“My Dog is Just Old...”

Quite frequently I hear this comment from clients and even from people active in the practice of animal health and science.  I provide a mobile rehabilitation and conditioning service to encourage better recovery after surgery or pursue therapies for other reasons, working toward better quality of life.  Roughly 80% of my client base is elderly dogs, usually with orthopedic and/or neurologic issues.  Following are some short comments on beneficial treatments for aging pets:

Any fitness/rehabilitation/conditioning/bodywork program should be acknowledged by or approved by a veterinarian. This may be accomplished by having your veterinarian refer you to me or by my contacting the vet after you have contacted me should you desire to work hands-on with me as a rehabilitation practitioner.  Dachshunds flying off couches is not the same as plyometrics training, and many owners may not know the risks or benefits to either activity!  So make sure to include your primary care veterinarian in your plans to have additional therapies practiced on your pets.

Massage is a common therapy that almost anyone can use beneficially to encourage circulation and subsequently possibly encourage healing.  Many owners may take a stab at performing massage, but instruction from me is always best to start.  Different massage techniques accomplish different results, and hands-on massage is not even recommended in some cases! 

Otherwise, I have found great benefit in using the little massagers produced by the Homedics company.  My favorite ones cost $9.99, have four balled feet, and the spread of the feet is usually just right to straddle the spine of different animals.  I recommend beginning by slowly using the massager from neck to tail without it turned on, travelling the spine one direction, again, slowly.  After a couple of passes, turn on the massager and do the same movement as when it was off.  I like to divide the body into 5 minute sections, beginning with the department giving the most discomfort, i.e. mid-spine to tail base, then neck to mid-spine, right thigh, right shoulder, left thigh, left shoulder.  If your pet has hip problems, start with the thighs then do the spine then the shoulders, etc…The idea is that doing this form of massage on the whole dog could take 30 min. in one sitting, but if you only have time for 10 minutes’ worth, then do the most important parts first.  It is all complimentary and helpful; an animal with hip problems is taking more stress on his front end, and one with elbow problems is straining the neck, spine, and other parts of the body in compensation, so hopefully you get the idea.

The same goes for PROM (passive range of motion) and joint mobilization.  PROM should usually be performed and instructed to owners by an experienced practitioner.  Some owners I have counseled have come away from doctor consults having been told to perform massage or PROM, yet the owner actually does not know what this means or how to perform it so that the animal is not injured.  A referral to a rehab practitioner to judge protocol and beneficial movements would be great for owners in these cases.  Joint mobilization should only be performed by an experienced practitioner.  PROM is not as necessary if the pet is moving on their own and other physical activities will be a better use of time.

Controlled, specific swimming in warm water can be beneficial for the improvement of muscle tone, fitness and strength, especially if an animal is too sore in their joints to walk well for just basic fitness.  Swimming for conditioning or therapy should be done in a controlled manner with the use of a dog life jacket and in short, steady bouts while better fitness is achieved.  Just because a 15-year-old dog "likes to swim" does not mean he/she should go at it for 15 minutes straight the first or even the fifth time.  I carry a full set of life jackets in my mobile practice should an owner possess facilities for swimming at home.  Small dogs with short legs, like Dachshunds, may be swum in many home tubs. 

I find that outside the home environment, elderly animals (and many of other ages as well) are usually not happy to be in a swim tank in a foreign environment.  I worked with a water tank/treadmill during the first years of my practice and determined that I would not miss it one bit in mobile practice.  Elderly animals are often slightly confused and seem to want to do things in the comfort of their accustomed environment.  In addition to incalculable fear levels when trying to use a facility-based water tank for therapy, this fear often induces nervous diarrhea in the water and is potential cause for new injury.  Travel to and from a facility can produce unnecessary stresses on both owner and animal.  Therefore, I have come up with a variety of exercises and slings to assist elderly animals while they learn to return to better function on land.

Many machine modalities may be used in the practice of rehabilitation.  I consider low-level laser therapy to be the most complementary and productive machine modality I utilise in my practice.  Laser therapy has immense benefits which I will not attempt to cover here.  A wonderful website to peruse is www.laser.nu, and much information regarding laser therapy may be found there.

Ultrasound therapy on arthritic or sore joints and muscles has been proven to be beneficial.  I also utilize this therapy in my practice and have had very positive owner feedback with regard to improved function in their animals.  Much research information, including evidence-based research, is available on the web regarding these modalities.

People often ask me about using heating pads on their dogs; the use of heat depends on the nature of the injury or disease process.  A combination of ice/heat/ice is often more therapeutic or the use of moist heat or brown rice in a sock heated in the microwave are usually preferential heat application options, but moist is good for some things while dry heat is for others.  When in doubt, use ice.  Instructions for the use of ice and heat may be found on my websites.

Chiropractic interventions are the choice of some and in my opinion should be combined with other therapies and should be administered by vets who have studied chiropractic or by chiropractors who have studied animal chiropractic—especially with regard to spinal issues—and are working in conjunction with the vet. 

Acupuncture intervention has been proved to be beneficial as well and especially for pain control.  There are several vets in the Austin area who practice acupuncture. 

There are commonly-recommended neutraceuticals for elderly and injured dogs as well as for young dogs that have genetic or early-onset of disease process in their joints.  Younger sporting dogs should benefit from these as well.  Animals, like people, are not always being fed an optimal diet, so the receipt of quality nutrition from feeding varies, and the supplementation of neutraceuticals is often warranted.  Among commonly-used and readily-available supplements in this catagory are Glucosamine Hydrochloride with Chondroitin Sulfate (synergistic benefit), MSM (additional synergistic benefit), SAMe (joint, liver, tissue, brain, pain), and Omega 3 fatty acids, preferably in the form of fish oil.  The only ones of these that may tend to cause problems in some animals are the Omega 3 due to some dogs difficulty with processing fat, and Glucosamine should not be administered to diabetics according to some research.  Oil-based supplements included in animal food are chemically altered during the production process to the point of diminishing their efficacy and/or they soon become rancid when the bag is opened.  Omega 3 fatty acid chains are very fragile and research shows use of the capsule form is best.  When in doubt about dosing, a check should be made with a veterinarian who is familiar with the animal's history and physical well-being. 

veterinary acupuncture: http://www.aava.org/pub/vet_acup_links.html 

veterinary chiropractic:  http://www.animalchiropractic.org/

link to D.M. Clemmons' site, DVM, PhD, Dept. of Neurology & Neurosurgery, Univ. of FL:

http://neuro.vetmed.ufl.edu/neuro/DM_Web/DMofGS.htm (scroll down for some more info on nutrition)

 I received the following article via e-mail from the group cited in the article.  The last paragraph made me think immediately of the challenges we face in keeping an older, otherwise very alert and reactive, animal more mobile in the face of degenerative changes.   

Dr. Gabe Mirkin's Fitness and Health e-Zine
July 1, 2007

Recovery Times Do Not Decrease with Age

Many older athletes notice that their muscles weaken with aging, even though their recovery times from hard workouts are the same as when they were younger.   A study from Griffith University in Queensland, Australia confirms this (Journal of Sports Medicine and Physical Fitness, September 2006).   Two groups of experienced cyclists raced in 30-minute time trials on three consecutive days.  The first group had an average age of 24 while the second group's average age was 45.  Both groups maintained their average power during the three trials. They had the same amount of muscle damage, measured by the release of a muscle enzyme called CPK.  Both groups had a drop in their maximal heart rate of three beats per minute during their third time trial.  The maximal voluntary isometric contractions of the quadriceps muscle were the same for both groups.  The authors concluded that  "high-intensity endurance performance is maintained in both well-trained young cyclists and veteran cyclists following three consecutive days of maximal 30-minute time trials."
 Every muscle is made up of millions of individual fibers, as a rope is made of many threads. Each muscle fiber is enervated by a single nerve fiber.  The non-preventable result of aging is loss of nerve fibers.  With the loss of each nerve fiber during aging, you lose its associated muscle fiber.  So aging causes you to have increasingly fewer muscle fibers, which makes you weaker.  However, the remaining muscle fibers function as well as those of a younger person. 

Dr. Gabe Mirkin's Fitness and Health e-Zine
July 1, 2007

This last paragraph reminds me especially of changes noted in degenerative myelopathy and also then other degenerative and neurologic disorders.

Rehabilitation for the Orthopedic Patient
Davidson JR, Kerwin SC, Millis DL
Veterinary Clinics of North America: Small Animal Practice- 2005 11 (Vol. 35, Issue 6)

Additions in italics mine-Deborah

Table 2.

Rehabilitation of joints with osteoarthritis

	Goals	Treatment
	Reduce joint stresses	Dietary counseling and exercise program to achieve and maintain lean body weight
		Lifestyle changes, such as ramps instead of steps or jumping
		Encourage controlled, low-impact activities
	Strengthen peri-articular muscles	Controlled, low-impact exercise (walking or aquatic exercise)
		NMES if too weak or painful for active exercise (I do not use neuromuscular electric stimulation, choosing instead other methods-deborah)
	Maintain or improve joint range of motion	PROM
		Active range of motion—therapeutic exercise (walking or aquatic)
		Joint mobilization
	Maintain or improve cartilage health	PROM
		Weight-bearing exercise with low impact (walking or aquatic)
		DMOAs (disease-modifying osteoarthritic agents, such as hyaluronic acid or polysulfated glycosaminoglycan, SAMe, glucosamine HCL, MSM, chondroitin sulfate, etc...)
	Limit inflam-mation	NSAIDs to treat chronic or acute inflammation
		cryotherapy for episodes of acute inflammation
		Limit high-impact or uncontrolled activities (I also add low-level laser therapy-doc)
	Pain management	NSAIDs and other analgesics as needed
		cryotherapy, hot packs, therapeutic ultrasound, or massage for muscle spasms (I also add low-level laser therapy-doc)

 

Rehabilitation for the Orthopedic Patient
Davidson JR, Kerwin SC, Millis DL
Veterinary Clinics of North America: Small Animal Practice- 2005 11 (Vol. 35, Issue 6)

Additions in italics mine-Deborah