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Hip Dysplasia in Dogs

4/29/2022

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Hip dysplasia is a medical condition that many owners of large-breed fear as it’s very painful for dogs. Though it can’t be cured, hip dysplasia can be treated to reduce pain and improve quality of life.

And, it’s even possible to start preventive treatment early to stave off the effects of hip dysplasia for as long as possible. This article includes what you need to know about hip dysplasia in dogs and what you can do to help improve your dog’s quality of life if they have it.

What is Hip Dysplasia in Dogs?
Hip dysplasia is a medical skeletal condition affecting the hip(s). The bones don’t grow uniformly, causing looseness in the joint, eventually leading to degenerative joint disease (DJD) or osteoarthritis. It’s often identified in older dogs when DJD or osteoarthritis sets in. However, it’s was there well before their advanced years.

The hip is known as a “ball and socket joint.” The head of the femur, or the thigh bone, is the ball and the pelvis is the socket. In dogs with hip dysplasia, the femur and pelvis don’t fit together properly and instead of sliding smoothly with movement, they rub and grind. The impact is the deterioration of the joint over time and eventually a loss of function.

Elbow dysplasia is similar and occurs in the elbow of the front leg instead of in the hip.

What Dogs are Most at Risk for Dysplasia?
The dogs that most commonly have hip dysplasia are typically large-breed dogs that weigh 50 pounds or more. Some common breeds are German Shepherds, Labrador Retrievers, Golden Retrievers, Great Danes, though there are others. However, this genetic condition can be found in dogs of any size and is not specific to a dog’s size or even their breed.

There are a number of factors that come into play with hip dysplasia, and genetics is the biggest one. Dogs with hip dysplasia have a genetic predisposition that they are born with. However, just because they have this predisposition, doesn’t necessarily mean they will show symptoms during their lifetime.

Other factors that impact this condition are exercise and the types of exercise, nutrition, and weight. All of these are within the owner’s control, particularly maintaining a proper weight level and feeding nutritious food.

Regular exercise is also important, including walking, running, and playing. One thing to note is that dogs in competitive sports like agility, flyball, dock diving, and others that are predisposed to hip dysplasia are at a higher level of risk of having issues with this condition than dogs who exercise more moderately.

What Are Symptoms of Hip Dysplasia
As is the case with many mobility issues, there is a wide range of symptoms you may see. Many dogs don’t exhibit any symptoms at all when they are younger, so you may not even know they have the condition. For these dogs, symptoms usually present when they get older as dogs with hip dysplasia often develop degenerative joint disease (DJD) or osteoarthritis (OA) later in life.

Other dogs may develop symptoms as young as four months of age. Here are the things to look for with hip dysplasia:

  • Pain, stiffness, or limping
  • Swaying “bunny hop” gait
  • Decreased activity
  • Decreased range of motion
  • Lameness in the hind end (or in the case of elbow dysplasia, a front leg)
  • A grating sound in the joint
  • Reluctance or difficulty rising, running, or jumping
  • Loss of thigh muscle mass and enlargement of shoulder muscles due to compensation 

If you notice any of these symptoms in your dog at any age, it’s a good idea to have a vet exam with your primary vet. When hip dysplasia becomes more advanced, dogs often develop osteoarthritis or DJD, so many of these symptoms are related to those conditions. They are more common as a dog ages.

Diagnosing Hip Dysplasia
There are a number of things your vet will do to determine if your dog has hip dysplasia. First, your vet will request a history of your dog’s health and any symptoms he has to indicate an issue. If your dog has ever had an injury that may have contributed to the symptoms, that’s helpful to share.

Then your vet will manipulate your dog’s hind legs. While doing this, they will check for any reduced range of motion, grinding, pain, and looseness in the joint.

Your vet may want to run blood work as inflammation due to joint disease can present in the complete blood count (CBC). Last, he will likely want to take radiographs, or X-rays, of your dog’s hips to determine the degree and severity of hip dysplasia if warranted from the physical exam. This helps to provide the best course of treatment for your dog.

Treatments for Hip Dysplasia
There are a number of ways you can help your dog with hip dysplasia. How you will treat your dog’s hip dysplasia depends on the amount of discomfort. 

Medications and Supplements
A common treatment is with non-steroidal anti-inflammatory drugs (NSAIDs) like Rimadyl and Meloxicam. These drugs may have side effects so it’s important to work with your vet to determine if it’s right for your dog. You’ll also want to monitor blood work regularly.

In addition to medications, it’s a good idea to put your dog on some nutritional supplements including glucosamine, chondroitin sulfate, and omega-3 fatty acids. You can get these at any pharmacy or even at Amazon. I also recommend Standard Process Canine Musculoskeletal Support and can supply that for patients.

Exercise and Physical Rehab
In addition to supplements and medications, exercise is very helpful for dogs with hip dysplasia. Moderate daily exercise is the key, avoiding high-impact activities like jumping which can stress the hip joints. Exercise alone can help to keep your dog mobile while strengthening the surrounding support structures around the hips.

As you might expect, physical rehab can also be very effective in improving a dog’s quality of life with hip dysplasia. We can work together to get your dog to a healthy weight to reduce excess stress on the hip joints and get your dog on a regular exercise regiment.

Alternative Therapies
There are a number of alternative treatments that can be quite effective for helping your dog. One that I offer in my practice is cold laser therapy, and I highly recommend it along with physical rehab.

Some other therapies that can be helpful include acupuncture, stem cell treatments, and traditional Chinese medicine. Though scientific data is limited from studies, they may be worth looking into for your dog, particularly in conjunction with some other treatment options.

Surgery
Another option is surgery, and there are several surgical procedures to treat hip dysplasia. The most common two are a total hip replacement and a femoral head osteotomy (FHO). Your vet or veterinary surgeon will determine what’s right for your dog based on their condition, lifestyle, and age. If you do go the surgery route, physical rehab is a great way to help your dog post-surgery.

What You Can Do if Your Dog Has Hip Dysplasia
If you think your dog may have hip dysplasia, make an appointment with your primary vet right away. Your vet will examine your dog and will likely determine the diagnosis with X-rays.

From there, you can determine the most appropriate course of action. Dogs with his dysplasia can often live long and full lives with treatment, so the sooner you diagnose and determine a treatment plan, the better off your dog will be.
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How to Cope When You’re Losing Your Dog

2/28/2022

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No one wants to think about that day we’re going to have to say goodbye to our beloved dog. We all know it’s going to happen, and though we understand that, it’s often just too difficult to think about. Are we unintentionally making the process harder for ourselves and even our dogs by avoiding the inevitable?

Loving a dog through the last stage of life isn’t easy, but there truly is nothing more rewarding than being there for your dog when she (or he) needs you the most. Here are some thoughts about the process and how we can make it a little easier to manage. 

Anticipatory Grief
We generally think of grieving as something that happens after a loss. We expect to grieve our dog when she is no longer with us, as that’s a given. What we often think about is when we no longer see our dog’s beautiful face and hear the pitter-patter of her footsteps following us down the hall for dinner, or snuggling up in bed to our favorite furry buddy.

However, the grieving process actually begins before our loss when we first realize that it’s coming. This is called anticipatory grief, or grief that occurs before death. The symptoms are often the same as grieving after a loss—all of the feelings and thoughts, social, and cultural reactions to an expected death.

There are some differences between anticipatory grief and the grieving that occurs after death. Not everyone goes through it. But when they do, it often involves more anger, more loss of emotional control, and sometimes atypical grief responses. It’s often not discussed, which can make it even more challenging to process.

What it does do is provide an opportunity to say goodbye. To recognize what’s coming and to make sure to cherish every single moment. It’s a time of personal growth to find closure, assess priorities, and start to map out a different future. 

Processing Our Emotions
We go through a wide range of emotions when we’re caring for our old and/or sick dog and preparing for her death. They may range from sadness, distraction, fear, guilt, and even anger to more serious issues like depression. Dealing with the fact that there is little we can do about what’s coming can be crushing.

And, if we’re in the position of being a caregiver, especially if our dog’s medical needs are especially intense near the end, it can be even more challenging finding balance. Trying to care for your pet when you are sad, exhausted, and burned out is, well, it’s exhausting. 

What is Bonus Time?
Bonus time is the idea of extra, or bonus time as you’re nearing the end of life. No one lives forever. We won’t and our dogs won’t, but we often happily and blindly navigate our time with our dogs until we know we are nearing the end.

The concept of bonus time is that we know we are nearing the end, but instead of looking at this time with dread where the clock feels like it’s counting down, we instead appreciate the extra time that we have.

Enjoying bonus time means not focusing on the upcoming goodbye, but instead, focusing on making the most out of every special moment we get knowing the goodbye is near. It’s those extra snuggles, it’s the day off you take to be with your dog, it’s the bucket list of things you complete knowing your dog will enjoy every moment. Bonus time is all about creating the beautiful memories that will sustain you after your loss.

How to Manage Our Fear and Guilt
Truthfully, there’s really no right or wrong answer for handling those painful thoughts and feelings we have when we’re dealing with something as difficult as death. Everyone and every situation are so very different. We all have different triggers and thresholds for what we can handle and what causes us stress. Being afraid and feeling guilty are normal parts of the process and they’re difficult emotions. Here are some things to consider that may help.

Be Gentle to Yourself
It’s normal, healthy, and totally ok to grieve before and after your loss. The grief process is varied and you’ll go through different phases. And it’s not always linear, either. You may have moments of guilt, anger, and other strong and complex emotions.

Keep in mind that your dog is not going to die because you forgot to refill their water bowl for an hour, missed their medical that one time, or went out to dinner with your friends. Remind yourself of this when you need to. Know that this is normal and your dog loves you in spite of and because of your thoughts and feelings. Your dog just loves you.

Take Time for Fun
As much as you may not want to, you need to take some time occasionally to step away. Being a caregiver is hard and emotionally draining at times. You need to get out and get away periodically. Take that long shower, meet your friend for a movie, go for a walk alone. You can and need to have those moments. Those little snatches of time you take for you make you a better caregiver so you can focus on your dog when you need to.

Get a Support System
Make sure you have someone to talk to. This may be a friend or family member or it may be a professional. You are not alone in what you’re going through. Anyone who has ever loved anyone, human or furry, will at some point suffer a loss. Find someone who will support you when you need a good cry, and find someone who will remind you that what you’re feeling is normal. Because it is.

Make the Most of the Bonus Time
A friend of mine once told me the lesson she learned after she lost her soul dog. She spent so much time fearing his death, that she realized after she lost him that she didn’t make as much of the time she had with him in the end. Her painful lesson became a mantra, “I will have the rest of my days to mourn you. I choose to not do it while you’re still here.”

That doesn’t mean she doesn’t battle anticipatory grief, but she allows herself to feel it, then lets it go to focus on her time with her dog. Connecting with our gratitude to have those precious moments and finding enjoyment in them is one of the purest displays of love there is.

Here’s the thing: dogs don’t have much of a concept of the future so they don’t fear death. They live very much in the moment. We have an opportunity to learn from our dogs and to force ourselves into the present moment.

Unfortunately, we and our dogs can’t live forever. But, we have the opportunity to continue making precious memories while they are still with us that we can cherish for a lifetime.

There Isn’t a Right (or Wrong) Way to Grieve
Death and dying are tough for most people to handle, and we each grieve in our own way. There truly isn’t a right or wrong way to do it. We each have our own ways of dealing with it, and that’s perfectly normal. Take a page out of your dog’s book and live in the moment—enjoy the bonus time and feel the grief. Take the time you need then open your heart again when you’re ready.
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Toxic Foods for Dogs

12/20/2021

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We all know there are some foods that we shouldn’t feed our dogs. It can be confusing as many of these are perfectly safe for humans to eat, so we may not really even think about it. But, how awful would you feel if you fed your dog something that makes them sick or worse? It’s devastating when it happens, and the sad reality is oftentimes it can be prevented. Here’s what you need to know about toxic foods that could make your dog sick, including those you should never feed them.

What Does Toxic Mean?
Toxic foods can cause medical issues with your dog ranging from stomach upset, vomiting, and diarrhea to even death. The amount that will cause a medical issue will depend both on the food as well as the size of your dog. Some dogs may be more sensitive to some foods than others as well. 

Toxic Foods Your Dog Must Never Eat
Some foods may cause a severe medical reaction no matter the amount your dog eats. These are the foods you should be very careful with that your dog never has access including:

  • Grapes and raisins
  • Xylitol (a sugar substitute that is often found in candy and gum)
  • Chocolate, especially dark and baking chocolate
  • Avocados
  • Macadamia nuts
  • Cooked bones
  • Onions
  • Coffee, tea, and caffeinated foods
  • Fruit seeds and pits including apple, apricot, peach, and cherry 
  • Alcohol and drugs (prescription or otherwise)

Will your dog have a reaction every time they eat these things, or if they eat a really small amount? It’s possible they won’t—but do you want to take that chance? 

Any of these foods has the potential to cause some very serious reactions in your dog. For example, grapes and raisins can cause kidney failure, even in small amounts. Bones can get stuck in the GI tract and cause damage. Xylitol can cause a dangerous drop in blood sugar in dogs which even in small doses can cause death.

Some foods can cause choking hazards. Things like fruit seeds and pits can get stuck, and they are dangerous if they chew them up as well. Other things can be dangerous as well, like giving your dog an ear of corn. While corn itself is fine, if your dog tries to eat the entire piece, it could easily get stuck.

Always Check Food Ingredients
Before you feed your dog any human foods, it’s important to check the ingredients. There may be things in the food that you’re not aware of. 

A great example is Xylitol as it’s in a lot of sugar-free products. It can even be in peanut butter. Sometimes it’s even called birch sugar, so you have to be especially careful. It’s important to read labels to make sure it’s not in any food you give your dog. 

If you put onion in your meatloaf, you shouldn’t give it to your dog. There’s a lot of hidden ingredients in foods so if you’re going to give your dog a human food snack, be really careful.

Another food that people will often give their dogs when they are sick and are not feeling well to stimulate their appetite is baby food. Though meat baby foods are generally ok to give a dog in small amounts (as they can be high in fat), you should check the label as they sometimes have onion or onion powder as a flavor enhancer.

Sometimes it’s very clear but often it’s not. So, it’s important to read labels for any foods you give your dogs to make sure they don’t contain toxic ingredients that could accidentally hurt your dog.

Foods That May Be Ok in Small Amounts
There are many foods that may be ok in small amounts, however, they have the potential to make your dog sick in large amounts. And, of course, you don’t really know exactly how much will make them sick, so it’s best to avoid these foods or keep the amounts very small.

  • Cat food 
  • Citrus
  • Fat trimmings
  • Garlic
  • Human vitamins
  • Liver
  • Milk and dairy
  • Salt
  • Sugar
  • Yeast

These foods can cause stomach upset and some may cause vitamin deficiency or pancreatitis. Some dogs are lactose intolerant and so milk and dairy products may cause issues. 

Human vitamins and supplements should only be used under the guidance of your veterinarian. Though these foods are usually not a problem in small amounts, it’s hard to know what the line is between what your dog can tolerate, and what may be too much. Caution is advised.

What to Do if Your Dog Eats Food They Shouldn’t?
Even if you’re careful, your dog might get into one of these toxic foods. Maybe you accidentally fed something to your dog or perhaps your child dropped something on the floor. Or, some dogs “counter surf” where they go up on the kitchen counter and grab things. It happens.

If your dog ate something in the first group above of foods that your dog should never eat—things like grapes, macadamia nuts, and chocolate, call your vet immediately or an emergency vet hospital. Or, you can call either the Pet Poison Helpline (855-213-6680) or the ASPCA Animal Poison Control Center (888-426-4435) for a fee. You may need to take your dog to the vet or to an emergency vet if it’s after hours. 

If your dog ate food in the second grouping, it’s a good idea to call your vet as well to see what to watch out for in terms of signs of toxicity. If it’s a small amount, chances are your dog will be fine. If it’s a larger amount or if your dog is exhibiting clinical signs, your vet will likely want to see them right away.

It’s important to know what foods are ok for your dog to eat. Most dogs will eat just about anything, so it’s up to us to make sure to keep them safe. Learn what’s on the list and if you think you may forget, put a copy up on your fridge or something you can easily refer to just in case.
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Degenerative Myelopathy

10/10/2021

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Degenerative myelopathy, also known as DM, is a tough diagnosis for any pet parent. There is no known cure and it causes significant mobility issues eventually leading to paralysis. However, there are things you can do to help improve and maintain your dog’s quality of life for a period of time. Here is what you need to know about degenerative myelopathy, and what you can do to help your dog.

What is Degenerative Myelopathy?
Degenerative myelopathy is a rare disease and the exact cause is unknown, but there appears to be a genetic component. It affects the spinal cord, causing progressive hind limb weakness and eventually, paralysis. It’s similar to a condition in humans called amyotrophic lateral sclerosis (ALS), also known as Lou Gehrig’s Disease.

In its early stages,  clinical signs of DM may appear similar to osteoarthritis, which can complicate diagnosing this condition. Dogs with DM generally have normal bladder and bowel function in the beginning, as well. As the disease progresses, dogs have weakness and ataxia, or stumbling and wobbling, and they may develop urinary and fecal incontinence as paralysis sets in. Dogs generally don’t appear to have pain, only weakness.

A gene mutation is suspected as a possible cause, though scientists don’t know for sure. It’s believed that dogs with two copies of the mutated SOD-1 gene can develop DM, however, not all dogs do. With DM, the nervous system pathways in the spinal cord are disrupted so the brain can’t communicate with the limbs to signal them to work properly.

Signs of Degenerative Myelopathy
There are a number of signs for DM that will progress as the condition worsens. Here are some of the early signs to look for:

  • Your dog’s hindquarters seem to sway when standing.
  • Uncoordinated gait. DM often starts with one rear leg and moves to the other.
  • Collapsing easily when pushed from the side.
  • Hind paws turn under (knuckle) so the dog walks on its knuckles.
  • Hind feet scrape the ground when walking. You may notice the tops of the toes lose hair from this happening continuously. The nails on the hind feet may wear down excessively too.
  • Your dog has difficulty getting up from lying down.
  • Loss of muscles in the hind legs.

As the condition progresses, these signs worsen. DM eventually leads to hind-end paralysis where the dog is completely unable to use his hind legs. Ultimately, the condition will progress to the front legs, and finally to the muscles involved in breathing.

Is My Dog at Risk?
Unfortunately, there’s really no way of knowing for certain if your dog is at risk. There is a genetic mutation, SOD-1, which has been identified as a risk factor for DM. Dogs can be tested for this gene, but as mentioned, just because a dog has this anomaly doesn’t mean they will develop the disease. This DNA test is readily available and easy to do, however.

Certain breeds may be more prone to it including German Shepherds, Siberian Huskies, Collies, Boxers, Poodles and miniature Poodles, Corgis, Ridgebacks, and some others. But the truth is that they have found a correlation but not a cause.

DM is most common in middle-aged to older dogs with the average age of onset being 8 years of age, but ranging from 4 to 14 years of age. Though, occasionally it has been diagnosed in younger dogs.

How is DM Diagnosed?
Your veterinarian will review the medical history, do a physical exam, and run diagnostic tests like X-rays and others to rule out other joint issues like hip dysplasia and osteoarthritis. It’s not easy to definitively diagnose as histopathology of the spinal cord is required. So, it’s a process of testing and ruling things out to determine the diagnosis. Your veterinarian may also refer you to a veterinary neurologist for further testing.

A neurologist may also run some tests including tissue biopsies, neuromuscular tests, cerebrospinal fluid analysis (CSF), or an MRI. For any dog that is an at-risk breed and displaying symptoms consistent with DM, a DNA test to check for the gene mutation is also recommended. Though it’s not a definitive diagnosis, it does show a likelihood that gets factored in with diagnosing this condition.

How is Degenerative Myelopathy Treated?
Degenerative Myelopathy is a progressive disease with no cure. Treatment is about managing concurrent medical issues like arthritis to provide pain relief and maintaining an ideal weight. Targeted exercise is important to maintain muscle mass, strength, and balance for as long as possible. The goal is to slow down the progression of the condition allowing your dog to retain function and mobility as long as possible. Consistent and aggressive physical rehabilitation has been shown to slow the disease down and extend your dog’s life, while also improving quality of life.

A variety of mobility assistive devices are commonly utilized to facilitate movement and allow as much independence as possible, for as long as possible, through the various stages of DM. A cart, or “doggie wheelchair” can help improve a dog’s quality of life when the disease advances. With the right care and guidance, many dogs with DM can enjoy a very good quality of life even in this stage of the disease. 

What Should I Do if I Suspect My Dog Has DM
If you think your dog may have DM, make an appointment with your primary vet right away. It does take some time to run the tests to rule other issues out. If your vet does believe your dog has DM, please consider physical rehabilitation as soon as possible. The sooner we start building and maintaining your dog’s muscle mass, the better they will be for longer.
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What is Electrical Stimulation Therapy and How Can It Help My Dog?

7/22/2021

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There are many different therapies that can be used to help your dog feel better when dealing with a musculoskeletal issue. Whether it’s an acute injury or a chronic condition, these holistic therapies can not only improve the quality of life for your dog, but they can actually help to stimulate the healing process. One of these therapies is called neuromuscular electrical stimulation therapy.

There’s a lot to know about electrical stimulation therapy including the types available, the benefits, and what conditions it may help. Here’s what you need to know so you can talk with your doctor to see if electrical stimulation therapy might be right for your dog.

What is Electrical Stimulation Therapy?
Electrical stimulation therapy, also known as electrotherapy or E-stim, is using low-to-mid levels of electrical current in the body. It has been used in humans successfully for years. E-stim was first introduced in racehorses, then in companion animals like dogs.

The primary goals of E-stim are to strengthen muscles that have begun to atrophy, relieve pain (often following surgery or an injury), reduce stiffness and inflammation, and optimize muscle range and motion. It’s commonly used with sporting dogs (who do agility and the like) though it can be used for most dogs. Though this type of therapy isn’t often used in general veterinary practice, it’s frequently used in rehabilitation.

There are two types of electrical stimulation therapies used for dogs: NMES and TENS. Both are non-invasive, non-painful, and safe therapeutic techniques that can be used in conjunction with canine physical rehabilitation techniques like cold laser therapy, heat therapy, therapeutic exercises, and others.

NMES
Neuromuscular Electrical Stimulation (NMES) stimulates muscle contraction using electrical impulses. It stimulates motor nerves in the central nervous system, often the spine. NMES helps to build muscles and has been found to be very effective in rehabilitation.

NMES uses higher frequencies than TENS to strengthen muscles, causing them to contract. It’s often used in patients who are too weak to move certain muscles or muscle groups. This weakness could be due to atrophy from an injury or from a neurological issue. NMES can also be used for preventive therapy for partially or totally immobilized patients.

TENS
TENS stands for transcutaneous electrical nerve stimulation. It’s a type of NMES that involves the use of electrical stimulation to primarily provide pain relief. It is used in lower frequencies and targets sensory nerves to override pain impulses.

To use TENS, electrode pads are placed against the animal’s skin or coat with a conductivity gel. When turned on, the unit delivers a low-level electrical current to the area touching the electrodes. The effect of TENS is short-lived, though, and may only last around an hour or so. It is sometimes used immediately post-operative to help manage pain and during therapy to help work through a potentially painful treatment.

Benefits of Electrical Stimulation Therapy
Electrotherapy, including both NMES and TENS, provides a number of health benefits for dogs since it can be used on both the sensory and motor nerves. It strengthens muscles and can re-educate them, reversing muscle atrophy. Electrotherapy can also provide pain control or relief, a reduction of inflammation, and promote wound healing.

Electrical stimulation therapy causes change at the cellular level and at the tissue level. NMES has been found to rehabilitate muscles, prevent muscle atrophy, and maintain or increase joint mobility. TENS is generally used for pain management. Both also help with lymphatic drainage and overall circulation, providing additional benefits.

E-Stim Sessions
The feeling of e-stim is similar to a tingling sensation and you can ask to try it out to see what it’s like before it’s used on your dog. Most dogs enjoy it once they are used to it and the sessions are comfortable and relaxing. Your dog won’t need recovery time from an electrical stimulation therapy session.

The frequency and duration of electrical stimulation therapy sessions will depend on a number of factors including the type of injury or surgery, the extent of neurological or muscular damage, and your dog’s medical history. Sessions often last between 10 and 20 minutes, and they may be recommended multiple times a week during an acute period (like immediately following an injury or surgery).

Because we don’t have the ability to ask about the sensation during treatment, vets start off low and slowly increase the frequency. The electrical current and duration is adjusted based on the dog’s size,  weight, and response to the sensation.

Should Your Dog Try E-Stim Therapy?
Talk with your vet or your rehab vet to see if electrical stimulation therapy may be helpful for your dog. It’s a safe and effective treatment and one of the great tools in every rehab vet’s arsenal to help your dog live a better, happier, and healthier life.

A word of caution: there are home electrical stimulation therapy kits available. Though you may be able to provide e-stim treatments at home, it’s important to only do so under a vet’s care and instruction to make sure you don’t worsen the issue.
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Common Conditions That Benefit from Canine Physical Rehab

6/20/2021

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Canine physical rehab can help your dog with a lot of different medical issues due to a medical condition or an injury. Incorporating rehab into the healing process safely promotes a faster return to health for your dog. 

The goal of canine physical rehab is to help your dog live a better life. By improving mobility and decreasing their pain, we can help your dog by improving their quality of life, and sometimes even help them live longer. Here are some of the most common conditions I see in my practice that have great results with rehab.

Hip Dysplasia and Elbow Dysplasia
Hip dysplasia is a genetic condition where the head of the femur (thigh bone) and the socket in the pelvis (the “ball and socket” of the hip joint) don’t grow uniformly. This causes looseness in the joint and eventually degenerative joint disease (DJD) or osteoarthritis (OA). Elbow dysplasia is similar and occurs in the elbow of the front leg instead of in the hip.

Dogs are born with this condition and though it tends to be more common in large-breed dogs (50 pounds or more), it can happen in any dog. Symptoms can present as young as four months of age though most show signs as they age due to osteoarthritis in the affected joint(s).
Symptoms to look out for:
  • Decreased activity
  • Lameness in the hind end (or in the case of elbow dysplasia, a front leg)
  • Decreased range of motion
  • Reluctance or difficulty rising, running, or jumping
  • Pain, stiffness, or limping
  • Swaying “bunny hop” gait
  • Loss of thigh muscle mass and enlargement of shoulder muscles due to compensation 
  • A grating sound in the joint

How Physical Rehab Can Help
There are several things we can do to help your dog. First, it’s helpful if a dog with dysplasia doesn’t carry extra weight. We can determine your dog’s ideal weight and work together to reduce it if needed. 

We can also discuss the supplements your dog can take and if medications like NSAIDs (non-steroidal anti-inflammatory drugs) may be appropriate. We can create an exercise regime to help improve mobility and muscle tone. And, we can also work to manage pain with treatments like cold-laser therapy, and others. If your dog does need surgery, we can work to rehab your dog to get him back to health as quickly as possible while helping to manage pain.

ACL Injuries
The cranial cruciate ligament (CCL) is a ligament in the knee that attaches to the femur (thigh bone), runs across the knee, and attaches to the tibia (shin bone). Its purpose is to hold the tibia in place, preventing hyperextension and internal rotation. This ligament is called the ACL, or anterior cruciate ligament in humans.

CCL ruptures are most common in large and giant dogs, however, they can happen to dogs of any size. They are the most commonly seen orthopedic injury in dogs. These injuries are often due to overexertion during high-impact activities, though that’s not always the case. Even a partial tear is extremely painful and a serious injury.

Symptoms to look out for:
  • Lameness or limping on one rear leg
  • Inability to bear weight on the leg
  • Swelling around the inside of the knee
  • Difficulty laying down or getting up
  • Tenderness near the knee

How Physical Rehab Can Help
Physical rehab may be an appropriate course of treatment in some cases. The ligament cannot grow back together, however, the dog can build up scar tissue to stabilize the joint to return to normal activity over time.

Treatment will depend on the level of injury and the dog’s condition, but it generally includes rest, anti-inflammatories, cold-laser therapy, and an Assisi loop. We start slowly with short walks and then work up to exercises to strengthen the muscles around the knee. It’s a long and slow process but in some cases, we can avoid surgery. Should your dog require surgery, we can certainly work together to help your dog with healing and improving mobility and strength.

Back Pain and Disc Disease
There are a number of different medical conditions that can cause back pain in dogs as well as nerve-induced weakness in the back legs. These include spinal arthritis, degenerative myelopathy, and disc disease (also known as degenerative disc disease or intervertebral disc disease, or IVDD). 

In the case of arthritis, inflammation or a bone spur in the spine puts pressure on the spinal cord. Degenerative myelopathy (DM) is a genetic disease affecting the spinal cord that results in slowly progressive hind limb weakness and paralysis in older dogs. And degenerative disc disease or IVDD are where the vertebrae bulge or burst into the spinal cord space, causing pain, nerve damage, and sometimes paralysis.

Each of these conditions is different, however, many of the symptoms and treatments are similar. The causes can range from genetics to an injury to aging.

Symptoms to look out for:
  • Abnormal gait
  • Paralysis, “knuckling,” where the hind paws turn under, or the dog’s hindquarters seem to sway when standing still
  • Difficulty getting up from a lying position
  • Unwillingness to play or jump
  • Reduced activity
  • Pain and weakness in rear legs
  • Crying out in pain
  • Anxious behavior
  • The dog falls over easily when pushed from the side
  • Loss of bladder and/or bowel control or inability to posture properly to eliminate

How Physical Rehab Can Help
The treatment will very much depend on the cause of the symptoms. Pain management is a very important part of treatment as well as trying to keep these issues from progressing further. Managing weight to reduce its impact and helping the dog build strength and muscle to counteract these issues are also important. 

Osteoarthritis (OA)Osteoarthritis is a progressively worsening inflammation of a joint that is caused by a deterioration of cartilage (also known as DJD, or degenerative joint disease). The cartilage acts to cushion joints allowing a smooth and full range of motion. The loss of cartilage causes inflammation, pain, and a decreased range of motion.

Any joint can develop osteoarthritis though it’s most commonly the lower spine and limbs. Any dog can develop osteoarthritis, and though it’s more common in aging dogs, young dogs may also have an issue with it. Large or giant breed dogs are more prone to osteoarthritis. 

Other risk factors include genetics, obesity, improper nutrition, injuries or conditions like fractures, ligament tears, hip or elbow dysplasia, and age. It’s also fairly common in athletic dogs due to repetitive stress to the joint(s) from things like agility and flyball.

Symptoms to look out for:
  • Reluctance to play, run, and jump
  • Weight gain
  • Lethargy
  • Pain when being touched
  • Stiffness, difficulty getting up, lameness, or limping
  • Loss of muscle mass around the spine and limbs
  • Accidents in the house or difficulty getting positioned to urinate or defecate
  • Changes in behavior or irritability

How Physical Rehab Can Help
We’ll first evaluate your dog’s mobility, weight, supplements, and medications to make adjustments as needed to help improve your dog’s quality of life. We can’t reverse osteoarthritis, but we can try to help it from getting worse quickly and can manage pain.

Then, we’ll work on an exercise plan to strengthen the muscles around the impacted joints. While we do this, we’ll incorporate treatments to help with pain management like cold-laser therapy, and an Assisi loop.

What You Can Do About These Common Conditions
Though I see a wide range of mobility issues in my private practice, these four are what I see most often. If your dog is showing any of the symptoms mentioned, know that there’s hope. As a rehab vet, I have a lot of tools in my arsenal to help your dog live a happier and healthier life. Generally speaking, the earlier you begin treatment, the better off your dog will be. Though many of these issues aren’t curable, they certainly are treatable.
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Options for Knee Injuries In Dogs — CCL Ruptures

5/23/2021

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If your dog suddenly starts limping or not bearing weight on one of his back legs, there’s a good chance he has injured their knee. One of the most common orthopedic injuries in dogs is tearing one of the ligaments in their knee, the cranial cruciate ligament (CCL). It can be a devastating and potentially costly injury. Here’s what you need to know about CCL tears and the treatment options for your dog.


What is a CCL Tear?
The cranial cruciate ligament (CCL) is an important ligament in the knee, also known as the stifle joint. The CCL attaches to the thigh bone (femur), runs across the knee, and then attaches to the shin bone (tibia). It holds the tibia in place, preventing hyperextension and internal rotation. The cartilage located between the femur and the tibia, called the meniscus, is responsible for absorbing impact.

This same ligament is called the anterior cruciate ligament (ACL) in humans. When the CCL is ruptured, it means the ligament suffers a tear. This causes partial or complete joint instability, lameness, and pain. Your dog may limp or may not be able to use the leg at all. When there is a CCL rupture, the meniscus can be torn due to the knee’s instability then.
Here’s the big problem: torn ligaments can retract, causing them not to heal completely. So, if the injury remains untreated, it may lead to degenerative joint disease and permanent damage to the connective tissues in the knee. What this means is that they can cause permanent lameness in your dog’s leg if not treated and leaves them at higher risk for injuring the other leg due to compensating for the injury. CCL ruptures are very painful and unfortunately, it’s a common and serious injury.

What Dogs Are at Risk for a CCL Rupture?
CCL ruptures are one of the most commonly-seen orthopedic injuries in dogs and they are the most common cause of degenerative joint disease in the knee. Any dog may be at risk for this type of injury. They happen to dogs of all sizes, though they tend to be most prevalent in large and giant breed dogs. Activity, breed, obesity, and age are all factors that may increase a dog’s risk of this type of injury.

Though CCL injuries in dogs often occur due to overexertion during certain kinds of high-impact activities, this may not always be the case. Some dogs are just prone to this and can tear their CCL doing something as minimal as jumping off the bed. Others may have this injury who are more athletic.

Another fairly common knee issue is called patellar luxation. This is a congenital knee condition that is more common in small dogs where the kneecap rides outside of the femoral groove when the knee is flexed. In “layman’s terms,” people refer to this as the kneecap popping out. It is important to recognize that if your dog has a luxating patella, it increases your dog’s risk of a CCL injury too.

Sign of a CCL Rupture and What to do if You Suspect One
The severity of the CCL injury will impact the dog’s clinical signs. You might see a range from a slight limp to the dog being entirely unable to bear weight on the injured leg. You might also see swelling around the inside of the knee. Your dog may favor one leg or have difficulty lying down or getting up. You might also notice your dog react to pain or tenderness near the injured knee when you touch him.

If you suspect your dog may have a CCL tear, you should call your vet to schedule an exam as soon as possible to avoid further damage and put your dog on crate rest. The vet can do a physical exam to identify this type of injury by testing for the presence of what’s called the “drawer sign.” When the vet holds the dog’s thighbone in place, if there is a CCL tear, the shinbone can be pulled forward, similar to a drawer sliding open.

A vet may also take x-rays to investigate the extent of the damage and to determine if there may be other issues like arthritis, bone fragments, and the presence of fluid in the joint.

Treatment Options of a CCL Injury
Though most people expect surgery will be required for a CCL tear, that’s not always the case. It depends on a number of things including your dog’s overall condition, activity level, and the extent of the injury.

Surgery
There are four common surgical options used to correct a CCL rupture in dogs including:
  • Arthroscopy — For partial CCL tears and meniscus tears with very minimal damage, they may be repairable through arthroscopy. It’s a technique that is minimally invasive and can be effective with very minor tears.
  • Tibial Plateau Leveling Osteotomy (TPLO) — This surgery entails cutting and leveling the tibial plateau. Then the surgeon stabilizes it using a plate and screws, eliminating the need for the ligament by changing the angle of the knee when your dog is bearing weight on it. It’s an expensive surgery often used for larger breeds and active dogs.
  • Extracapsular or lateral suture — This technique stabilizes the knee using sutures placed on the outside of the knee joint. It’s commonly used for small-to-medium-sized dogs that are 50 pounds or less and typically less active dogs.
  • Tibial Tuberosity Advancement (TTA) — This surgery cuts the top of the tibia, moves it forward and stabilizes it using a plate. It replaces the function of the CCL instead of repairing it.

Physical Rehabilitation for CCL Ruptures
In some cases, physical rehabilitation may be a helpful and appropriate course of treatment. In my practice, I have rehabbed many dogs with CCL ruptures. The ligament cannot grow back together—think of it as a fraying in a rope. However, a dog’s body can build up scar tissue that stabilizes the joint so he can return to normal activity over time.

The treatment varies based on the dog’s injury and condition, but it generally includes restricted activity, anti-inflammatories, cold-laser therapy, and the use of an Assisi loop (which you do at home). We start slowly with very short walks and work up to exercises to strengthen the muscles, other ligaments, and tendons around the knee, much of which you do at home.

It’s a long and slow process requiring consistent work and vigilance to ensure the dog doesn’t do anything to further the injury. However, for the right dog (and family), it may be a great option worth considering to avoid costly surgery or if surgery is not an option. If you think your dog may have a CCL rupture, schedule an appointment with your primary vet or rehab vet.
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Safe and Effective Ways to Manage Pain in Dogs

4/4/2021

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The last thing any of us want is for our dog to be in pain, especially when there are things we can do about it. Take note of any symptoms you think may be due to pain and talk with your primary vet as they have the training to help assess your dog. If you and your vet do decide your dog is in pain, there are many treatment options available, depending on what is causing the pain. Here are some of the holistic options for musculoskeletal excluding pharmaceuticals.

How to Tell if Your Dog is in PainIt can be challenging sometimes to know if your dog is in pain as they tend to hide it and may only show subtle behavioral and physical signs. Pain in dogs can be acute or chronic, and the type of pain they are feeling can impact their response to it.

Acute pain is typically due to a recent event or over a short period of time due to things like surgery, injury, or illness. Acute pain tends to be a bit more obvious and your dog is more likely to show signs of things like limping or an unwillingness to get up.

Chronic pain lasts for a longer time and doesn’t improve once the issue is healed as acute pain does. It may be caused by things like osteoarthritis and neuropathy. The signs of chronic pain are often much more subtle, making it much harder to identify that your dog is in pain and where the source is.

Some common signs of pain include panting, trembling, sensitivity to touch, restlessness, excessive licking, and unexplained barking or whining. There can also be behavioral signs, like if your dog stops wanting to do the things they love or possibly even if they are following you around less. 

Why You Should Try to Manage Your Dog’s Pain
Dogs feel pain just like people do. If you have ever been in pain for a prolonged period of time, you know how exhausting and debilitating it can be. Not only is dealing with pain wearing, but pain can also impact healing time and quality of life. Dogs who are in pain may socially isolate, and may not behave as they normally do, drawing pleasure from activities like eating, going for walks, and others. 

So, if you see your dog retreating from normal behaviors, this may be a sign that their pain is at a level that needs to be better managed. By managing your dog’s pain, you can actually help them  heal faster and be happier overall than doing nothing . And, don’t you want the very best for your best buddy?

Holistic Options for Pain Management
Instead of running to pharmaceuticals like NSAIDs which can cause some undesirable side effects, there are a number of other options to help with pain management and strengthening your dog.

Canine Physical Rehabilitation
Canine physical rehab is a treatment that adapts human physical therapy techniques to improve the mobility and function of joints and muscles in dogs. It seeks to improve the quality of life for dogs while decreasing pain.

Trained canine physical rehab vets will use a number of modalities and therapies in their practice including those listed in this article. Additionally, they incorporate things like therapeutic exercises, therapeutic massage, manual therapy, the use of orthotics and prosthetics when required, and others. 

By choosing a vet with the Canine Rehabilitation Therapist (CCRT) certification, you know they have the training required to safely and effectively help your dog. They have advanced knowledge of pain management, strengthening, and conditioning to help improve your dog’s quality of life. 

Cold Laser Therapy
Cold laser therapy uses beams of light to stimulate cell generation and to increase blood circulation, known to help reduce pain and inflammation and increase mobility. Essentially, it helps the body heal at a cellular level.
Cold laser is non-invasive, drug-free, and there is no pain with its use. This isn’t the laser you may be thinking of! It’s an effective option on its own or with other treatment modalities.

Though it can be used on most dogs, cold laser should not be used on a dog with metastatic cancer (where cancer has spread to multiple areas), not at the site of a tumor as it does stimulate cell growth It also should not be used on the uterus of a pregnant dog.

Assissi Loop
An Assissi Loop is an FDA-approved device that emits bursts of microcurrent electricity that penetrates the tissue around where the loop is placed. It causes a chemical process known to promote healing and since it penetrates fur, casts, and bandages, it can be used effectively on humans, dogs, cats, and horses.

The loop uses 15-minute timed treatments and it’s easy to use as it’s non-invasive. In fact, most won’t feel anything at all, and those that do generally only feel a mild tingling sensation.

The Assisi Loop promotes blood flow, and not only speeds up the healing process but also can reduce inflammation and reduce pain. It’s an effective treatment option and has no known side effects.

TENS Unit
Transcutaneous Electrical Neuromuscular Stimulation, or TENS, sends low-level electrical current to injured or weakened muscles, stimulating them to contract. It’s used primarily for pain management.

An electrode may be placed at trigger points—tight balls of muscle fiber that can’t completely let go of the contraction. These muscle knots, as they are called, cause pain. The electrical impulse stimulates sensory nerves, causing an overload that limits the ability of the nerves to transmit pain signals to the brain.

Treatment benefits are short-lived, often only lasting for an hour or up to a few. However, it’s a helpful therapy for acute pain following surgery or other trauma.

Hydrotherapy
Hydrotherapy is one of the best-known forms of physical rehabilitation used for dogs. It is the therapeutic use of water for improving health and it consists of two types for dogs: underwater treadmill and therapeutic swimming.

The underwater treadmill is probably what comes to mind when you think of hydrotherapy. It’s a manual or motorized treadmill encased in a glass or plastic chamber that the dog enters. The door is closed and the chamber fills with water until it’s just above the dog’s legs. The water provides resistance while reducing stress to provide a low-impact workout.

Therapeutic swimming is an exercise using controlled swimming to help your dog gain strength and build muscle. It’s a no-impact workout and can be done in a pool specifically designed for it or even in a regular swimming pool if the water is a comfortable temperature for your dog.

Hydrotherapy provides a good cardiovascular workout as well as building strength. However, it doesn’t enable the targeting of certain muscles. It may be beneficial, though, and it can be used effectively with other therapeutic treatments

Consider the Many Ways to Treat Pain for Your Dog
There are a lot of options at your disposal for effectively and safely managing pain in your dog. If you think your dog might be in pain, make an appointment with your vet if you don’t know the cause or before you introduce any new treatment for your dog to manage it. If you’re not sure—ask. Your dog will thank you for it.
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Psychological and Emotional Aspects of Pain in Dogs

2/22/2021

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When we think of pain, we generally think of the physical effects—our dog cannot walk or walks with a limp, a surgery wound, or something similar. But pain doesn’t only impact us in physical ways—it also affects them in psychological and emotional ways.

If you have ever had surgery or broken a bone and have been down or frustrated by your limitations, you’ll probably understand this. Here’s what you should know about the other aspects of pain that can impact your dog and what you can do about it.

Types of Pain in Dogs
Pain in dogs is typically either acute or chronic. Acute pain is caused by a recent event occurring over a short period of time due to an injury, illness, or surgery. It often comes on quickly and improves quickly as well, once the issue causing the pain is healed.

Chronic pain lasts for a longer period of time, and longer than the expected healing time would be. Acute pain can become chronic pain if it extends longer than expected. An example would be if an injury doesn’t heal properly, leaving some residual pain. Chronic pain can be from many things, and some of the common causes are osteoarthritis and neuropathy.

How Do You Know When Your Dog is in Pain?
We know dogs feel pain as they have ways of indicating that they do. Your dog may express their pain in physical ways, like limping, panting, restlessness, excessive licking, and other ways. Sometimes these signs can be quite obvious, and other times your dog’s signs of pain can be subtle, so it’s not always easy to be sure.

You may also notice behavioral changes in your dog, either with or without these physical demonstrations of pain. You may see that your dog stops wanting to go for walks or playing their favorite game of fetch. So, these behavioral changes can be similar to some of the physical signs. Or, they could be more general, like if your dog seems withdrawn or anxious.

It can be hard to tell as many of these signs of pain can be subtle. And, for something like your dog not wanting to go for a walk, there could be other reasons for the change in behavior that are not due to pain. When It’s a slow change over time, it can be even harder to link the behavioral change to pain.

Impacts of Pain
According to the International Association for the Study of Pain (IASP), pain is “an unpleasant sensory and emotional experience associated with actual or potential tissue damage…” Generally speaking, it’s is our body’s way of indicating something is wrong. Though the more traditional view of pain is a physical issue, IASP’s definition indicates equal significance given to the sensory experience and the physical issue. 

Physiological Impacts of Pain
Dealing with pain over time can lead to physical changes in the body. The intense physiological stress response due to pain can lead to delayed healing, which can prolong pain. It can also cause decreased gastro-intestinal (GI) mobility, leading to bacterial overgrowth and issues like sepsis, a systemic infection that can cause multiple organ failures.

Prolonged pain can also cause water and sodium retention, which can be particularly problematic for animals with heart disease. It can also cause a decrease in taking in oxygen and getting it to the cells throughout their bodies that need it. All of these issues can negatively impact our dog’s quality of life, which, at its most dramatic levels, can cause a threat to survival.

Psychological Impacts of Pain
Pain isn’t only unpleasant physically, but it’s also negative from an emotional level as it causes fear. It can bring about undesirable consequences as pain can trigger a continuum of fear, anxiety, and stress, leading to more pain and suffering.

Critically ill and critically injured dogs may exhibit social isolation where they hide themselves away somewhere. They also may not behave normally, not wanting to eat, go for a walk, or snuggling with you. 

Benefits of Treating Pain
So, it’s not just a matter of their pushing through to deal with the pain. You can actually help improve their life by helping them to manage it better. The impact of pain is not just the reaction that something hurts, but the true impact is suffering.

By treating pain, you can improve your pet’s physical, psychological, and emotional condition. Many of the improvements can be measured through blood work, testing, and a physical exam. The psychological and emotional improvements can’t be so easily measured but often have a greater impact on your pet.

If you have ever had a dog that either gets sick or goes through surgery, you’ll likely understand this as you have seen the impact. At first, your dog may just want to sleep a lot, doesn’t move around much, and may not want to eat. As your dog heals, you feel like you “got your dog back.” Maybe they seek your attention again, eat, and are more playful—regardless of the specific behaviors, your dog is acting like your dog again. It’s a cycle as when your dog feels better, your dog will heal faster, and their body will run more effectively.

What to Do if You Believe Your Dog is in Pain
If your dog is exhibiting symptoms of pain, and particularly, multiple signs, schedule an appointment with your vet. It’s a good idea to document what you’re seeing and when to help you and your vet find any trends to help identify the cause.

If you know the cause, share that with your vet to discuss treatment options. Some pain is ok, and it’s part of life. For example, your dog is going to be in some pain after surgery. However, you can help to manage and reduce the pain for both acute and chronic medical issues to help your dog live a better and happier life.

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Subtle Signs of Pain in Your Dog (That You Might Miss)

1/24/2021

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It can be a tricky thing to identify pain in your dog. Since your dog can’t tell you how they’re feeling, dog owners are reliant on looking for signs that can be rather subtle to identify pain. And to make it even more challenging, dogs tend to hide their pain and often show only subtle behavioral and physical signs, making it even harder to notice. Here’s what you need to know about the subtle signs of pain your dog may exhibit.

The Types of Pain in Dogs
The most common types of pain in dogs are either acute or chronic pain. With acute pain, the cause is due to a recent event over a short period of time. This could be due to injury, surgery, or illness. It generally improves quickly and once the issue is healed, the pain generally is gone. 

Chronic pain lasts for a longer period of time than the expected time-frame for healing. Or, it is sometimes associated with certain medical conditions like osteoarthritis, neuropathy, cancer, and others. Acute pain can also become chronic pain that extends over a period of time. 

Signs Your Dog is in Pain
Some of the signs of pain your dog may express are physical and some are behavioral. For example, if your dog is limping, that’s a pretty clear physical sign of pain and one that should be checked out by a vet. Signs of acute pain tend to be a bit more obvious, though not always. 

Some signs of pain can often be a lot more subtle or hard to define. Here are some examples and things to consider:

  • Trembling—Could your dog be cold? Does he have a history of anxiety? Trembling for no identifiable reason can be an indication of pain.
  • Panting—Has your pet recently been active? Is your dog hot and possibly overheated? If the panting is not otherwise explainable, it may be a sign of pain.
  • Sensitive to the touch—Is your dog not letting you pet him as he normally would? Does he cry out, flinch, or move when you touch a certain area? Sensitivity to touch can be another indication of pain.
  • Restlessness—Is your dog pacing a lot? Does he pop up quickly after sitting down or laying down? This sign of agitation can be a sign of musculoskeletal pain.
  • Unwilling to lay down—On the flip side, does your dog not want to lay down at all? Or perhaps, he puts his front end down only and doesn’t put his back end down. When dogs do this it could be abdominal or musculoskeletal pain.
  • Inability or reluctance to move its head—Is your dog not willing or hesitant to move its head or neck, either side-to-side or up and down? This could be when taking a treat, eating from its food bowl, or other situations. If so, this could be caused by pain.
  • Unexplained barking or whining—Does your dog bark, whine, or vocalize when not expected? So, not when you get his leash or grab his bowl, but at an unusual time. This is something to keep an eye on as it could be a sign of pain. 
  • Changed tail position—Does your dog’s tail usually hang down but it’s upright? If it seems unusual to you, it’s something to keep an eye on.
  • Excessive licking—Is your dog licking a certain area frequently or just licking more in general? This could be an indication of anxiety and of pain.

Another thing to be aware of is changes in your dog’s behavior. Have you noticed increased anxiety or withdrawal? This could be similar to some of the signs above, or it could be more generalized. For example, if your dog stops wanting to go for walks or doesn’t want to eat. 

Chronic pain can trigger depression and anxiety in dogs, just as it can in humans. If you notice your dog doing any of these things, or several, keep an eye out. 

When You Should Go to the Vet
Some of these signs can be really subtle. And with chronic pain, they can slowly increase with time so you don’t notice them. It’s easy to get caught up in life and when they progress slowly, it’s easy to attribute them to general aging. However, once you notice any one of these, or especially if there are multiple of these signs, it’s a good idea to get your dog checked out by a vet.

Keep a list of the signs that you’re seeing and when you notice them. It’s particularly helpful to understand how frequently they are happening and if there is some precipitating activity causing them. Does your dog seem reluctant to lay down after a long walk? Does he get restless after a game of fetch? This can help you and your vet determine what the issue may be so you can help to manage it.

It can be really challenging figuring out if your dog is in pain. Unfortunately, they can’t tell us! If you notice unusual behaviors or you realize they are not doing things they have always enjoyed, it’s a good idea to get them checked out by a vet.
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    Dr. Sonnet Jarvis

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