TOKYO: CHIEKO USHIYAMA visits a doctor every two weeks, spending a minimum $200 (£114) a month on medical care; however the treatment is not for Ushiyama herself but for Pepe, her 12-year-old Shih Tzu, who has heart disease.
The number of aged dogs in Japan has risen sharply until half the country's canines are now elderly - surpassing even the well-known greying of the nation's human population. The trend has led to a spate of new products and services for which owners are more than willing to pay.
"Pepe is one of the family, so of course I'll take care of him until the end," said Ushiyama, who is 56. "But the medicine and trips to the hospital cost money, and there's the worry about him. So things can be hard."
Ushiyama and dog owners like her now have many options for care. There are nappies for incontinent dogs, spas and hot springs, special food, and even special wheeled carts for dogs whose back legs can no longer bear their weight.
"Just the way services are evolving to take care of ageing humans, many of the same things are developing, or will, to take care of ageing animals," said Eriko Kanazawa, a senior researcher at Yano Research Institute in Tokyo.
Although there are few firm figures, an average Japanese household with one dog spends as much as 120,000 yen (£585) a year on their pet, according to the Japanese Pet Food Manufacturers Association.
Elderly guide dogs can even live out their final days in one of two homes for the aged once they are too feeble to work, though such care facilities have yet to be built for pets.