My Dog is Just Old...

Quite frequently I hear this from clients and even from people active in the practice of animal health & science.  Following are some short comments on beneficial treatments for aging pets. 

One of the most beneficial modalities in animal rehabilitation for geriatric patients is water therapy of different varieties.  I have written many training/workout prescriptions for eldercare utilising water, and a large percentage of these animals have had improved function in their home life as a result.  For some of these animals I was in search of workout methods to strengthen them simply to stand and eat or to improve ability and stance during defecation and urination.  As a result, several began "running around the backyard with the others" again.  

Controlled, specific swimming is beneficial for the improvement of muscle tone, fitness and strength, especially if an animal is too sore in their joints to walk well for even 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. 

If an animal has had health/orthopedic problems and especially spine issues, any fitness/rehabilitation/conditioning program should be approved by a veterinarian, even through the referral of the animal to a rehab practitioner.  Dachshunds flying off couches is not the same as plyometrics training, and many owners may not know the risks and benefits to either activity! 

Ultrasound therapy on arthritic or sore joints and muscles has been proven to be beneficial, as has low-level laser therapy.  I utilise both of these units 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. 

Massage is a common therapy that almost anyone can use beneficially to encourage circulation and thereby healing.  Many owners may take a stab at performing massage, but instruction from a practitioner is always best to start.  Different massage techniques accomplish different results, and massage is not recommended in some cases!  The same goes for PROM (passive range of motion) and joint mobilisation.  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 mobilisation should only be performed by an experienced practitioner.  All of these techniques are considered alternative therapies by the TBVME and should be practiced by experienced persons under the general supervision of a vet.  This means the vet may refer the owner to a rehab practitioner to perform and/or instruct the owner in proper mechanics.  Some vets may know how to instruct owners in these techniques yet may choose to refer to rehab for ongoing collaborative effort. 

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. 

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.  Athletic 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, 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.  Oil-based supplements included during the manufacture of food are often altered during the process to the point of diminishing their efficacy.  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 along with their having studied the subject of these neutraceuticals and their effects on different species. 

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