Q: I have a six-year-old senior pooch, and for the past two months, her appetite has dipped, and she has become very lethargic. This week, she started refusing her meals, and seems too weak to walk. She has also had pee accidents, so we put her on diaper. Is my dog dying?  

A: The symptoms that you have mentioned show that your dog is obviously unwell. From her decline in appetite (especially if she never had eating issues before), weight loss, and lethargy, you can tell that your furkid is experiencing a significant degree of discomfort and pain. These point towards a sick pooch, but because the symptoms are vague (non-specific clinical signs), achieving an accurate diagnosis is challenging.

Based on the symptoms described, she might be suffering from a range of diseases:
• Cancer: Nausea, poor appetite, and lethargy.
• Cardiovascular dysfunction: Lethargy, and poor appetite.
• Dental disease: Pain, and poor appetite.
• Hormone imbalance: Lethargy, weakness, nausea, and poor appetite.
• Joint disease: Pain, poor appetite, weakness, and inability to walk herself to urinate appropriately.
• Organ failure: Nausea, pain, poor appetite, weakness, dehydration, and inappropriate urination.

As you can see from the list, there are quite a few diseases that share very similar clinical signs. In some cases, the animal may also be dealing with multiple issues at once, further complicating the situation. Hence, it is advisable to bring your dog to the vet, so a diagnosis can be made and treatment can be administered as soon as possible. While not all diseases are curable, the vet may be able to help alleviate some of the discomfort she is experiencing. 

When the vet does a head-to-tail physical examination, he should pay special attention to her neurological function, cardiovascular abilities, and overall joint health. Depending on his findings, he will then decide if further diagnostic tests (to check on her internal organs and joint health) are necessary. This may include blood tests, radiographs, ultrasounds, and more. While not all treatment is curative, there is the option of palliative care, which aims to alleviate pain and discomfort.