aging dogs

Wisdom … and Resignation

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2 golden retrievers and a black Lab swim in a mountain stream
Cali’s Morris study exam is always around the time of our first visit to Packer Meadow and the very cold stream there!

It’s that time of year. Cali always knows. She saw me setting out a small paper plate, ziplock baggie, and a poop bag one evening, and she knew. No breakfast in the morning, and a visit to her pals at the vet clinic who would steadfastly refuse to give her cookies, no matter how good she was.

It was time for her annual Morris Golden Retriever Lifetime Study physical exam. She’s usually pretty resistant to the sample collection, particularly the urine sample.

I think that, with Cali’s advancing age and important new role as the teacher of all good things to Orly (you know, how to thoroughly coat yourself with mud, which plants to chew in the garden while avoiding all the weeds, and the most strategic spots to dig holes in the lawn), she has also learned wisdom and patience. She knows how this day will unfold and, for the first time, she (mostly) cooperated.

I took her out, on leash, first thing. She gave me a disgusted look when I grabbed the plate and baggie, but went willingly. She did not stop peeing when I shoved the plate into place and she did not kick it. Progress! She provided her other sample during our walk.

At the vet’s she briefly objected to going into the back area without a cookie … she was hungry, after all. Once all the samples had been collected and she’d been examined from nose to tail, Cali showed me how well she had trained our vet. As the doc and I talked, all Cali had to do was shift her glance slightly and Dr. Z handed over a cookie or a squeeze of cheese whiz. Cali’s consistent, clear communications were quite impressive!

Best of all, we were out of the vet’s office in well under an hour, and Cali’s breakfast was duly served. Late of course.

As a Golden Ager, Cali — along with other study participants — has been invited to be part of an additional study about aging. Cali doesn’t have to do anything; her mom gets more questionnaires to fill out. With her white face, she increasingly looks like a senior dog, but Cali is aging well. She’s fit and energetic; she loves playing with Orly and going hiking. Let’s hope she has many more annual study exams ahead!

Koala’s Day Off

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Black Lab Koala runs with a red and white fabric frisbee on grass
Girls just wanna have fun sometimes!

Sometimes, a girl needs a day off.

Koala let her boss know that a couple of weeks ago. It was a Saturday, and they were going for a walk. A nice leisure activity — for the human. But Deni wanted Koala to guide. To work. After a long week filled with lots of work.

Koala wanted a day off. She wanted to wander and sniff and run on the grass (and maybe go into the water…?) … not work.

Koala is pretty clear in communicating what she wants (or doesn’t want) to do. If she doesn’t want to work — and, this is critical, she knows that her work is not essential — she slows down, gives Deni that look, and indicates that she’d rather head toward the grassy park or lie down than put on her harness.

She does have a strong work ethic, and if Deni and Koala are in any kind of situation where Deni needs Koala to work, Koala excels.

But, more and more, she has days when she’d really rather not (I can relate!). She might be dreaming about retirement, though she’s still a relatively young 7-and-a-half years old.

Or, she might be reading up on the Great Resignation / Great Reshuffle. And, like millions of other American workers, she might be re-thinking her work-life balance. I’m guessing that Koala has realized that there’s too much work and not enough life in that mix.

A friend asked me not long ago when I get a full day off — not only off from my job, but free of all types of work, errands, obligations, and other have-tos. I rarely do — and Koala is likely in the same boat.

The great thing about giving Koala (or any dog) a “day off” — a fun day — is that it feels like a day off for the human(s) too: I’m getting ready for a visit to the dog beach with Koala, as I am taking (most of) a day off following a busy work week at a Florida conference. I think it will do both of us a lot of good!

But even on regular work days, I think we all need to build in some fun time for ourselves and our dogs, especially the ones with demanding careers. If Koala gets more time to run and play, will she return to work with more pep and enthusiasm? It’s worth finding out.

 

What Happens When a Service Dog Retires?

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Yellow Lab Ryan and Black lab Koala relax in a play tunnel
Ryan, left, and Koala, enjoyed a short vacation in Florida just before Ryan’s 2020 retirement.

When a service or guide dog is no longer able or willing to work, what happens?

Many of them stay with their families, living a life of leisure, enjoying many belly rubs, and watching some young whippersnapper do “their” job. Poorly, of course.

But not all people who partner with service or guide dogs can keep their retired partners. There are many reasons for this: Some are elderly folks or people who live on a very tight budget, and they simply cannot care for a second dog. Some are busy professionals who travel frequently and feel that they owe their retired dog a better life than frequent stays at a kennel and long, lonely days while they — and the new dog — head to work. Sometimes a guide or service dog retires because their partner dies or becomes seriously ill.

Whatever the reason, the guide or service dog’s partner or family often looks for a retirement home for the dog. Often extended family eagerly step up: Deni’s first guide, Oriel, spent a couple of years with family in Indiana before moving to Florida to live with us. Alberta, who retired young due to an eye tumor, lives with Deni’s nephew & family, including her new charge — a human puppy!

If family placement is not an option, many guide dog partners ask dog-savvy friends and acquaintances; I was a finalist in the retirement-home search for a Guiding Eyes dog recently, but the dog opted to stay closer to her partner rather than move to Montana (her loss …).

When neither of those options works out, guide and service dog schools generally place the dog with someone on their extensive waiting lists. These are usually volunteers, donors, puppy raisers (perhaps even that dog’s puppy raisers!), or others with ties to the school.

The dogs never end up panhandling for cookies or living under a bridge somewhere.

How Old Is Your Dog?

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Golden retriever Cali relaxes in the grass with a tennis ball
Cali keeps fit to stay youthful

How old is your dog in “human” years?

We used to just assume that a “dog year” equaled seven human years and estimate our dogs’ human-age-equivalent with a simple multiplication. Cali is 7 1/2 years old (calendar years) so she’s  … roughly my age in human years. (She still has a lot more fun though.)

Turns out that that doesn’t work.

Sometime last year, I first saw a chart that estimates dogs’ ages with adjustments for smaller- and larger-breed dogs since smaller dogs tend to live longer. Cali’s vet has this chart hanging on the wall, and I have seen it several places online. Essentially, in a dog’s first calendar year, she matures about as much as a human does during her first fifteen years. Then in year two, while your human offspring is a terrible two, your dog becomes almost civilized — roughly as mature as a 24-year-old human adult.

Guess what? According to this chart, Cali’s human-age equivalent is … drum roll … roughly the same as my age. And exactly the same as the old “7 years” trick.

But … yeah, that one doesn’t work anymore either.

Now we’ve got a shiny new method of calculating dogs’ ages. All you need is an advanced degree in mathematics …

Seriously. According to the Washington Post, all you have to do is “Multiply the natural logarithm of the dog’s age by 16, then add 31.”

Easy-peasy. Wait, what’s a natural logarithm??

Wikipedia to the rescue: “The natural logarithm of a number is its logarithm to the base of the mathematical constant e, where e is an irrational and transcendental number approximately equal to 2.718281828459.”

Or … not.

I have no idea what Cali’s age-equivalent would be with this formula. I’m going to just pretend it’s something like 25. And holding.

 

 

Cali is 7!

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Cali turned 7 a few days ago!

Naturally, we celebrated at her favorite place in the world, conveniently located a short walk from home: Big Dipper ice cream. I know, it’s December. Cali does not feel the cold. Or have much sympathy for anyone who does.

We got our order (to go) and she collected and devoured her puppy cone.

The real treat was the cup of vanilla ice cream she got to eat at home. A few photos, above, show her delight.

Coincidentally, this week I heard about a new way researchers are calculating a dog’s human age equivalent. The common formula of a dog aging seven (human) years for each calendar year is too simplistic.

This new method looks at changes in our DNA over our lifetimes and compares dogs’ DNA changes to map a roughly equivalent human age onto the dog. There’s a calculator at the link above. The study used Labrador retrievers, but claims that the mapping is similar for all dogs. I am curious about whether they will repeat the research on smaller-breed dogs, because those dogs tend to have a longer lifespan so it seems like the mapping might turn out a little different.

In any case, Cali, a golden, is similar to a Lab in size and typical lifespan, so I checked out her age.

I was not happy with the results. Under the old mapping, she’d be roughly at the same life stage as a 49-year-old human; under the new mapping she’s 62!

The aging seems to slow way down after the first year, though. A 1-year-old Lab is roughly equivalent to a 31-year-old human, while a 13-year-old dog maps to only age 72.

Whether she’s 49 or 62 or 7, Cali is still a puppy at heart, silly and playful. And I hope she stays that way for many more years!

Tips for Keeping Older Dogs Safe and Comfortable

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A beloved friend, Molly, turns 14 today (November 13). Happy Birthday, Molly!

In her honor, I wanted to share some tips for helping older dogs stay safe and comfortable.

When Jana started having trouble getting up because she slipped on the smooth floors, I followed a tip from my aunt and got rubber mats. They are not the most attractive addition to household decor, but they work. Yoga mats can be used as well. The most important place to put them is near the dog’s bed(s). We lived in a tiny apartment, and I put them all along the hall and in the bedroom, giving Jana a non-slip path from bed to door. Oh, and the bed? A really nice, big, memory foam dog bed from Costco. Jana sure loved to sleep on the floor next to that bed …

Keep the dog as active as is feasible. Even a slow walk is important. It gives the dog a chance to stretch her legs, move around, sniff and catch up on the neighborhood news. Even when she was well past even pretending to want to play ball, Jana wanted to walk with Cali and me to the park, where she greeted friends, begged for cookies, and rolled in the grass.

Keep nails trimmed. Long nails can hurt when the dog walks. They also exacerbate any balance or joint issues, which are common in older dogs. Many dog owners neglect their dogs’ nails. Even if long walks on sidewalks kept the nails to a reasonable length when the dog was young, an older dog who walks less (and experiences poor balance and possible joint pain) is likely to need more attention to the nails.

Make it a priority to do activities that you know your dog loves doing. A huge regret I have is not taking Jana to the dog beach more often. Other activities she enjoyed included hanging out at the corner cafe (sans Cali), solo walks, sunning herself in the yard, visiting her friend in a nearby office, and any activity that involved cookies.

If there are younger pets or kids in the family, teach them to treat the senior with gentleness and respect, and intervene if necessary to ensure that the youngster doesn’t push the older dog around or treat her roughly.

Make sure that her food and water bowls are in a place that’s easier for her to reach, or elevate them so a large dog doesn’t have to lean (that balance again …) down to eat and drink. Jana seemed to really appreciate her elevated bowls.

Take a look around your house. Are there stairs that the dog has trouble navigating? Does she have trouble getting into or out of the car? We had no stairs, so that wasn’t an issue for Jana. I kept the passenger seat in the car moved up so she could easily step into the foot space and then onto the seat. She needed help sometimes, but preferred to get in and out alone. When she was weak, though, I used a sling to help lift her into the car. A towel works in a pinch. If you do have stairs, and your dog is prone to stumbling or becoming confused, consider blocking the stairs with a baby gate for safety. When we were in a house with lots of stairs, I would block the stairs to discourage Jana from following me if I ran up to get something. She always wanted to follow me, but if I was coming right back, I wanted to spare her the effort and pain of extra trips. She disagreed, so I used the baby gates.

Look into supplements, medications, and alternative treatments than can help with chronic issues, especially pain. I limited the amount of Rimadyl that Jana needed by taking her for regular laser therapy treatments, which reduced her arthritis pain and stiffness. Not all dogs respond to the same treatments, so you might need to try a few different things. But once you hit on something that helps, you will know; the dog will be more playful and happy. Some of the lying around and sleeping is a response to pain, not an inevitable part of aging.

Get regular vet checkups. I took Jana in for checkups and blood work twice a year after about age 8. Watch for behavior changes and discuss them with your vet. Some older dogs get a form of dementia. Learn more about what that looks like on this blog: Dog Dementia: Help and Support. Regular vet visits are a great place to learn about supplements and treatments; I also recommend the Whole Dog Journal and Dogs, Naturally; both are great resources. Also, consider a home visit from a palliative care vet. A veterinarian with expertise on aging issues can look around your house and recommend steps to make it safer and more comfortable for your aging dog. She might pick up on behaviors or problems that you hadn’t noticed or had gotten used to.

Older dogs are great company, and, like any longtime friend, you want them to be with you forever. Keep your senior dog safe and comfortable, and treasure every day you get to share.

 

 

A Scary Incident (That Ended Well)

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Jana and Cali_post vestibular_crop

Jana’s had a rough week.

She’s dealing with something that is fairly common, but a lot of her friends and family weren’t familiar with it: vestibular disease. It’s also called “old dog vestibular disease,” since it is especially common among older dogs. But Jana regards herself as neither a dog nor old, so we’re just calling it vestibular disease.

It shows up suddenly and looks for all the world like your dog has had a stroke. She might have. She also might have an inner ear infection, a brain bleed, a brain tumor — or none of these. Most vestibular incidents are idiopathic. A fancy way of saying the vet has no idea why your dog cannot stand up or staggers around like she’s drunk. Very drunk.

In Jana’s case, she woke up in the middle of the night and struggled to stand up. I know this because what woke me up was the sound of her flailing and falling. I calmed her down and we went back to sleep. In the morning, she could not walk. I got her outside to toilet and then into the car. Her vet offered the suggestions of vestibular disease, inner ear infection, or tumor. The tumor idea arose primarily because Jana’s left eye looked much larger than her right and was bulging a little.

I got her home and settled her in the yard. She spent the weekend struggling to stand and unable to walk without a lot of help. But by Sunday afternoon, she was noticeably better. I made arrangements with two wonderful individuals, our longtime friend Sally and our new dog walker, Stephanie, to care for Jana on Monday and Tuesday, as I had work meetings that I could not miss.

By Monday afternoon, Jana was taking herself outside. She was very unsteady and fell a lot but did not want help.

Since she’s a golden retriever, it might be unnecessary to mention that her appetite did not suffer a bit during any of this, but she needed help eating.

The vestibular system is what helps you balance and orient your body. Hers was way out of whack. This was not paralysis or muscle weakness. It was extreme dizziness and disorientation. She got meds for the supposed nausea (though she never seemed nauseated) and for the possible inner ear infection. She slowly recovered, walking a bit better each day, all week, and we went for a neurological consult at the end of the week. The neurologist said that her excellent progress, along with the improvement in her eye, indicated that a tumor is not likely. The only way to know for sure whether she has (or does not have) a tumor and to figure out (maybe) why this happened is an MRI and spinal tap. I’m not doing that for a number of reasons.  If Jana stops improving or gets worse, I will have to figure out next steps. But right now, she’s doing well.

It’s important to know several things about vestibular disease.

One is that it’s not painful. It is probably scary and miserable, though. I had an inner ear infection once and was horrifically dizzy. If Jana was experiencing anything like that, she has my sympathy. She was also much more of a trouper than I was; I couldn’t even keep water down. She scarfed down cookies, water, meals … a true golden.

Another is that most dogs recover — and quickly. The most significant recovery happens in the first two or three days. Many dogs have a wobbly gait and maybe a head tilt for a week or two. The head tilt might never go away. Jana’s head tilts noticeably to the right when she’s standing up. When she’s lying down, I don’t see it. And it too is a little better every day.

Many dogs recover and continue living perfectly normal lives, though some have additional episodes. Some have permanent effects — a limp, unsteadiness, the head tilt.

Finally, it’s important to emphasize that Jana had no personality changes, no cognitive damage — she’s still very much herself. As soon as she could stand, she was asking to go out on her own, did not want help, and did not want me or anyone else hovering over her. She was back on the job, demanding that I let her out to get the paper, by Tuesday morning.

It’s scary to wake up to a dog who cannot stand up. It is also scary to have to figure out how to get a 60-lb. dog outside to pee or into the car when she cannot support her own weight. We really need 30-lb goldens. If she had not recovered quickly, I would have had to make some hard decisions. I was very relieved to see Jana trying to stand, and, slowly, getting her bearings back.

A vet tech who takes care of Jana said that lots of owners panic when they see their dogs’ initial symptoms, and many make the difficult choice to euthanize. So I want to emphasize again that dramatic improvement in the first two-three days is the norm. If that is not what happens, then the dog might have something other than vestibular disease.

Cali was concerned and attentive throughout all of this — to me and to Jana — but also worried about missing her ball time and park visits. She bumped into Jana a few times before understanding that she needed to be more gentle. She’s been remarkably patient overall, though, and very good company.

Jana is still unsteady, but she doesn’t fall every time she shakes off or turns a corner. She’s cautious on steps, but we only have a couple of small ones. She wants to go for walks and visit her friend in the neighborhood. She wants to sniff and check out the news and get to her favorite grassy patch. I’m looking forward to the day that she’s stable enough to head out to the coast for a beach day. We all deserve one.

Does Jana Need Glasses?

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Jana and I are both learning the effects of getting older firsthand. I’ve written about her increasing anxiety, which I attribute, at least in part, to declining acuity in her vision and/or hearing. Now I have scientific backup: Jana might need glasses.

Jerome Hernandez and five other authors published a paper in February that investigated whether ophthalmologists’ tools could be used to measure the effects of aging in dogs. Turns out they can. “Dogs, like humans, experience eye changes with aging, i.e., hardening and clouding of the lens and accumulated oxidative damage from UV sunlight. Development of cloudy lenses in older dogs, referred to as nuclear sclerosis, occurs with the aging process,” the authors say. Many pet owners think that this cloudiness is a cataract problem; it usually is not, and it generally does not significantly affect the dog’s vision.

The researchers used with the dogs a “refractive evaluation” technique that is commonly used to assess vision in pre-verbal children. Now, many humans notice that, as they age, it gets more difficult to read things that are close up. When their arms are not long enough to compensate, they get reading glasses. With dogs, it’s the opposite. They become nearsighted, which means they have greater difficulty seeing things at a distance.

Here’s where Jana and I have something in common! I’ve been nearsighted since I was about 12, but I’ve noticed my vision changing a bit lately. But not for reading; like Jana, I seem to become more myopic with age. I’ve noticed that she has more trouble finding me again when she wanders across the large field where we play in the morning. She also seems to have more trouble hearing me call her, but selective hearing is not an age-related issue in Jana (or most dogs); that problem shows up in very young dogs.

Joking aside, I do think that her hearing is less sharp. She seems to be startled more easily, especially by cars approaching from behind us on our walks.

I haven’t had Jana’s eyes (or ears) checked, but this article backs up my suspicions. Jana’s world is getting a bit fuzzier, and that makes her feel less secure. If her hearing is also less sharp, that would compound her confusion and insecurity. It happens slowly, but those of us with aging dogs need to be aware of these changes. While I don’t know of any purveyors of doggie glasses and hearing aids, we can help in other ways: Using larger hand signals when trying to communicate across distance, for one, and going over to the dog if she seems confused or agitated.

The article is available on PLoS One here; and an article about it by Dr. Stanley Coren is here.

 

Jana’s Fine … For Her Age

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I recently had a health scare with Jana. She’s fine, but it was worrisome. Added to a number of recent losses among my friends whose dogs were Jana’s contemporaries and, well, it’s rough.

Jana was in for her semiannual check-up. She gets far better health care than I do, but then again, in human age, she’s nearly 90. I hope I am as healthy, energetic, and playful when I get there!

Anyhow, during a brief ultrasound, the vet saw what looked like a mass on Jana’s spleen. She recommended a more thorough ultrasound and exam. In the days between the checkup and the exam, I had time to Google, ask around, and worry.

I read up on spleen tumors and treatments. None of it sounded good. I thought through the various possible scenarios. I hugged Jana a lot. She hated that.

The exam, I am pleased to say, showed nothing more than some discolored patches on Jana’s spleen. Jana has the heart and lungs of a much younger dog, is at her perfect weight, and has nothing more wrong with her than some (severe) arthritis. Except for the arthritis, she’s in better shape than I am.

But I see signs that she’s more frail. She stumbles sometimes. Has senior moments. Has mornings when she chooses to go back to bed rather than trek to the park. But there are also days that she asks for extra walks and rolls happily in the grass or wants to play tug or catch.

Another sign of her age is anxiety. When she’s anxious, she barks at … well, I can’t figure out what. I think she’s not seeing as well as she used to, and she gets startled more easily. I’ve tried several remedies for her anxiety. Some of them help some of the time. Treatibles are her favorite; she’ll often go into the kitchen, stand in front of the cabinet where I keep them, and bark. Melatonin, a new addition to the lineup, also seems to help. Sometimes a Comfort Zone plug-in helps; sometimes a wrap. If our friend Christina lived closer, she could offer regular Reiki treatments; that would probably help a lot.

Sometimes, though, when she’s agitated, Jana just wants to play. Or even (those who know Jana will know just how rare this is) cuddle! Those are my favorite remedies.

Older, Wiser … and Far More Painful

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Opening birthday presents helps keep Jana young and happy!

We celebrated Jana’s twelfth birthday recently. Her friend Leti (also a golden retriever) just turned 15.  These girls still walk to the park nearly every day and enjoy a vigorous roll in the grass. They make the rounds, saying hello to the other dogs’ people and trying to cadge a cookie or two from each human.

I do everything I can to see that Jana’s quality of life remains high. Despite their good health, both girls are showing signs of their age. Jana has severe arthritis and wakes up feeling stiff and painful many mornings. Though she’s usually very sharp mentally, I’ve noticed a few senior moments, when she seems to be a bit confused.

Hoping to deal with both those issues — without breaking the budget — I’ve put together a regime of supplements and exercises that help Jana a lot. If you have an aging dog, some of this might be helpful. I have no veterinary training, but I do check everything with my vet and vet techs before I try it on Jana, and I recommend that you do the same:

  • Even Cali, age 2, is taking a small amount of glucosamine each morning. It helps ease joint pain. Some people take it, too, particularly for knee pain.
  • New Zealand Green Lipped Mussel. Jana takes one green mussel capsule daily, emptied onto her breakfast. Like glucosamine, it can help people and dogs with joint pain. Jana behaves very differently when she’s talking it — asking to go on walks and soliciting tug games — so I am convinced that it helps.
  • Fish oil. Each girl gets two fish oil capsules a day. The omega-3 is as beneficial for them as it is for humans, and the dogs like the fishy taste. They get sardines once or twice a week as a treat for the same reason.
  • Coconut oil. A spoonful a day is great for their skin and coat. Coconut oil also might help with brain energy and metabolism (Thanks to Tom Morrare for sending me the link to this great article!), and it has anti-inflammatory properties (in lab rats, anyhow).
  • Turmeric, another anti-inflammatory. Jana likes spicy food; for some dogs, turmeric capsules or tablets might work better than the powder. Also, the bright orange powder stains everything it touches. If your dog is prone to tummy issues, you might want to use tablets.
  • Rimadyl or one of the generic equivalents. The active ingredient, carprofen, is an NSAID for dogs. It reduces inflammation and therefore pain. It also can cause liver damage if given in high dosages or for a very long time. Since I have started giving it to Jana regularly, I will make sure to get bloodwork done every six months.
  • Cold laser therapy. Jana goes about once a month. Some dogs get it more often; some less. Figuring out the frequency is a complex formula that factors in cost and distance and time. The treatment really seems to help keep Jana limber and, if not pain-free, certainly far less painful. It stimulates blood flow, healing the tissues and reducing inflammation, thereby reducing pain. I get Jana as many laser therapy sessions as I can so I can reduce the amount of Rimadyl she takes.
  • Jana does daily exercises on an inflated exercise disc, as recommended by her laser therapist. The idea is for Jana to strengthen the muscles that support her arthritic joints. She’s also working her core and having a great time. She’ll “dance” (prance, alternating paws) and turn around on the disc and balance with front or back feet. Cali usually joins in.
  • Treat toys. There are many. Jana’s favorites are Squirrel Dude and Nobbly Nubbly, both from PetSafe, and the Kyjen Cagey Cube. Other dogs will like different toys; these are the ones that hold Jana’s interest, even if I give them to her over and over again.

There are other options that we have not tried (or haven’t tried yet) or haven’t liked: Adequan injections, for example, which is used for arthritis pain; acupuncture, which Jana didn’t react well to; surgery; massages and body work; Chinese herbal treatments … the list is long. If you find something that works for you, let the Thinking Dog know at thinkingdogblog@gmail.com!

The important elements are to keep the dog moving and challenged — physically and mentally — and as pain-free as possible. Jana has jobs as well: She gets the morning paper, brings my shoes when we’re getting ready to go for a walk, and picks up the bowls after each (doggy) meal. She loves interactive toys where food or a tennis ball are hidden or trapped (her favorites are mentioned above); she’ll spend a long time trying to figure them out, whereas Cali gives up much more quickly.

It’s also important to make sure your older dog has a comfortable bed (in Jana’s case, so that she can sleep next to it) and is warm in cold and damp weather. I’ve put down rubber mats so she no longer slips on the bamboo and linoleum floors. I haven’t gotten her a ramp or stairs yet, but I do have to help her into the car.

My goals are to reduce Jana’s pain without heavy use of pharmaceuticals and maintain her quality of life. I started with the supplements and only added a small amount of Rimadyl when Jana was clearly painful. I want to accomplish all of this at what I consider a reasonable cost. Obviously, this means something different to everyone. And I understand that not everyone is willing to spend several minutes measuring out supplements at each meal or hours schlepping a dog to a laser appointment. Every individual dog and family needs to figure out what works best for them.