Home Nursing Care

posted: by: Dawn, RVT Tags: "Clinic Specials" "News" 

As pets are living longer, it’s becoming more frequent that pet owners are doing more nursing care at home with their aging pets.  Whether it’s an acute (sudden) health issue or a chronic disease such as kidney disease, there are a few things pet parents need to pay close attention to.

First and foremost is to make sure your pet continues to eat.  Many pets lose their appetites when they are sick.  Or sometimes the medications they are taking cause an upset stomach.  However, pets still need to take in nutrition to help them battle their illness.  Cats, especially, cannot go more than a couple days without eating or it will cause other problems.

So, how do you get your sick pet to eat?  First, consult your veterinarian about what your pet can or cannot eat.  When pets stop eating dry food, try first a canned version of their food.  Sometimes that’s enough to entice them to eat again.  Cats especially are more likely to eat canned food than dry when they are ill.  Remember to refrigerate opened cans with a lid, and to warm the chilled food before serving it (depending on the amount of food, 5-10 seconds in the microwave is usually enough).   Cans of food are typically good once opened for 4-5 days. 

You may try soaking dry food in low sodium chicken broth to add a little flavor and soften the food. You may also try adding a few bites of cooked skinless/boneless chicken mixed in with the food.  Cats may also be willing to try chicken baby food (usually a step one formula).

If your pet still doesn’t want to eat, ask if Hill’s Prescription A/D or Purina’s Prescription CN would be appropriate to try.  These are high fat, high protein canned foods that are very palatable and usually well-liked by both dogs and cats.  Sometimes even just mixing a little in with the normal food is enough for a pet to eat.

Pets that won’t eat despite all that’s offered may need syringe-fed a canned food mixed into a gruel (add a little water to make it a thick soup then force-feed with a syringe).  This can be messy and even stressful for pet and pet owner.  Your veterinarian or their staff can help show you techniques for syringe feeding your pet if that becomes necessary.  Medications to stimulate the appetite are also available under the doctor’s discretion.  Neither appetite stimulants nor syringe feeding are good long-term solutions, but rather short-term until the pet us feeling better and willing to eat on their own.  There are also options to hospitalize the pet at a specialty 24hour hospital with a feeding tube, although most pet owners do not wish to do this.

Second to eating is hydration.  A dehydrated pet will not feel well.  Dehydration can occur due to the disease or illness, or can be due to the pet refusing to drink water.  Pets with kidney disease may have trouble maintaining good hydration because their kidneys don’t function properly.  Water enters and exits the body so quickly the body doesn’t have time to absorb it.  Body systems cannot function properly without enough water in the body.

You can monitor your pet’s hydration at home one of two ways.  If your pet allows your fingers safely in their mouth, feel your pet’s mucus membranes, or gums, on the upper lip or above the top teeth.  A well hydrated pet’s gums will be very moist (you can test this out on yourself as well!).  A dehydrated pet will have sticky or tacky gums.  Another way to monitor hydration is skin turgor…you may have seen your vet to this during an exam.  They will pick up or tent loose skin, usually behind the neck, and watch it go back to normal.  A well hydrated pet’s skin should bounce back quickly.  A dehydrated pet’s skin will be much slower to return to normal.

How can you help your pet’s hydration?  Severely dehydrated pets may require hospitalization and intravenous (IV) fluids.  Some pets with chronic or long-term illnesses, (kidney disease is a very common illness that affects hydration), your veterinarian may recommend giving fluids under the skin (called sub-cutaneous or sub-q).  You would pick up a bag of special fluids from your veterinarian, and give the prescribed amount with a needle in the skin, usually along the back where there is a lot of extra skin.  This is something your veterinarian can show you how to do if it becomes necessary.

At home, encourage your pet to drink water.  Provide fresh water at all times for your pet.  Some cats may prefer running water, either from a faucet or a special pet fountain.  If your pet doesn’t want to drink water, you can add some low sodium beef or chicken broth to flavor the water.  If your pet is eating canned food, he or she is also getting water that way, as canned food is 70-75% water.

What goes in, must come out.  It’s important to monitor your pet’s elimination habits, especially while they are ill.  Is your pet urinating?  How much?  How often?  Where (ie is your cat using the box or going elsewhere)?  Is this normal or abnormal for your pet?  Same with the stool-is it formed or loose?  What color is it?  How often does your pet go?  Is this a normal amount for your pet?  All of these can be clues to your pet’s health, both for you and for your veterinarian.

Finally, medications…medicating your pet can be easy, or it can be difficult.  There’s not usually much middle ground.  The important thing is to be sure to give all medications as directed by your veterinarian.  Never stop a medication early or alter how much or how often is given unless told to do so by your veterinarian.

Many dogs can be fooled into taking their medicine.  Pills can be hidden in a small amount of peanut butter, cream cheese, a marshmallow, a piece of hot dog or cheese, or a meatball of canned food.  Always give your pet a bite of pill-free ‘treat’ before giving the ‘treat’ with the pill in it.  Pill pockets, special soft treats with a hole in the middle for a pill, are also available for dogs and cats.

If you have to resort to ‘pilling’ your dog, be careful not to get bitten by accident.  Your veterinary staff can show you techniques for pilling your dog.  The goal is to get it as far back in the mouth as possible quickly, then hold your dog’s mouth closed until he swallows.  Try aiming your dog’s nose towards the ceiling and stroking the throat downward to encourage swallowing.

Cats are harder to fool when it comes to giving medications.  Pills are usually given in pill pockets, or by actually pilling your cat.  You can coat the pill in a small amount of butter to help it slide down easier.

Many cat medications can be made into a liquid form (often through a special compounding pharmacy).  Most cat owners find giving a liquid is easier than giving a pill.  You put the tip of the syringe (no needle) in the corner or your cat’s mouth facing the back of the throat, tilt your cat’s chin towards the ceiling, and push the plunger to deliver the medication.

Another tip for medication small dogs and cats is to put them on an elevated surface.  This gives you a bit of an advantage over stooping down on the floor over them.  You can also wrap them in a towel to help control their legs while giving medication.

There are a few medications that are available in an ointment you can rub on the cat’s ear.  These are available only through a special compounding pharmacy and usually reserved for long-term maintenance medication.  If you are unable to give your pet pills or liquids on a daily basis long-term, ask your veterinarian if an ointment (called trans-dermal medication) is available.

For powered medication that can be sprinkled in the food, add it to a small amount of your pet’s food to encourage it to eat the part with the medication, then give your pet the remainder of the meal.  This way, in case your pet only eats part of a meal, or a housemate sneaks a couple bites, you know the correct pet got the necessary medication.

Keep in constant contact with your veterinarian while your pet is ill or battling a long-term disease.  Be sure to keep follow-up visit appointments so your veterinarian can see first hand how your pet is progressing.  If you have any questions or concerns, never hesitate to contact your vet.  They are your second line of defense in helping keep your pet healthy and happy….you are their first!