It’s one o’clock in the morning. I can’t get comfortable. I have bursitis in my hip, and it hurts. I toss and turn. If I fall asleep, I will almost certainly wake up again at three because, well, you know … nature calls. They say aging is a natural process, not a disease, but the hard reality is that things start to wear out as we get older. Human, canine, feline — different species have vastly different lifespans, but we all eventually have an “expiration date.”
As I try shifting to the other side, I think with compassion and empathy about the elderly pets I care for in my practice. Take Nonna, a 15-year-old Labrador retriever. Nonna is also restless at night. In the morning, she has trouble getting on her feet from lying on the floor. She occasionally leaks urine in her dog bed. Seems like she doesn’t hear too well anymore. She is less energetic, less playful, spends more time snoozing. Sometimes Nonna acts confused, and she’s definitely more irritable, snapping occasionally at the other dog in the house. Let’s talk about common aging changes in senior pets.
Eyes. Most older dogs will have some degree of nuclear sclerosis, a normal aging process in which the lenses appear cloudy, but which has minimal effect on vision. Owners often mistake this for cataracts (which do affect vision). Your veterinarian can differentiate the two conditions with an ophthalmoscopic exam. Nuclear sclerosis is usually bilaterally symmetrical, meaning both eyes look the same. The milky-white appearance is only in the center, where the lens is visible through the pupil. (If the white appearance is only on one eye, or on the corneal surface of the eye, consult your veterinarian.) Even without cataracts, Nonna’s vision may not be as sharp as when she was a pup. We don’t have her read an eye chart annually, but aging dogs, like aging people, probably experience presbyopia, a condition in which the lens begins to lose its ability to change shape and focus as sharply.
Ears. Geriatric deafness. Happens to people. Happens to pets. Definitive diagnosis requires the brainstem auditory evoked response (BAER) test, which needs specialized equipment and training. All we can do here is have someone in the next room bang two pots together and see if Nonna reacts. Age-related deafness usually has a gradual onset, and dogs acclimate fairly well. What about hearing aids? Dogs tend to scratch them out, then chew them up. Your best bet is to teach Nonna some hand signals, and try not to sneak up on her or startle her. Nonna’s senses of smell and taste may also be declining. Combine this with her failing vision and hearing, and you have a state called “sensory deprivation.”
Nonna may sleep through your vacuuming around her, then startle suddenly if she is touched. She may not respond when you tell her to sit, or call her to come in. She may become more anxious or short-tempered. Her appetite may wane. You can help by keeping her environment and her daily routine as consistent and predictable as possible. Sometimes, however, Nonna may seem confused beyond what one might expect just from these sensory changes. Wandering aimlessly around the house. Getting stuck in corners or under furniture. Losing her housebreaking. This may be canine cognitive dysfunction syndrome — the veterinary version of dementia. Your veterinarian can do a behavior consultation and, although there is no known cure, medications may ameliorate some of the symptoms.
I roll over. Now my back hurts, so I get up to stretch. Drat. My left ankle acts up. I have a chronic condition called sinus tarsi syndrome. I hobble around until it starts feeling better. Which brings us to our most common geriatric problem — musculoskeletal issues. We often lump these all together and say Nonna has “arthritis,” but it is really more complex than that.
Degenerative joint disease (DJD) or osteoarthritis (OA) is an irreversible, degenerative condition of the joints, in which cartilage that normally cushions the bones erodes. Nonna may limp or seem stiff when she first gets up. It can get better as she moves around, or worse if she overexercises. Lesions may be visible on radiographs, but not always, and there are other conditions that cause similar clinical signs. For example, bursitis — inflammation of the small, fluid-filled sacs called bursae that pad the bones, tendons, and muscles near certain joints. Old dogs can get bursitis, tendonitis, all kinds of aches and pains, just like old people can. Some can be diagnosed with X-rays, but many require tests such as ultrasound or MRI for definitive diagnosis. Older animals also have trouble maintaining muscle mass, leaving them weaker than they were in their youth.
We can’t cure these age-related conditions, but we can do things to keep Nonna comfortable. Watch her weight. Provide moderate, regular, low-impact exercise. Get rubber-backed throw rugs to provide traction. Buy her Dr. Buzby’s toe grips (Google it), or even a harness, she can wear with handles on the back, so you can help her up (helpemup.com.) “Nutraceuticals” such as fish oil and/or chondroprotective agents like glucosamine and chondroitin sulfate may help support the cartilage and reduce joint inflammation. Be sure to buy such products from reputable companies. Ask your veterinarian for recommendations. Finally, your veterinarian may prescribe pain relievers, usually prescription nonsteroidal anti-inflammatory drugs (NSAIDs) designed specifically for dogs, but sometimes other medications, ranging from corticosteroids to opiods, depending on her particular needs.
Nonna may not be able to tell us in words why she is restless or irritable or confused, but if we pay attention to the clues, provide environmental supports, and treat the treatable, we can often improve her quality of life. Don’t deprive elderly dogs of optimum veterinary care just because they’re senior citizens. We can’t turn back the clock, but we can give these venerable old-timers all the love, dignity, and medicine they deserve. Now where did I put the pills for my bursitis?