Methocarbamol is a muscle relaxer used in the arthritis “triad” I published on recently. How could a MUSCLE relaxer impact arthritis, especially in the hips? It’s possible that it’s a little-known spasm in the pectineal muscles. Continue reading Methocarbamol for HIP Arthritis? Whaaaaaaat?
Category Archives: Aging
The Epic “Arthritis Triad” Approach to Canine Arthritis
I’m no genius but these three medicines work wonders on Arthritis in canines. I’m sure it’s because it intercepts three out of five of the common factors in canine arthritic symptoms. (I’ll pick all that in another article)
- Here’s the three medicines
- How they’re used
- What we want to achieve
- What we do with those results
Best regards
Doc Johnson
Goodbye Dear One
Goodbye Dear One
How old am I?
I just couldn’t say,
I lived in the moment,
From each day to day.
All I’ve known
Is chase, and play
Guarding you, and to
Do as you say.
It’s been so great
to be in your Pack
Included in all things,
We each “got our backs”
But when life got harder
I gladly endured,
For the love of my family
It kept my heart moored.
Then like a pen,
I ran out of ink,
It got harder to move
Even harder to think.
And when it got bad
My people took note;
“We should send him to Heaven”
Came the merciful vote.
So, again I’ll stand tall,
with The Dog’s endless spirit
To serve as a new pup,
The one who endears it.
by Dr. Erik Johnson
What REALLY Kills Dogs? (Longevity threats)
What are the BIG Threats to Longevity in Dogs?
I’d like to do an article that describes “what really kills dogs“, or “What gets in the way of dog and cat longevity?”
There’s just so much stuff out there. With the advent of the Interwebs, veryone can sell advertising! 15 or 20 years ago it was just the major networks that could make money from a Nabisco ad. But now, anyone with Internet access, and enough of an audience can make money from advertisements running on their channel or web site. I’m fine with that.
The problem is that you have to have people (traffic) in your channel or website for those ads to make any difference, and so what you see is a lot of embellishment and hysteria and headline-grabbing and sensationalism; basically, which has been going on since the start of mankind.
Since EVERYTHING with dogs and cats is an overwhelming crisis, nowadays, how do you know what’s real?
I publish my longevity articles understanding that nobody’s really going to look at my stuff, and this has been borne out over and over again, because I don’t know how to trick Google into putting me at the top of the rankings and I’m not going to use headlines like “The president is dead“ to get people to click on my channel.
Don’t you think it’s funny that when Google started it was their job to be the best search engine there is. But now, instead of doing a good job of finding good information, they sit back and let the content provider come to THEM. It’s not about finding good content for them. It’s about content providers “toeing the line” and creating pages that Google “likes” whether there’s actually good content or not.
So what I’m going to do is write a quiet little article on pet longevity, what’s really killing cats and dogs based on experience in a suburban small animal practice.
Because it’s not dog food. And it’s not spay and neuter. And it’s not shots. Not hardly!
First, I’m going to brainstorm all the reasons dogs and cats died this last year.
- Extreme age and infirmity 75
- Cancer 35
- Complications from obesity 30
- Kidney failure 15
- Complications from Oral infections 7
- Biting and safety 6
- Hit by car and accident 6
- Heart disease 5
- Unexpected unexplained 3
There’s some overlap but not much. #2 is sometimes part of #1 and #4 and #8 find their root in #5.
Keep in mind that this is simply the number of cases that are subjectively assigned to a particular cause of death, from one little small animal practice in Marietta Georgia.
I think it sheds a lot of light on the reason people leave my clinic without a dog or cat (aka: pet expires or is put down).
What are the BIG Threats to Longevity in Dogs?
I noticed that a preponderance of animals face the end of life simply because they wear out. Their overall condition becomes so aged and infirm that quality-of-life is robbed from them.
As a distant second, lots of pets cross the rainbow bridge because of cancer, and a LOT of them have shortened longevity from complications from malignant obesity.
Many a day I will be putting asleep putting an animal to sleep that is considerably overweight and can’t get up. These dogs have carried the weight most of their lives, and into old age and then as their joints stiffen and their muscles weaken, they get down and cannot get up.
They pee on themselves, and in the house, and there is no dignity, and we put them down.
That is a commentary on overweight in dogs as they move into their twilight years. “Overweight past eight” – just doesn’t go well for them.
On the other hand, it’s never too late to start, putting them on Atkins diet which is essentially Paleo. Ultra low-carb feeding getting the carbohydrate fraction down to 10% or less eating eggs and non-starch vegetables with a little pumpkin stirred in for soluble fiber.
And, administering DHEA to these pets to shave her weight off of them. This can add as many as three years to the longevity of some of the larger patients, as their physical abilities deteriorate with age.
DHEA
This is a pseudo-hormone that can restore many of the metabolic benefits of the sex hormones like testosterone and estrogen to the dog, increasing resistance to cancer, and aiding in the metabolic acceleration of weight loss.
Establishing thyroid status
Many older animals are hypo thyroid and when that is corrected, they get a new lease on their metabolism, a big boost to longevity and weight loss is remarkable.
Feeding ultra low-carb, once known as Atkins, achieved amazing weight loss, suppression of the ravenous appetite after several months, and extraordinary benefits to overall health.
I will never mention feeding dogs Atkin’s style, without simultaneously mentioning that when people feed their dog Atkin’s style, but also give carbohydrate treats and table food on the side, that will kill the dog! Atkins style feeding is high protein and significant amounts of fat, and if given with carbohydrates, the fat is deposited and the animals become PONDEROUS.
It is difficult to contemplate the extension of life through weight loss if pain remains. Who wants to extend a painful life?
Allow me to take a moment to describe an “arthritis diagnostic” regimen that I am very fond of.
We take an animal in reasonable health, we put them on three medications to ameliorate arthritis in order to see how much of an impact arthritis is actually having on the dog.
Let me explain that:
If you put a dog on medicines for
- pain
- inflammation
- nerve pinching
- bone-on-bone grinding
…and you don’t see any difference in the dog, it suggests that these issues don’t manifest in the dog. That he doesn’t need those medicines.
However, if you use a comprehensive panel of medications for a week that address most causes of discomfort in elderly dogs and it’s “the best week of his life“ then you know you have a candidate for long-range arthritis management. You can’t tell a dog in back pain, it does NOT cause limping, right? How can you tell if they have a sore neck? They can’t tell you and it doesn’t cause a limp.
But when they respond to empirical arthritis / nerve pain medications “tried for a week” – these are exciting cases.
Quite often, it’s not necessary to use all three of those medications all the time once you know that arthritis is a factor and can be controlled, you can reduce the amounts and frequency of certain medications and still get excellent results.
The key is the initial diagnosis based on therapeutic response.
The initial cocktail does not include a painkiller. No narcotics, as I do not want to mask the pain, in this protocol I want to alleviate it.
We use Deramax, methocarbamol, and gabapentin. Depending on the pet, we may also use a stomach protectant like famotidine or omeprazole.
After the first week, if the Pet is doing very well we may continue to manage him or her using the following protocols:
Perpetual low-dose gabapentin, perpetual low dose methocarbamol, and “as needed“ Deramax. There is economy and safety in that message.
Some people are so crazy about the way their dog is feeling on the three medications given every day, that they decide to stay with that, and it is perfectly OK.
Most vets will bother you every six months for blood work to check to make sure nothing is happening with the kidneys and liver on the nonsteroidal anti-inflammatory.
Joki Surprises Us All
Joki C. Came in after a round of meds, looking terrible.
We decided he could spend a few holiday evenings at home before we let him go, or we’d do an exploratory surgery on his sinuses. The case turned out surprisingly well.
Aspirin Use In Dogs Is “Just Okay”
There is a period of time in the life of a dog where it has arthritis but not very severely. It just needs “a little help.
Keeping in mind that dogs are aging seven times faster than we are, you realize that the period of time where they just need a little help is kind of brief. But during that time there are two things you can do that are:
- Safe
- Over the counter
- Not very expensive
For mild arthritis.
One of those is glucosamine chondroitin sulfate. There are lots of products out there including human version is that your dog could take, across the board to premium priced Cosequin and Dasequin. As well as the superior Phycox product.
Phycox is superior because it contains multivitamins and anti-inflammatories along with a hearty dose of glucosamine chondroitin.
Another thing you might consider doing is using some CBD, or cannabidiol, cannabis therapy which over the course of three or four weeks will bind up certain pain receptors and inflammatory cytokines in the body and reduce the impact of inflammation and arthritis. I have a ton of information on my website about Cannabidiol. CBD.
Finally, the intent of this article is to step you through the potentially safe use of aspirin for dogs.
First let me say that “aspirin” is inherently not safe for dogs. It will almost always burn the stomach. Therefore I strenuously recommend that if you use a SPECIFIC form of aspirin, that it would be a BUFFERED type of aspirin (Click).
And I do NOT mean enteric coated. The dog’s GI Tract is half as long as yours and by the time the ‘enteric coated’ aspirin is through the system, it’s barely dissolved.
DO NOT USE ENTERIC COATED ASPIRIN!!
Finding buffered aspirin is harder and harder all the time. You need to see THIS on the label:
Aspirin Use In Dogs – How Much?
An effective dose of aspirin for dogs is 5 mg per pound per day.
That means a 60+ pound dog would get one adult 325mg aspirin per day.
A 5 pound dog would get less than half of a baby aspirin.
A baby aspirin is 81 mg. (Not available at all, in buffered)
An adult aspirin is 325 mg. (Click)
Aspirin Use In Dogs – How Often?
It is important NOT to give aspirin more than four days a week because aspirin decreases the quantity AND quality of platelets in the dogs body which may contribute to stomach ulceration as well as easy bleeding.
When we had my dog Buster on aspirin, we used it on Friday Saturday Sunday and Monday and left him off that medicine Tuesday through Thursday. He was his most active on the weekends so that made the most sense.
It will not be long before aspirin compounds are inadequate to control arthritis. It is true for humans as well, and they eventually end up on Aleve or Celebrex or something stronger.
Dogs are no exception, usually aspirin is “enough“ for a year or less.
Then, we start some stronger medicines on an “as needed basis” and then eventually as they age we use more and more medicine of more and more kinds. Nothing particularly expensive, most things are very safe, we can get a dog walking comfortably out to 18 years old most of the time.
All of the above is predicated on the dog not being fat.
Fat dogs are simply going to suffer with arthritis whether you give them medicine or not. It is just physically and mechanically painful to carry a lot of weight when you are old.
It is rare to find an owner who will acknowledge that their pet is overweight, let alone do something about it. Therefore, medications to combat arthritis are always extremely in demand.
Euthanasia Consent Form
All dogs and cats ‘wear out’ or face ‘end of life’ and when it’s time, there’s things we do. Euthanasia is one of those things.
Georgia and a bunch of lawyers got together and made it necessary to make a “form” that gets signed to allow euthanasia. Nothing fancy, really. But it identifies someone as the legal “owner” and then provides ‘direction’ as to putting their pet to sleep, and they’re signing that they’re authoritative to make that elective*.
I had a guy drop off a pretty-healthy dog once for euthanasia. I knew the dog personally. I knew the owner I normally would see, and I didn’t think this was like, HER decision so I called her. And she broke down crying. Her soon-to-be ex-husband had picked up the dog and taken it to me to be euthanized as an act of cruelty to her. She came and got the dog. I don’t know what happened after that, between that guy and his ‘wife’.
It’s stuff like that which makes a signed euthanasia consent form such a good idea in case the Vet doesn’t know to intervene, at least it shows due diligence and identifies the person electing euthanasia.
Euthanasia Consent Form
Then, since it’s unlawful to euthanize a dog or cat that’s bitten a person recently, (10 days) in case Rabies observation or testing is necessary, the owner signs that the pet has NOT bitten anyone in the last ten days. (This has necessitated people living with a ‘doomed’ biter for several days knowing they’re going to put him down at the end of the wait. It’s hard.)
So here’s the form. You might have been sent here to download and sign it so you’re ready when you come in. Or, if more than one signature is requested. It helps to have the form to carry to the other consenting party.
Euthanasia Consent Form
Euthanasia at Johnson Vet Services
Here, putting a dog down is done as peacefully as possible.
You can be with them for all of it.
Everything’s done in the exam room. Anyone you want can be there in your family, friends.
When you’re ready, I give a shot of Morphine.
The dog might wince for a second.
Then you give whatever treat(s) you may have brought. Some dogs aren’t eating, which is sad. Other times they can have a big old Brisket Sandwich and not worry about diarrhea tomorrow. Candy. Whatever they like.
Five minutes later they get ‘drunk’ and roll onto their side and go to ‘sleep’ with their eyes half open. Limp as a dishrag. But they’re not “gone”.
I have to give Pentobarbital for that, (the end) so I put them on the table and I give the second shot in the vein, in their arm.
They’re passed out on Morphine so they don’t feel any of that aggravation and arm pinching.
Seconds later, that’s it.
Rarely, a vein is hard to find. Again, they’re unaware of discomfort if I have to find a vein twice.
After they’re gone you can stay a while and think. Pray. Recollect. Get used to the idea that it’s done. Other people are just ready to go and head out immediately. It’s all good. Everyone’s different.
Folks like to book this first thing in the morning at 8 am – so there’s minimal waiting. Or first thing after surgery time, again so there’s no delay for a previous appointment, and some people like the last appointment of the day so it’s really quiet. Whichever you like.
What to do with the remains?
Most people select cremation with ‘no ashes back’ in which case the pet’s sent to the cemetery and we don’t request ashes.
Other times, people want ashes returned and we have them send ashes back to give to you. They can present those in something simple, and something extremely fancy. They have a picture book.
And some people like these little ‘foot prints’ where they make a paw imprint in a piece of soft resin / plaster to keep. It’s a tangible thing that represents the dog, in my opinion better than a lonely looking container of ashes. When it’s home you pop it in the oven and harden it. A lot of people write the name in the clay before they harden it.
Backend
Back and Leg Problems For Older Dogs
Back and Leg Problems for older dogs include five different areas we have to consider. The purpose of this article is to help people understand that a cortisone shot, or some glucosamine aren’t going to ‘cure’ their old dog’s back end problems because these things only help TWO of the five issues.
Once we understand the five things that contribute to “down in the back end” we can start to make realistic efforts.
https://drjohnson.com/wp-content/uploads/2019/09/Back-and-leg-problems.pdf
Very Important For Older or Heavier Dogs on Hardwoods
Very Important For Older or Heavier Dogs on Hardwoods
If you have an older dog that is losing his agility on hardwood floors especially in the back feet, it may not be just his age. The fur on his foot pads may be causing him to lose traction. Not unlike wearing dry socks on a hardwood floor.
Especially as you get older it is sometimes hard to keep your footing.
Look at the two pictures. They are a before, and an after picture.
The first picture shows excessive hair crossing the surfaces of the various toe pads causing them to be very slippery on hardwood or laminate flooring.
The second picture shows what the feet look like after the hair has been removed and the pads have been freshened up with a little bit of soap and water. It’s not crazy to consider softening the pads (for a little bit more grip) by applying a very thin film of handcream.
Hopefully this will improve a lot I have quite a few old dogs who actually aren’t as bad on hardwoods as you thought! Maybe their hips are actually OK!
By the way, if you have not read my articles on CBD, please do so.
Doc
Euthanasia in Dog and Cats
I Think We Are Lucky We Can Choose to Euthanize Suffering Companions.
A Life Well Remembered
A woman wrote me a kind letter after I euthanized her really good dog, and she said “Thank you for your work to make Thor’s life so well remembered.”
And what that means is that his life was good. And at the end when quality of life declined and was finally irretrievable, she made the decision to let him go. An “obvious” decision without alternative in that case – but impossibly hard nonetheless. How can you “end” something you love with all your heart? Easily actually, from a certain perspective. My good customer lives with no regret, nor cruel memories, of her dog suffering. He had a life well remembered without a grueling, tormented ending.
Chapters of a Book
If your dog’s life was a book (and it is) how would it read? How will you remember it?
All books come to some ending. We may love a book and sigh as we close it, sorry to see it end. Dogs and cats may be the same sort of relationship in a way. Each chapter could be a year in the life. The chapters should read with dignity, a bright flame of fierce love of life and engagement in all the things a pet loves to do, the whole book through. In the last chapter, we should not read about degradation or suffering, long dark days and isolation. You write the last chapter. Chances are you will remember your good decision, or your bad decisions in the foreseeable future.
“Not going to get any better.”
Hopefully your vet, and your good judgment, will indicate an ‘unstoppable’ situation when it’s encountered. Your vet owes it to you to tell you when they’re at that terrible point where all they’re doing is putting their finger in the dyke, or trying to brake before the inevitable crash. And if, during this attempted deceleration you perceive that overall quality of life isn’t what you ‘want’ for your pet then why make the pet experience every grueling yard of the downward spiral? This by itself might not compel you, but taken in light of other points I want to make, it does factor in.
Who am I to decide?
You are the only one that can decide. God put a series of checks and balances in place to dispense the suffering or infirm souls of animals. In nature a dog or cat with depleted vision and agility would be consumed by the circle of life. Always, in nature the predator eventually becomes the prey. Compounding this are the earnest efforts by owners and veterinarians to keep pets as comfortable and stable as possible into later years. So pets can literally wear out, and remain in limbo; overdue for their natural release, in a broken body for quite some time. Only you can abbreviate the decline. How far into the decline you decide to take a pet is TOTALLY up to you. You are the one to decide.
How do you know it’s time?
Your pet will do any one or more of the following things, within the context of their prevailing condition, age or illness:
1. They stop eating
2. They often stop sleeping, and perhaps start pacing
3. They may lay down and not get up for any of the normal reasons
4. They can cry or whine
You know it’s time to let a dog or cat stop suffering when:
1. Your children and your neighbors encourage you to consider it. Denial can make their voices and comments seem so distant and small. Almost unheard. But when your dog is long-gone after a long, sad end, their words will thunder in your ears. You kept her on, way too long. They tried to tell you.
2. Your heart hurts when you look at your pet and you know it’s wrong to keep him keepin’ on.
3. When your dog or cat is “pitiful” in your eyes or the eyes of those you love and trust.
4. When you can’t even kid yourself that “He’s got his dignity; Oh yeah, THIS is a dignified existence. This is what I want for him.”
Your Sacrifice, Tribute, And Final Gift to Your Guardian:
Your dog served you all its life. Sure, you took care of her and gave her the essentials like food shelter and healthcare. But she was by your side any time you were available. She never let you come home from work or vacation without coming to see how you were. She would do anything for you. She would stay with you if you could not even afford to feed her anymore. She would die for you, or with you.
If you want to honor her, if you want to give her a sacrifice on par with the life she spent on you – let her have her dignity and a painless and unfrightening release. You can’t give your dog money or jewelry. They’re not motivated by much other than love, and tasty treats. When they’re hurting, and there’s no way to stop it, it’s over. And it’s time for you to stop being selfish and thinking about how YOU’RE gonna hurt when she’s gone. She’s hurting, and if you’re reading this; it means you’re still standing by focused on your own heartache. Do the honorable thing. Make a sacrifice even if it pains you, to stop hers.
Think Of Them, But Think LIKE Them:
What’s on the mind of any old dog or cat with severe infirmity or sensory deprivation?
A blind or sick animal has to assume that sooner than later, a predator will discover it, in its compromised condition and tear it to shreds. This is the way of things in nature, the circle of life. It’s gone on this way for millions of years before we came along. If you think an animal is coping with blindness, deafness and an inability to move around with the rationalizations that we can use, you would be wrong.
Your sick, blind, isolated dog or cat has a HIGH anxiety level, is fearful and as you may have seen in recent months, easily startled because at any moment, they believe a predator will erupt from the shrubs and consume them. Can you honestly say your elderly, weak, or end-stage dog or cat is easy-going and self-assured; the way it might have been as a younger pet with capable vision, hearing and agility? Old age is a stage of relative anxiety for infirm and very-elderly dogs and cats.
IS MY DOG SUFFERING?
What is suffering? Can you honestly look at the dog or cat, and think “He doesn’t feel that. He doesn’t know that a problem exists there. He feels fine. He is unaware of his illness or infirmity.” This is delusional. Perspective must be maintained, however; that we all have aches and pains. Most of us have a lump or two. Some of us even hurt from time to time and many of us have handicaps. It all comes to a head when we’re very very old as it does for dogs and cats.
But a dog cannot rationalize it’s gradual loss of ability and we don’t assist or reassure them the way we can encourage and empower our flagging relatives. They don’t speak a human language and if they’re very old they can neither see nor hear us try to reassure and assist them. Is suffering the experience of pain? Why do people always define it that way?
Is not “suffering” the experience of ANY helplessness, such as fear, pain, isolation, hopelessness or loss of control? Is there a way to make people understand that even without human words or understanding, these five conditions of helplessness are experienced as sharply by animals as they are by us???
Think of It Another Way:
If I could produce an ornate wand from my robes, and cast a spell on you, allowing you to BE your dog for a month; all your obligations would be handled, your life would not disintegrate in the meantime – Would you even be willing to *BE* your dog for a month? …What influences your belief that your dog should be that way for another month?
Dogs Don’t Smoke Pipes, Drink Wine and Read Good Books:
What’s important to a dog: Ability to move around, to be pain-free, to have dignity and smell pretty good, to enjoy communion with the pack (that’s you by the way), to be able to serve and protect. Where does your dog’s ‘day-to-day’ fall short?
Five Years Ago Did You Think Like This?
Do you ever wish you might just come down in the morning and discover that they passed peacefully in their sleep? What does that tell you about your true, unvarnished or even subconscious estimation of your pet’s condition? Do you feel that way about other engaged, comfortable pets?
The Daily Agony of Being “Too Old”:
- Are your dog’s eyes crusty, red and gooey?
- Is your dog’s mouth infected or rotting?
- Does your dog have open wounds which will not heal?
- Does your dog have red, gooey or swollen ear canals?
- Is there ANY chance that the conditions listed above don’t hurt, pretty badly?
If you saw a human child with rotting eyes, ears, or teeth, enormous skin lesions or untreated cancers, would you not turn your head, cry out loud for the poor child, and be sick with the sorrow? These are the kinds of things you see in documentaries on child-neglect among impoverished non-industrialized societies!!!! …oh, and commonly in the homes of people with very old and very sick pets.
So much suffering seems to be acceptable before the demise of our dogs and cats that would not be accepted for a dear, innocent child. Does a dog or cat understand very much more about its weakened, terminal condition than a small child?
I want to thank you, on behalf of a suffering pet who is unable to speak for itself; for your kind consideration of these points.
Dr. Erik Johnson
Post Script: This document represents twenty six years of one man’s thought on the subject of euthanasia. I began to work with animals at East Marietta Animal Clinic in 1981, as a nurse-of-sorts, at the age of sixteen. I’ve seen countless animals go down; some gracefully, some in utter agony. This has shaped my thought on this subject. SOME of the above will apply to you. Some will not.
Just so you know; I will never euthanize an animal that does not badly need it and I have declined a few. If I can find a home for an unwanted pet I will find it.
On the other hand; if an owner does not want to euthanize a suffering dog or cat I will try and get them to put their broken pet on something to make it easier for them to open their eyes to the fading, miserable world for another day.