Care Guides

You will almost certainly not notice the day your dog stopped enjoying her walk. Decline in an old animal does not arrive, it seeps, and the people who love the animal most are the worst placed to see it. We adjust as fast as they fade. The stairs get a ramp, the walk gets shorter, the bad night becomes normal, and then one afternoon somebody who has not visited in six months says something careful and kind and you realise how far things have gone.

That is the whole reason to use a structured quality-of-life scale rather than your own impression. The best known is the one built around hurt, hunger, hydration, hygiene, happiness and mobility, finished with the honest question of whether there are more good days than bad. You score each one out of ten, once a week, and write the number down. The score itself is not magic. What it does is force you to look at six things separately instead of blurring them into a general feeling that everything is more or less all right because she still wags her tail when you come in.

Hurt comes first, because it is the one most often missed and most often fixable. Animals in chronic pain rarely cry out. They pant at rest. They shift position constantly, or stop shifting at all. They stop jumping onto the sofa and you decide they have lost interest in the sofa. They get slow to stand from lying, they sleep somewhere new, they go quiet, they get short-tempered with the other dog. Cats are subtler still: a cat in pain mostly becomes less. Less grooming, so the coat over the hips and the base of the tail goes matted and greasy. Less jumping. Sitting hunched with the feet tucked in, in a room they never used to sit in.

Take that list to your vet and ask for a pain plan rather than a prescription. Modern veterinary pain control is layered — an anti-inflammatory where the kidneys and liver allow it, a nerve-pain drug alongside, monthly injectable arthritis treatments for dogs and cats that did not exist a decade ago. Ask specifically for a two-week trial of proper analgesia if there is any doubt. It is remarkable how often "she is just old" turns out to be "she has been sore for a year". And never reach into your own bathroom cabinet: paracetamol kills cats, and ibuprofen causes ulcers and kidney failure in both species.

Alongside the weekly score, keep a diary. Three lines before bed is enough. Did she eat, did she drink, did she get up on her own, were there accidents, did she come and find you, and was today good, average or bad. Put a green dot or a red dot on the kitchen calendar. Nobody can hold four weeks of an animal's decline accurately in their head, but anybody can look at a month of dots and see that the reds have taken over. That calendar is also the kindest possible answer to the question that torments people afterwards — how would I know? You will know because you wrote it down.

The practical side of hospice at home is mostly about dignity and dryness. A washable waterproof protector under the bedding saves you both a lot of misery. A thick orthopaedic bed in the room where the family actually sits, not tucked away in a quiet corner where they will be alone. Water within a couple of steps of the bed, food offered little and often, warmed to bring out the smell. A litter tray with one low side for a cat who cannot climb. For an animal who cannot stand, turning them every few hours prevents pressure sores, and keeping the back end clean and dry matters more to them than we tend to credit. A towel folded under the belly as a sling gets a big dog into the garden with their pride intact.

Appetite will come and go. Warm the food, try strong-smelling things, hand-feed if that is what it takes, and ask the vet about anti-nausea medication and appetite stimulants. But do not slide into syringe-feeding a dying animal without talking it through first. There is a point where feeding is something we do for ourselves.

Plan the ending before you need it. If you choose euthanasia at home, a vet comes to the house, usually with a nurse. In almost all cases they give a heavy sedative first, under the skin or into the muscle, and over the next ten or twenty minutes your animal falls deeply asleep in their own bed with your hand on them. The final injection goes into a vein and works in seconds. There can be a last deep breath, some muscle twitching, eyes that stay open, and the bladder may empty. All of it is normal and none of it is distress. You can stay for all of it or step out. Decide in advance about aftercare — individual or communal cremation, or burial where that is legal — and settle the payment beforehand so there is no card machine at the worst moment of your year. Home visit slots are limited at most practices, so book earlier than feels comfortable; you can always cancel. Letting the other dog or cat see and sniff the body afterwards is usually recommended, and often stops them searching the house for days.

The last thing is the hardest to say and the most important. Most owners who look back with real regret regret waiting, not going early. The fear of acting too soon is precisely what produces the 3am emergency dash, the crisis in a strange room with strangers, which is the ending nobody wants. Ask your vet the plain question — if she were yours, what would you do — and most of them will tell you the truth. A quiet afternoon at home a week early is a gift you give an animal who trusts you completely. A week late is something you carry on your own.