Tag Archives: quality of life

Reflections on palliative care

My latest palliative care dog passed away about 2 weeks ago.  While it has been a busy couple of weeks for me, I do think about her.  I sometimes wonder if owners really believe me when I say that I think about their dogs not only when they are active clients but also after they have passed.

This old girl was 17 years old and came with a long file of veterinary records for me to review.   From the outset, I knew I wouldn’t be working with her for very long.   Her owner was very open when booking an appointment with me, “I’m just not ready to say goodbye.”

At the first consult, we talked about expectations, her vet’s advice, and quality of life.  I provided the owner with a quality of life checklist that I’ve developed specifically for older and palliative care dogs.

This old girl had fighting spirit, but she was also frail.  So the focus was on acupoints for immune system strengthening and endorphin release.  The first session went well and the feedback was great – “she’s been her old self….”

Having personal experience with this, I know that sometimes these dogs at the end of life have a final burst of life energy.  It rarely lasts.

We ended up having only one additional session.  Although we re-booked for a third session, it wasn’t to be.

I am grateful to all the people who entrust their dog to me, but especially honored by those who are facing critical and emotional decisions and are not afraid to share their distress.

Kathleen Crisley, specialist in dog massage, rehabilitation and nutrition/food therapy, The Balanced Dog, Christchurch, New Zealand

Is love enough? Some thoughts on the five freedoms

It’s been a while since I blogged about the Five Freedoms.

For a number of reasons over the last week, I have been reflecting again on these basic rights of animals in context of whether an owner’s love blinds them to their dog’s actual quality of life.

A good example will be an obese dog.  Yes, the owner is feeding it (more likely over-feeding it or perhaps not feeding the right diet), but the dog’s body condition means that the animal is not healthy.

For example, the Chihuahua I wrote about that had heart problems.  It was then revealed upon discussion that the dog was grossly overweight.  Thankfully, in that case, the owner accepted advice that their dog needed to go on a weight loss program and they stuck to it so the dog dropped the weight and the heart problems disappeared.

fat-chihuahua

What an obese Chihuahua looks like

A dog with a diagnosed orthopedic problem like hip dysplasia, elbow dysplasia, or arthritis (as examples) needs to be kept trim, with a fitness regime that is appropriate to their condition.  It’s rather disheartening to see a dog yo-yo with its weight.  They are going good and then drop off my calendar only to be booked in weeks and months later because they are limping.  More often than not, the dog has re-gained all of its weight (if not more) due to improper diet and exercise.

Another circumstance is when an owner has a very elderly dog who is showing signs of pain and discomfort – even with medication.   This situation is one reason why I developed my Quality of Life checklist to help clients understand what their dog is telling them.  We have to look at behavior and health and ask ourselves if the dog has quality of life and make changes wherever we can.

Is love enough?  It’s a big part of caring for our dogs.  But, it isn’t everything.  And it can be an excuse – consciously or subconsciously – for neglect.

Kathleen Crisley, specialist in dog massage, rehabilitation and nutrition/food therapy, The Balanced Dog, Christchurch, New Zealand

Building a dog wheelchair

During the fall semester, three College of Engineering students working as on-campus co-ops at New Mexico State University designed and built a wheelchair device to assist a dog who had his right hind leg amputated due to cancer.

“When I started to research mobility options to help Kita after his amputation to remove bone cancer, there were a lot of ideas online about using 3-D printers to create custom dog wheelchairs or walkers,” owner Michelle Lebsock said. “Even in his old age, Kita is the type of dog who absolutely loves walks, and although he healed well and adjusted to getting around on three legs, he would get tired very quickly and I could tell he really missed his long walks.”

After realizing regular pet wheelchairs wouldn’t work for Kita, Lebsock contacted the Aggie Innovation Space for advice on do-it-yourself dog wheelchair instructions she had found online.

“I first spoke to Natalia, and instead of just offering advice she took on the project as her own,” Lebsock said. “The talented engineering students at the AIS including Natalia, Abdiel and Arturo worked all semester to create a functional and ergonomic device that was custom-built for Kita. Even though the idea of 3-D printing brought me to the lab, the final product used traditional materials, and the students worked tirelessly to make sure each piece was exactly right. Their work has made one little three-legged dog and his owner very happy.”

Kita dog with wheelchair and students who designed it

New Mexico State University College of Engineering students and Aggie Innovation Space mentors (from left to right) Natalia Perez, Abdiel Jimenez and Arturo Dominguez designed and developed a wheelchair for Kita and his owner Michelle Lebsock. Kita’s right hind leg was amputated due to cancer in spring 2016.

“The AIS team became very passionate about this project sharing ideas, collaborating to assess specific constraints and requirements, and evaluating ideas for build-out materials. Collectively, we were able to design a device that was cost effective, functional, comfortable, strong enough to support the weight of the dog, and ultimately, easy to use,” Jimenez said. “We selected specific materials and specific design features to meet the unique needs of Kita. Michelle was kind enough to give us feedback, which allowed us to further refine the design.”

Throughout the fall, Perez, Jimenez and Dominguez met with Kita and Lebsock many times to determine the correct height, comfort, and restraint requirements of the device. Ease of assembly and disassembly were also important factors the Aggie Innovators had to consider to ensure the device was portable and easy to use.

“We were excited to have met a functional level of comfort for Kita with our first design, as he realized he could move around freely,” Dominguez said. “From there, we studied and evaluated Kita’s movement in the device, which allowed us to adjust the design to make it more comfortable and functional. With each iteration, Kita became more and more comfortable. During our final test, Kita was able to run for the first time since surgery and was able to move much more naturally. We then spent a week enhancing a few aesthetic features and branded it NMSU, including a specialized 3-D printed name plate.”

Kita dog in special wheelchair

Arturo Dominguez, a New Mexico State University College of Engineering student, fits nearly 17-year-old Kita with a wheelchair that was designed and built in the Aggie Innovation Space.

Dominguez said the group faced many design challenges throughout the duration of this project.

“Some of our initial design considerations required us to adjust the height of the device while ensuring that we provided adequate support of the shoulders and hips so as to minimize weight on pressure points,” Dominguez said. “As we adjusted the saddle mechanism in the device, we had to be sure not to pinch or irritate the underbelly and other sensitive areas of the dog.”

Perez said the challenges and hours spent working on this project was worth it when she and her fellow Aggie Innovators saw Kita run freely in the device and saw the happiness expressed in Lebsock’s reaction.

“This project reminded us how engineers can enhance quality of life, and made us realize that our duty as engineers is not just for people and the environment but for our furry friends that make our lives happier,” Perez said.

Source:  New Mexico State University media release

Unlikely Best Friends

I’m always a little surprised when, after I explain that one of my services is to help owners measure and fit dogs for mobility carts, that I get answers like “I’d never do that to a dog.”

Stories like this one, an ad sponsored by the Kleenex brand, show you why some dogs can do very well in a cart – and experience quality of life while also sharing unconditional love.

Kathleen Crisley, specialist in dog massage, rehabilitation and nutrition/food therapy, Canine Catering Ltd, Christchurch, New Zealand

In mourning

It is with a very heavy heart that I announce the passing of my beloved Daisy on the 26th of July.  As any dog lover will know, one of the hardest things about having a dog in your life is knowing that they do not live as long as we do and many of us will face the decision to let them pass in peace and without pain.

Daisy was 14 years, 17 days old.    Although slowing down, she always showed in an interest in twice-daily walks until about a month ago, when one afternoon she looked up at me to say “I’ve been to the toilet, now I just want to go home and rest.”  We have had more days like that – sporadically – until about the last week when once daily walks were enough for her.  After her last acupuncture treatment on Wednesday afternoon, she was very happy and energetic – walking longer and at a quicker pace than the last few weeks.

That was to be our last walk together.

One of the things that is an owner’s responsibility and duty is to manage quality of life.  In Daisy’s case, she had the look in her eye that many people describe – it told me “I’ve had enough.”

As part of my grieving process, and in tribute to my dear Daisy, here are a few photos of her life.  We were together for 10 years and 7 months – and I wish I had them to do all over again.

Kathleen Crisley, specialist in dog massage, rehabilitation and nutrition/food therapy, Canine Catering Ltd, Christchurch, New Zealand

 

This is one of the first photos I took of Daisy, shortly after adopting her.

This is one of the first photos I took of Daisy, shortly after adopting her

Daisy 'upgraded' to a red collar and I love this photo because it gave a better perspective to her size and conformation

Daisy ‘upgraded’ to a red collar and I love this photo because it gave a better perspective to her size and conformation

 

In 2004, Daisy allowed me to dress her in a Boston Red Sox sweatshirt to celebrate their World Series win

In 2004, Daisy allowed me to dress her in a Boston Red Sox sweatshirt to celebrate their World Series win

 

In April 2008, Daisy helped to pose in the garden to show off some new landscaping

In April 2008, Daisy helped to pose in the garden to show off some new landscaping

 

In April 2008, we celebrated Daisy's 8th birthday a wee bit in advance as part of launching Canine Catering

In April 2008, we celebrated Daisy’s 8th birthday a wee bit in advance as part of launching Canine Catering

 

In February 2011, following our big earthquake, Daisy revealed that she was suffering from arthritis in her hips and spine.  Swimming became a fortnightly activity from then on

In February 2011, following our big earthquake, Daisy revealed that she was suffering from arthritis in her hips and spine. Swimming became a fortnightly activity from then on

Daisy loved food and treats; here she enjoys a Busy Bone whilst visiting with her Uncle Guy in 2012

Daisy loved food and treats; here she enjoys a Busy Bone whilst visiting with her Uncle Guy in 2012

On her 13th birthday, I took Daisy for an off-lead walk at The Groynes as a special treat

On her 13th birthday, I took Daisy for an off-lead walk at The Groynes as a special treat

We celebrated our 10th anniversary together by taking a trip to Ruby Bay.  Daisy was so happy during our 5 days there.

We celebrated our 10th anniversary together by taking a trip to Ruby Bay. Daisy was so happy during our 5 days there.

My last photos of Daisy were taken on July 12th as part of a photo shoot for the business

My last photos of Daisy were taken on July 12th as part of a photo shoot for the business

Old dogs and quality of life

Old Dog
As our dogs age, we have to face the fact that they are likely to have special needs and health concerns that need following up on.  In my massage and rehab practice, I see a lot of older dogs and most still enjoy life.  Some need some help getting around, which may be having some ramps installed around the house or perhaps they need a wheelchair for getting outside.

The important thing about older dogs is creating a life for them that accommodates any limitations they have.

For owners, it is important to work with your healthcare team on what constitutes ‘quality of life.’  Some questions to consider in a quality of life assessment are:

  1. Is your dog eating and drinking normally?
  2. Is your dog ambulatory?
  3. Does your dog have normal elimination habits and are they continent?
  4. Does your dog interact with other people or animals in the household?
  5. Has your dog secluded itself in an area of the house on a regular basis?
  6. On balance, does your dog have more good days than bad?

Dogs often surprise us with their acceptance of physical limitations, but it is up to us to monitor their quality of life.

Helping pet owners make tough choices

When your dog becomes seriously ill, it’s your job as the owner to make decisions about quality of life.  And it’s one of the toughest decisions we face during our lives.

Researchers at Michigan State University  are developing a new tool to help people assess their pet’s quality of life, a key factor in decisions about when to order life-prolonging procedures and when an animal’s suffering means it’s time to put them to sleep.

The research team, led by veterinarian Maria Iliopoulou, created a survey to help dog owners monitor the quality of life of 29 dogs undergoing chemotherapy treatment for cancer.   The owners completed the questionnaire when they received their dog’s cancer diagnosis and answered questions about how their dog was behaving then and how they behaved six months prior to the diagnosis.

Similar questions were asked in questionnaires administered at three and six weeks into chemotherapy. Meanwhile, the veterinarians treating the dogs filled out shorter surveys based on their observations.   The research team wanted to see if owners and clinicians agreed.

The research found that there was a close match between owners and vets, particularly in questions involving play behaviour, the dog’s happiness as perceived by the owner and clinical signs of disease.  These areas of commonality create the basis for a tool that will help to facilitate client and vet communication.  If there’s agreement about what constitutes quality of life, then it is these criteria that owners and vets should use to help agree on next steps for the dog’s care.

For the study, dog owners completed a questionnaire at the time of diagnosis about how the animal was behaving then and how they typically behaved six months prior. Follow-up questionnaires filled out three and six weeks later documented changes in behavior as the dogs underwent chemo. Meanwhile, the veterinarians filled out shorter surveys based on their observations. – See more at: http://msutoday.msu.edu/news/2013/helping-pet-owners-make-tough-choices/#sthash.aUqdUd6n.dpuf
Dr Iliopoulou and her dog Rocky (photo by G L Kohuth)

Dr Iliopoulou and her dog Rocky (photo by G L Kohuth)

The research team has published their results in the Journal of the American Veterinary Medical Association.  All dogs were patients at the Michigan State University Animal Cancer Care Clinic.  The plan is to expand the work using a much larger sample size of patients and Iliopoulou hopes to develop questionnaires for dogs suffering from other diseases as well.

Source:  Michigan State University media statement

ichigan State University researchers are developing a new tool to help people assess their ailing pets’ quality of life, a key factor in decisions about when to order life-prolonging procedures and when an animal’s suffering means it’s time to let go. – See more at: http://msutoday.msu.edu/news/2013/helping-pet-owners-make-tough-choices/#sthash.aUqdUd6n.dpuf
ichigan State University researchers are developing a new tool to help people assess their ailing pets’ quality of life, a key factor in decisions about when to order life-prolonging procedures and when an animal’s suffering means it’s time to let go. – See more at: http://msutoday.msu.edu/news/2013/helping-pet-owners-make-tough-choices/#sthash.aUqdUd6n.dpuf