end-of-life care at home
Wondering how often acupuncture treatment is recommended for your pet, or how soon it might start helping? Dr. Bruner discusses this question here, with some insights into how the benefits of acupuncture can add up over time.
Dr. Bruner discusses how a no-nonsense Western-medicine-focused veterinarian discovered that acupuncture isn’t just fairy dust, as she had always secretly thought.
One of the most common challenges that older dogs and their humans face is the progressive hind-end issues many dogs develop as they age, especially large breed dogs. Arthritis (often from hip dysplasia), neurologic degeneration (progressive weakness and unsteadiness of the back end), and loss of muscle mass combine to make getting around very difficult for most senior dogs.
It becomes harder and harder to get up stairs and into vehicles; and this in turn can lead to isolation and boredom, when your dog can’t come along with you. Most dog owners assist by lifting the dog, which can be awkward or risky for both pet and owner. The larger the dog, the greater the challenge.
But there are other options. I’m a fan of support harnesses, like the ones from GingerLead. They’re a simple concept– you have a wide strap with a handle on each end. The strap wraps around the dog’s abdomen, just in front of the hind legs. With the strap attached back to itself, you’re free to gently hold the handles as you walk your dog.
When there’s need for stair climbing, or your pup needs assistance for any reason, you simply give a lift on the handles. It’s far more ergonomic and safer than picking up the dog.
Harnesses like these are useful tools for dogs suffering from arthritis, hip dysplasia, degenerative myelopathy, vestibular disease, recovering from amputation, and more. They come in a variety of sizes to fit dogs from the smallest to largest. They can also be used temporarily for recovery from surgery or joint replacements, and as an aid for physical therapy and rehabilitation.
In addition to the GingerLead option is a product from Blue Dog Designs. The Help ‘Em Up harness is a bit more extensive than the other product, as it has two sets of handles. This makes it a better choice for weaker dogs or owners who need to use both hands to lift, and it has the added benefit of being wearable all day. It’s a bit more flexible in the way it fits, and can be configured with several options for the hind-end portion, allowing it to be customized for the varying anatomy of male dogs.
I don’t have any special relationship with the companies– they’re not paying for this write-up, and I don’t have a discount code for you. These harnesses simply are a product I like, and one I think you should know about.
You can find the GingerLeads, and their Dog Support and Rehabilitation Harness, at http://gingerlead.com/ They’re also available at a number of pet stores, including locally at One Stop Country Pet Supply in Barre, Vermont.
The Help ‘Em Up from Blue Dog Designs is available at https://helpemup.com/ but does not have any official sales outlets in Vermont. The website is easy to use and there are actual human customer service reps available to help you choose the right harness options for your dog.
In the early days of my housecall practice, I went to see a fifteen-year-old Lab and her person at home for a quality-of-life consultation. People often call me for a talk like this about their old pets. Their regular vet might not have time for the hour or so that it takes to fully discuss an old pet’s situation. It really helps me to see the pet at home; sometimes there are adjustments to make everyone’s life easier that I wouldn’t know about unless I see the house. And of course, old pets prefer not to have to travel to the clinic! Most of what we’re talking about is low-tech, but if I see a situation where diagnostic tests or an in-clinic procedure would be useful, I’ll recommend a visit to their regular veterinarian.
Diane showed me the ramp she had made for Mocha to get up the few steps to the house. I looked at the medications and supplements Mocha was taking, and reviewed the special diet of fresh foods Diane was cooking for her. Diane made sure to get Mocha out for the short walk she could manage several times a day. She had acupuncture every 4-6 weeks and went for car rides, which she loved, at least once a week.
Although Mocha’s energy level and limited mobility didn’t allow her to run and play much, she loved to hang out with people. And, of course, other dogs. Instead of going on long hikes as they had in the past, Diane would take her to a friend’s house for the afternoon. Mocha would bark and trot around with the other dogs briefly; then she would flop down and spend most of the visit snoozing under Diane’s chair. Even so, she seemed to enjoy the energy of the younger dogs and the interesting smells wafting from the kitchen.
Despite all of this, Diane was worried she wasn’t doing enough for Mocha. Was there another medication she could take? Something Diane could add to the diet? A new supplement she hadn’t yet heard of? Some piece of hardware that could help Mocha get around better?
In Diane and Mocha’s case, there weren’t many changes to make. Diane was already doing so much for Mocha that I felt at a loss. I couldn’t offer something new and useful to say. I pointed out to Diane all the things she was doing and offhandedly remarked that it was more than many people do for their elderly family members. Struggling for something to suggest, I mentioned that Diane could simply sit down with Mocha for a bit, at least once a day, and just be with her. We talked about a few more things, and then I headed off to my next appointment, wondering if I’d been useful to them.
A few weeks later, Diane emailed me to say that she had gotten a lot out of our consultation. To my surprise, she mentioned that the most useful part had been my casual suggestion to sit down with Mocha. She had been focused on external things, on doing more (as I had, too). It was a huge relief to her to realize that the most important thing she could do for Mocha, and for herself, was just to be together. Diane saw that she could really use a break in her busy day, and had been setting aside 30 minutes each evening to read with Mocha by her side. Even if Mocha was asleep, which she often was, Diane felt that they were connected.
Thanks to Mocha and Diane, I learned about the tremendous importance of actively making time to express the love we have for our old pets. Both veterinarians and clients can get so focused on material things sometimes. Is there a pill for that problem? A technique? Special garment? Sometimes, but often all we can do is accept the inevitability of the aging process, and remember to be there with our old pets. We used to bond by taking long walks together or through intense laser-pointer play sessions. Now they aren’t interested in or can’t do those things, but they still want to be with us. We need to slow down to their pace. This way we can rediscover the simple but magical power of just being together.
I also learned how important it is for my clients to celebrate the love that is the foundation of the work we do to care for our old pets. As our pets age, we make more and more accommodations to their changing needs. They become less flexible, both physically and mentally. Often there are more messes to clean up. Many people haven’t been on a trip in several years because they know it will disturb their animals. They change their own daily routines significantly to adjust to what their pets need.
People with elderly pets can lose sight of the efforts involved. Taking care of them can require a huge amount of time, energy and emotion. It’s similar to taking care of an elderly person. Yet there is no support system around this role, no visiting nurses or home health aides. Recognize yourself as a true caregiver. This can help you see that you are already doing a ton for your pet and that you need to care for yourself too. Quiet time together can help both of you.
I’m right in the midst of an advanced acupuncture class at the Chi Institute of TCVM (Traditional Chinese Veterinary Medicine) and it’s super exciting! The class focuses on a style of acupuncture inspired by the balance method of Dr. Richard Tan, a celebrated human acupuncturist. This style uses minimal needles placed far away from the painful area in a location that mirrors it on another part of the body. The balance method is used to treat pain, mobility restrictions, and other conditions with almost instantaneous results.
Watching both people and animals in our class sessions has been truly amazing. Our head teacher, Bruce Ferguson, is also a certified human acupuncturist, allowing contrast. Most people and pets experience decreases in pain and mobility improvements of greater than 50%, and usually more like 80% (by their own assessment, or in the case of pets, by a demonstrated range of motion) within a few breaths of the placement of the needle.
As we are learning, it has taken us a few tries to find the right spot to place the needle; or we find we can improve results by adding a needle or two. Most of these points are in the foot or leg below the elbow or knee, and they can be a bit “zingy” at first. However, the chance of rapid and significant pain relief is worth that short-term discomfort. All the dogs (and horses) in our labs tolerated their needles well.
According to Dr. Ferguson, repeated visits are important to maintain the benefits of treatment for the long term, with the length of treatment typically depending on the length of time the problem has been going on, as with the original style of acupuncture we learned in our initial certification program. We recommend retreatment before the problem fully recurs.
The first section of the class involved some lectures online. In May we had two days onsite in Florida. This format gave us valuable tools to immediately bring the benefits of this new style to our patients. I’m very much looking forward to the final section in November!
I truly enjoy these classes. Not only because I enjoy learning, but because I can share my knowledge with my acupuncture patients.