Hannah's Hospice: A Reality Check and Our CBD Trial

It's been awhile since I checked in here, and that's because for the last month or so, Hannah was doing so well that we were actually in denial about her medical diagnosis. She just wasn't acting like a dog who is sick, and it was starting to look like she was going to keep moving along as she always had—enjoying meals and treats, taking in a football game or two with her best lab friend, and taking long and leisurely naps. In the past few weeks, though, she's been struggling off and on and it has us doing a bit of a reality check. On any given day, there are times where she acts like her old self, but there are also many moments when she gives us glimpses of what's really going on, whether it's decreases in her energy levels or even bouts of vomiting.

Although these aren't new problems, they're increasing in frequency and so they're something we're paying close attention to. The increase in Hannah's vomiting is especially troubling, since there is still no regularlity to it, which makes therapeutic decisions to try to help her more difficult. Sometimes she's just vomiting brown liquid many hours after eating, but other times it's undigested food a few hours after eating, which is even more abnormal. She's also started vomiting in her bed and then continuing to lay in her bed, which she has never done and which is heartbreaking to watch. We still go for daily walks but she is starting to wear out more quickly, and I've dropped to about half the normal distance for our walks each day as a result.  

In an effort to help Hannah feel more comfortable without starting down a path that would lead to a dramatic increase in our medical intervention in her case, we started giving her Ellevet CBD chews to see if they would do anything to help her. Although these chews have only been scientifically tested for their ability to alleviate joint pain and increase mobility, cannabinoids have been reported to have numerous other therapeutic effects, and so these chews fell into a category of things that we weren't sure would help, but were definitely sure wouldn't hurt. For the first few weeks, we weren't convinced that the chews were really helping Hannah, so we stopped them when our bag ran out and that was when we began to think that they were making a bigger impact on her quality of life than we realized. We recently restarted them and feel like they are helping her remain more comfortable and more energetic than she otherwise would be. Although we're not sure what, if anything, the CBD is doing to ease any discomfort caused by her lung tumor, it is likely helping with her osteoarthritis and we will continue to use it as long as she continues to feel better with the chews than she does without them. The bulk of her pain relief still comes from an NSAID called Galliprant that we give her daily, but the CBD chews seem to be giving her an extra boost of comfort.

In addition to starting CBD, we also recently changed her diet to Royal Canin Gastrointestinal Low Fat after she started rejecting the Hill's prescription i/d food she had been eating for years. Hill's recently had to do a recall for excess Vitamin D in the i/d canned food, and I don't need to be wondering whether this vomiting is being caused by her food or by another factor, so I made the switch and she seems to be enjoying her new food better than her old food. This week we'll do another xray of her chest and an abdominal ultrasound so I can continue to try to make the best decisions possible for her hospice care and have as much information as possible available as I decide what drugs may help her along the way. We could continue caring for Hannah without this information and just make guesses as to what may be the best course of treatment for her, but considering her unexplained decrease in appetite and increase in vomiting, the results of these imaging studies will go far in helping me to make the best decisions to keep her comfortable and cared for.

Because our pets cannot talk to us, it can be hard to care for them through sickness or even just as they age, but paying close attention to Hannah's body language helps me keep tabs on how she's doing. Animals, and especially dogs, talk to us through their eyes, their body posture, and their facial expressions. Hannah really does not need to say a word, as after 12 years with her I can easily interpret the signals that tell me how she's feeling. Right now Hannah's body language tells me that she's still ok, but signs of gradual decline are starting to appear, and we'll need to pay close attention to those signals as time goes on. It's not easy to watch Hannah decline, but as long as her quality of life remains high, we'll keep on with our daily routine with her. She is still a joy to have around and we wouldn't trade this time with her for anything.

Until next time,

Dr. Hawk