Helping Your 'Good Old Dog' Navigate Aging Owners of aging dogs often struggle with their pets' dementia and incontinence — as well as navigating through end-of-life decisions. Veterinary behaviorist Nicholas Dodman talks about the best ways to care for your aging dog.
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Helping Your 'Good Old Dog' Navigate Aging

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Helping Your 'Good Old Dog' Navigate Aging

Helping Your 'Good Old Dog' Navigate Aging

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This is FRESH AIR. I'm Terry Gross.

Many dog owners who've enjoyed years of close companionship dread their dogs reaching old age. Our guest, veterinarian Nicholas Dodman, says that of the 4 million dogs taken to shelters every year, a million are given up because their owners say they're simply too old.

Dodman says old age isn't a disease, but a stage of life. He's collaborated with other vets from Tufts University, and writer Lawrence Lindner, on a new book called "Good Old Dog: Expert Advice for Keeping Your Aging Dog Happy, Healthy and Comfortable."

The book deals with what kinds of diets and exercise old dogs need, the diseases they'll face, and how to confront end-of-life decisions. Dodman spoke to FRESH AIR contributor Dave Davies.


Nicholas Dodman, welcome back to FRESH AIR. Let's start with when we think a dog enters old age. Everybody knows the old saw that one calendar year equals seven dog years. Is that about right?

Dr. NICHOLAS DODMAN (Author, "Good Old Dog"): It's not a bad sort of middle-ground reasoning. Perhaps it applies more to dogs in the 40, 50 pound range. But the smaller dogs live longer and larger dogs, very large breeds, live really quite short life spans.

So if you take dog years, for an older dog, you might want to multiply by eight or so to come up with its human equivalent years. And for small dogs - say, you know, 10 or 15 pounds - that number drops to six.

So if you took a young dog, a small dog who's 10, that might he might be equivalent to, you know, a 55- or 60-year-old person. But that same dog, if he was a giant breed, at 10 years old, might be more like an 80-year-old person.

DAVIES: Hmm. OK, so size matters. Let's talk about some of the, you know, basic things that we need to know about caring for an older dog. One of the things -you said that they are typically more vulnerable to heat and cold. So how should we take account of that as we take care of our pets?

Dr. DODMAN: Yes, well, they certainly are more sensitive to extremes of temperature, and that's something to bear in mind when you take your older dog out for a walk on a freezing-cold day in a 15-mile-an-hour, ice-cold wind - that they are unable to take charge of that.

They're really like old people. I mean, you know, older people are often the ones who are the victims of these sudden, you know, sort of freezing bouts or extremes of heat. It's the same thing with a dog. They're less able to thermo-regulate, it's called.

So you know, we have to take account of that by, you know, possibly - say, in cold weather, with a dog with a short coat, making sure that they actually have some kind of blanket-like coat or contraption on to sort of help keep them warm, and not keep them out so long in cold weather.

And same with the heat - that you really don't want to leave them out in the yard, you know - especially tied up - on an extremely hot day. They can dehydrate; they're less well-able to cope with the change in temperature; and it's a recipe for disaster.

DAVIES: Now, you tell us that you want to - certainly - moderate exercise as they get older because heart and lung function does deteriorate. But one of the more interesting parts here was diet. And there are a lot of dog-food makers that offer what they say is a senior-diet dog food. And you warn that some of these could actually be worse for the animals. How?

Dr. DODMAN: Yes, that's true. You know, the fact is that while there are some laws that govern - for example - what comprises a puppy food, and while there are recommendations and rules and regs concerning what goes in dog food, there's no real legal requirement or definition of what constitutes a senior dog food. So they're out there, but the composition is highly variable - from those that have fewer calories than have more calories, those that have lower protein and higher protein.

And what the pet food companies are doing is basically trying to tap into a market, and some of the things that they've done to these so-called senior foods are logical, but they haven't really been tried or tested. And sometimes, you can do more harm than good.

You might have a dog who, for example, is eating food with 400 calories per cup, and you're feeding him one or two cups per day to try and do the right thing by him. As he crosses some arbitrary line into what you consider to be old age, you switch him to a quote, senior diet. And that may contain as low as 250 calories or even a little lower per cup, or as high as 450 calories or 500 calories per cup.

On the one hand, if you go with a lower-calorie diet and feed him the same amount, he's going to lose weight. And you wonder why suddenly, he appears ill and weak. On the other hand, you feed him the high-calorie food and all of a sudden, he starts to gain weight, which is very bad for most old-age conditions.

So it's really bad to switch to these arbitrary diets without knowing what's in them, without calling the manufacturer, without talking to your vet. And basically, don't do it until there's a reason to switch the diet.

DAVIES: And I guess I should ask: What about table scraps? You know, dogs love them, and people have gotten used to giving their dogs leftovers. Bad idea?

Dr. DODMAN: Well, that's funny because, you know, I remember I did - many years ago - sit the National Board Exams, and there was a question on the National Board Exams to be a vet, which I sat 19 years post-grad because I graduated in England. And I passed, I'm happy to say.

(Soundbite of laughter)

Dr. DODMAN: But one of the questions was: Should you feed your dog table scraps? And the answers were: A, always; B, sometimes. Well, the correct answer was whatever was answer C, never feed them table scraps.

Now, I don't believe that for one minute. So my dog does get table scraps, and I'm proud of it. But the thing is you can't do this too much. I mean, it has to be very regulated, especially if the dog is on some diet.

I mean, you can really mess it up by feeding too much human food because the dog food actually is pretty well-designed to meet all their requirements for carbohydrate, fat and protein - and all of the additives and amino acids and vitamins and stuff that they need. And the more of something else you give them, the more you can unbalance that equation, Plus, you don't want a dog that sits at the side of the table and begs all mealtime.

DAVIES: Now, arthritis is common in dogs. I mean, a lot of people have dogs who will occasionally limp or just get stiffer with time. And I was interested to read in your book that the cause is different than in humans. Explain.

Dr. DODMAN: It is. You know, with humans - well, there's two types of arthritis in dogs and humans. There's osteoarthritis - which is, you know, kind of the bones get kind of rusty, as it were. You know, they've got little spikes on them, rough edges, and they grate and grind - osteoarthritis. And then there's rheumatoid arthritis. Well, both humans and dogs get both types, but the common type in old age is the osteoarthritis.

In humans, osteoarthritis is almost exclusively a wear and tear lesion - just, you know, been using these bones and joints for so long that they get a bit sort of creaky, cranky. And, you know, there are actually architectural changes that lead to stiffness and soreness, and so on.

In dogs, that isn't usually the case. I mean, most frequently, arthritis arises because of some condition that the dog had when it was very young, which has now progressed.

I mean, one condition, for example, is hip dysplasia, where the ball and socket joint of the hip is not properly congruous. So you know, the head of the femur bone, which is the thigh bone, is sort of misshapen and doesn't fit properly into the socket, the so-called acetabulum.

And so there's a bit of moving around of this over the course and over the course of years, you find these osteoarthritic changes that you can see on an X-ray. They - you know, it's just like it's corroded, and this becomes progressively more painful.

There are other conditions - elbow dysplasia and shoulder dysplasia, too - which also lead to arthritis. Sure, you can get an occasional wear-and-tear lesion lower down on the legs; you know, the carpus - the wrist, that is. But it's different from humans, like you mention. Not all wear and tear, mostly due to things the dog had younger that weren't fixed, and then cause a problem later on.

DAVIES: And it seems like it's just more typical for dogs to have limbs that simply don't fit together very well.

Dr. DODMAN: Yes, I don't know how common it is in people. I know that hip dysplasia, for example, is more common in women than it is in men, but I'm sure it's not as common in people in general as it is in dogs.

And sometimes, you know, the line breeding that they call the inbreeding of certain breeds - like for example, the epitome would be the German shepherd - has produced a dog that is prone to this disorder, I think partly due to giving them this low-slung appearance. That's a sort of modern look for a German shepherd, relatively modern, where they sort of slope from front to back. And in the process of going for the slope, I believe they've caused some issues with the hips not fitting properly into the the hip bones not fitting properly. And then that leads to this lesion down the road.

So a lot of genetic problems with line-bred - which really is a kind of inbreeding dogs - that causes these kind of issues.

DAVIES: And when people have a dog whose joints seem creaky, or they may be limping - you know, you wonder how much pain the animal's in. And people will some people will think well, just give him an aspirin or something anti-inflammatory. What how do you treat these issues?

Dr. DODMAN: Well, we outline that in the book. And you know, one of the big things - as is the case with people - is weight loss. So if the dog is marginally or even more so - very common these days - overweight, you need to bring the weight down because the large, you know, mass or weight of the dog will stress the joints further. And you can often get a lot of relief from reducing the weight by an equivalent amount or whatever, to get him to his fighting weight.

Also, moderate exercise is good because muscles that are in proper shape, as opposed to being allowed to become flaccid and unused - proper development of muscles around joints can help to stabilize them.

So these are two big, sort of really fairly conservative things that can be done. There are also aspirin-like drugs, so-called non-steroidal anti-inflammatory drugs. And there are some very good, very powerful, aspirin-like drugs on the market in veterinary medicine that can make night-and-day difference for a dog with joint pain.

DAVIES: We're speaking with veterinarian Nicholas Dodman. We'll talk more after a break. This is FRESH AIR.

(Soundbite of music)

DAVIES: If you're just joining us, our guest is veterinarian Dr. Nicholas Dodman. He's collaborated with other vets from the Tufts School of Veterinary Medicine on a book about how to care for senior dogs. It's called "Good Old Dog."

A lot of older dogs get cancer, you tell us in the book, and you outline the different kinds. But it was interesting for me to read that the goal of treatment is, in some ways, fundamentally different from treating humans with cancer.

Dr. DODMAN: Yeah, cancer is the leading cause of death in dogs - which is, you know, different from the situation in humans. And over 50 percent of dogs 10 years old or greater will acquire this dreadful disease. And oftentimes, you know, it will result in death. So the actual stat is something like one-half million dogs per year in this country die of cancer. So this makes it a major cause of death.

And there are a number of different types of cancer that can occur - which we outline in the tome - from cancer of the lymph system to cancer of the bones, especially in very large dogs. They get osteosarcoma, mass cell tumors, tumors of blood vessels and breast cancer - all biggies.

DAVIES: But when they're treated, you say that they're often not really aimed at curing the illness, as it is with people.

Dr. DODMAN: Yeah, that's true. I mean, it depends a bit on the cancer, its location, whether it's benign or malignant; you know, how easy it is to get at, whether it's amenable to surgery, for example.

But you know, if we take a benign cancer - say, a lipoma. It's a fatty tumor. Somebody doesn't like this ugly-looking lump; the vet can remove it. It's gone, that's the end of the problem. So that would be, perhaps, the same as in humans.

But when it comes to these more advanced treatments, like radiation or chemotherapy - you know, in people, the goal is to completely rid the body of cancer. This is the objective, to get rid of it - because, you know, a person who's 50 or 60 or 70 years old can have another, you know, 10 or 20 or 30 years to live.

But then when you think of a dog, you know, first of all, if you're going to give him, say, chemotherapy, a lot of people don't want to make their dog that sick that they're going to give them monster doses of chemotherapy. They just don't feel right to impose that on their dog when they cannot understand that there's a light at the end of the tunnel.

And secondly, the dog is not going to live that long anyway. If you've got a 12-year-old dog, and you extend his lifespan by two years with moderate doses of chemo or radiation, it's more palliative and sort of extending the course of life rather than trying to actually eliminate every last cancer cell. That is the strategy for veterinary cancer treatment.

DAVIES: There was an interesting case that you describe in the book, of a dog owner who chose to get a fairly, you know, expensive treatment for cancer after considering the options. And the dog lived about another six months - and that they felt great about that decision because that was the equivalent of a couple of more years in life or more, were it a person.

And it struck me that, you know, it's still six months. Does it make sense to aggressively treat a disease if a dog is that close to the end?

Dr. DODMAN: Well, there certainly are a number of things to consider when you are presented with an option of treating an older dog with cancer or any other condition.

You know, the first of them is, you know, how much longer is he going to live? Second of them is, you know, what sort of pain or suffering are you going to put him through in the way of treatment? You know, cost is a factor for a lot of people, too; quality of life, and so on.

So you know, if, for example, you had a relatively non-invasive procedure that wasn't going to cause your dog a lot of pain, and it was going to buy him an extra six months, and you could afford that treatment, and those six months were quality life - the dog's running around happy and eating, and so on - you know, why not, if you can afford it?

But on the other hand, just to drag out an existence which some people, I have known in the past, have done that. Owners, with cooperating vets, have just kind of gone step after step after step when really, you're on a hiding to nowhere. And you know, if the dog is, you know, in chronic pain and doesn't have long to go, you know, sometimes I question the wisdom of that approach.

DAVIES: The book is filled with all these advances in veterinary medicine. And there's a lot of expensive stuff here - tests and medications, and even surgery and physical therapy, you know. And it takes us into a very different age from when people had pets and if they died, they died.

Should somebody be prepared to commit thousands of dollars to a dog's medical care? And that raises a question of whether, you know, poor and working people can afford a pet's companionship.

Dr. DODMAN: Well, that's certainly something to think about ahead of time. I mean, you know that as we get older, we need more and more medical care. I mean, after the age of 50 years old for a person, you're going in for annual physicals and having this measured and that measured, and things start to go wrong. And it's the same with dogs.

So the book does teach about the expense of keeping a dog and how to prepare for it, including things like health insurance for pets. Or even, you could be your own insurer and just put away a small amount of money per month to make sure you're ready for that contingency plan - that is, for something bad happening down the road.

I mean, invariably it will. I mean, all of us are going to run into a brick wall - and our dogs - at some point. And it's either a sudden demise or a protracted one, and a protracted one is often very expensive.

So I think it's good to gird one's loins and prepare for that day. And if it doesn't happen, you have an extra fund available to you. And if it does happen, you know, if it's not a you know, if the dog dies suddenly, you wouldn't have to spend that money. But if it's drawn out, at least you're covered.

DAVIES: Yeah, but if somebody comes in and, you know, they have, you know, a middle-class job and are struggling to keep their family together, and the dog needs a $1,500 treatment and they say, I just can't afford a $1,500 treatment right now, do you judge them?

Dr. DODMAN: Well, I would do if they were, you know, smoking three packs of cigarettes a day, driving a BMW, and filling it up with an expensive gas. I mean, you know, I think that, you know, you shouldn't get a pet if you're not prepared to make some kind of commitment to it.

But I must admit, on the other side of that, there are some treatments that are, you know, violently expensive, and, you know, how do you deal with that?

Well, I mean, I met a dog like that yesterday. It wasn't as old as some of the books dogs we're talking about in the book, but this dog had a heart murmur, and the owner was advised to have an ultrasound exam. They couldn't even afford the ultrasound.

So they took the dog not to the shelter, where he would have a two-thirds chance of a death sentence. They took him to his breed rescue group, where they actually managed to find a home for him several states away. So, you know, the people saved the dog, they saved their pocketbook, and the dog found another home. So sometimes there can be a happy ending even in that difficult situation.

We do talk in the book about resources, like angel funds, that are available for people who are in difficult trouble. We have one at our hospital for truly needy people. So there are all kinds of ways of weaseling it: second homes, angel funds and so on. But I must admit, you know, some of the numbers that are mentioned in the book - like a person who spent $60,000 on their dog - I mean, there's a time when it's going to outprice even reasonable citizens.

GROSS: We'll hear more of Nicholas Dodman's interview with FRESH AIR contributor Dave Davies in the second half of the show. Dodman is a veterinarian and an animal behaviorist. He's a professor at Tufts University's Cummings School of Veterinary Medicine. His new book is called "Good Old Dog." I'm Terry Gross, and this is FRESH AIR.

(Soundbite of music)

GROSS: This is FRESH AIR. I'm Terry Gross. We're talking about taking care of aging dogs, and dealing with chronic conditions and difficult end-of-life decisions. Our guest, Nicholas Dodman, is a veterinarian and animal behaviorist. His new book is called "Good Old Dog." Let's get back to the interview Dodman recorded with FRESH AIR contributor Dave Davies.

DAVIES: So let's talk about some of the behavioral problems that the owner of an older dog confronts. One of them is incontinence; they just - they don't hold it; they're starting to go in the house. Can you do anything about it?

Dr. DODMAN: Yes, there's a lot of things that can be done. And one of the common causes of incontinence in an older dog, especially a female, is just a looseness of sphincters, which are the little muscles that hold urine in. So they just kind of dribble and leak. So the epitome might be - say, a 10- or 11-year-old, sort of larger breed, female, spayed earlier in life - removing all these reproductive hormones that help to maintain tone - and sleeping away quietly. Gets up, and there's a puddle of urine. That can easily be fixed with medicines that increase tone in the urinary tract.

One of the common ones that's used is - the acronym is PPA; that's phenylpropanolamine. You can also supply very low-dose, missing estrogens -another acronym, DES, for - basically - stilbestrol, which is the female sex hormone. I've heard people fix this problem with treatments even as simple as adding canned pumpkin to the diet because pumpkin - and actually, various soybean extracts and so on - contain phytoestrogens, which are the - with a PH - the plant, estrogens. And these things can all tone up the sphincter. So that one really is pretty easy to fix.

DAVIES: And those were cases where you're not seeing the dog squat and do its business; it's simply leaking when they are not aware of it.

Dr. DODMAN: That's right. So it's not house soiling, as such, as just incontinent, which is literally just unable to control the flow of urine properly.

But then, you know, you can also have, you know, various medical conditions. So, you know, one would not want to miss out the fact that, you know, a 10-year-old dog who started to soil in the house - you wouldn't want to miss out the fact that he might have kidney disease - he's producing too much urine; he's drinking a lot. He's urinating a lot, he gets caught short more often, or he has some kind of diabetes. And all of these medical things can be ruled out and/or treated as well as this post-spaying incontinence we just talked about.

But when all that is ruled out and it isn't any of the above, and you have a mystery case - say, a 10- or 11- or 12-year-old dog who previously was completely house-trained and there's been this breakdown of house-training; he just kind of lost the place - that is a cardinal sign of dementia, so-called canine cognitive dysfunction, which is the canine equivalent of human Alzheimer's disease.

DAVIES: You know, I wanted to talk about that because I - my family just put to sleep a dog about two years ago, a terrific little corgi mix that we had for many, many years, named Buddy. And I think he suffered from dementia. And for quite a long time, he would exhibit this behavior where he would pace around the house - just walk and walk and walk and walk for hours and hours - and then occasionally, you'd realize you didn't hear him walking, and then you would hear him howl. And you would find him with his nose in a corner. He would get into a corner of a room and somehow be unable to reverse himself, and kind of howl out in frustration. What was going on?

Dr. DODMAN: Well, that does sound very much like dementia. That's exactly the kind of behavior that you would expect to see. First of all, I must say, like in humans, it's a diagnosis of a certain constellation of signs that are not accounted for by any other physical finding or disease. So it's a diagnosis of exclusion, or rule-out.

To make the diagnosis of canine Alzheimer's or canine continence dysfunction, there is a helpful chart on the Pfizer Animal Health website, where it divides the signs that a dog with Alzheimer's - I'm calling it, loosely - might have. But you can go down and check the boxes. And you might find you've got, you know, six checks in the box - in the various boxes. Then a month later, you do the same thing again. If you find the number of checks is increasing, that's a very good sign that you are on the Alzheimer track.

But that dog that you described - this aimless wandering, increase in purposeless activity, especially if accompanied by sleep disturbances and especially if accompanied by house soiling with no other medical explanation -that really does sound very much like it.

DAVIES: And you know, one of the things that we wondered is, what's his quality of life; what's going on in his head? I mean, when he used to love to greet us and to, you know, chase balls and look forward to his meals - I mean, he's at least still eating. How do we know what kind of quality of life he's experiencing? What's going on in that little pooch's head?

Dr. DODMAN: Well, you never do know exactly what's going on in a dog's head, and that is the art of the science of veterinary medicine - is, you know, sort of reading the signs when you can't, you know - have no language, and you can't communicate in that way.

But you know, judging by what happens to people, it's not so much the people with Alzheimer's themselves who are affected, as much as their relatives. I mean, that may not be true in the early stages, where they get very angry with themselves because they can't remember things, and they can feel themselves slipping. But there comes a point where, you know, really, the issue is more for the family. And this is somewhat true with the dogs, too - is that the dog doesn't seem to be unhappy, will eat, might enjoy some things.

My mother had Alzheimer's, and she would really enjoy singing nursery rhymes, you know, with my sister or myself. And it was kind of, you know, back to childhood. She wasn't suffering at all. She just had this - it's almost like reversing the clock of time; you sort of go back in years. And I think she thought, you know, Winston Churchill was the prime minister of England. And it was very strange, this sort of retrograde - except that she wasn't unhappy. And I think that's the same with dogs.

I think they just kind of lose the place, and they're wandering around. But of course, if they start to have accidents in the house, this is when the owners -you know, oftentimes the husbands, I'm afraid to say - say, you know, out, damned Spot. We can't suffer this. And it's a sad fact that something like 20 percent of all dogs that are brought to shelters and pounds are brought there because they are - quotes, too old. And I suspect that house soiling, as a result of dementia, may be one of those reasons.

DAVIES: We're speaking with veterinarian Nicholas Dodman. We'll talk more after a break. This is FRESH AIR.

(Soundbite of music)

DAVIES: If you're just joining us, our guest is veterinarian Nicholas Dodman. He's collaborated with other vets from Tufts University to produce a book about caring for older dogs. It's called "Good Old Dog."

I want to talk about end-of-life decisions. I mean, these are so difficult. And in many cases, you know, there are medical matters where a dog is unable to, you know, rise or support itself. But the book says that there may be a time when the dog indicates by its behavior that it's time to let go - that it's showing no interest in life, not being itself even though it may not appear to be in pain. How do you help people sort through that?

Dr. DODMAN: Well, it's really done on a case-by-case basis but you know - and it's very, you know - so really, it is an art, again, of the science of veterinary medicine, that - well, we listen carefully and we - to what the people are telling us about the dog's life, and we look carefully at the dog. And the fact is, if they have reached a point where they've almost given up - which some people do, too; they just quit - so they are just basically lackluster; you know, not enjoying life, not playing, not interacting, haven't responded to any therapies, especially if they are losing interest in food and any social interactions, and nothing that you do can bring them back - you know, you have to think very seriously about what is the quality of life because it's not about -for humans, I would believe, too - it's not about how long you live. It's - I think what they call at the Tufts Nutrition Center, which is dedicated to aging humans, you know, solving - they talk about a health span.

So I think all of us want to live as healthy a life as we can, for as long as we can. But there comes a point when, at least for dogs, it's too much. You know, the rest of life, you know, after a certain point - and like I say, it's a judgment - is really a hiding to nowhere. You have no interest. You're not responding to any treatments. You're losing your appetite. And that's the point where in humans, they might put in a feeding tube and keep them going longer. But you know, mostly people with dogs just say, I think enough is enough. And with the help of their veterinarian, they make the difficult decision. And then it's curtains.

DAVIES: You know, I guess one of the things underlying my question is, how much do I think of the dog, and how much do I think of the family? I mean, he's not the same animal that we loved. On the other hand, does he deserve another day? Does he deserve another week? And yeah, it's a pain to clean up when he messes in the house but, you know, it can be done. To what extent should people think of themselves in this decision?

Dr. DODMAN: I don't think they really should be part of the decision. I mean, they are because they own the dog. And they are his, you know, caregivers, his guardians and whatever, and they must get involved in the decision. But you know, as a veterinarian, I always think of the dog, and advise the people accordingly.

So you know, if I think that the dog is doing fine and has, you know, has some quality life, you know, I listen to what they say and incorporate what they say, and then I give them my opinion. I say: I think this dog is actually doing pretty well, and he seems to enjoy being petted, and he has a lot of fun when you do this and that, and he's enjoying a good meal, you know; I think he's in good shape, relatively speaking, although he is on a slippery slope. And they often listen.

But people are strange because some people, you know, at the first accident or the first sign of a problem, they'll pull the plug and say: That's it; he's old; he's gone. And that was that shelter statistic I mentioned earlier. He's too old; take him down to the shelter - which I really can't understand. And other people go the exact opposite extreme. They keep their dog alive despite the fact he can't walk; he's lost the place; he's sitting in a pool of urine and feces, and there's really nothing left. And they'll just keep going because they can't make that final decision. And I don't think that's kind to the dog.

I think there comes a point - I mean, it's always difficult to pinpoint the precise day. And once you know it - that day you decide is the last day, all of a sudden there will be a momentary perking up. And then it isn't the last day, and you leave it another week. It can get very tricky. But there's a case where it clearly is too early. And there's a case, in my opinion, where it clearly is too late. And deciding what the right time is, is between the family and a good veterinarian.

DAVIES: In cases where there's been a decision to euthanize the dog, the book advises that owners, if they're up to it, that it's good for them to be present. What about kids - do you think it's good for kids to be there?

Dr. DODMAN: I think it's a good idea for, you know, anybody who's close to the dog to be there, and that would include children. As a matter of fact, children often deal with the decision to put the dog down better than the parents expect. And it's, you know, death is part of life. And it's an education for them - not that we're doing that for that reason but, you know, there's no point in hiding their eyes from things that go on.

And for the dog's point of view, you know, it's like a person. I mean, you often hear in the news that such and such a person passed away peacefully, surrounded by his family and, you know, it's the way that most people would want to go. And I extrapolate that, you know, a dog would want to have his near and dear ones around.

I mean, if there's some kid who really hates the dog and doesn't get on with it, I wouldn't force that kid to sit in on the euthanasia. But anyone who's close to it - including children, family - by all means. It's better, I think, for the dog and it's something that - well, that's my yardstick really; it's better for the dog and not bad for the children.

DAVIES: And do you advise families to get another dog soon after they lose a dog?

Dr. DODMAN: Probably not. You know, I think that's kind of getting a dog on the rebound. I think it's a good idea to take a breather. You know, maybe to have six months or so, and just really think out whether you want to have another dog and, you know, if you did, what kind of dog and whatever. And I would really hope that people would put a shelter dog in the equation when they're thinking of, you know replacing an old friend six months later, when everyone's had a chance to get over the grieving and it's not an impulse buy.

There's so many dogs these days are put down in shelters. It's 2.2 million per year. We should be helping to recycle these dogs and especially the older ones, because if you go to a shelter or pound, you'll find that the younger, smaller dogs are easily adopted. And the larger dogs who are older, you know, they often, you know, just are put down for no reason of their own. And they got there because homes split up, owners die. They need, you know - you can replace an older dog with a well, other, older dog, and do another old dog a good turn. I think adoption is the way to go.

DAVIES: Well, Nicholas Dodman, thanks so much for speaking with us again.

Dr. DODMAN: Thanks very much, Dave.

GROSS: Nicholas Dodman spoke with FRESH AIR contributor Dave Davies. Dodman's new book is called "Good Old Dog." You can read an excerpt, and find a link to a checklist for the signs of canine Alzheimer's, on our website,

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