DEAR DR. FOX: OK, we need help here... We have a 13 1/2-year-old female black lab. Eight weeks ago, she went to the vet for blood work -- she's in perfect health. Six weeks ago, she walked away from her Eukanuba food for the first time ever. Since then, she's been eating less and less. Her last meal was Wednesday, some ground pork. She's thrown up every day, especially after she drinks water, though she is still drinking. She's lost 10 lbs. Yesterday, she sat in the yard all day, drooling; she ate a lot of grass.
We almost put her down last night, but couldn't. She still follows me from room to room. It is hard to let her go as she is still alert and can move fine, but she's no longer playful.
She is now on mirtazapine and prednisone. Her spine sticks out in the back due to weight loss. It clearly hurts her. I just want her to eat, but it seems spinal pain causes a gag reflex. I use an oral injector on the side of her mouth to administer medications. What now? Better pain medications?
Vets here want $1,500 for an endoscopy -- mine was $1,200! How can they charge such high prices? Give me some ideas, please. -- P.G.
DEAR P.G.: I'm so sorry to hear about your old dog. You could spend a small fortune on diagnostics. My response following all of those tests: "Then what?"
I would first suspect and check her blood for renal failure and have an X-ray done to check out her vertebrae. Spondylosis and other degenerative diseases of the spinal cord can cause dogs pain, fear and lack of appetite. Analgesics and anti-inflammatory drugs can provide temporary relief, but can cause nausea and disinterest in food, and affect kidney and liver functions.
Massage therapy -- as found in my book, "The Healing Touch for Dogs" -- acupuncture and laser therapy may give some relief. Give her a heated pad to sleep on. Injections of vitamin B-complex are old-school remedies for poor appetite. She may eat Gerber's baby food or something similar made at home in a blender.
You need to consider a third-party evaluation of your dog's quality of life if you are undecided about the final hard decision of euthanasia, which, considering your dog's age and breed, may be the kindest step to take. In-home hospice care is catching on, with veterinarians and trained veterinary nurses coming into the home.
The bottom line here, considering your dog's age and symptoms, is palliative or comfort care. You and your dog are victims of the kind of veterinary practice which mirrors the human health care industry's costly diagnostics and treatments of terminally ill patients, focusing on organ functions rather than on the whole patient. It may be good business, but is it ethical and humane?
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