Welcome back to the Senior Dog Digest from Grey Whiskers — In this week’s issue here’s what we are sniffing out

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It takes a village

Our dog Uma is the last young dog we adopted. We call her our OG 2.0: the longest-term family member of our second generation of dogs adopted since my husband and I got married. We adopted her at 1 year old, and she’s rapidly heading toward 14 now. And Uma has been sick. At first it looked like something minor, something new, something straightforward. But as anyone who knows Uma will tell you, nothing about her health is straightforward or minor…

flashback…

During the COVID lockdown, Uma started having joint problems that didn’t seem to come with an easy diagnosis. We went back and forth to the vet for different tests, more exams, different medicines. I asked Uma’s veterinarian to contact our other dog’s internist while we were waiting for the appointment I had scheduled with her. The two of them conferred and decided to check Uma for a relatively uncommon and (of course) complicated disease called Immune-Mediated Polyarthropathy (IMPA). They did taps on her joints, removed a little fluid from several, and sent it to be tested. Sure enough, she had IMPA. Once we knew what it was, the doctors discussed treatment amongst themselves and got her back up on her feet (literally) in no time. The disease has been managed pretty well and has not affected Uma’s well-being much.

Fast forward to 2024

Early this November, Uma starts limping on one hind leg. She’s 13+ now, so… osteoarthritis? That’s straightforward, right? We take her to the doctor and it seems like a simple issue, simply fixed. 3 weeks later, I noticed that she couldn’t open her mouth all the way when trying to yawn. Hmmm, that’s not normal. So back to the doctor, we go. Everything else about her looks great; it’s her only symptom. Arthritis in her jaw? Easy enough to manage. We start pain medicine again and wait to see if it helps. Instead of improving, every day or two, a new symptom crops up.

The first week, we are advised to take her to a neurologist. They rule out scary things like neurological issues, a new auto-immune condition, and masses. They also tap her joints again, just in case, to see if the IMPA is flaring up. The test takes some time to come back. We are told it will be fine to drive with the dogs out of state for Thanksgiving. During the holiday away, she started having trouble with her appetite, so we started supplementing dog food with more valuable food, trying to keep as much weight on her as we could. She is not critically sick, but at her age, I know that being sick at a low level for an extended period will make any possibility of recovery that much more challenging. She’s always been thin, so losing any weight will make it worse. At this point, I am talking to Uma’s veterinarian, neurologist, or the internist who handles the IMPA almost daily to give them updates and let them know of new symptoms as they arise. They’re super smart people and very generous with their time for my old girl. We drive back home after the holiday, and as we wait for the joint tap results, I’m getting more and more anxious. Everything so far has come back normal. That seems like the news we want, but after two weeks of waiting for the joint tap, it’s not that simple. Now she’s not eating, she’s having vomiting, diarrhea, and shivering. She stops playing, has no interest in walks, sleeps all the time, refuses most food, and her muscle mass is decreasing daily.

Reality check: what is her quality of life? Am I overreacting? Am I in denial, refusing to see the obvious? This is one situation that I caution my clients about. Changes like this are NOT a normal part of aging, and if Uma was slowing down at the age of 15, 16, or 17, and this happened, we would most likely choose to offer palliative care for her instead of going down the rabbit hole of searching so hard for an answer. But evaluating her quality of life right before all this: she was doing race course zoomies in the backyard, playing chase with us, barking at us in demand to throw her squeaky toys, disemboweling said squeaky toys, chomping fingers off for snacks, and walking 2 miles a day. Plus she has this complicated history of autoimmune disease, and a flare-up of that hasn’t been ruled out, even though her symptoms aren’t presenting consistently with that at all. Uma has been so healthy that I am convinced even at nearly 14 that she’s not at the end…

But how do I navigate this scare for her? How do I make sure the vets have all the info they need to figure this out? I keep track of things that might help: how much/what she’s eating, her heart rate, respiration, when and what she vomits (bile, vs water/foam, vs food) when each symptom starts, and new medications are added. I stay in contact with the vets even though they may think I’m crazy (thank you for not getting irritated with me!). I advocate for alternatives to medicines that don’t seem to be helping. I ask the doctors to contact each other so they can share ideas, test results, and thoughts.

The Story Continues….

At four weeks into this, things are really looking grim. I start thinking we might actually be at the end, that I was wrong. My heart starts to change course, and I’m feeling the beginning of anticipatory grief settle around me. I’m not ready, but is Uma? This isn’t about me, after all. My husband and I always want what’s right for our dogs over what’s right for us. We start thinking about what palliative care looks like for Uma, and how much time we might have with her before we need to let her go. I’ll tell you, it doesn’t look like much time is left. My heart starts to break. While we wait for the last test results, I ask for an injection for nausea since she isn’t eating and can’t hold a lot of what she does eat down, and for fluids even though Uma is not technically dehydrated. I want her to get one good night’s sleep without shivers, groans, and vomiting while we wait. I want her as comfortable as she can be. If the test comes back normal, we will definitely be letting her go very soon. I cannot really swallow this yet, but we may be helping a third dog cross the rainbow bridge in ONE year. Not only that, but this time it’s our rock, our OG 2.0, our dog who has been with us for almost 13 years; the housemate to 5 broken senior dogs who have joined us, grown whole, and left our family while she stands healthy and strong, as our hearts break again with each loss.

And finally, in the 11th hour, the joint tap test comes back… Her IMPA is flared up after all. According to her internist, this can be a very tricky disease, and her symptoms didn’t indicate this would be the cause, but finally we have a reason for her decline, and a course of action. I practically yell with relief, and we get her started on the medicines and treatment needed. Don’t get me wrong, we aren’t out of the woods yet, but I’m hopeful that with the help of all the doctors we have been working with, Uma will get through this and go back to being her normal self again. When we revisit this issue in a few (or 25… you can do it, Uma!) years, I hope I have the presence of heart and mind to do the right thing for her again when doing the right thing is letting her go.

I guess the primary moral of this story - aside from Yay, Uma! - is that caring for a senior dog like Uma is never a solo act—it’s a team effort. Over these past weeks, navigating her health crisis has reminded us just how much it truly takes a village. From her devoted veterinarian and neurologist to her internist and everyone in between, it was the collective expertise and compassion of her care team that helped us uncover the cause of her mystery illness. Our friends, family, and my clients who checked in on us really made me feel like we weren’t in this alone, and that was HUGE. Finally, it’s also important to do your best to keep a clear head - be real with yourself about what’s right for your dog, your situation, and your family. Trust your intuition, ask questions, and be realistic. Evaluate quality of life often. And…. go hug your dog. Appreciate every moment you have with your senior pup, because each one is truly a gift.

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How did we do with this week’s newsletter?

• High Paws

• Pooped in the House