DEAR DR. FOX: I'm concerned about the recent experience I had with a sick cat. There doesn't seem to be any palliative care for pets the way there is for humans who are suffering, and I don't understand why that is.
Jingles, my lovely little buddy, was about 16 years old. I'd had her for 12 years. In early December 2011, she started to have upper respiratory problems. I took her to my vet on Dec. 5, and she was given a shot of what I believe was an antibiotic for a possible sinus infection.
She continued to get worse, so I took her back on Dec. 12. She was given a blood test -- she had high white blood cell counts, but otherwise normal liver and kidney values -- and Pepcid and dexamethasone injections.
As a last-ditch effort on Dec. 13, I brought her back to the vet, and she was given a Convenia injection.
Jingles only got worse. My vet doesn't do in-home euthanasia. The people the vet's office recommended didn't want to do the euthanasia unless I had taken her to an animal hospital -- which I did on Dec. 14. I was there for hours. I knew she was dying, but I made her go through all these tests in her weakened state because they wanted to make sure she was sick. Four hundred dollars later, the diagnosis was that she probably had lymphoma. She had lost half her weight, was no longer eating and was the sickest I've ever seen any living thing. Because of her age, I opted for euthanasia rather than chemo. Before I left the hospital, they gave her mirtazapine, a famotidine injection and subcutaneous fluids.
She found peace on Dec. 16 with the help of the in-home vet.
What I've left out of this narrative is the emotional wreck I was. I carted her all over town in her final days, made her get shot after shot, missed work, cried at work, etc. I'm still so sad just writing this. I understand that animals get old and sick. What I don't understand is why there doesn't seem to be any type of hospice mentality in the veterinary profession. I'm no doctor, but I think all those injections were a futile attempt to save her, and none was to ease her suffering -- except the final one. I knew she was dying; surely these professionals did too.
Please help me understand why there is no kitty morphine or even kitty aspirin. Why did my sweet old girl have to toss and turn in pain in her final days, waiting for the in-home vet, when she could have had some of her discomfort ameliorated with a little palliative care? -- M.T., Oakton, Va.
DEAR M.T.: Your detailed, tragic account of the last days of your poor cat raises serious ethical questions for companion animal veterinarians to address.
I have discussed these in my new, controversial book, "Healing Animals and the Vision of One Health" (CreateSpace), where we see similar parallels in the extended, costly care and suffering of the terminally ill victims of the human health-care industry. Providing security and relief from fear and pain when there is no chance of recovery is the best medicine.
In-home hospice care for humans (which we provided for my late father-in-law) is a blessing that is becoming more widely practiced across the U.S. It is just a matter of time before such services are provided for companion animals like yours -- who already had the unquestioned benefit of in-home euthanasia. There are a few veterinarians where I live (in Minneapolis) who operate an exclusively in-home hospice care practice. I hope your letter encourages more veterinarians to follow this compassionate path.
DEAR DR. FOX: In late August, we adopted a very handsome, neutered, longhaired German shepherd, Bear. He is about 5 years old and as sweet and gentle as can be.
A month or so after we got Bear, he began to whine loudly whenever we went anywhere in the truck. He willingly jumps into the truck when we are ready to go, but the whining starts before we've left the driveway. There appears to be nothing in particular that causes Bear to do this.
Since we were driving to see my mother on Christmas Eve, we got a prescription of alprazolam from his vet to try to calm him while on the road.
At 7:30 that morning, we gave him a half tablet. We left at 9. We had not gone a block before he started howling. It continued to get worse and worse until we stopped 10 minutes later and gave him the other half. We opened the window and let him hang his head outside for a few minutes -- when his head is out the window, he is 90 percent better -- but it was cold. After our experience with his behavior while under the influence of the prescription drug, we probably will not drug him again.
Today we took him to the dog park about 25 minutes away. Loud howling started immediately. For the few minutes I allowed him to have his head out the window, he was OK; when the window was closed he howled until I filled his Kong toy with treats to keep him quiet and occupied. Sometimes even when the window is open, he whines.
It appears to be an anxiety attack, but what would have brought on such behavior? Do you have any suggestions as to how we can change it? His Bark Buster trainer has no ideas. At his suggestion, we tried the Thundershirt, but it made no difference. -- C.B., Springfield, Va.
DEAR C.B.: Your dog is probably suffering from a combination of anxiety and excitement.
Alprazolam is a potent anti-anxiety drug, effective for many dogs who are afraid of fireworks or have developed specific phobias. But the effective dose for many dogs can make them groggy and uncoordinated, which can have the effect of making the dog more fearful, possibly because they feel more vulnerable.
Many dogs benefit from wearing a bandanna imbued with a few drops of lavender oil around the neck.
Since getting treats out of his Kong works briefly, fill it with peanut butter and freeze it so it will last longer. Get two or three for a longer drive, and store them in a cooler. Try giving him a Nylabone. For motion sickness, a big piece of ginger candy can provide relief.
(Send all mail to email@example.com or to Dr. Michael Fox in care of Universal Uclick, 1130 Walnut St., Kansas City, MO 64106. The volume of mail received prohibits personal replies, but questions and comments of general interest will be discussed in future columns.
Visit Dr. Fox's website at www.twobitdog.com/DrFox.)