Insights into geriatric medicine and more

Monica Tarantino, DVM, MBA, is the cofounder of the Senior and Geriatric Dog Society (nicknamed SAGDS) which trains veterinary professionals and hospitals to enhance their senior dog care and produce better outcomes for geriatric patients. She was also previously the chief of staff for the Veterinary Medical Center of Fort Mill in South Carolina. Tarantino sat down with dvm360 in an interview during the Fetch dvm360 conference in Nashville, Tennessee. Additionally during the conference, Tarantino gave several lectures focusing on veterinary geriatric medicine, as well as, a joint lecture on advice for new veterinarians coming into the profession.

During this exclusive interview, Tarantino shared her insights on canine cognitive dysfunction, client communication and resources, and more. Learn more about Dr Tarantino in this Q&A style interview.

Monica Tarantino, DVM, MBA

Can you tell us a bit about the Senior and Geriatric Dog Society?

I cofounded the Senior and Geriatric Dog Society (SAGDS) alongside two amazing veterinarians, Lauren Adelman, DVM, DACVIM (SAIM), and Lisa Lippman, DVM. Together, the 3 of us, really wanted to figure out if there was a way to target and enhance the care of elderly dogs above and beyond what we're currently doing in our profession. Senior dogs are the true “underdogs” of veterinary medicine! They are up against diseases of age, comorbidities, chronic pain and quality of life issues to name a few and taking a more focused approach with them will allow us to enhance the quality of life of more older dogs out there. For our fellow vets, we're really interested in creating a space for those that are interested in this area of medicine to become 'geriatricians' for these elderly dogs and also help vet techs, vet professionals and clinics who want to be known for their senior dog management and care in their area. There is so much opportunity here and we can't wait to help practitioners enter this exciting area of medicine!

Can you share some tips on identifying canine cognitive dysfunction?

Canine cognitive dysfunction (CCD) is a really difficult disease, because it's a disease of quality of life. And it's not just quality of life for the pet, but also for the pet parents. Oftentimes, if you're thinking about those pet parents that come into the exam room to see you, many of them are exasperated, they're frustrated, they’re feeling guilty because they're getting frustrated with their pets at home because they're not acting like they normally do. So, it can be a really challenging disease.

Screening dogs age 10+ in practice is one place to start and that can be done with any of the scales DISHAA, CADES etc. In addition, when talking to pet parents if you are hearing things like 'he's just more senile' or 'you can tell he's getting older' that's a sign to dig a little deeper and see if these pets are displaying any of the behavioral signs that we typically see with CCD.

What are your best practices for client communication about making adjustments at home with senior pets?

When our dogs first enter their senior years, they often still look pretty spry! So many people aren't picking up on some of the small behavioral changes in their older dogs or are even just chalking things up to old age. I think one of the most important things to do as far as that goes, is to start having a conversation earlier with parents about the fact that their dog is a senior now and what that means for their pets even if they are still 'acting like a puppy'! Alerting them to common ailments that are missed in senior dogs and what to look out for in terms of common diseases older dogs are prone to can be helpful in getting these pets in to see us sooner. It really does take a lot of teamwork, with a veterinary team and a senior dog pet parent to help manage that pet as they get older and make sure they’ve got a good quality of life as they age.

What resources are available to help support clients with anticipatory grief and caretaker exhaustion?

Both anticipatory grief and caretaker exhaustion truly impact pet parents of a senior pet and there are some resources that are online. For example, at www.petlosscommunity.com we have anticipatory grief handouts and free resources for folks to download. We also have anticipatory grief support groups for pet parents that are just struggling with that intense feeling of fear of losing their pet, even when they still have their pet right now in their life. 

Any other thoughts on geriatric medicine in general?

I think one of the best ways that you can help a senior and geriatric dog is really dialing in more on chronic pain management. Establishing chronic pain management plans for patients and looping pet parents in that these plans will evolve and require constant reassessment can really help our older patients. Setting expectations for what comes on for dogs as they age will only help everyone feel more prepared and focused on best supporting that pet's quality of life.

What is your biggest piece of advice for a new veterinary student graduating this year?

I think my biggest piece of advice for a veterinary student who has just graduated is to not be scared to say “I don’t know” when it comes to cases or walking into the exam rooms. When I was a brand-new vet, because I was so hypersensitive about being brand new, I never wanted to make it seem like I didn’t know what I was talking about. But here's the thing: brilliant vets say 'I don't know.' Because there's no shame in being at a place where we're working on the diagnosis, but we're not there yet. That's a part of the practice.