Hospice Care
What do you do when your dog is mentally all there, but is basically bedridden? Many would say euthanize, but let me give you other options. Our girl Jazzy has been bedridden now for going on 2 years. She's generally happy, fairly healthy and lives for dinner, yelling at one of our other dogs and watching what's going on. I don't know if it would work as well if we were both working, but since we are retired someone is home most of the time so it's really not that difficult to take care of her and let her live out her remaining time among her family.
A typical day involves moving her from her bedroom bed (next to mine) into the living room (where everything is going on). Her living room bed is a little larger so she can rotate easily into more positions. I put down a clean pee pad, and she assumes the position on her throne for the day. She always has water in a no spill bowl and is content to watch the other dogs and us go about our daily routines. She even makes it a point to snark and snap at her nemisis Simone as she goes by...fortunately Simone never takes the bait! Jazzy is deaf, so she can't hear us, but her eyes are still good and she watches everything like a hawk. Her back legs haven't worked for almost 2 years now...she has already outlived 2 of her kids. Most of our malamutes have lived about 12 years max...but she's going on 15 3/4 - about 120 in people years, which is really incredible. As long as she's happy and reasonably healthy, we will support her in "hospice". There are many things we do that make it work, and make her not a burden, and avoid that awful "e" word (euthanasia).
1) She has 2 beds...a day bed in the middle of the living room, and a night bed next to me in the bedroom. Both are 4" dense foam covered with trash bags (to make them waterproof) and then covered with a thin washable quilt. On top of that I put pee pads (link below) that are washable and waterproof. They keep her as dry as possible which is difficult because she is a long coated dog. Having 2 beds seems to help her keep her days and nights from being mixed up.
2) I trim the long fur shorter on her legs because that makes them easier to clean and air dry. Lots of coat will hold the pee and begin to smell. Clipping the fur (no matter how bad the haircut) is more sanitary and less likely to cause urine burns and smell. We also make it a point to flip her hips to the opposite side as often as possible. We've had no problem with bedsores thanks to flipping her regularly, and the 4" dense foam beds. If you get washable pads, I would suggest at least 4, more is better....otherwise you'll be washing non-stop. As she's had a harder time holding the urine, and her kidneys don't concentrate it as much anymore, so I've gotten more. At night I stack them 3 deep under her so if she wakes up and is wet, I can flip her over and remove the wet pad easily, because there's another one still under her.
3) Always provide water. Bladder infections will be constant so get on good terms with your vet so you can have access to antibiotics before you need them. If there is excessive smell of ammonia or other nasty smells, she is likely getting one. It may be advantageous to just keep her on antibiotics long term. I found if she is on them pretty much constantly it helps. About 2 months into them though, she gets fussy and refuses to eat. So we give her a day or two break, until the smell returns, and then continue. This has worked well for her, your mileage may vary...talk to your vet about a plan because the lack of movement can cause bacteria to build up within the bladder or kidneys and cause life threatening infection..
4) I have never had a more picky dog when it comes to taking meds. She was on Clavamox for the bladder infections and no matter what I did she'd spit them out. I suspected it was the taste. Others suggested hiding the pills in foods, stuffing them down her throat, and pill-poppers but NOTHING worked. As a last resort, (we make our own tumeric capsules with powdered tumeric), I tried putting the pills in a gelatin capsule. Then put it down her throat...SUCCESS! I didn't expect that, but whatever works! Sometimes you just have to keep trying things and get creative.
5) To help move her we use a sling for her rear, and a harness on the front. The harness is for steering, the sling is for lifting her legs. She has no use of her legs at all now, and even the front is weak, so you need to be able to control both ends. She has learned what to expect. When my husband moves her we call it flying because he just lifts her (and her front feet go strait out like "I'm ready!" - it's hilarious)...when I move her it's more like walking as I slide her across the floor and she helps a little supporting her front.
6) I found an excellent solution for baths. A product called Self Rinse Plus is a shampoo you can use to clean the fur without worrying about rinsing, not irritating to skin and cleans quite well. Blot it dry and then blow dry. Blow drying a long coated dog that sheds in the house is a nightmare, but I found if you use a large piece of netting over the area blow dried, it contains most of the hair that would otherwise be flying around your house. Tulle or mosquito netting works great. Occasionally you'll want to really wash the rear area. A hand held wand on your shower works good for this. I'll have someone hold her front so she doesn't fall, and put her back legs in the tub. Then I'll use the sprayer to rinse off the back parts. If you have a long coated dog, dry thoroughly afterwards.
7) For smells between baths a spray bottle of vinegar, water and some lavender essential oil works great. The vinegar neutralizes the smell and alkalinity of the pee, and the lavender is a disinfectant (yet gentle). I put about 10 drops of lavender, 1/2 bottle of vinegar then fill it up with water.
8) If we need to go out for a few hours I'll put her in the bedroom on a pee pad, on her bed with water in a spill proof bowl. Next to our bed is a somewhat confined space and if she's positioned so she can't wiggle under the bed it works good. She realizes we are leaving (because it's not her day bed) and usually sleeps. I have a webcam pointed at her so I can always check on her when we are out .
9) Food: As she's gotten older she needs spoiling. So she is getting a raw egg, some canned pumpkin (for fiber and to keep her stools solid) in every meal. Sometimes we add little bits of cooked meat. When she doesn't want to eat dog food, stirring it in with the egg or some yogurt makes it more tasty.
10) Communication: Since Jazzy is deaf, she's learned to watch closely and often knows what I plan to do (like flip her over) before I do it. I reach for the sling and she readies herself. As for her communication, she has various was of telling me she wants to flip, needs water, etc. She's really the official timekeeper in our house as that's all she HAS to do. She wakes us up, makes noises for breakfast and dinner, etc. Since she goes on her pads, she no longer has to ask to go out. Getting to that point was a very gradual process. Actually it's easier than hauling her butt outside! LOL
In conclusion, it's not that hard to enjoy an older dog that has limited time left, or a dog that is immobile. They are still the same loving dog you have always had...except now they can't get into as much trouble!
Canine Icers: Icers for shoulders, hocks, hip, stiffle, and neck, for warming or icing sore muscles and joints.