Signs a Dog Is Dying: What to Expect When Your Dog's Health Declines
How to Cope With Your Dog's Natural Process of Dying
Learning more about the declining health of your dog and how to recognize the signs that your dog is dying is important for owners with aging dogs or those suffering from advanced terminal cancer.
Although it's not a pleasant topic to talk about, we dog owners owe it to our dogs to learn more about the death process since dogs have filled our lives with so much joy for many years.
It's important to recognize that the dying process in dogs (much like in humans) takes place months, weeks, and days prior to actual death. Dying, therefore, starts happening well before actual death occurs.
Dying is also a very individual experience. Just as dogs are unique in their own little ways, their dying process will be different from one another and there are no rules set in stone.
During the dog dying process, owners often feel anticipatory grief while their dogs undergo several physical, behavioral, and psychological changes during the transitional journey away from this world.
Early Signs a Dog Is Dying
Many dog owners will witness only the early signs of dying, considering that, upon noticing them, several dog owners elect euthanasia. Some dog owners who elect hospice care under the guidance of a vet, will witness the more advanced changes which often take place when death is imminent.
Many dog owners wonder when it is "time." The truth is, nobody knows this. We can only make an educated guess based on how the dog is feeling. Many vets suggest judging this based on there being more bad days than good.
When to put a dog to sleep is ultimately a personal decision considering that only owners know their dogs best. Many dog owners use quality of life scales as a measure, but not always these are accurate considering that, as mentioned, the dying process unfolds in dogs in different ways. For those considering hospice care assistance with their vet and natural death, a helpful quality of dying scale is offered by the Gratitude and Respect for Animals and Their Care at End of Life (GRACE) Consortium.
Death generally unfolds following several milestones, but not all dogs will stop at each milestone. Some dogs may skip some or go through them very quickly, while others may take months to reach the end of their journeys. It's important, therefore, to recognize that none, some, or all of the changes described may be observed.
You may stumble on some dogs who remain active, eating and being up on their feet up to their final day, while others may be sluggish and sleep for hours on end in their final weeks. There are no rules set in stone.
Described below are generalized early signs that a dog is dying. These signs start taking place months to weeks prior to death, although they may also show as well in dogs just days away from death.
Some dogs may show these signs and bounce temporarily back, while others may progress slowly towards a steady decline. Since dying in dogs is a process, it means that dog owners can actively take several steps to help their dogs through these changes.
We are so used to seeing our dogs in perpetual motion most of their lives that, the day they start acting lethargic, we tend to worry-and rightfully so. In the veterinary field the term "ain't doing right" (abbreviated in medical charts as ADR), is often used to depict a dog who is moping around and not acting as his normal self.
Lethargy, of course, is not necessarily a sign of dying in dogs and is not pathognomonic of something necessarily dire, but it can be one of the initial signs of some serious illnesses or the start of the dying process and tends to gradually worsen over time.
A dog may start sleeping more and seek isolated areas where he can be undisturbed. As time goes by, dog owners may notice how some behaviors may start reducing or disappearing from the dog's repertoire of behaviors.
The dog may no longer greet the owners at the door or may no longer be interested in going on walks or playing. The dog may get weaker and may start walking at a slower pace. The dog may also no longer groom himself as before.
As the lethargy progresses, the dog may start becoming reluctant in getting up to eat, drink and go outside to potty. The dog may lie down in the same area and position for extending periods of time. These are signs seen when the dog's body metabolism starts to fail.
How you can help: Let your dog sleep as much as he likes. Provide him with comfortable and quiet places to rest. Keep your dog away from loud noises, boisterous kids and the commotion of family members fighting.
2. Reduced Appetite
The dog may start eating less and may have a hard time finishing his daily portion. This reduced appetite may be a consequence of certain cancer treatments or part of a terminal illness.
For example, dogs with cancer may have nausea from chemo or they may fill up quickly due to certain tumors pushing on their digestive tract and therefore do better with small meals. Dogs with mast cell tumors may also have reduced appetite due to the fact that these tumors release histamines which cause increased stomach acid production and nausea.
Reduced appetite in dying dogs is natural. The body simply no longer needs the energy from food as it once did. Dogs may show a lack of appetite out of the blue, or the reduced appetite may go through ups and downs.
Many dogs will eagerly eat cookies and treats or some types of people food, but may turn their nose at kibble. Some dogs may eat only warmed-up meals. Other dogs may develop some new behavior quirks such as eating only if they are hand-fed or only if the food is placed on the floor.
As dog owners, we feel very aggravated by this loss of appetite because we associate feeding our dogs with nourishment and taking good care of them. Nothing hurts us more than observing our beloved dog walk up to the bowl, give a quick sniff at the food and look back at us as if the meal we just prepared with love was poison. On the other hand, nothing makes us happier than seeing our dogs dive into the bowl and gobble up food with great eagerness.
For dogs on medications, food is often used to hide capsules and tablets and things can get particularly frustrating when food is no longer desired. Dog owners often have to get particularly creative in getting their dogs to take pills.
How you can help: Warm up meals and hand-feed your dog. In the last days, feed him what he wants as long as it's not something toxic or that may cause digestive problems. There are medications vets can prescribe to increase appetite. Prednisone, mirtazapine and the newer product capromorelin (Entyce) are some options. As the dog keeps declining, soft to liquid meals may be preferred up to only accepting small amounts of water.
In any event, it is always best that a dog with cancer eat something rather than nothing. Your veterinarian can help you choose the best option for your dog.— Robin Downing, DVM
3. Weight Loss
As dogs eat less, weight loss is the common consequence. This can be quite upsetting for dog owners to witness especially when dogs become skin and bones. It is not unusual to see geriatric dogs who become very thin and emaciated just because of old age, but in many cases, this weight loss is due to some degenerative disorders such as chronic renal or hepatic inefficiencies and/or some types of potential malignancies.
In dogs with cancer, significant loss of body condition takes place. This loss of muscle and fat stores is known as “cancer cachexia." Cancer cachexia in dogs may take place even though a dog may be eating fairly well.
What happens is that cancer cells use up a lot of the dog's calories. This is not surprising considering how fast cancer cells tend to divide, and making all these new cells takes a whole lot of energy, explains veterinarian Dr. Damian Dressler.
How you can help: ask your vet for appetite stimulants and discuss the option of starting a diet high in protein and fat to combat the weight loss seen in cancer cachexia.
4. Social Detachment
As dogs approach the journey of death, they may seek more and more solitude. They may detach a little bit more each day from their routines and seek resting areas away from all the hustle and bustle of busy homes.
Before my uncle's dog passed, he reported that in the previous days his pretty collie dog was not showing up as much as before. He preferred sleeping in the barn rather than being present in the mornings to greet him and have breakfast as he always did in the past 10 years.
However, this is not a general rule of thumb. There are many owners reporting their dogs remaining very present and affectionate for most of the time. Some report them even being clingy, although at times they may still seek distance.
Generally, as death gets closer, the occurrences of the dog distancing himself will increase and owners report both physical and emotional detachment. Some dog owners even report noticing this detachment in their dog's eyes. "It's almost is if Ranger wasn't fully there when I looked into his eyes" my client reported when I asked her about her dog's days prior to ending the journey.
How you can help: Respect your dog's need for peace and quiet. Approach him quietly to prevent startling him. Calmly touch him and reassure him. Avoid loud noises or bright lights. Spray some Rescue Remedy in the room.
Imminent Signs a Dog Is Dying
While the above are early signs a dog is dying, there are some signs that are more likely to occur as dogs are days away from death. However, as mentioned, there are no rules set in stone when it comes to the dying process and some signs may pop up earlier in the process.
Most dog owners who elect euthanasia after witnessing the earliest signs may never witness the signs described here; however, in some cases it can happen that natural death in dogs unfolds either because the owners willingly elect to do hospice care with assistance from a vet or they may be dealing with a fast-moving illness that catches them unprepared (when vets are closed, distant or the caretaker is stuck in the middle of a storm).
It is always best to never be caught unprepared though. Most towns and cities have emergency vets on staff 24/7. Many vets now offer to do house calls. There is even a new franchise company called Lap of Love that specializes in vets offering hospice care and humane euthanasia at home.
Animal hospice accepts that it is the pet owner’s ethical and legal right and responsibility to decide whether the terminally ill animal will die by euthanasia or by hospice-supported natural death. Animal hospice does not accept a pet owner’s decision to allow a pet to die without euthanasia unless effective measures are in place to alleviate discomfort under the care of a licensed veterinarian. Such practices are considered unethical and inhumane.— ~American Animal Hospital Association
5. Reduced Mobility
As the dog nears death, he will become less mobile. The dog may start getting weak and no longer have much strength in getting up. His legs may start giving out. He may have trouble climbing stairs and difficulty navigating slippery floors. As things progress, the dog may no longer be able to get up and walk around. Some dogs may struggle to lift their heads.
How to help: Provide nonskid flooring. Some dogs require assistance getting around. There are several mobility harnesses, slings, carts and wheelchairs available nowadays. A towel or blanket placed under the dog's belly may come handy to help support his weight. As your dog no longer gets up to potty or drink, place some incontinence pads underneath and offer water as needed as long as the dog can swallow.
6. Decreased Drinking and Eating
Water and food are meant to provide energy and hydration, but these elements are meant to sustain life, not death. It is normal for dying dogs to start wanting only soft foods and then only liquids such as bone broth or water.
Owners may notice that, as the dog advances through the journey, swallowing ability gradually reduces. Dogs may be seen having a hard time chewing hard foods like kibble and they may be seen coughing and choking on solid foods. As the dog's digestive system starts getting weaker, eating solid food starts turning into discomfort more than something that's appreciated. On top of that, dogs may weaken and no longer walk to the water bowl as usual.
How to help: If the dog is mobile and able to swallow, ensure easy access to food and water. If the dog in a weakened state, caution is needed when offering water. Forcing water down a dog's throat in a dog with no swallowing ability may cause choking and aspiration pneumonia. Also consider that if your dog is on medications, dehydration may potentiate their effects. Consult with your vet for instructions to avoid side effects.
This refers to both bladder and bowel incontinence. In the dying dog, this may occur due to lack of sphincter control or the dog may soil because he is very weak and no longer can get up and move around as he used to. As the dog stops eating and drinking, accidents will occur less frequently considering that gastrointestinal functions are starting to shut down.
How to help: Keep pads under your dog if he is no longer mobile, and clean up messes as soon as you can. Failure to clean up may lead to sores from the waste irritating the skin.
Sometimes during the journey, dog owners may notice their dog becoming restless. It's important to understand whether this is part of the dog transitioning or whether the dog is in discomfort either due to pain or some needs that to be addressed. Dogs may pant, get up and change resting spots frequently, lick their paws or vocalize.
A dog who is unable to walk and laying down most of the time may be trying to communicate a need to drink, relieve himself, or perhaps a need to be turned. Dogs like humans who are bedridden may develop bed sores and pain if they lie on the same side for hours on end. It's important to turn these dogs every 2-4 hours as needed. This is a two-person job, with one person holding the front legs and the second person holding the rear, while the dog is gently turned from one side to another.
Some dog owners report a surge of energy a few days prior to a dog's death. The dog suddenly walks or eats and appears to have more energy. As pleasant as this is, it's often short-lived and not a sign of getting better, rather, it's often a sign of nearing death. Indeed, just afterwards, the signs of dying return and are often more pronounced.
How to help: Determine whether your dog is too hot or cold or whether he is thirsty or needs to be turned. Keep calming aids on hand in case of need. Talk to your dog softly with a gentle touch.
Pain in a dying dog is not unusual. Dogs owners may have pain relievers on hand from the vet. Dogs who are unable to swallow though may require drugs given by injection. These can be provided by a vet specializing in hospice care. Homeopathic remedies may be suitable to ease some discomfort due to the fact that the pellets can be placed in the mouth and melt.
How to help: Have your vet check on your dog and keep quick acting pain meds handy.
When an animal hospice patient is in the last hours of life, recognition and alleviation of pain are top priorities for the pet owner and the healthcare team. Pain should be addressed as soon as it is suspected, when physiologic or behavioral signs are noted. Contrary to a common fear, there is no evidence to suggest that pain suddenly intensifies during active dying.— American Animal Hospital Association
10. Labored Breathing
You have been familiar with your dog's breathing for many years, and now you notice that your dog's breathing pattern is changing. As dogs near death, it is common for their breathing patterns to change.
This change may take place just hours or days prior to death and is a sign that the dog's body is beginning to slowly shut down. The breathing can appear as slower and irregular and attentive dog owners may notice some pauses between breaths. As death nears, the dog may open and close his mouth.
While changes in breathing patterns are common when death is near, labored breathing may also take place when a dog is running a fever, is in pain or has fluid in his chest.
How to help: Ask your vet to check on your dog and make sure he is not congested or in distress.
11. Change in Gum Color
Looking at the dog's gums is an optimum reference when it comes to determining a dog's health status. In a healthy dog, you want to see nice bubblegum pink gums. These pink gums are proof of oxygen-rich blood circulating throughout the dog's body. The gums are alsl typically moist.
In a dying dog or in a dog in critical conditions, the gums and tongue tend to turn gradually pale to perhaps bluish and then eventually white. The mouth also turns dry, but in dogs who cannot swallow, fluid may leak from the mouth.
How to help: There is nothing you can do to reverse the mouth dryness and the color in gums as it's caused by reduced circulation, but you can help keep the lips and gums moist with lukewarm water using a cotton swab if the dog appears to appreciate this.
12. Cool Body
As death approaches, the body cools down because of reduced circulation. Owners often notice cold paws and the breath may feel cold. This is normal considering that the body temperature lowers by a degree or more and the blood pressure lowers.
How to help: Keep a very light blanket on your dog for comfort, but make sure it's a very light one only as a regular blanket may feel very heavy on a dying dog.
What to Know About Death and Transition
After a dog displays some or several of the signs described above, death takes place. Sometimes muscle twitches may be seen after death. Breathing or gasping may be noticed too; it's not to get oxygen though, but a reflex of the nerves. These bodily reactions are part of the natural event of dying and should not be interpreted as suffering as the dog is not aware.
The bladder or bowels may empty. Diarrhea may seep out. Keeping towels under the dog may absorb messes. The eyes of a dead dog remain open. After a few minutes, it's normal for the cornea to assume a glassy appearance. Death rattle is not as common in dogs as it is in humans.
Death is usually confirmed by using a stethoscope and listening for lack of a heartbeat, but what is death? Death is the collapse of the dog's cardiovascular system, which translates into failure of oxygen delivery to the dog's tissues and cells which once supported life. It's the end of the journey.
Death in dogs may occur naturally or through injection of euthanasia solution by the vet. Most dogs are euthanized by a vet, but more and more owners are now electing hospice care for their dogs with the assistance of a vet. Hospice care doesn't mean that euthanasia is never considered. On the contrary, it is considered, but as a last option should the dog be in unmanageable pain.
It's important that dog owners remain in constant touch with their vets during this time and that they keep on hand injectable pain relievers should their dogs no longer be capable of taking pills by mouth. Keeping in touch with a vet specializing in hospice can help ensure the dog is comfortable as much as possible through the process.
As seen, death is quite a journey. It is part of life and sadly it's one that all of us dog owners will eventually have to face at one time or another. As the saying goes though, "forewarned is forearmed" and therefore being acquainted with the dying process in dogs offers an important advantage.
Although several of the signs depicted here may be indicative of impending death, it's important to recognize that they may also be signs of several conditions that require treatment and may not necessarily result in death. If your dog is old or was diagnosed with a terminal disease, keep in contact with your vet or seek the aid of a hospice vet.
- American Animal Hospital Association:2016 AAHA/IAAHPC End-of-Life Care Guidelines
- Gratitude and Respect for Animals and Their Care at End of Life (GRACE) Consortium Peaceful: The Quality of Dying Checklist
- When Your Dog Has Cancer: Making the Right Decisions for You and Your DogBook by Lola Ball
My Dog Is Dying: What Do I Do?: Emotions, Decisions, and Options for Healing Wendy Van de Poll Center For Pet Loss Grief, Mar 2, 2016
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© 2018 Adrienne Janet Farricelli