Full Dog Pod Transcript : Episode 10
Scott Groves: Well, welcome back to another Dog Pod Episode, and back with me this week is our award-winning vet, Dr. Kevin Cruickshank, from Gold Coast Vet Surgery. So welcome back, Kevin.
Dr. Kevin Cruickshank: Thanks, Scott. Good to be with you.
Scott: Yes. So, this is our tenth episode. Do you believe it already? We have made it to a double-digits.
Dr. Kevin: What a milestone, fantastic.
Scott: Unbelievable. So this week, we have actually got a question from Simone that has come through on Facebook, and I thought this would be a good one to talk about today, probably flows on a little bit from some of the things we have spoken about, a little bit, but she has got a very specific example here. So I might just read this out first. So it says, “Can I suggest- so, thank you, loving your podcast and all that,” which is great, thank you so much, “but can I suggest a podcast on elderly dogs, i.e., the aging process, what to expect, warning signs, and when to take to vet. Example, my fifteen-year-old Dingo has suffered from effects of gravity, breathes more heavily, glazed eyes, graying, walking more rigid, I thought would make an interesting pod”. So thanks very much, Simone, for the questions, the cracking questions.
Dr. Kevin: Certainly a great topic, very, very important. And, yes, nobody knows exactly when and, I find it’s a big burden on people, they worry when should they be speaking to a vet. They can’t necessarily put their finger on one particular thing, and it is like so much in medicine, the earlier you pick up on things sometimes there is more that you can do about it. You might not be able to cure things, but you can keep the quality of life good as well.
Scott: Yes, absolutely. So let’s go through some of the things that she talks about here and a Dingo is an unusual pet. You do not see a lot of people with Dingos.
Dr. Kevin: You do not see a lot, you do see quite a few crosses. It also depends on which part of the country you are working in, but even in suburbia here, there are sometimes people who have been working in a more rural area, and yes, they can make fantastic pets, definitely.
Scott: Yes, fantastic. So effects of gravity I guess is probably just the, I guess, the weight on their body over time. I guess that might be what Simone is referring to there, and it probably comes back to the arthritis which we spoke about in many a podcast before but it is a big one for elderly dogs and so I am not sure where to start with that, really, but I do not think it is… take it away, take it away [crosstalk].
Dr. Kevin: Yes, I would be happy to. So to go through some of the symptoms and really, often, the thing is that people say, “Oh, my dog is just getting old,” and in fact, that’s because there are certain things that are going wrong that we are seeing when we say they are just getting old. Getting old itself is not an illness or disease. So, just being that little bit slower to get up when they get out of their bed and warm-up fairly quickly after a few minutes. They’re moving around a bit better, but they still may be cannot get up on the sofa like they used to, on your bed, can’t jump into the car, just sort of every day to day things that you might notice. They do not necessarily limp on one specific leg. They don’t cry and yelp. Often people say to me, “My dog is not in pain because it does not cry,” but when we think about ourselves, you can be stiff and sore and you are not actually vocalizing or crying. So they are walking slowly and gingerly because they are sore, so it is a very painful condition and I think that is one of the nicest things is to keep them free of pain.
Scott: Yes, you have mentioned something to me when we are on a run, about the vocalization of dogs, when they finally do, if they are vocalizing some sort of pain whether it is a grimace-y type, groan, or–
Dr. Kevin: Whimpering, as well. They sometimes do, yes.
Scott: That is when it’s actually got pretty bad, is it not?
Dr. Kevin: That is my opinion, yes. We do not– and you could have a very painful tooth, you could have a sore leg or toe or something like that, but you can be walking along, and that person with you may not even be aware of the pain that you are in. You can hide it fairly easily and you are not– but you might be in quite a lot of pain but you are not actually crying or yelping out or anything like that. So it is only when it is really quite advanced or it might be a sharp shooting type of pain that you or then a dog would actually cry out.
So if we think about the amount of pain that we sometimes endure on a day-to-day basis, even something like a migraine or headache, how do we express that? We’re not– it is not only through crying or vocalizing, and so we have got to look for more subtle symptoms of pain, animals that would normally be coming running over to greet you, don’t really. I suppose getting back to Simone’s questions, some of the other things that we see as dogs get older is loss of some of their senses. So, their hearing, you might find that you can actually surprise your dog, walk up behind it without it having heard you coming or it’s no longer meeting you at the door because it has not heard the car drive up, and so deafness, unfortunately, is something that we suffer with as we get older and so do dogs.
The other sense is their vision, unfortunately, they can start to get– a lot of people recognize cloudy eyes and–
Scott: Yes, and I think that might be what Simone is referring to with the glazed eyes a little bit there as well–
Dr. Kevin: The glazed eyes, indeed.
Scott: So it is–
Dr. Kevin: And so–
Scott: It is that white, milky, sort of look over the top–
Dr. Kevin: Yes, or sometimes it looks a bit blue-y. It is much more noticeable in dim light and especially if you have got a bright light behind you and then look in their eyes and you see this cloudy appearance. Now, it in itself does not necessarily mean that the dog is going blind. It is a process that goes under quite a few different names but something called lenticular sclerosis, or nuclear sclerosis, or very colloquially, people often say, “I think my dog has got cataracts,” and we understand what people mean by that. It is actually not a true cataract, just the same as when we hit our sort of mid to late forties.
Lots of us need to start getting glasses for reading and that sort of thing and that is because our lens capsule is not as flexible as it used to be so it can’t get fat or thin to accommodate and focus for reading. It’s the same process in the dog’s eyes, the lens capsule is not as flexible anymore but, unfortunately, theirs gets discolored, ours stays clear.
So it is probably very similar to getting very dirty glasses and it is a slow process and sometimes you would not notice that your glasses are actually smudged or dirty until you take them off and have a look at them. So, in the early stages, the dogs cope very well with that. Sure, if they had to read a book they probably would not be able to, but luckily for them, they don’t have to. But where you might notice it is in dim light. They might just misjudge a step, trip over at something that you would have expected them to have seen.
Dr. Kevin: And then as it progresses, and not all of them have trouble in daylight, but as it progresses, you might find that if you are at a park they don’t recognize you from thirty or forty meters away, and only when you are a bit closer they might be able to make out your outline. So, it is a subtleness and, unfortunately, we can’t ask dogs to read an eye chart, but also they are not so dependent. They are not driving vehicles, or so dependent, or watching TV and needing that very acute vision. So it’s– I do not feel that they are suffering too badly if they are slowly starting to lose that, but just thinking about if you take them out for their last wee before bedtime or something, turn on an outside light for them, it will help and improve, just simple things.
Scott: So they do not slip and then hurt themselves in other ways as well too.
Dr. Kevin: Absolutely, yes.
Scott: Humans get like pterygium across the eye as well. It is like that little blob that sits on the white of their eye. Do dogs get anything like that, as well? Or is it just another–?
Dr. Kevin: Yes, dogs do get certain growths, and certain breeds can be prone to it, it is not necessarily part of the aging process, but there is a condition called pannus that breeds like a German Shepherd, unfortunately, are very prone to, and that is a brown pigment that often grows from the corner of the eye outwards. Pugs, unfortunately, also suffer with that a lot and it is sometimes associated with dry eye or sun exposure but it is an immune-mediated process and it is very treatable and manageable. You can’t cure it but you can manage it, but it’s not really an aging one.
Scott: Yes, okay. What about the breathing more heavily part, is this something that a lot of dogs start to suffer with where their breathing gets a lot more labored as they become into the real elderly years?
Dr. Kevin: It can be but that is certainly something that would be a signal I would say to see your vet because there can be so many different conditions. It can be simply that the lungs are not as elastic as they used to be or they starting to get a bit of calcification, but it could be because of a heart condition, even just arthritis and a lot of exercise, that will make them breathe up a lot. They could have some sort of respiratory condition. So these are obviously very different conditions, but all of them very, very serious.
So if you are noticing that their respiratory rate is up, they are taking longer to recover from a walk, or they are having some coughing, definitely, that would be a signal I would strongly recommend that that sort of symptom being checked out by a vet because there’s– and then depending on what is found to be the cause, some of those are more treatable than others.
Scott: Would you see a dog, like stopping mid-walk and trying to rest more often and things like that and–
Dr. Kevin: Yes. So we would think also about heart conditions. Often, arthritis, yes, they will battle on a walk but they might cope while they have warmed up and they sort of plodding along okay. They might reach, depending on how long the walk, they might reach a point where they don’t want to walk any further, but that is about it. I would be checking out their hearts as one of the first things because heart disease, and dogs do not get the same type of heart disease that humans do.
Scott: How does it differ?
Dr. Kevin: So, in humans, we have a lot of problems with our coronary arteries. So that is clogging up, unfortunately, things like smoking and fatty diets make you a higher risk factor but there is genetics as well. So you hear about people having a heart attack and that is when they get a blockage to some of the blood vessels that supply part of the heart. Dogs don’t really get heart attacks. We do not have to worry about monitoring dog’s cholesterol. So it’s different heart disease. In dogs, it is predominantly to do with the valves in the heart, and that those valves then become a leaky valve. They get like wrinkles on the valves, and so the heart, the pump mechanism of the heart, doesn’t work as efficiently as it used to.
Dr. Kevin: Then you can get a– heart failure is not such a short-term sudden thing like a heart attack, but it is where that heart is no longer pumping efficiently and you get lots of secondary consequences from that.
Scott: Okay. What are some of the secondary stuff because there is a fascination here, obviously, with how that affects circulation around the body as well, so what is happening?
Dr. Kevin: So the most common one is that you get a back pressure in the blood vessels, and then you get fluid building up in the lungs, and then that fluid causes you to cough, and it also then, if there is fluid lining the membranes in the lungs you cannot transfer oxygen as efficiently into the body so, therefore, you cannot get oxygen to your cells and that sort of thing.
Scott: Okay. What sort of things do you start to see degrade when that starts happening?
Dr. Kevin: So coughing is the big one to look out for, and exercise intolerance, so just not being able to cope or recover from exercise as well as they used to.
Scott: Yes. What sort of advice would you give someone around exercise and walking dogs? Do you try and sort of track how many minutes? Is it starting to get shorter? Is that something that would be good to do? They used to walk for twenty minutes, now it is eighteen, now it is sixteen.
Dr. Kevin: That would be a good one to be aware of, how long they are going, how they managed to recover. If you find yourself walking in front and sort of encouraging them to come along instead of you starting to drag them on the lead, that is a clear indicator that they are not coping. If they are comfortable walking at your pace next to you or they still pulling out in front, they are probably coping quite well.
Scott: Okay. It is a pretty clear tell-tale sign. Cool, yes, I like that.
Dr. Kevin: But, I think, as dogs age, some of the other things that we are yet quite concerned about is some of the internal organs. So kidney failure or liver problems, and the symptom that we look out for there is drinking more water.
Dr. Kevin: And as a consequence drinking more water, urinating a lot more.
Scott: All right.
Dr. Kevin: So, it is a long list. It is a sort of very typical student exam question, list us all the things that if a dog is drinking more it could be but the big ones– so it is quite a strong indicator if you were to see that happening in your dog, it is time probably for a senior health check.
So a lot of vet clinics actually do offer and when dogs are in for their annual health check and vaccination, it, we’ll always check relevant to their age and go through that sort of thing, and then a lot of clinics offer actual senior consultations for that, and that normally includes a urine test and a blood profile as well because catching these sorts of things earlier, there is a lot more that can be done. So even if you had to pick between the blood test and the urine, probably the first one would be the urine test. It is much broader, but it is not as costly as blood test.
Dr. Kevin: And you can really get some good indications because if that urine is very concentrated, well, then you probably do not have the types of problems like kidney failure and they might be drinking more because they are a bit dehydrated. Whereas if they are drinking a lot and that urine is very dilute, then that is a reason to start thinking more seriously about doing blood tests and that.
Scott: Okay, interesting. Another point that Simone raised was the graying and it might not sound like a big deal and maybe it is not, I am kind of curious like when you are– we see it in all people aging, their hair starts to turn gray. I have heard and I have seen a lot of sort of scientific papers around certain minerals and nutritional deficiencies that will lead to the greying of hair. Do you think that is fairly valid or do you think it is something that is relevant in dogs?
Dr. Kevin: I think the person who can solve the situation of graying without having to resort to dyes, they are going to get a lot of recognition and do well. So it is a fact of life and some breeds show it more than others, unfortunately. I think some even just show their age a bit more, something like a Cocker Spaniel, it is a beautiful young dog, but they start to show their age as they get a bit older. Another one that does that sometimes is Beagles, and yet some other dogs really don’t show their age that much.
Scott: Is it something that happens really light in their sort of more senior years or is it something that is sort of progressively happens from midlife on or–?
Dr. Kevin: From early senior. So, in general, it is variable, on breed size. Older dogs, unfortunately, age earlier, so like Great Danes.
Dr. Kevin: But as a generalization, we consider a dog a senior over seven and eight years of age.
Dr. Kevin: But some of them are happily living into fourteen, fifteen years of age. So that is, for those types, then that sort of midlife really, it is seven or eight. But, often, it is in certain areas like around the muzzle and the face and I do not think there is much that would stop that and it would not be– that would not on its own be a reason to have them investigated, but what you sometimes see is, black dogs in particular, so something like a black Labrador, might lose the luster of its coat, or actually the black is starting to change to be a bit more of a brown color and that very much I think is a nutritionally based thing.
Dr. Kevin: We often find putting them onto a really good quality diet with appropriate, especially the oils, the omega-3 and omega-6 fatty acids, and good quality protein. There are also senior dog foods because we actually don’t want senior dogs to have too much protein to have to digest, you want enough, you want good quality proteins so that you do not start losing muscle mass but not– if there is too much, then, in particular, the kidneys have a harder job to process and get the waste products out of the body.
Scott: Yes, makes sense.
Dr. Kevin: So that– and the brown also sometimes, this is a bit more applicable to cats that lick and groom themselves a lot more in certain parts on the body, but saliva in contact with fur long term has a chemical reaction and then with sunlight and causes a lot of brown coloring. You often see it on dog’s paws, especially some of the white dogs, going brown-pink, reddy-brown color, and that will immediately tell me that that poor dog is very itchy that it licks a lot at its feet or wherever else it is turning brown.
Scott: It is a good sign, yes, excellent. I suppose there is the inevitable part with dogs aging, when they are getting obviously too old and one of the questions I want to ask about was, I guess the percentage of dogs, and maybe it’s a hard one to answer but a percentage of dogs sort of dying naturally versus being put down at some point. It is in human beings, we let everyone go til they drop themselves naturally, but in dogs, it is more of that euthanasia.
Dr. Kevin: Yes. We are very privileged that we have got the option of euthanasia. A lot of people ask me, “How can you be a vet? How can you put dogs to sleep?” I see it as a real privilege to be part of that process and help people decide. It is a big burden. I see a lot of stress with people when they know their dogs is getting older but is it the time now, and the dogs typically play on your emotions, not intentionally, but just when you are thinking, “Yes, it must be coming,” then they rally around and they are so much better and you think, “Oh, no, it’s not his time yet.” So, that is hard but that is a role that your vet can help you with, it is discussing when is that approaching, when is it appropriate.
Scott: Yes, because people want to feel like timing it right is the right thing to do, because they–
Dr. Kevin: Nobody wants to keep them going too longer–
Scott: No one wants to do it too early, no one wants it to go too long. It is a hard one, is it not? I have been there with you and I know you are amazing the way you sort of gently guide people through it and we have talked about off air some of the other experience you have had with people doing it nicely down near a beach or–
Dr. Kevin: Absolutely. If we can accommodate a home visit or a sentimental place, we would always try and accommodate that for people.
Scott: How do you time it though, I mean, it is hard and I have personally been through it as well, but you still, as a dog owner, you question did I do it right? Have I waited too long? There is all that sort of stuff that can play on your mind as a dog owner.
Dr. Kevin: In your original question, you are saying what percentage pass naturally and those that we have to decide when we put them to sleep, difficult one, I don’t really have an answer to that but we always mostly hope and wish that our pets will pass away in their sleep and we would not have to be in this position. But probably–
Scott: Do you see a lot of that though?
Dr. Kevin: Not that much, and probably more of them because we are able to, I think more we do make that decision and help guide owners as to when that is right because we can often save that loss without suffering, that their last bit of time does not have to be effectively dying of dehydration or starvation and the consequences of a lot of the end diseases.
Dr. Kevin: So I find that a lot of people inherently, you know, you have a gut feeling, you have probably had that pet for a long time and you know when they are having more poor quality time or more bad days than good days. So that is one very simplistic way of looking at it. They are having more bad days than good. Sometimes you will just wake up and you really know something is a bit different and you will know that is the appropriate day. Suddenly, they can’t do a certain thing, but what I talk to people a lot about is helping– is looking at the five tenets of quality of life and you will see that these are a quite sort of advanced or extreme things but it helps people to realize that just because they are little bit unwell does not necessarily mean that is definitely the time.
Dr. Kevin: So I think a big overriding one is mobility because you need to have your mobility as a dog to go to the toilet, and that is actually number two, is how are they coping with toileting. Can they squat still comfortably, or do they keep falling over into their urine or their feces, or they are having a lot more accidents indoors because they can’t get outside? That is not a nice quality of life for them.
They know that inherently they should not be messing inside, so they feel bad when they keep on having accidents with that. With their mobility, if they want a drink of water they have got to walk there to get that. We can have all sorts of devices, mobility scooters, live-in carers, all that sort of thing, so if we are not that mobile, it does not matter, but mobility is such an important one for them.
Dr. Kevin: So, number three is how are they eating and drinking. Not eating for one day, whilst it is concerning, that would not necessarily be a reason that their quality of life is poor enough, but if we are getting to two or three days, and especially if that is while they on already some medication and they have had a diagnosis and we know why, and then they are just not responding to treatment and going for three or four days without eating, that is a poor quality of life. That dog is not well, not happy.
Dr. Kevin: And then number four is uncontrollable vomiting. That is a very unpleasant thing to have, vomiting. If you can’t keep your food and water down– by uncontrollable, meaning that they are already under the care of a vet and have been investigated as to why they are vomiting and they are on some medication. There is lots of good anti-nausea or sometimes treating the primary problem will control the vomiting. But if we just cannot manage to keep vomiting controlled, that is a quality of life issue.
Scott: Yes. Can I just distinguish something here-
Dr. Kevin: Sure.
Scott: …because there is a difference between you can’t get it under control for the dog versus you as a dog owner does not want to clean up a dog vomiting for a day or two. That is not a reason to put a dog down-
Dr. Kevin: No, it is not.
Scott: …because if you can get it under control, what you’re saying –
Dr. Kevin: Then you would not be having to clean up either.
Scott: That is right, yes. So I think it is just a really important one. It is all about the dogs first because you hear these stories, and not pointing fingers at anybody, but you hear these stories about some pet owners that just they do not want to have to be cleaning up after this sort of stuff and that is not a good situation.
Dr. Kevin: Admittedly, I think we see people bring their dogs and cats in a lot quicker if the problem is vomiting or diarrhoea than for a lot of other conditions, and cynically, that is because it’s having a direct impact on them. They are having to clean it up for them.
Scott: So your attention, does it not.
Dr. Kevin: Yes, it does.
Scott: Absolutely, yes.
Dr. Kevin: You cannot ignore it, really.
Scott: So that is the fourth one, the fourth tenet of quality of life.
Dr. Kevin: The last one is probably the most important, if they have got uncontrollable pain, if we can’t keep their pain comfortable then it is fairer to let them go peacefully. The medication, the drug that we use to put a dog to sleep is an overdose of an anaesthetic. So the very first thing that happens, it’s all instant, straight on top of each other, a lot of people are amazed at how quickly that process of drifting off to sleep does take place, but the first thing that happens is all pain is relieved.
Dr. Kevin: So what a wonderful thing. They just suddenly, even whatever pain they have been in, they might often be in the owner’s arms and that is gone. Then they just feel light-headed and I am going to fall asleep. If anyone has had any sort of procedure where they have had a sedation or an anesthetic-
Scott: You will get an idea of what it feels like.
Dr. Kevin: -this will get you– yes, but the anaesthetist will have you count back from ten and we do not get past eight and we can’t remember anything else, and that is literally– so it is very apt that we say we put them to sleep because that is what they experience, the sensation. A lot of people are scared about what is that going to be, do they feel a lot of pain, is it traumatic to witness, and it is not.
Scott: No, it is– I can speak from experience, it is very calming, actually, for the dog. It is not so much for us witnessing it and sitting there knowing that you are letting him go, but the dogs themselves are in a very, very relaxed state. One that is incredibly peaceful for them.
Dr. Kevin: The scenarios where I really feel– feels, in a way good, about what we have done is when it is a dog that is battling to breathe and they are gasping and battling that and it all just goes quiet. It sounds very sad, but you really feel that you have now relieved it from its suffering. It is like so in your face that they do not have to gasp for every breath as well.
Scott: I really love those five tenets. The quality of life is [crosstalk]–
Dr. Kevin: Maybe we should just recount on them. So, they are the dog’s mobility, the ability to do their normal bodily functions, going to the toilet, their interest in food, uncontrollable vomiting, and then uncontrollable pain.
Scott: Yes, love it.
Dr. Kevin: And those five key things can just help us make it a more analytical decision rather than such an emotive decision. It has to be an emotive decision but when you are feeling all caught up in emotion, then one can just go back and look at those. Obviously, there are many I have not even mentioned. Breathing is another one, but just to put it down to the bare crux of things you can assess it against those.
Scott: Yes. I think those five tenets of quality of life are brilliant and it is probably a great way to wrap up this Dog Pod Episode Ten. Dr. Kevin Cruickshank, thank you so much for being with us again. You are a wealth of the wisdom.
Dr. Kevin: Thank you, Scott. I mean I think it is a very important one and just probably as a closing remark, when people have these sorts of concerns, don’t be shy to discuss it with your vet, mention it to the person who is making the appointment because often, us vets will schedule extra time. It is not a conversation that we want to rush with people but it does not have to be as serious as this, as we started out at the beginning, senior– and so there is a lot that can be done for seniors. We did not get to chat about dental disease as they get older. That is a big one as well. So looking at having a senior health check even once a year, or ideally, twice a year with a blood panel and a urine analysis can help keep those very difficult decisions a bit further away from people.
Scott: Yes, fantastic. Well, in true tradition of the circle of life, as well, we are picking up a new puppy next week which is really exciting.
Dr. Kevin: So exciting.
Scott: The kids are beside themselves and Mel is incredibly excited. So we are going to try and capture a little bit of video footage of that in picking up the little one. So maybe next week we will throw the pendulum the other way-
Dr. Kevin: Absolutely.
Scott: …and we will go from elderly dogs and what we can do with brand new puppies and-
Dr. Kevin: Something for people to look forward to.
Scott: -talk about all that stuff. So, yes, that is a nice way to finish off. Thanks so much. I hope everyone has a great week and like anyone else, if you have got any questions, please shoot ’em through on our Facebook. Check out Dr. Kevin Cruickshank on Instagram and Gold Coast Vets Surgery, and we look forward to seeing you on the next episode. Thanks.
Dr. Kevin: Fantastic. Thanks Simone for a great question.