You have been with your dog through every stage of their life, from house training and teaching them that shoes are not appropriate chew toys to countless walks or games of fetch. However, as your four-legged friend gets older, owners need to begin having important conversations with their veterinarian regarding end-of-life care. Monitoring your pet at home after receiving a terminal diagnosis or watching out for your elderly dog is an essential part of pet ownership. As a pet owner, you, at some point, may even have to consider euthanizing your pet for their own well-being. When making this decision, both owners and veterinarians want what is in the dog’s best interest. Therefore, they should consider if the dog is in pain or suffering – or if this can be appropriately managed with medication. 

As their owner, you will likely notice changes in your dog’s behavior as they age or after your dog has received a terminal diagnosis from your veterinarian. This change may have been what prompted you to take them to the veterinarian in the first place. To ensure your pet’s wellbeing, it is important to monitor several key aspects of your dog’s behavior to evaluate their quality of life. Please note that this list is just a starting point and is not exhaustive; your veterinarian will likely recommend specific vitals or behavioral changes to watch for in your dog based on their diagnosis. It is important to use your dog’s “normal” in your evaluation of each of these categories. 

Activity Level

Your dog’s activity level can indicate how they are feeling. Often elderly dogs experience a decrease in their activity level but can still find joy in a shorter walk outside. If your dog struggles to navigate up and down stairs or jump on furniture, this may indicate that more is going on. While dogs can live a happy life with an adjusted routine (being carried down the stairs or implementing a ramp system), discuss with your veterinarian if this change is cause for concern. 

More serious changes in activity level, such as being unable to walk, warrant a serious discussion with your veterinarian. The veterinarian will probably complete a physical examination of your pet and may request additional diagnostic tests such as radiographs to determine the cause of your pet’s recumbency. Depending on your pet’s prognosis, it may be in your pet’s best interest to consider euthanasia. 


Some dogs are always picky eaters and prefer to graze at their food, while others typically wolf down their entire meal. Therefore, it is especially important to evaluate changes in your dog’s appetite compared to their normal. A decreased appetite can indicate that your dog has an upset stomach, serious problems with their GI tract, or that they do not have enough energy to try eating. To encourage your dog to eat, owners can offer canned dog food or a small treat of dog-safe human food. 

Vomiting and diarrhea can similarly indicate serious problems and lead to dehydration. Dogs can vomit for many reasons, and diarrhea can be associated with helping themselves to snacks that are not part of their regular diet (such as cat food). However, a good rule of thumb is that owners should be concerned and seek medical attention for their pet if they vomit multiple times in one day or for multiple days in a row. 

Hydration & Urination Levels

It is especially important to monitor your dog’s water intake and urination if diagnosed with kidney disease. Changes in thirst and/or urination can indicate various conditions, from a urinary tract infection to kidney failure. Your veterinarian will likely require further diagnostics (such as a urinary analysis or bloodwork) to make their diagnosis. 

Dehydration can result from various conditions, including lack of drinking, vomiting, diarrhea, and poor kidney function. Owners can monitor their dog’s hydration status by looking at their mucus membranes – their gums! A typical dog’s gums are a healthy pink color. If your dog’s gums are tacky to the touch, this is one indicator they may be dehydrated. Additionally, if you check their capillary refill time by gently pressing your finger into their gums and releasing, it should take less than 2 seconds for the color to return to normal. If it takes longer than 2 seconds, this is another sign of dehydration in dogs.

Note – some dogs have naturally colored gums, which do not allow for the capillary refill time to be easily evaluated. Talk to your veterinarian if you have further questions.

Resting Heart Rate

Like humans, dogs can have many heart conditions, most of which become increasingly common as your dog ages, though some breeds are predisposed to these problems. After your dog has been diagnosed with a heart murmur or other related condition, your veterinarian may recommend you monitor their resting heart rate. If their resting heart rate increases over time, this may indicate that their condition is worsening as their heart has to pump more frequently to circulate a sufficient level of blood throughout their body. 

To take your dog’s resting heart rate, cup your hand around their chest. You will feel their heartbeat the strongest on their left side, near the 4th rib. If you move their elbow back as far as it will go, this is typically an appropriate spot to palpate. 

Pet Pain

Your dog’s pain levels are significant to monitor and often play a key role in making end-of-life decisions for your pet. Common signs of pain to watch for include panting, yelping/wincing, and being more aggressive than normal. 

Monitoring a terminally ill pet is difficult, but this time allows pet owners to gain closure that is not found with sudden death. Discussing your dog’s health with your veterinarian is extremely important throughout their lifetime but does have additional significance in terminally ill patients. 

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