Kindred Spirit Kindred Care, LLC.

Shannon Fujimoto Nakaya, DVM

Complementary and adjunct care for dogs and cats with special needs.


Graceful Aging, Graceful Exits: Caring for Animal Companions During their Senior Years.

Written by Shannon Fujimoto Nakaya, DVM


Why would I write a book about aging and dying?

First, because like it or not, aging is happening, and death is going to happen. Acknowledging aging and dying as an unavoidable reality does not mean that we are racing to the finish line. Knowledge is power and being aware allows us to get the most out of the journey and maybe delay the final parting. I have had many patients live quality lives for longer than statistically ordained because someone cared for them and made life comfortable and worth living. Accepting that life is finite allows us to appreciate every good day as a gift, and to facilitate graceful aging and graceful exits.

Here are some quotations on the same theme (because different writers will resonate with different readers):

"Death is a natural part of life, which we will all surely have to face sooner or later. To my mind, there are two ways we can deal with it while we are alive. We can either choose to ignore it or we can confront the prospect of our own death (and those of our animal companions) and, by thinking clearly about it, try to minimize the suffering that it can bring. However, in neither of these ways can we actually overcome it. " (From the Forward written by the Dalai Lama in the Tibetan Book of Living and Dying.)

"This whole aging thing is just one of those things that happens. It is a blessing to be among those who love us when it does." (Greg Hamer, 2011)

Second, so that when you are ready ot think about aging and dying, or forced to because you are suddenly facing a SITUATION, my experiences will hopefully help to fast-track you so that you can be functional and be useful to your animal companion in his/her time of need.

I didn't plan for my veterinary career to take me down this path. I started off aiming to be a bird surgeon (something I did achieve and still do, by the way). Once I got my degree and license to practice in 1995, I campaigned for a job with one of the most respected avian veterinarians in the country. She also happened to be a brilliant and remarkable veterinarian overall, who would take on the cases that intimidated all our other colleagues in the region. Being exposed to the animals declared "hopeless" by board-certified colleagues yet really didn't look like they were ready to die, and their wholy committed people had a profound influence on me. Eventually, those experiences led to my first book, Kindred Spirit Kindred Care: Making Health Decisions on Behalf of Our Animal Companions.

In 2004, I fledged from the Windhover Veterinary Center, returning to the islands of my birth and starting my own house call practice. I also started studying Traditional Chinese Veterinary Medicine (TCVM) –  acupuncture, herbals, and food therapy. The combination of the ideas I set forth in Kindred Spirit Kindred Care, along with a house call practice that integrated western and eastern therapies, was most beneficial to senior patients and those with special needs. At the same time, my own canine companion and partner was getting older, forcing me to think about creative ways of getting the most out of his senior years. And as is the nature of a writer, I write to think and think to write. So here is Graceful Aging, Graceful Exits: A Practical Guide to Caring for Our Animal Companions During their Senior Years.

As in the first book, it is the animals who have taught me many of the most important lesssons that I share in this book. I must also acknoweldge the humans who have invited me to be a part of their animal companion's health care team and to bear witness again and again to the depth and beauty of the human-animal bond – it is for those humans and those like them that I write this book. Having now practiced in greater Boston and in rural Hawaii, and having convened with other pet guardians, veterinary and veterinary hospice caregivers nationally and internationally, I realize that there are people who care deeply about their animal companions everywhere on the planet. So part of the reason for posting this manuscript on the web, in its entirety, with a "comments" column, is to make it more interactive and allow the world-wide community of people committed to the idea of graceful aging and graceful exits to share their ideas with each other and support each other. I am just one blade of grass, but together we can sow an entire field.

shannon fujimoto nakaya, dvm


As with any self-help or do it yourself or guidebook such as this, there is always the potential for misinterpretation and/or misuse. There is always the potential for someone to extract a phrase from my work, apply it in a different context, and use it to justify an action that I wouldn't myself advise. At some level, the risk may be even greater because I do not tell people exactly what to do; I merely provide information and suggest things that they might consider. Empowerment requires a leap of faith that they who you empower will not use it inappropriately. In both Kindred Spirit Kindred Care and Graceful Aging Graceful Exits, I choose to empower the humans who truly do care about their animal companions and desire to make informed, thoughtful, and selfless decisions on their pet's behalf. I hope that my sincerity as an advocate for the animals and the human-animal bond comes through and that the cases where that tone is misconstrued and misused are rare events at best.

This text is by no means a substitute for veterinary evaluation, assessment, and treatment. This text is meant to help people provide supportive and nursing care for their pets. Particularly with middle-aged and older patients, however, I often enough meet people who assume that their dog is "old" and therefore, whatever is ailing them must be bad and incurable. It would sadden me to learn that someone has skipped over a professional assessment and unwittingly short-changed their animal companion a straight-forward medical solution. 

Reproduction or distribution of any part of this manuscript without the author's permission is a violation of copyright law.