“Old” Is Not a Disease
I HAD MET Bucky four times over the previous eight months. He wasn’t the kind of dog who bounded around the waiting room, but this gigantic, obese ten-year-old was a happy goober, always glad for a belly rub or an affectionate stroke on the side of his face whenever he came to the clinic. He still had plenty of good-natured slobber in him; it was always a treat to see him.
His owners were referred to us from his primary care veterinarian. I could see from their address that each visit meant a forty-mile drive down the turnpike, then ten more miles past the office parks, until the road gave way to cows grazing on the hills where we let out the larger animals that we take care of.
They brought in Bucky, a velvety chocolate Lab, because he had a condition that makes it difficult to breathe — laryngeal paralysis, which occurs in older dogs. He needed an operation to correct the problem, but his owners kept resisting because they were afraid for their old dog to undergo surgery. They felt it was too much to put him through.
A lot of owners fear surgery for their dogs, particularly their older ones, in part because they project their experience, or that of a relative, onto their animal. But while dogs do contend with postsurgical pain, they tend to deal with operations very differently than people do and heal faster, putting them back on their feet and into their normal routine much sooner. That’s true even for dogs of ten or older.
I explained this to Bucky’s family at our first meeting, but still, they were skittish about the surgery and asked whether there was any alternative. Because Bucky was so overweight, I explained that slimming him down would at least buy some time by helping to keep the problem from progressing rapidly. Relieved, they went home determined to curb Bucky’s calories and also have him burn off some pounds with increased activity.
But a couple of months went by, and when Bucky showed up at our clinic again, his breathing was more labored. He had not lost an ounce.
This happened two more times. Finally, Bucky came in barely able to breathe. He was so unable to take in air that he had to be anesthetized so a tube could be put down his throat to help with respiration. We thought that might give him the boost he needed, but every time we woke him up to see if he could breathe on his own, his tongue turned blue from lack of oxygen.
Sending him home and waiting for the next crisis was no longer an option. This was the ultimate crisis: he couldn’t breathe on his own.
With misgivings, the owners gave permission for the procedure. Bucky came through with flying colors, as most dogs do, and went home within two days, breathing normally and comfortably.
About six months later, a chocolate Lab came in with a laceration in his paw that needed to be tended to professionally. The dog had been running along the beach and cut himself on some rocks. He was happy and calm, albeit dripping some blood from his foot pad.
It took only a moment to realize the dog was Bucky — not Bucky as I had first met him more than a year earlier, but Bucky the way his owners remembered him from before his laryngeal paralysis ever developed: exuberant, charged up, and happy to run around — as well as a little thinner because he became more active with the improvement in his breathing. The old boy lived a couple more years after that, with a wonderful quality of life unhindered by significant health problems.
— Scott Shaw, DVM, Assistant Professor, Department of Clinical Sciences/Emergency Critical Care
BRANDY SUDDENLY collapsed at home one morning while chewing on some rawhide. The family rushed her to the emergency room. They had no idea what was going on. She was eleven, but she had seemed perfectly fine until then. She was so sweet — a little curly-haired dachshund.
It turned out she had advanced heart disease that hadn’t been picked up. But that morning, a valve malfunction in her heart apparently caused the pressure there to go high enough that she actually tore the wall of her left atrium. So much blood spilled into the sac around her heart that it just looked like a huge round basketball on an X-ray.
It was a bad sign — advanced heart failure. Her prognosis was only six to eight more months of life.
The family was panicked. They didn’t see this coming. They had first brought Brandy home as a young puppy when the wife was pregnant with their first child, and the tiny thing would cuddle on the woman’s stomach, even though a kick from the baby was enough to send her tumbling. Now the family numbered four — the children were ten and nine.
Scared as they all were, they sprang into action. They kept Brandy on the necessary exercise restriction. They enrolled her in a clinical trial at Tufts to test a new drug meant to treat heart failure — never knowing whether Brandy would get the drug or the placebo. They kept her from being startled, even telling people not to ring the doorbell, because the excitement would cause Brandy to faint. They taught the kids to administer extra Lasix to Brandy if they found her short of breath. They even allowed us to put her on Viagra, a potent pulmonary vasodilator that would open the vessels in her lungs, although it was prohibitively expensive.
The parents would come in with spreadsheets listing all the medicines Brandy was on, her dosages, and how often she was supposed to take them. And, beyond all probability, they rigged an oxygen cage for her at home from the wife’s late father’s oxygen concentrator — he had had emphysema — which we tested at the hospital to make sure it worked. That cut down on hospital stays, which cut down on costs. They were the most amazing people, and Brandy would always continue to run around like a loopy bandit, even though her heart by that point literally took up her entire chest.
My office isn’t in the small-animal hospital itself. It’s in the red barn on the other side of the road. I don’t know how many times I ran across the way to see Brandy for various emergencies. When she finally died in the emergency room one night at age thirteen, twenty-two months after her first visit, we all had a good cry, including the husband, a six-foot-four lug of a man who was not prone to displays of raw emotion. It was cathartic. Though shaking with tears, the family had done everything they could to give Brandy almost two good years she wouldn’t have had without them.
— Suzanne Cunningham, DVM, Cardiology Assistant Professor, Diplomate of the American College of Veterinary Internal Medicine (Cardiology)
Owners of old dogs often come in understandably frightened. They hear terms like “heart failure” or “laryngeal paralysis” and assume all is lost. Or maybe it’s simpler. Their dog has lost bladder control to the point that expensive rugs in the house have been ruined and the owners are at their wits’ end. Or a dog’s joints are so stiff she can’t make her way into the car, and they assume they will soon need to make an awful decision. Maybe nothing in particular is wrong, but the very idea of a dog’s drawing near to the full span of life expectancy often fills owners with dread. Indeed, of the four million dogs relinquished to shelters every year in the United States, almost a million are given up because they’re “too old.”
But old age is not a disease. It’s a stage of life.
Yes, the older a dog, the more vigilance is needed to combat various illnesses, and the more challenging the medical treatments. But, as they say, with age, what is l...