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To Help Your Old Pet
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NOTE: This discussion will focus on death as it relates to the elderly animal, whether from old age itself, or an associated malady. However, the process of dying is similar in all beings, whether young or old.
If your pet is at the final stage and is actively dying, go to “VISUALLY UPSETTING SIGNS” near the end of the article.
Death, or “to die,” is the end for every living being, and we should all understand that life is a finite miracle that will come to a conclusion at some point, no matter what is done to prevent it. When death occurs, the body goes through a cascade of events that ends with stoppage of the brain, respiratory system, heart and other bodily functions. In our animals, this natural proceeding is not well documented, and the view by both veterinarians and the global pet community, is that it’s a “horrible” incident, fraught with pain and suffering, and should not to be allowed to happen at any cost. As a result, euthanasia is performed under the guise of “compassion” to prevent death’s normal and natural occurrence.
In many cases, the intuitive caretaker will notice subtle differences in their pet long before the animal is close to dying. In fact, these changes are often part of the aging process, which is actually a form of preparation for the “final chapter.” If the changes are concerning, then a visit to the veterinarian usually occurs. Strangely enough, the doctor may not find anything specific during one of these initial visits. This is likely related to the stress and anxiety of the visit for the animal which mask what is actually going on. Changes in the animal’s mobility or demeanor may not be apparent to the doctor until later in the course of events. The wise veterinarian, however, will listen to the concerns of the caretaker and will be more thorough in the examination, perhaps taking radiographs and checking blood and urine. Early on, there may not be any specific findings, but rather a suggestion that the aging process is progressing. Evidence of arthritis may be found on the radiographs and slight elevations of the kidney values may be noted. There may be a low grade heart murmur present. None of these may be significant enough to require treatment, but more frequent check-ups may be recommended. Of course, in some of these situations more worrisome findings are present, leading to more significant testing to determine the specific malady involved.
The progression of age related problems appears to occur much more rapidly in our animals because their ages are compressed in time. In the older cat and dog one day in our time equals about 4 days in theirs, or one year for us is approximately equal to four years for them. It is also important to understand that the aging process is essentially the same in our animals as it is for us. There is a pet age determination chart under Resources
I find that both veterinarians and pet caretakers have preconceived misconceptions about what is considered to be the actual end of life. I hear it too often: “My dog (or cat) is just old and needs to be euthanized,” or “my dog (or cat) has cancer and needs to be euthanized,” or “my dog can’t get up and needs to be euthanized.” The reasons are numerous, but are often based on misconceptions related to how people view the life of their pet. They don’t want their pet to “suffer,” or their pet’s quality of life (QOL) in their misconception is poor, or they don’t want to be “selfish.” Please see: Validating Euthanasia under News on this site.
As pets age their ability to get up from a prone position becomes more difficult as does walking. This is often related to diminished nerve function to the rear legs and not arthritis as the pet caretaker and their veterinarian believe. Breathing patterns may change with more shallow and rapid breaths. Bowel movement intervals can be increased and urination intervals and amounts can seem different if the animal is not drinking as much water.
People nearing death feel tired and sleep more. This is also common in both the cat and dog, although many older pets tend to sleep more than usual as they age. The appetite may change, and the animal may not want to eat its normal diet. This is often true for prescription diets that are directed at kidney, heart or intestinal disease, as they may not be palatable to the older pet. Changes in the appetite are especially worrisome to pet caretakers, and they often base the need for euthanasia on the diminished appetite and the weight loss that accompanies it. Animals know their bodies better than we do, so if they don’t want to eat, there is usually a reason. It may be because they are nearing death or there may be other causes. In both dogs and cats, pancreatitis can be an underlying condition that is often not diagnosed and will result in inappetence. The conditioned state of our animals begins the digestive process by releasing acid into the stomach in preparation for the upcoming meal. When the being doesn’t eat, this leads to increased acid content in the stomach, and that by itself can contribute to a diminished appetite. Famotadine (Pepcid AC, an over the counter human medication) can help to decrease the acid and sometimes will start the animal eating again. When a pet stops eating completely, people tend to think the animal is at the end, and they often call for euthanasia. Actually, animals can live a relatively long time without eating. However, if coupled with not drinking, death ensues in 5-7 days, much like it does with elderly people who stop eating and drinking. Cats are a little different, although not eating and drinking results in death in about the same length of time as for dogs and people. With cats that still have internal fat, not eating can result in a condition called hepatic lipidosis (fatty liver). This will make cats nauseous and will result in the cat’s demise if not treated.
The dying process is actually a miraculous affair for the creature undergoing it. There is no awareness or pain because the brain is in a coma state. Even prior to dying, and before the brain becomes comatose, there can be a long period of preparation for the end. A deep and unaware sleep sets in with periods of wakefulness, and even periods of lucidity, with possible recognition of those present. In both cats and dogs there can be shivering, muscle twitching and even moaning, along with occasional vocalization, and the respirations become shallow and more rapid. People, and veterinarians alike feel that any or all of these symptoms mean pain, and they are quick to seek, or recommend euthanasia. For veterinarians, this approach of using euthanasia to end life is normal because that is the way we have been taught. Because of the veterinary methodology and view, the pet caretaking community feels the same way, and understandably so. It is only in the last few years that I have developed a different and an educated viewpoint that is completely contrary to this concept that a natural death of an animal involves extreme discomfort.
Human death, and what happens therefrom, has been well documented, whereas animal death and what happens has not. Why is this? I believe it is because the animal at its end of life is euthanized and not given the option to die naturally. Therefore, there is no need to determine the course of events that occur with a natural death. It is important to realize that many animals die while in the care of a veterinarian, not from euthanasia, but because of the the malady that caused the caretaker to bring their pet to the veterinary hospital in the first place. We veterinarians, cannot save every animal no matter how much we want and strive to. Many pets also pass at home from a multitude of causes. No one desires their pet or a loved one, to die, but it is inevitable, and it’s important to understand that it is not a “horrible” event, but a well designed and pain-free one.
Death can be a rapid affair with little symptomatology that indicates its immediacy, or it can be a long, drawn out process with many different stages that occur with organ shutdown. The former version is what everyone hopes for, but the latter one is not uncommon either, and it can be visually and emotionally upsetting. There are many occurrences in between and no one can tell how death will play out until the actual end of it.
My favorite cocker spaniel, Agatha, died in my arms with one final breath, so I know how quick it can be. A few seconds prior, she was responsive to my petting her. When death occurred I was carrying her to the back door of the veterinary hospital which I owned at the time, with the purpose of euthanizing her. She had severe neurological disease and was fading rapidly, but she was still aware, and then, in a second she was gone.
I now coach people on the specifics of allowing their pet to die a natural death. This would be frowned upon by both veterinarians and the misinformed caretaking public. Their view, as I have stated previously, would be to choose euthanasia, and preferably sooner than later. Many pet caretakers take their veterinarian’s advice, and proceed to allow euthanasia when the animal is sick, has been diagnosed with a terminal illness or cancer, or is just “old.” Had I not seen hundreds, if not thousands, of animals live longer lives after they have been given an immediate expiration date, I might be of the same opinion. However, it happens so frequently that pets live longer when I give their caregivers a different perspective. Therefore, I am very careful to not recommend euthanasia too quickly.
The actual process of death can be extremely short, as with Agatha, or it can take a variable period of time as it runs its course. Following are several signs that can be visually unrewarding for anyone observing. It’s extremely important to understand that none of them mean the animal is in discomfort. The brain is in a comatose and unaware state as these occur. None, one, several, or all of these signs may be seen. People that have witnessed any of these without understanding what is actually happening will never allow an animal to die naturally, and their previous observance of them will often haunt the individual for the rest of their lives. It is with this in mind that I want people to know that no pain is involved, and that these signs are a natural occurrence with the process.
Some animals will want to be away from their caretakers, and may seek unusual locations to rest prior to dying. They may not respond at all to being touched or talked to. Other animals want more attention as they near death. Neither approach is unusual, but the former can be difficult to understand from the human standpoint, while the latter is a welcomed behavior. I remember two instances involving cats, where each passed peacefully on their pet moms’ chests. Another recent situation occurred where a little dog passed while next to one of the caretakers. The dog and the caregiver were sleeping next to one another, and the caregiver was unaware of the death until awaking the next morning.
Some animals become extremely manic as a precursor to dying, but most caretakers do not recognize that this is a part of the process of dying. Fortunately, this group of symptoms is not very common, but it can be the most emotionally challenging and difficult phase to deal with if it develops. It seems as though nothing can be done to comfort the animal. They may lie down for a short time, then move to a new location, or go to a location that they never go to. They can be in a continual stage of motion. Both dogs and cats often vocalize during this stage. They may want isolation and usually are not responsive. Either species may become aggressive and often will not allow being touched or given medication. Finally, they will relax as the proximity of dying draws nearer. Understandably, the pet’s family may find that they are unable to emotionally deal with this behavior, especially the vocal part of it. This is related to the idea that their pet may be in extreme distress and discomfort, which then elevates their own level of emotional angst. Knowing that discomfort is not a part of this manic syndrome is difficult, if not impossible to achieve. However, if the realization can be understood that this is a precursor to death and will soon end, then it may be possible to persevere until this stage passes. In most cases the manic part of it will be short lived, but dealing with it may seem like it will never end. It will, however, so hang in there.
This is a mechanical appearing respiratory pattern that is characteristic of end of life in animals and people. It often involves open mouth breathing with variable periods of deeper respiration followed by periods of shallow breathing and periods of no breathing (apnea). The animal is not aware (no pain). This can last a short period of time, but can go on for hours. Many animals do not develop this at all.
Vocalization at the end of life (moaning, crying, whining and barking in dogs, and moaning and unusual meowing in cats) is often felt to be associated with pain for most people and veterinarians. This is not true and should not be thought of as pain at all. It’s cognitively related and often reflexive in nature, and occurs at the time of death in many cases.
This is seen more often in cats than dogs, and usually occurs at the time of brain death. There can be a sharp vocal response associated with it. This vocalization sounds completely different from the animal’s usual meow, bark or whine, and should not be thought of as a painful cry. Often, the head will arch backwards and the mouth will open during this period as the legs become tense and splay out from the body. The muscles then relax, and the limbs and muscles become flaccid with death. This process can last a few seconds, but the longer it lasts, the more upsetting it becomes. It’s important to understand that the animal is in a coma and completely unaware of this happening.
It’s quite common to see muscle twitching and shivering prior to death. We are all electrical creatures, and the nervous or neurological systems are especially susceptible to changes that occur with dying process. Shivering, like vocalization, indicates pain in the minds of many pet caretakers (and veterinarians). However, it rarely means that, and is most often associated with anxiety in the dog, but during the end of life, these signs can be an indicator of electrolyte imbalances, low body temperature or diminished neurological function.
As the body goes through its final stages of living, release of urine and/or bowels is a common occurrence, although evacuation of bowels doesn’t happen as often as bladder emptying does. This can happen prior to death or shortly thereafter. Urine is almost always released, especially if the animal is picked up or moved. In many cases there is a significant amount of waste. This is normal and expected.
To many people, when their pet dies, there is concern that the eyes remain open after death. This is a normal occurrence at end of life (humans, too). Closing of the eyes requires active muscle and nerve function. Death removes those functions and, consequently, the eyes remain open. Also, dogs and cats, along with many other creatures, have three eyelids (humans only have two). The third eyelid forms the tear film on the cornea when the animal blinks. When life has ended, the third eyelid remains retracted, keeping the eye open. It is possible to close the eyes, but as soon as the pressure is removed, the eyes open again. I always explain this when I help with the transition, but it’s an important thing to know if the animal passes naturally at home.
Unfortunately, there are often conflicting signs that the animal may be dying. The actual point of death, however, is a constant that no amount of intervention can prevent. This is extremely important to understand, because in many cases the animal is rushed to the emergency hospital, where it is handed over to trained technicians and doctors who will want to try to save the creature at all costs, but to no avail. I believe it is a much better alternative to allow the pet a dignified and natural death in their home environment, especially when they are at death’s door. Yes, it is upsetting, but it is also a natural process that was originally designed to occur without medication. It’s also a pain free and miraculous ending.
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