Last Meals: Feeding the Terminally Ill Dog

Cooking vs Death

by Patricia Gail Burnham

An elderly Sheena, dam of the Kira Series litter

At a pet bereavement meeting an owner asked the group how one could tell that it was time to have an elderly loved pet euthanized. I replied that usually the pet will indicate when it is time by refusing to eat anything at all. When they refuse their favorite foods and special delicacies, when there is nothing I can find that they will eat, then I make an appointment for euthanasia. I don’t think it is kind to allow an animal to starve itself to death. The majority of my very old or terminally ill dogs have refused food to indicate their acceptance of the end of their life.

My response to this cue is to engage in an orgy of creative cooking to keep them eating and to delay their final refusal to eat. My dogs eat well when they are healthy, but when they are approaching the end of their life they eat incredibly well. Their normal diet consists of kibble soaked with the addition of home cooked meat and vegetables. When that is no longer appetizing enough to keep them eating, it is time to call in the fancy food. And with the postponement of death as the motivation, my cooking can get very fancy indeed.

Special Diets

When a dog is in poor health there may be diet restrictions to help him recover or postpone his deterioration. Dogs with kidney failure may be on a low phosphorus diet. Dogs with heart problems may be on a low sodium diet. Dogs with pancreatitis may be on a low fat diet. But once a dog is too ill to eat any of the special diets, once it is terminally ill, then I throw the diet restrictions away. When he will no longer eat the special diets that were designed to help treat his condition, it is time to feed him anything that you can get him to eat. I try to keep a balance between protein and carbohydrates in the diet for as long as possible but at the very end many dogs will eat nothing but meat. When that time comes I will feed them straight meat and accelerate their kidney failure before I will let them starve. Starvation is a faster killer than kidney failure.

Sheena’s Example

My latest challenge was Sheena, a twelve-year-old Greyhound who was diagnosed with liver tumors. She had half her liver removed and she spent a happy two years. Then new liver tumors led to severe weight loss and lack of appetite. Her blood values for alkaline phosphatase were forty times higher than normal. She had been eating kibble with boiled lamb heart. When she refused that, I changed to cooked rice with ground lamb. It was the start of a campaign of creative cooking, as I set out to delay the final refusal to eat that would mean I was about to lose her.

When she was recovering from her second liver operation, she had refused to eat her normal diet. I asked her vet about it and was told that lack of appetite for several weeks often followed that major a surgery. I kept her eating by remembering that she liked seafood. She was always begging crab and shrimp and asking for the skin off my salmon. So for two weeks she lived on poached salmon and buttered egg noodles until she regained her normal appetite. At the end of her life, I gave the salmon and noodle combination another try and found it successful. When she tired of that we moved on to:

1. Any of the following with or without the addition of white rice:.Boiled chicken, or beef or lamb. (Even pork if you cook it well.)

2. Boiled lamb liver with the boiling stock added to rice or kibble. Also lamb hearts and tongues.

3. Strips of raw beef

4. Loaf dog food like Rollover, Red Barn, or Dick Van Pattens.

5. Homemade tapioca pudding, made with whole milk, eggs, sugar and quick cooking tapioca. (It is easy. The recipe is on the box.)

6. Eggs that were either boiled or scrambled with cheese and cream.

7. Poached salmon (also canned salmon)

8. Shrimp

9. Fruit: Always fond of fruit, Sheena still liked cantaloupe, home grown raspberries and homegrown super sweet tomatoes.

Canned Delicacies

It helps to have some canned foods that can tempt a failing appetite for moments when you get caught without home cooking.

1. Vienna Sausages: The ultimate high calorie canned food that dogs love is Vienna Sausages. A little can of them contains nearly 400 calories. They are very high in fat.

2. Evanger’s canned foods: Especially their small cans of rabbit. But also the larger cans of chicken or chicken and beef. They have a wide variety of tasty recipes.

3. Canned salmon, mackerel, or sardines: These are available cheaply from most discount Dollar stores.

4. ID: The ID canned prescription diet is always good to have on hand.

Feeding Techniques to Fool the Nose

Because the tumor on her liver pressed on her stomach, Sheena couldn’t eat large amounts of food at one meal. But she could eat frequently in small amounts. I boiled eggs to feed her for a lunch snack and they were a hit.

Dogs with liver or kidney failure reject food because the disease makes food smell and taste bad to them. Human kidney patients have reported that perfectly normal food tastes soapy and bad. So part of getting the ill dog to eat is getting the food past the dog’s sensitive nose. Quite often they can be spoon-fed single bites when they can’t bear to put their nose in a large bowl of food. The smell of a large amount of food overwhelms the dog’s appetite. Putting a small amount of food in a bowl is one solution, but spoon-feeding works best. It has the advantage of your being able to whisk a spoon full of food past the nose and into the mouth before the nose can reject it. It is a good idea to teach a dog to eat from a spoon when they are young and have lots of appetite. Then, when they are older the act of spoon-feeding stimulates their appetite.

Another way to avoid having the smell of food cause the dog to reject it is to feed dry food and biscuits. Dogs in kidney failure will typically eat dog biscuits and dry kibble when their nose leads them to reject canned food or soaked kibble. This is such a predictable reaction that when a dog rejects wet food and eats dry food, I will generally have a blood test run to check their kidney function.

Post Surgery Lack of Appetite

Sometimes dogs that have had surgery show the classic kidney failure food rejection pattern for a couple of weeks following their anesthesia and then recover their appetite. Sheena did this after one of her liver surgeries and it scared me into having her tested for kidney failure. Her kidneys were not affected and the veterinarian said that sometimes that reaction follows anesthesia and that it would stop in a week or ten days. Sure enough, right on schedule, Sheena regained her normal appetite.

Favorite Foods

When trying to come up with menus to keep a dog eating, it helps to remember what her favorite foods were when he was healthy. What did she beg for with particular intensity? The chances are that she will still be interested in her favorites. I once helped a teenaged Greyhound with heart problems through a period of lack of appetite by remembering all the loaves of sourdough bread that she had stolen off my kitchen counters over the years. Throughout her life, every now and then a loaf of bread would turn up missing, and I would find the empty wrapper in the living room with Lady looking happy and well fed. When her heart problems and medication killed her appetite, I bought her fresh sourdough bread and bagels and kept her eating for nearly two months until her appetite returned and she lived for several more years. (Digitalis, which is given for heart problems, is an appetite suppressant. If your dog is put on Digitalis and suddenly refuses to eat, then ask your vet to lower the dosage. That is what we did with Lady. You can only give as much Digitalis as will still allow the dog to eat. Starvation will kill a dog faster than most heart problems.)

In Sheena’s case I was betting that she would be eating seafood at the end of her life. She also proved very fond of Chinese takeout food. The grocery store near home has a Chinese takeout section called the Hot Wok and Sheena was happy to indulge in their Egg-Foo-Young over rice with gravy. She liked it so well that I added eggs scrambled with melted cheese to her diet and kept boiled eggs for treats. Her all time Hot Wok favorites were Peking pork and sweet and sour pork or chicken. Never a vegetable lover, she would actually eat the broccoli in broccoli beef. She was not fond of chow mien and I stayed away from the hot and spicy selections. But the sesame chicken was a hit. Fortune cookies were so popular that I visited a Chinese food store to buy them by the pound.

When I had to be away for a few days and a friend was to dog sit with Sheena and my other dogs I left Peking pork in the refrigerator and money to buy more takeout. I had promised that Sheena would eat for her and it worked. She broadened Sheena’s choice of take out to include roast beef and gravy from a truck stop, and a roast chicken from the grocery store deli.

Sheena had always begged to finish the milk in the bottom of my cereal bowl in the morning so I took to adding cream and sugar and letting her drink it in the morning to stimulate her appetite.

By this time Sheena had lost twenty pounds and was rejecting all but high protein foods. But she was also happy and cheerful and seemed to be enjoying her life. It was as if we had developed a game in which she would eat-if I could just offer the right food. She tired of each food after four or five days of eating it and then it was time to offer something new. But the rejected food could be offered again in a week or two. She was on a classic rotation diet. And at least she would still eat if I could come up with the right food. As long as I could keep her eating, then I didn’t have to face putting her down. In the meanwhile the other dogs loved her rejected leftovers. I fed her first so that her rejected foods could become treats for the other old dogs’ dinners.

Human Food

I  tend to think of this cooking marathon as cooking vs. death. It can provide time to say goodbye and it can give a few final fond memories of a dog that you are close to losing. Sometimes it can buy you more than a few weeks or months. Sheena lived happily on Chinese take-out and my home cooking for more than a year. When my vet asked what she was eating and I recited her menu, he said, “Oh, human food.” For folks who think that human quality food should only be eaten by people, providing good quality food to a dog is one of the least expensive things that you can do to extend your dog’s final days.

Published in several places. Updated for our website May 2010.

ALL RIGHTS RESERVED This article and any photos or artwork contained within may not be reproduced or reprinted without express written permission from the author, artists, and/or photographers. 

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