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Senior Pet Care Awareness & Techniques with Laurie Brush

Special Guests

Dr. Laurie Brush, DVM

Dr. Brush is the founder of Heaven at Home Pet Hospice. She is a graduate of Kalamazoo College (BA) and earned her Doctorate of Veterinary Medicine (DVM) at Michigan State University. As a practicing vet since 1998, she became involved in the movement toward in-home palliative care and euthanasia, beginning with her own 17-year-old rescue dog, Herkemer. Through her personal experience, she became a passionate advocate for peaceful at-home transitions. She is a member of the International Association for Animal Hospice & Palliative Care (IAAHPC), the American Veterinarian Medical Association (AVMA), the MVMA, the WMVMA and the West Michigan Academy of Small Animal Practitioners (WMASAP). Dr. Brush is among the first 100 graduates to receive advanced Certification as a Hospice & Palliative Care Veterinarian through the IAAHCP.

We’re back with a new Hey Joe! This week, Dr. Laurie Brush of Heaven at Home Pet Hospice offers sage advice on grooming senior pets. Learn how to keep older dogs comfortable on the grooming table, how to recognize pain in senior animals, and how to talk to your clients about pet health.

  • How do I accommodate senior pets in my care?
  • Should I use a muzzle on an older dog?
  • What kinds of mats can I get to comfort senior pets?
  • What issues should I bring to my clients’ attention?

Tune in to find out.

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    Announcer: Welcome to the Hey Joe!, a podcast answering questions asked by our listeners, created by pet professionals for pet professionals. And now, your host, Hey Joe!’s very own Joe Zuccarello.

    Joe Zuccarello: What’s up everyone? Joe Zuccarello here, and welcome to Hey Joe!, a podcast brought to you by Paragon School of Pet Grooming. Check out our site paragonpetschool.com for lots of really cool information on a variety of programs, products, and to connect to educational resources such as webinars, podcasts, current events, special news, certifications, and lots of other helpful information to help you grow yourself, your team, and, of course, your business. Let’s get started with this week’s episode.

    Joe Zuccarello: Hey everyone, Joe Zuccarello here again, and your host of the Hey Joe! Podcast. And every week, we bring you subject matter experts and people that you might be able to find on your own as you go out and search for specific topics or information on specific topics. But the topic we want to bring you this week is one that’s just so near and dear to us. And because we’re in such an emotional-centered industry, we will all experience the need for more education and more knowledge and understanding of how to properly handle this topic, and that is senior pet care. And more specifically, how do we, as pet professionals, position ourselves as not only the expert when pet parents come asking us for our advice, but also how do we accommodate the needs of senior pets while they’re temporarily in our care, whether it’s boarding or grooming or training? I don’t know how much training you’d do with a senior pet, but definitely during boarding and maybe even daycare, but certainly also grooming.

    Joe Zuccarello: So I have a really special guest with us today on the Hey Joe! Podcast, and that is Laurie Brush. She’s a veterinarian, and I’m going to ask that she does a lot more of the introduction of herself, but she has an organization called Heaven at Home Pet Hospice. And it caught my attention because you think of hospice and you think of senior citizens or elderly human beings, right? And not necessarily hospice four pet beings. Right? Our pet family members.

    Joe Zuccarello: So Laurie, thank you so much for joining the Hey Joe! podcast today. And would you tell our audience a little bit more about yourself and your organization?

    Laurie Brush: Thank you, Joe. I am so happy to be here. We’d love to spread the word about pet hospice. I have been a veterinarian since 1998 and did routine care practice in the Michigan area. And about eight years ago now, coming up on eight years, I decided to start Heaven at Home Pet Hospice. And I did that after hearing people speak about hospice at a national veterinary conference, and I had done some house call practice, which I absolutely loved, and saw the difference in how much more comfortable pets are at home, and their people are with them and that’s where they want to be for that end of life care process. So I started Heaven at Home.

    Laurie Brush: And this field of veterinary medicine has been rapidly growing. I’m part of an international association for animal hospice and palliative care that just had its 10th anniversary. So it’s still, even though it’s 10 years old, it’s quite a new field in veterinary medicine, and many people have still not heard of it.

    Joe Zuccarello: Well, and again, when you and I first started talking about this topic and bringing this to the Hey Joe! listener audience, I was just intrigued by it because we all face this. And as a pet owner or in a client of pet care providers, but also being a pet care professional and been in the industry for so long, every single time we encounter this, it’s almost just as challenging and almost just as … I don’t want to say awkward, but definitely challenging, having that conversation. So anything that we can do to better equip our pet care providers out there with maybe some process improvement or maybe even some things that they can do to help communicate to the pet parent what they can do to make sure that their pets are taken care of during their latter stages of life.

    Joe Zuccarello: And because our pet care providers are 10, 12, 15 more times likely to see a pet in any particular year than even the pet’s veterinarian, we are seen as that partner in the pet’s care, all the way up to and including their end of days. And this end of life care for companion animals not only exists the need for that not only exists in the home, but also in the professional pet care space.

    Joe Zuccarello: So let’s talk a little bit about the old and cranky dog. So kind of tell us about what is old and cranky? What does that mean? What’s going on with the pet when they’re starting to get to that age and us pet care providers are starting to see those attributes, that personality starting to surface?

    Laurie Brush: Right. There are so many different things that can be going on with a senior pet. And I’ll just put this in terms of dogs initially, but very often, senior dogs have started to have a lot of arthritis. It can vary depending on their size. It might be everything from even their toes are arthritic, to it hurts when they walk, when they try and get up, when they lay down. Bigger dogs tend to get very weak in their back end. That can be an arthritic change or a couple of disease processes that make it very hard for them to stand up or stay standing. And it’s painful when they’re trying to stand up or lay down and changing positions.

    Laurie Brush: So often they can have some cognitive dysfunction that’s part of the whole thing. They don’t see as well, so you have to make sure you understand the difference there. But they might just see a shadow coming toward them, so they’re startled more easily. They don’t hear as well, so they’re startled more easily for that reason. And they might not be as aware of where they are. They can get a little doggy Alzheimer’s. It happens with cats, too. We can see them get some cognitive dysfunction, and they might have symptoms of getting more vocal, not recognizing people, barking at strange things, pacing at night, just generally being more uncomfortable in having a hard time settling down. They might get stuck in the corner of the room and they start becoming incontinent, and not so much because they have a urinary tract infection or bladder stones, those are definitely things you want to check out with your veterinarian or recommend that your clients have checked out by their veterinarian; but it may be a cognitive dysfunction issue. They might have a little Alzheimer’s disease kind of stuff going on.

    Laurie Brush: So there’s a long list of things that you, as a pet professional, to your listeners can do to help make that whole experience easier for the pet.

    Joe Zuccarello: Right. And I think in making it easier for the pet, we’re probably in turn also making it easier for the pet parent. So let’s dive into that a little bit. So when we talk about our processes, what improvements, what areas should we be targeting? And I know that a lot of the Hey Joe! listener audience out there, you’ve dealt with senior pets, but I just encourage you to kind of fill in the gaps. What are maybe some of the tips that that Laurie’s going to share with us that, “Oh my gosh, I didn’t think about that,” or, “Oh my gosh, I should go that one extra step?” Because she’s going to share with you, now, some process improvement methods that might command maybe even some extra time allowance or … And sometimes, we’re just not able to care. So there’s these triggers or these milestones or these check boxes that we have to pay attention to. So as far as process improvement, so facility readiness and sometimes it’s … it’s noisy, it’s busy, there’s lots of other pets, there’s lots of other people. What are some of your high points, Laurie, that you can talk to the Hey Joe! listener audience about, as far as facility readiness?

    Laurie Brush: Well, it can start right from the time of the appointment. You can talk to the client about what their dog’s routine is. Do they wake up more slowly? You need to make sure they get outside and have their bathroom routines so they’re not all uncomfortable already when they get there. And it might be something like making the time of the appointment a better time of day for them. And then probably shortening up that time span, because that pet is going to get more uncomfortable. We know if they’re in pain, they’re more likely to bite. And some of them, just because of the cognitive dysfunction, are going to be more likely to bite.

    Laurie Brush: So you can do … Muzzles are always an option that I would recommend to keep everyone safe. But you can also use some big blankets to wrap around them, or things to help them be comfortable but not feel like you’re pushing and prodding. And it might take two people to do this process. You know? A toe trim might not be a thing where they can just stand there on the table anymore, or you might have to break it up into pieces. You might have to do one foot and let them rest or lay down. Could do it even while they’re laying down.

    Joe Zuccarello: So let me ask you a quick question, because you said something about muzzles. And I agree, and it keeps everybody safe. But I would think that also maybe sometimes we forget that some of that pain comes from dental hygiene issues, and it’s sometimes even years of neglect or maybe when putting a muzzle on, we’re actually … Do you see that we could also be actually compounding the pain issue?

    Laurie Brush: I doubt you’re compounding it, but you want to make sure it’s a muzzle that fits appropriately and that they can breathe through. Basket muzzles can work. Many times, groomers now are helping to clean a dog’s teeth, do some brushing for them. You’re going to be the first person who sees this dog has gingivitis. His gums are bleeding. He hurts when I touch this tooth, he pulled away or yelped. So you are the person who can say to them, “You need to get to the veterinarian. This dog needs some dental health.”

    Laurie Brush: Dental health is a huge problem in our senior pets. As those teeth … Their mouth gets full of bacteria. When you see all that buildup, you can just visualize the bacteria running around in there, and that can travel. It can travel to their heart, their kidneys, lungs. It can cause some other problems for them, so it’s definitely … It’s not the thing you see, and I have many clients who will make their dogs all pretty by having them groomed regularly, but then they’re not doing anything about their dental health, their oral health care. And there are quite a few things we can do that’s too long a list for this podcast, but have them talk to their veterinarian.

    Laurie Brush: One of the other things that’s really important, I think, when these senior pets are coming into your facility is can they walk in there easily? Many of them are already nervous that they’re going into a strange place. You want to make sure they’re not struggling to stay standing on a slippery floor. You might need to put up yoga mats for them to walk on. That gives them a little traction. You can get office supply floor mats that you turn upside down, and they have some cushion and grip for them to lay on. You could ask the clients to bring their own beds in with them. You might even be able to provide a heated bed, but you could definitely provide something that’s up off the floor, so it’s a little warmer, and some blankets. Let’s see, I had some other-

    Joe Zuccarello: Well, and I … Yeah, and I think, too, sometimes I think our pet care providers, it seems like everybody’s always so, so busy. And this commands a different approach to taking care of this particular pet. So do you see pet care providers, or are you seeing that they’re putting, sometimes, the senior pets at the beginning of the day or at the end of the day? Is that a safer practice for the pet care provider, and especially for the senior pet? Do you see any trends there that you might recommend?

    Laurie Brush: Most definitely. And I think it needs to be not just the time of day, but how long the appointment is. Maybe they can’t do everything they’re used to having done in one appointment anymore. Maybe it needs to be spread out a little bit. Are they going to be … Because as you know they’ve got to get there. They’ve had the ride in the car. Is that a stressful thing? They might not be able to get them right home afterwards. They might be getting cold where they are. So our senior pets are definitely more susceptible to getting chilled. Cats, you could provide a heated cat bed for them. Dogs, you could even consider … There are some different mats and pads that are warm. Electric heating pads aren’t such a great idea unless you’re really sure they can get up off them if they get too warm. But there are some safe heat things that you can do now, and some that cool in the summer. There are cool gel pads that you could get to put in the pet’s cage, or wherever he’s going to be staying while you’re keeping him there to groom.

    Joe Zuccarello: You know what? You just said something, and I wrote a big note as soon as you mentioned it. You said something about the time might need to be broken up between maybe a couple of different appointments, or maybe even abandoning doing a particular service that maybe that pet just won’t tolerate anymore. But you said something that I wrote down, and I want to come back to, and that is I think sometimes, and I’m guilty of this, we think about the pet’s time with us as pet care providers, but we do not necessarily take into full consideration how long that whole process has taken for that elderly pet, for that senior pet. That is, getting up, getting ready, getting to the car, getting through the car ride, getting from the car to the salon or to the pet care provider’s place of business. And then all of that has to happen in reverse after that time when they’re with us in our care. So that, it could be …

    Laurie Brush: It’s a long day for them.

    Joe Zuccarello: It’s a long day! And then you’ve got what, just recovery, right? So you’ve got afterward, how long does it take, in your opinion, what kind of toll does that take on that senior pet for recovery once they get back home from their full day?

    Laurie Brush: Oh, it’s so hard on them. I’ve talked to clients who won’t take their pet back into the groomer anymore because it was too stressful for him. It was too long a day. They come home and they collapse, they sleep, or it takes them a couple days to recover from that experience.

    There might even be … consider for them, that you could suggest if maybe they need an in-home groomer, someone who can come to them, or doing that shortened up visit where you’re just worrying about their eyes and ears and the mats in their feet and simplifying what you do for them.

    Joe Zuccarello: And then sometimes, being the best care provider is recommending an alternative method of care, even if it means we’re not able to care for that pet any longer. And pet parents, myself included, we continue to kind of do this to ourselves. We know we’re going to outlive pets. We know we’re going out live probably numerous pets in our lifetime. Right? If we’re fortunate enough to have pets in our lives. And by recommending to the pet parent at a certain particular time that it might be best that they find an alternative care provider that can do something in their home doesn’t mean, necessarily, that you lose that client forever. It just means that, for that moment, you might be taking a break from servicing that client. Right? Until maybe that pet does spend the last days on the planet. But then when they rebound and they get another pet, then you’re back into the picture. So I think that’s real important to mention, is that sometimes recommending alternative care is the best care you can provide.

    Laurie Brush: Yep. And it might make them more likely to be back to you in the end. You know? they know your interest was for the pet’s comfort. And that’s what you’ll put first, because this is the hardest part of a pet’s life and decision making process for caregivers.

    Joe Zuccarello: Yeah, I think … So that kind of drives us to what I think is the second part of our podcast time together. And just a reminder to all of the Hey Joe! listener audience out there, we’re talking with Laurie Brush, who is a veterinarian. And she operates an organization called Heaven at Home Pet Hospice, and it is end of life care for companion … . And if you go to paragonpetschool.com, you can find all of the information you want to and find out how to maybe contact her or maybe even ask additional questions and such, or just to learn about more what you can do as a pet care provider, as a pet professional for pet parents and their pets as they reach nearing the end of their life here and during their senior care.

    Joe Zuccarello: But obviously, senior care can go on for quite some time. So let’s talk about, now, what role are the pet professionals out there, the Hey Joe! listener audience out there, what role can they play when helping the pet parents understand what to do with a pet in their latter days of life, in their senior days of life? And what’s interesting is that all of us go through that at least once. Most of us go through it once, but all of us go through it for the first time. So are pet care providers, as I mentioned earlier in this podcast, we’re probably seeing that pet 10, 12, 15 more times per year then that pet’s veterinarian. So we’re the resident expert during those times. What recommendations, what tools, what can we give our pet care professionals out there to help them talk to the pet parents during these times?

    Laurie Brush: Well, they’re definitely the first line. The boarders, the groomers, the trainers, daycare providers; these are the people who are seeing the pets, often touching them extensively. They’re going to be the first ones to know that something has changed; that something’s not quite right, that maybe that pet’s routine has changed, they’re getting crankier they can’t stand as long as they used to, they’re a real fall risk.

    Laurie Brush: And we know that our seniors need routine, and each pets life is going to tell its own story. They all have their own personalities, so it’s going to be a very individualized thing. But you can talk to your … You’re going to see when you’re looking at them, is this pet now having some skin problems it never had before? Is this a change, a condition that should be really addressed, or does he just need to be groomed more frequently? You might be the first one to notice eye changes; when this pet’s eyes are getting all these goobers and glocky stuff in them, if that’s normal. And if they haven’t been to their veterinarian to find what they can do to prevent that, you are the first person who says, “This is probably a change that could be dry eye or indicate some other kind of disease, and you can help this to make them more comfortable.”

    Laurie Brush: I think very often, the pet parents have no idea how miserable their pet’s eyes can be when they have all that discharge and they’re really dried out. I, as a veterinary student, when I was in school, I had my 17-year-old dog … and I hadn’t realized how bad his eyes had gotten. And I was in vet school! I was looking at him every day, but he had all this discharge from his eyes, and I finally realized that he had a condition called dry eye, and I had the ophthalmologist see him, but it was very treatable. We had to do some things to make him more comfortable because he was pretty miserable with those eyes. But they’re not walking around saying, “Ow, ow, ow.” Or, “My eyes are really bothering me.” You know? You just have to pay attention to the signs. Might have rubbed them a little more. He had a lot of discharge, and they looked different. And that was the main thing you are going to see as a pet professional, “This has changed. This needs to be addressed.”

    Joe Zuccarello: So there gets to a point where the pet care professional is not only pointing these things out … And I think we’ve all probably experienced, “Hey there’s a new lump or a new bump and … ” Now, we do have to be careful that we’re not also trying to diagnose. And that was always one of my guiding principles for the teams that I’ve led in pet services was, “Be careful you’re not diagnosing because we’re not the veterinarian. We’re calling attention to it.”

    Laurie Brush: Right.

    Joe Zuccarello: But don’t overstep our bounds.

    Laurie Brush: That’s so true! Because I’ve had many people tell me, “Well that lumps been there awhile. The groomer told me I didn’t need to worry about it.” Well, you did need to worry about it. So there are many lumps and bumps that we can’t know without doing something like a fine needle aspiration or a little mini biopsy, what it is. And some people make those palliative care end of life decisions that they’re not going to do anything, anyway, for a lump. They wouldn’t make any changes.

    Laurie Brush: So it’s really a whole set of things that go into this. But you, if you’re discovering something new as a pet care provider, to point it out to them, if they’ve never seen it, they don’t pet him that way. You’re going to find the most subtle things doing what you do. So you can let them know, “He’s lame now. He hurts when his toes are handled.” You can find activity and behavior changes, too. Is he getting snappy because there’s something that hurts? They need to go to their veterinarian and find out.

    Laurie Brush: But there are so many things that pet professionals can do, and know in advance to help those old and cranky dogs be happy older senior pets. This-

    Joe Zuccarello: No. And we don’t want to freak out the pet owners, also. Right? So we don’t want to over-exaggerate, we don’t want to panic them. But there’s also that balance where we also don’t want to underplay or be dismissive about what it is. But certainly in any case, we don’t want to diagnose. So there’s got to be that … How do you recommend for pet care providers to kind of walk that happy medium? Is it observe and report? Is that the safest process to follow, do you think?

    Laurie Brush: Oh yeah, that’s exactly how I would … Observe and report. That’s a wonderful way to put it. So that’s all you can do is point out to them what is there. “Look, I just … Feel this. This is a new lump. I would suggest you have this checked out by your veterinarian.” That’s probably as much as you need to say, or, “These changes in his eyes concern me. I think he’s pretty uncomfortable. You should probably see your veterinarian to find out if there’s something to help him be more comfortable.”

    Joe Zuccarello: And there could be that delicateness of the conversation, too, where maybe it’s a lack of affordability option for the pet parents. So we also don’t want to make them feel guilty. So I think that that direction of observe and report, observe and report … And part of the observation and the reporting could be if it changes, if the lump gets bigger. Right? But it’s still always that nice safe … I like to stay kind of agnostic or stay kind of Switzerland in these conversations. Because listen, I’ve seen the best, most caring individuals get themselves into trouble because they’re either seen as putting not enough importance behind their comment or overdoing it, or making somebody feel guilty. I’ve actually had a pet parent report to me that a staff member made them feel guilty because they weren’t getting treatment. And we just have to be careful, we have to be … That’s a very delicate conversation.

    Laurie Brush: I bet that’s one of the big challenges of your job as pet professionals; to walk that fine line. And you might find some resources for … There, in Grand Rapids, we have an organization called Pets In Need. There’s an organization called Frankie’s Friends that helps people who can’t afford it, do surgeries that are needed for their pets. I have seen people who say they can’t afford to go to the vet, but they’re having their dog groomed regularly. You know? Those are tough trade offs.

    Joe Zuccarello: Mm-hmm (affirmative).

    Laurie Brush: That’s probably a whole separate conversation to have.

    Joe Zuccarello: Yeah. I think going to have to … Well, I’m sure, based on the feedback we get from our audience, I’m sure we’re going to have lots of questions and additional time together at least on one or more future episodes.

    Joe Zuccarello: So let’s talk, now, about that conversation when the pet care provider may need to provide some of that final conversation or that final advice for a pet parent. And that’s kind of the, how will the pet parent know when it’s time? Right? And again, really, really tricky, tricky, delicate conversation. And of course, I always like to defer back to the medical professionals for this, for consultation, as well. But one of the things that you’re making available to us that you found is a resource produced by the Ohio State University Veterinary Medical Center. And it’s titled How Will I Know? And this is a … I got to tell you, this is probably one of the most complete and professional and friendly resources that you’re going to share with us, and we’re going to now share with the podcast audience. So all of our podcasts audience members out there, you can go to paragonpetschool.com, and we’re going to put you in touch with … We’re going to actually provide you a way to download this document. And it’s assessing quality of life and making difficult decisions for your pet. So this might provide pet care professionals out there a way to kind of navigate that conversation without even really having to have that conversation.

    Laurie Brush: Right. It’s something you can recommend for the pet parents, that they go to this website. And it helps you think about all the different aspects of your pet’s life. And making those decisions of what’s important to you, what’s important to your pet. How can you see it from your pet’s point of view? And I think those are very, very valuable resources.

    Joe Zuccarello: Yeah, I know that it talks about questions to ask yourself before making a treatment decision; surgery or chemotherapy, making the difficult decisions. Anticipatory grief. What are you going to experience at that moment, or after euthanasia? And let’s face it, guys, this is one of those things that, it’s going to happen. So what can we do to be that resource for our pet parents out there, for our clients out there?

    Joe Zuccarello: And so again, Laurie is making this … She’s sharing this resource with us. It’s not something she created, but something she found. And not something we created, but something that we found through her, but we feel that it’s appropriate enough and solid enough to definitely make sure that you have access to that … . And you’re going to want to go to paragonpetschool.com so that you can gain access to this really great resource.

    Joe Zuccarello: And Laurie, to kind of wrap things up with our podcast audience, when you talk about in-home hospice, what does that look like? And are there providers part of your organization? I know you said it’s international. If they want to find out if there’s a hospice provider in their area, is there a directory, of sorts?

    Laurie Brush: Yeah, there are a couple of directories you should know about. There is a pet hospice directory. I just looked it up earlier. Let me see if I can find it again. Just a pet hospice directory. It’s a national … I think it’s under Pet Finders and it’s a national directory. You just put in your location, and you can find a pet hospice provider near you.

    Laurie Brush: And the wonderful thing about hospice or end of life care palliative care providers is if you’re having to choose between doing a surgery or keeping your pet comfortable, they’re going to be the ones who know how to guide you on that path. So many of my clients feel totally abandoned when they get that terminal, life-limiting kind of diagnosis, “Your pet has cancer. Your pet has this going on. We don’t expect that he’s going to live long without surgery.” And then not everyone wants to put a senior pet through that. Not everyone wants to make the financial decision that’s sometimes involved in a very senior pet. So there are lots of factors and realities to deal with. And that Honoring the Bond programs through the OSU Vet School is wonderful, the guidelines they have.

    Joe Zuccarello: Yeah, I agree completely. Laurie, thank you so much for joining us on this episode of the Hey Joe! Podcast. I’m sure that we covered quite a bit of ground, as I normally do on my podcast, but I hope that all of our pet care professionals out there, pet service providers out there have learned one thing that they can take from this to make that elderly pets, that senior pets experience while in their care, even that much more comforting or comfortable, but certainly arming our pet care providers out there with some tools and some resources when it comes to helping the pet parents kind of navigate these waters, as well.

    Joe Zuccarello: Thank you so much, Laurie. We appreciate it, and we wish you and your organization the very best.

    Laurie Brush: Thank you so much for having me, Joe. I hope everyone does well. And the main things I’d say you should think about are pain control for those senior pets. Make sure they’ve got something to keep them comfortable. And another thought is, should providers have an advanced directive for their pets? We are talking end of life care in my field, but should you have information about what they want done if the pet has a crisis? Definitely have the veterinarian’s name and the contact information handy.

    Laurie Brush: Thank you, Joe.

    Joe Zuccarello: Thank you very much. Take care.

    About Joe

    Joe Zuccarello is president of the Paragon School of Pet Grooming, leaders in grooming education on campus and online. He possesses more than three decades of experience in the pet grooming, product development and pet business consulting disciplines.

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