Saturday, May 24, 2014

1 of 2: Does arthritis mean euthanasia?

Early one evening Liz called. “Dr. Cohn, I got your number from the Tucson Pet Cemetery. I wondered if you could meet me at the cemetery and look at my dog. He’s 14 years old and I think it might be time to put him to sleep. He has a really hard time getting around. If you can’t help him, you can put him to sleep at the cemetery. I already have a burial plot. I’ve talked to the director and she has no problem with us meeting at the cemetery for this examination and possible euthanasia.
(There is a part of me that has to wonder how a dog feels about going to see the vet at the pet cemetery. I know if my wife arranged for me to meet with my physician at the mortuary I might have some second thoughts.)

At 1:00 the next afternoon I was visiting with Liz and her 85 pound shepherd mix, Roscoe. “Please tell me all about Roscoe, how long he has been like this and what your other veterinarian has suggested and anything you are doing to help him.”   

She wiped her eyes and briefly talked about her pet’s earlier and very healthy years. Then she told me why we were meeting. “I guess about two years ago I first noticed he was having more trouble getting up in the morning. It took about five minutes for the rear end to catch up with the front. But, as the day went on, he always did better and better. He’s never been much of a walker and he continued to do well on any short walks we might take, but over the last year or so we’ve stopped taking any walks. I just go out in the yard with him. Now he is having more and more trouble getting up during the day. Last week I noticed he was having a hard time going down the few steps into the back yard. Over the weekend he tripped when he was coming down the steps and cried out. That’s when I knew it was probably time. After all, he is 14 years old and he’s had a long, wonderful life. I don’t want to watch him suffer like this. I know his arthritis must be terrible!” 

“Has your current vet made any recommendations?”

With no hesitation she explained. “It’s so difficult to get him up into the car; we haven’t been to the vet for several years. I did talk to him over the phone, and he agreed that Roscoe had arthritis and maybe it was time. “

Roscoe was laying comfortably in the shade, so my exam began with him right where he was. I always start with the easiest and least painful things. The ophthalmoscope showed some increased cloudiness in his eyes caused by lentricular sclerosis which is due to the normal aging process of the lenses. This is obvious to us but not to the dog and there is no interference with his vision. In most dogs this process is not due to cataracts. The otoscopic exam showed very clean canals (common in the dry desert southwest; much less common in the humid Midwest where I saw yeast ear infections almost every day). His teeth showed early tarter but his gum tissue was still healthy. (Smaller breeds tend to accumulate tarter and suffer from associated periodontal disease at a younger age than do larger breeds probably due to the increased space in the larger breeds’ mouth.) His heart beat was slow and regular; his coat was clean and healthy in appearance. His nails needed cutting (quite common in less active aging pets (canine and feline).
Next we helped Roscoe stand and I deeply palpated his abdomen and began to evaluate him for neurologic or arthritic changes that would make it more difficult for him to get around.   

You’ll have to wait to see what I found to read about Roscoe’s destiny in the second part of this story. (You can make some guesses in the meantime.)



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Thanks so much for your interest and comment. I'll be back to you as soon as possible.

Ken