’m saying to you, and I’ll rephrase it this way, if you’re going to use one of these chondroitin, glucosamine, green lips, sea mussel type products in your pet, then read the literature about that particular product! DON’T read generic literature about green lip sea mussel, chondroitin, glucosamine and green lip sea mussel and assume that it’s transposable to your product, the product you’re using. It may not be.
Unless you’ve got scientific validated independent data about that particular product you’re using, assume it’s not going to work and go to a product that has the scientific basis behind it.
Back to PAW Osteo Advanced. There are also two ingredients in here that are pain killers.
One of them is curcumin or turmeric, and the other one is Boswellia.
Turmeric is not highly biologically available.
If you walk into the local health food store and grab some turmeric, and put it on your dog’s food, it may have some benefit.
But it’s not going to be nearly as beneficial as a turmeric curcumin product that has been treated specifically to be bioavailable.
In the Osteo Advanced, turmeric has been treated to be specifically available for dogs and cats.
Most turmeric is very poorly available.
You may feed a whole heap of turmeric to your dog, but it’s not going to get into the dog’s system to do very much good in most cases.
Be really careful about the type of curcumin or turmeric it is that you’re using.
Boswellia is a very new ingredient; it’s not around in many products at all. It’s harvested from tree bark in Africa and Asia, and it has an amazing anti-inflammatory effect, just like the correct curcumin.
Let’s move on to another disease-modifying agent, fish oil.
We’ve got omega-3 and omega-6 fish oils. Omega-6 fish oil is actually pro-inflammatory. It creates issues, whereas omega-3 fish oil is anti-inflammatory.
You’ve got to have exactly the right ratio of the omega-3, omega-6 fish oil to have a beneficial effect on your dog’s joints.
Just racing out and getting any fish oil type product that may be used on people or horses or whatever isn’t necessarily going to work. You need a product with the right ratio of omega-3 to omega-6 to have the beneficial capabilities.
One of those products again is a PAW product or a Blackmore product. There are many others available, but that’s one that we use.
There is another product, and this will be the last one of the disease-modifying agents that I’m going to discuss – even though there are another 10 or 20 we could talk about…
… this is a product called 4CYTE, which is a very new drug, and it has been shown to grow cartilage.
When you have a dog or a cat or a horse or a person with arthritis, then you have bone on bone contact.
When you have two pieces of bone in a joint, there is a cartilage cap on each piece of bone which stops bone to bone rubbing.
Up until now, there’s been no product that has been able to grow new cartilage.
Chondroitin, glucosamine helps repair cartilage if the cartilage is deficient in those products, as does omega-3 fish oil, it helps the cartilage maintain and what not.
But there’s been nothing up to now that has helped grow new cartilage.
Well, 4-CYTE has been shown to grow new cartilage.
It’s available for horses and dogs and cats, and as of this week actually, and there’s a product coming out for people as well.
Fantastic product and use of 4-CYTE in studies in dogs and cats and horses have shown that it allows a significant decrease, at least the halving or almost the elimination of a lot of pain relievers, especially in the early stages of the disease.
A number of my dogs have arthritis, and they’re 4-Cyte, and they are on the Osteo chews as well.
They’re getting a whole mishmash of things to maintain their joint health and to improve their joint quality as long and as much as possible.
Over time the disease-modifying agents can’t really do what they’re designed to do anymore.
At some stage, most of my clients come in and say, “The Zydax is no longer working. The 4-CYTE’s no longer working. The Osteo chews are no longer working.”
Whatever it is that their pet is on is no longer working, and then we have to move on to a pain-relieving plan.
Initially, we use a combination of disease-modifying agents and painkillers.
Typically the painkillers are on an as-needs basis, but over time, the disease-modifying agents stop working, and therefore, we move more to the painkillers, initially on an as-needed basis and then eventually on a permanent basis.
There are lots of things that we can use for pain relief on an as-needs basis;
Acupuncture; absolutely superb; you may or may not believe in it, and even if you don’t believe in it, it works. So it’s worth doing acupuncture or having acupuncture done with your dog.
Exercise; the other really important thing I’ll deviate sideways a little bit here for pain relief is to maintain your dog’s level of exercise.
All dogs and cats and horses with arthritis should have some level of exercise to maintain joint mobility, joint function, to keep muscles and tendons and sinews strong and supple.
They shouldn’t overdo it, and yes, having them move is going to create some pain; there’s no question about that.
But having them not move, over time, will seize or freeze up all those joints, and consequently, there will be much, much, much more pain.
We don’t want them Frisbee chasing or ball chasing or doing all sorts of crazy stuff. But we certainly do want them to be active.
As I say to many of my clients, “Take your dog for a one or two-mile walk or walk around the block or whatever it happens to be, to maintain flexibility, mobility, joint health, joint strength, muscle strength and tendon and sinews strength and health as well. And yes, it will be uncomfortable, but to not do so will cause a lot more failure, a lot more quickly, and we all know that from a personal perspective.”
If you’ve got a super active dog like my Ava or a dog like the Kelpie or dogs like that, that no matter how sore they are if you throw a ball or throw a Frisbee, they’re just going to go crazy about that.
If you were to throw that Frisbee 40 or 50 or 60 times, then they would just do that Frisbee chasing thing until they drop.
If your dog wants you to throw a Frisbee 20 times, just throw it once and then take them for a long walk.
Mentally get a lot of fun stuff out of that one Frisbee throw, and they’d like you to throw it more, but that’s going to be hugely detrimental to their joint health over time.
Just have a little bit more common sense with that for their benefit.
Also, a jacket in winter to help keep them warm.
Also, a heated pet bed to keep them warm. Get them inside, and we still have clients that even in this temperature – it was minus three when I went on my first farm call this morning at six o’clock – and you don’t want an old pet sleeping outside in this sort of weather. And unfortunately, I still see that happen.
At least get your pet inside, in the garage or preferably in the house or on the porch or something like that.
Nice hot water, a hot, warm blanket, or you get these discs now that hold heat for 10 hours. You put them through the microwave for a couple of minutes.
As I said;
- a jacket,
- a pet heater,
- a bed that’s elevated off the ground
- firm, supportive, but the comfortable bedding,
- all those sorts of things help and help quite significantly.
Let’s get to the non-traditional pain management drugs that we can talk about, and the last one I mentioned is acupuncture.
There’s also avocado and soya bean, which is a fairly new one that works reasonably well.
Then green tea extract, and the last one is Cannabinoids or whatever you want to call it, TCH.
There is now a licensed veterinary medical type product that works very well that we can get for you from an online pharmacy, and that’s all they deal with, and in many pets, that’s been a huge boon. That’s an option as well.
Let’s talk about the classic painkillers.
First of all, we have anti-inflammatories or non-steroidals.
These are two of them.
On this hand, there’s a drug called Previcox and on this hand is an older drug called Carprofen, and I didn’t bring with me a drug called Panadol, which you probably know very well.
If we look at these drugs, the older they are, the more side effects they have, and the more modern they are, the fewer side effects they have.
Previcox is a much more modern drug than Carprofen.
All anti-inflammatories have similar side effects;
- tummy upsets
- kidney damage and
- liver damage is the three big ones.
If we look at an older drug like Panadol, it can be very safe; it can be very useful. We have many dogs on Panadol.
Panadol had actually just been licensed about six months ago; there’s a licensed form of panadol for dogs now in the UK.
It’s now licensed in the UK; it’s not licensed anywhere else around the world. Quick sideline, panadol kills cats. Even a tiny piece of panadol will kill cats, so never give it to your cat.
The more modern these anti-inflammatory drugs have become, the fewer side effects there are
Carprofen and Previcox
Carprofen is older, has more side effects, and Previcox is newer – fewer side effects.
And there’s a new one that comes out about three or four months ago called Galliprant, which is an even more modern anti-inflammatory, and it’s supposed to have almost no kidney, liver side effects at all.
These drugs work very well.
Previcox is one dose a day drug, the Carprofen or the Carprieve is a twice a day drug.
Galliprant is a one a day drug.
These work very well. However, those classic side effects that I just mentioned are potentially fatal.
Therefore any pet that’s on these drugs should receive regular kidney and liver function tests, and it depends on your vet as to how often that happens.
In my model of the world, it’s TWICE a year.
These work really well, and as I said right up front in training, there’s no reason in the modern-day and age for any pet to be suffering from pain.
I’ll go to this one next which is Tramal or Tramadol. A very good drug.
It’s the first synthetic opiate or the first synthetic morphine if you like.
Let’s talk about anti-inflammatories.
If your dog or cat has a sore wrist, there is inflammation which consists of;
swelling and loss function.
These medications are anti-inflammatories;
they take away the heat,
they take away the pain,
they take away the swelling and
they improve the function at a local level.
Anti-inflammatories work at the site of the pain – they work at the local level.
Tramal or Tramadol works at the spinal level and changes the perception of the pain.
It’s almost like putting on rose-coloured glasses about the pain.
And so, anti-inflammatories and the Tramal can be used really effectively together because they work in different ways.
Tramal has no side effects on kidneys or liver or anything else, fantastic drug, and works really well.
Perhaps there is one side effect that maybe is some dogs get a little bit dozy on it as some people do with opiates.
Another drug we’re using a lot lately is a drug called Gabapentin. Gabapentin is fantastic for spinal pain, and again, this is a human drug.
Many of us have been on Gabapentin for all sorts of different pain type problems.
It works very well, as I said for spinal pain, you know, absolutely sick, and we’re using it more and more and more and more for osteoarthritic pain as well. Minimal liver, kidney, gut side effects. I still recommend doing regular blood tests to check on the liver, kidneys, etc., but a fantastic drug.
Symmetrel and Lyrica
Then we have two drugs that are relatively new in our field. They have been around in people for quite a while, and we’ll often use these together.
One is a drug called Symmetral or Amantadine, and then there’s a drug called Lyrica or Pregabalin.
These two together, fantastic combinations their methodology of working is quite complex. They work on the transmission of the pain sensation. They don’t actually kill the pain; they just prevent the pain message from being carried on.
Really good drug, a bit more expensive than the others, with minimal side effects, so absolutely fantastic.
One last thing – if a pet is on any of these medications for more than a few weeks – we NEED to run a min-blood health screen once or twice a year to ensure that there are no side effects from the medication.
Those are the main things that I wanted to go through with respect to pain relief.
Heat and Cold
A couple of other things to think about are heat and cold.
Cold- if you’ve got a dog with an acute or a cat with an acute injury, let’s say been kicked in the leg by a horse. The cold will take the swelling out of the leg and decrease the bruising and the inflammation, cool it down and help a lot.
Heat – if you’ve got a chronic injury, for example, if you’ve got a dog with a sore knee with arthritis, putting heat packs on that during winter will really help mobilize that dog.
You can even use things like a TENZ machine.
There are many, many, many other modalities that we can use that are not classic painkillers.
In many cases, we’ve locked ourselves into this; ‘we need to give a drug’ scenario when there are so many other things available.
Like I said, like acupuncture, massage, chiropractic, reiki if you believe in Reiki and then, hot and cold and things like that.
I’m hoping that everything we’ve been through tonight has answered a lot of questions that you have about arthritis in your pet.
If have, if you have any other questions at all, please reach out.
If you’ve got any questions at all, please give me a ring at the practice or send me an email, and I’m only too happy to help answer any questions.
I’m absolutely, absolutely passionate about pain relief in pets and everything that we can do now to mitigate against it, to minimize it, to control it.
In my opinion, there is no reason why any pet should live with pain. There are so many, many things that we can do about it.
I hope you’ve enjoyed tonight…
Our next live session will be on the first of September, and it’ll be all about a very challenging topic, why are vets so expensive, and what can you do about it!
I look forward to seeing you then, bye.
We’re talking about ‘when is the right time for euthanasia?
This is a topic that’s fraught with a lot of emotion, and this topic is different for everyone.
I’ve made some notes that I want to go through, and I’ll just do this in no particular order. If you’ve got any questions, please put them in the chatbox, and Michele can read them out to me.
I want to present this topic from a number of different viewpoints, and the first viewpoint I want to put out there is the problem of ‘Convenience Euthanasia.’
I know that you, the listener, reader, and viewer would not have any part in Convenience Euthanasia and wouldn’t even consider it.
But, we get, and I’m not just talking about ‘us’ at Highlands Veterinary Hospital, I’m talking about ‘us’ as vets in general. We see quite a number of people bringing their pets in for Convenience Euthanasia. It’s not nearly as often or common now as it was in the 70s and 80s.
But I remember many people coming in December of one year, bringing their pets in and giving us some sort of excuse for “It’s time to euthanize my pet,” and then in January, they’d come in with a new puppy or a new kitten for vaccinations.
Back then, to some degree (as an industry), we would tolerate that because we didn’t know any better. But now that’s just totally unacceptable, and if you’re bringing a pet into us for euthanasia, we’re going to sit down with you and work out ‘is this the right thing to do for both you and the pet’?
And it’s terrible that people will do this, but they’ll do it because they think that it costs too much to board the pet over Christmas while they’re going on holidays or some other feeble excuse.
As much as we’d like to believe that society is well and truly past this, Convenience Euthanasia for all sorts of reasons STILL does exist.
I need to be really careful how I phrase this, but I have a new acquisition in our lives at the moment, and this animal, and I’m going to be really careful because I don’t want to put my foot in someone else’s mouth.
But this pet came in for a procedure a little while ago; it’s a very simple procedure. We ran some pre-anesthetic blood tests as we do on all animals, which are over 15 years of age… there was a slight elevation in one of the kidney functions, which meant that this pet should go on medication.
But aside from that, this pet was perfectly healthy, and the procedure that the pet came in for was totally simple and easy, nothing to be concerned about.
The owners chose this slight elevation in kidney function meant that they would have to pop pills in this pet for as long as he or she was alive, and they elected euthanasia instead (as the easier option).
We asked them to sign a handover so that we could rehome this particular animal, and now he is living a perfectly healthy, happy, long life with me because I took him over, and he’s too old to rehome, and he’s living happily with me and popping some pills morning and night to help his kidney function.
That story is something that may be totally unheard of for good pet owners like you.
But unfortunately, we go through that and see this type of scenario on a fortnightly basis that we’ll get an animal in like that.
At Highlands, we’re fairly tough on this situation.
If there’s a pet to be euthanized, we will sit down with the client and discuss whether it is necessary or not, and if we don’t believe it’s necessary, then we’ll seek permission to re-home that pet or medicate it at no charge or whatever can be done.
Unfortunately, most practices don’t do this, and they will euthanize the animal.
Let’s get back to the topic, ‘When is the Right Time’?
Is NOW the Right Time?
If you’re not sure whether ‘this is the right time, then there are quite a number of things that you can get from us or online to help you answer this question.
I’m holding up a quality of life scale that we use with our clients.
If a client comes into us and says, “I’m not sure whether I should euthanize my pet or not,” then this is one handout that I can give them to help with that decision.
I had a client in today with a dog with a sore back, and she’s a really great client and really wants to look after their pet in all the best ways possible, but they’re not sure whether euthanasia is the right thing or not.
So I gave them this Quality of Life Scale that they could complete as a family to help them come to a decision.
This isn’t something designed by me; this is designed and validated by people who are much more intelligent than I am – and someone who is unsure of the ‘right’ decision can go home, fill out the answers and decide whether euthanasia of this pet is the right thing to do or not.
There’s another handout that we use a lot called, ‘How do I Know When it’s the Right Time’? Again, there is a whole heap of simple questions to help in making the correct decision.
There are plenty of those sorts of things available online.
…. if you’re not sure whether it’s time to euthanize your pet or not, then those sorts of things are available from us or go online.
The other thing that I like to look at is; I ask myself a very simple question – and previously we were talking about this pet who I saw today with these lovely owners, I used a phrase that I use a lot, it’s a very harsh phrase, so I’ve got to be careful how I deliver it but as I said to them….. “Does she want us to kill her?”
And that’s a very deliberate phrase, and it’s designed to make people really THINK – and their immediate reaction was, “No, of course not. She’s got a bad back, and she falls over a little bit because her legs aren’t functioning, but she doesn’t want us to kill her.”
In my mind, that’s a simple, direct question to ask with respect to what would that pet want us to do for his/her best welfare.
In some cases, the answer is “yes”; in some cases, the answer is “no.”
This ‘answer,’ I think is the same if you’re an older person or a person of any age who has some sort of serious or chronic disease….
Would you want to die at that point in time or not?
Let’s move on!
Price Shopping For Euthanasia
The other thing that we as a Veterinary industry run into is ‘price shopping’ for euthanasia. How inappropriate!
We get quite a lot of; I was about to say quite a lot of people, I’ll rephrase that; we regularly, now once a week or once a fortnight get people ringing us, and it happens with all practices, and the question is “How much is it going to cost to euthanize my pet?”
These people are price shopping euthanasia, which is, to my mind, incredibly inappropriate, and At HIGHlands Vets, we don’t go down that line.
But as I said a minute ago, there are plenty of practices that will just do that if someone rings up to find the lowest price to euthanizing a pet, which I think is just terrible.
As an aside, there are many different ways to euthanize a pet – some of them very unpleasant for the pet and even for the owners. And typically, they are also the cheapest ways to do it.
To make a ‘death’ pleasant (at least as pleasant as it can be) requires more in terms of drugs and therefore, in costs.
But most owners have no idea of the difference…
WE – we will just not go down the ‘cheaper’ road; compromise in HOW we perform that procedure will just NOT happen.
The other thing I want to talk about is terminology.
The terminology of ‘putting to sleep is just absolute, excuse me, crap.
Pets aren’t put to sleep; they’re being euthanized, they’re being killed….
This terminology is really important.
There have been plenty of studies done on children where their pet has been ‘put to sleep,’ and in many cases, these kids are scared to go to sleep at night because they believe they’re not going to wake up because their pet has been put to sleep and their pet never wakes up, never comes back because it’s been euthanized.
Please don’t ever use that term with your children.
The studies on these kids are quite horrendous with respect to the ongoing mental issues that many of these children have.
The term is euthanasia; it’s being killed, whatever term you’d like to use, and maybe being killed is not the right term, but certainly being euthanized is.
The other thing with respect to children is when and less so now than in the past when people bring their pet in during the day, and the pet will be euthanized, and they’ll tell us, “Oh, we were doing it during the day so that when our daughter, our son gets home tonight, the pet will just be gone and we’ll say, well we don’t know what happened it just disappeared or we had euthanized him or her euthanized.”
Again, totally inappropriate with children.
When children suddenly lose their pet like that, it creates a huge hole in their life or in their lives and creates mental issues for years and years and years to come.
If you’ve got a child and your pet needs euthanizing, all the right reasons, then involve them in that conversation, involve them in that decision-making, and they will cope with that decision of appropriate euthanasia much better than if their pet was suddenly disappeared out of their lives.
It’s a really important thing to involve them in the decision-making, even at a very young age, like four or five. They may not totally understand what’s going on, but it’ll set them up for a much better future without that pet than if their pet suddenly disappeared. Which is what some owners elect to do, or some parents elect to do.
With respect to the actual euthanasia procedure, there are quite a few things to think about (as I alluded to previously) and some practices are very ‘cheap’ with euthanasia, and some are more ‘expensive’ with euthanasia, and euthanasia can be done well, or it can be done inappropriately.
The euthanasia solution itself is a product called Phenobarbitone or Phenobarbital, and it’s simply a VERY concentrated solution of anaesthetic, and we give the pet an overdose of anaesthetic, and it’s a horrible way to die, being given on its own. It’s absolutely shocking.
Euthanasia is typical, in MANY practices, done just by an IV injection of Lethabarb, Phenobarb, and Valabarb-as it’s often called ‘green dream,’ whatever it’s called it is quite a terrible process for that pet.
To be done ‘nicely,’ it needs to be combined with a number of other (more expensive) drugs.
The way to do that is to sedate the pet with some form of opiate, some form of morphine, whatever you want to call it, then wait 10 – 15 minutes, and once that animal is zoned out with morphine with Buprenorphine, with some form of opiate then giving the Lethabarb, Phenobarb, and Valabarb whatever you want to call it.
It is not ‘literally’ going to sleep, but going under an anaesthetic exactly the same as we would do an anaesthetic for a desexing or a lump removal or a dental treatment or whatever, and that’s a very pleasant way. To drift off to ‘sleep.’
This way is very peaceful for both the family and the pet…
But just doing it without the appropriate sedation is terrible. But again, some practices elect to do it that way, because frankly, it’s cheaper and it’s quicker.
Then we get to the question of should it be done and where should it be done?
There is obviously doing it at home versus doing it in the clinic, doing it with the owners present or with the owners not present.
My personal opinion is that, and this is obviously debatable or arguable, but I will give you my personal opinion is, a pet would much prefer to pass on in the comfort of his or her pet parents and at home than on his or her own with strangers.
And also, he would prefer to pass on in the comfort of his or her surroundings at home rather than in a strange place. Those are some thoughts about that.
The other question becomes on one of timing, and I’ve shown you these handouts on, ‘When is the Right Time’?
There are lots of decisions to be made about that – but with respect to the actual details of timing, for example, is it better earlier than later?
I’ve changed my mind on this a little bit in the last few years, and typically I’ve always been someone who prefers to persevere as far as we can go maybe, the right term is to the ‘bitter end,’ or that’s the term I used to use is the ‘bitter end.
…leave no stone unturned
I’m still of that mindset, but it’s really important to relate that with; it’s far better, in my opinion, to euthanize a minute earlier than an hour too late, if that makes sense.
I never want to wake up as a pet owner or as a veterinarian and kick myself in the bum in the morning, saying, “Why didn’t I just try this before I euthanized? Why didn’t I just try that before I euthanized?”
But that’s got to be considered and balanced against the fact of having that pet suffer, and we certainly do not want any pet to suffer.
Therefore I believe that euthanizing a fraction earlier is a lot better than euthanizing too late.
The other aspect is physical versus mental breakdown.
Unfortunately, we see pets who are mentally fantastic and physically decrepit, and we can’t manage them anymore because they’re so physically decrepit, and that may involve issues like urinating and defecating on themselves, eliminating on themselves in the bed at night or in the house or whatever.
And if that was you or me, would you really want to stay alive if you couldn’t move out of your own excrement?
Even though you have a pet who is mentally 100 percent and physically decrepit, then would you want to do that to yourself?
If you’ve got a little pet like a 5 kilo Chihuahua you can move him/her around and carry around and clean up; that situation is a lot easier to manage than if you’ve got a 50-kilo Mastiff or Great Dane that takes two or three of you to wash and move around.
Those are the sorts of things to consider as well….
Then the other side of that coin is a pet who is mentally shot, but physically a hundred percent.
We’ll do a FB Live session in the future on dementia in pets, and pets do get a disease called CDS or cognitive dysfunction syndrome, call it Alzheimer’s, and there are some fantastic treatments for that now. My own dog, who has unfortunately passed away, Jack. If he wasn’t on his dementia medication, he would literally eat the garbage out of the garbage can if he could get to it, and he was like, just a dumb zombie. But on his three tablets a night, he was quite smart and quite ‘with it’ and doing really well.
NOW – there are progressively fewer and fewer reasons for us to have to euthanize pets for physical debility or mental debility because there are so many fantastic treatments around now.
The other thing I really want to talk about, and then then I’ll get to some of the questions, is the cost of euthanasia.
The mental cost and the mental impact of euthanasia to us as veterinarians, as veterinary nurses, as providers of that service.
Even though euthanasia, if we perform euthanasia on a pet and it’s appropriate, even when it’s appropriate, and you’re releasing that pet from ‘pain and suffering,’ it’s still emotionally draining on us!!
At some level, we’re all crying, and I’m talking about us as the practice when a pet’s euthanized.
Even though, in many cases, it can and definitely is the right thing to do.
We’ve got that responsibility to do it, and even though doing it is the right thing, you are taking away life, and that is terribly emotionally draining.
Because of having to perform that procedure so often and because of the stress in our industry, I’ve been down the road of having a breakdown because of that emotional overwhelm, overload of- there’s a word, and I can’t think of it at the moment.
Yeah, I just can’t think of the word I’m after, but it just gets to you after a while, and even as I said with a pet, when we’re doing the right thing at the right time, it’s challenging and difficult.
But when it’s inappropriate euthanasia, it’s much worse. At HIGHlands, we no longer do inappropriate euthanasia!!!
As I said, we’ll ask permission to rehome the pet, or we’ll find a way around it if we can.
But industry-wide, it is STILL a huge problem. When it’s inappropriate euthanasia, it’s even more debilitating, and we have even more emotional suffering in our teams.
Let me just go to some of these questions now.
Anne De Bono says, “You know when a surgery is required for a child, I would say they put you to sleep.”
Yes, you’ve underlined my point exactly, and the terminology in the community is “a pet’s put to sleep,” and I’m sorry, I just won’t go there, they’re not being put to sleep, they’re being killed, or they’re being euthanized, maybe euthanasia is the better term.
But please, for golly’s sake, don’t use that term with your children. It can have some horrible ramifications.
Gabby Cole, “You euthanized Daisy after doing everything you could; she had Cushing’s.” Yes, thank you, Gabby. That’s a situation in which it’s hard to do, but it was the right thing to do, and therefore, in a way, it’s sort of uplifting to help someone like Daisy pass on to a better and more appropriate life.
There are no other questions at the moment that I can see.
I hope that what we’ve talked about is- has been helpful, and I guess I’ll finish on this note which is;
if you’re if you yourself as a human have pain and suffering, whatever that happens to be
If you have dementia or some mental disability.
We all have different ‘pain’ points for ourselves.
If we have two people with horrible arthritis, one person may be happy being euthanized if it was legal in your state, and the other person would be happy to fight on with pain relief and all those sorts of things.
Just as there are differences within us, I believe that there are differences in our pets…
… and some of our pets, if we ask them that question ‘previous’ question – I literally- if I’m in this situation with a client’s pet, I literally ask myself that question to the pet and listen to what they say back to me, “Do you want me to kill you?”
…and I mean that in a nice way, it comes from a place of compassion, and then I listened back for that answer.
YOU as your pet- you, as a pet parent of your pet, have a lot better handle on that question than I would ever have with your pet.
That to me is the best indicator of, ‘when is the right time’?
The right time is when both you and your pet are in agreement that ‘now is the right time to euthanize, for whatever reason.
It may be just because it’s time, it may be for arthritic pain, it may be for dementia, and it may be for none of the above.
I hope that I’ve given you something to think about. I hope that you’ve got some answers to some questions.
If you have a pet and you need any of these handouts; Quality of Life handout, Quality of Life Scale, then just contact us at the practice.
…..that’s the ‘quality of life scale,’ and this is ‘how do I know when it’s time’ hand out.
If you want those, please drop in the practice or ring us and we can email them to you; you can also get very similar things online.
I look forward to catching up with you next month when we have another Facebook live about another interesting topic, so see you then, good night.