AZ- Dr. Sonnet blogs on nutrition, exercise and physical rehab for dogs in Phoenix

What to Expect from a Canine Rehabilitation Session & How to Prepare

12/26/2022

There are many ways we can help our dogs live happier and healthier lives, and canine rehab can be one of these ways. It’s aimed at helping your dog achieve the best quality of life possible with the highest level of independence and function possible while decreasing pain.

Rehab can be an effective way to help your dog heal from a surgery or injury or deal with a mobility issue. Here’s what you can expect from canine rehab and how to prepare for your first session.

Check out this post if you’re wondering if you should consider canine rehabilitation.
What is Canine Rehab Therapy?Canine rehabilitation is a field of veterinary medicine that treats dogs for the treatment and ongoing management of injuries, pathologies, and functional impairments. Rehabilitation is practiced by a vet, but human physical therapists may also offer animal physical therapy.

Rehab vets are trained to perform an assessment of a canine patient’s gait, mobility, flexibility, strength, endurance, range of motion, and other functional activities. Additionally, they evaluate a dog’s medical history to develop a tailored plan of care with short and long-term goals.
How to Prepare for Your First Canine Physical Rehab SessionThere are some activities you can do in advance of your first session with a rehab vet to ensure it’s as productive as possible. First, pull together all of your dog’s medical records, including diagnostic tests and results of procedures like x-rays.

Or, you can request that your vet send your dog’s records directly. If you saw multiple vets, like your primary vet and a surgeon, have both send their medical records.

Also, keep track of any symptoms you may see. Is your dog limping? Does anything specific seem to bring this out or is it a regular issue? Document anything you think of that could be related and what, if anything, you are doing about it.

Last, consider your commitment to a treatment plan. Treating your dog’s mobility issues will likely not be a “one and done” appointment with a rehab vet.

It may include regular visits, supplements and medications, and regular work at home including walks and structured exercises. This takes time and money. So, consider what you can and are willing to do to be prepared when you meet with the vet.
What to Bring to Your First SessionIt’s a good idea to bring a copy of your dog’s medical records to the first appointment if you can or to confirm the rehab vet received them.

Additionally, bring your pet’s supplements and medications. You can also bring an updated listing with you instead. Also, bring any documentation your captured tracking any issues you’ve witnessed that your dog is having and the details.
What You’ll Do During Your First SessionAt AZ Canine Rehab, the initial consultation consists of two sessions that are 55 minutes each. The first is an evaluation. I discuss the medical history with you as well as your observations. You complete a new client registration form.

We get to know each other a bit, then I evaluate your dog. This includes a full-body physical evaluation. We discuss treatment goals as well, as your participation is vital to your dog’s successful outcome.

The evaluation includes placing your dog on a stance analyzer to determine how the dog is standing and shifting weight. This important tool can identify issues before they can be directly observed, and it provides an objective measurement a rehab vet relies on for evaluation.

Following this first consultation, I craft a customized treatment plan designed for your dog based on the medical records and my evaluation. This may include a combination of the following:

Therapeutic exercises
Cold laser therapy
Manual therapy
Thermotherapy
Muscle stretching
Transcutaneous electrical stimulation (TENS)
Neuromuscular electrical stimulation (NMES)
Education

A treatment plan is designed specifically for each dog. I demonstrate any therapeutic exercises I recommend for your home program to ensure you understand how to do them effectively. This includes if there are any tools you’ll need to do them.

Doing the exercises at home can help to reduce the frequency of visits. Though, it’s a good idea to follow up in person to ensure they are done correctly and to follow up on progress. This way, we can modify based on how your dog is at that time.

Once I complete the treatment plan, I share the results of the evaluation and the plan with your primary vet. Additionally, I share updates as the treatment progresses.

Ultimately, follow-up appointments depend on your dog’s needs, goals, commitment to care, and financial abilities. Please know that I’m committed to helping you and your dog, regardless of where you’re at.
Follow-Up SessionsAt subsequent appointments, your dog returns to the office for a workout. We run through some of the exercise plan you have for continued work at home to make any needed adjustments. This could be postural changes or an exercise change.

Your dog may also get therapeutic treatments like cold laser or others, depending on his or her needs. Follow-up appointments may be 25 or 55 minutes.

Canine rehabilitation can be an effective way of helping dogs with a variety of medical needs. I hope this helps to demystify what happens during the initial and subsequent sessions!

How a Stance Analyzer Helps a Canine Rehab Vet

11/1/2022

There are a lot of tools in a canine rehabilitation vet’s arsenal to help diagnose mobility issues in your dog. One of the first you may see in your introductory appointment is a stance analyzer.

Learn more about what a stance analyzer is and how it helps your vet determine a game plan for helping your dog.

What is a Stance Analyzer?
Stance analyzers are a tool your dog steps on, placing a paw in each quadrant on the plate. It assesses the weight distribution on each leg, detecting unequal weight distribution.

This tool can help a vet diagnose medical issues like hip dysplasia, degenerative myelopathy, osteoarthritis, intervertebral disc disease, and cruciate ligament tears (CCL).

It’s an accurate, objective, non-invasive, and fast method to collect data. And, it’s easy to use as a vet can remotely control it to take fast snapshots of the dog’s stance.

The system then averages the data collected by each capture to provide an overall assessment.

How Does a Stance Analyzer Help?
A stance analyzer helps your rehab vet quickly evaluate how a patient is standing and shifting weight. This is particularly helpful as collecting this data removes subjectivity and provides an objective reporting.

Knowing how a dog is holding their weight can help to identify lameness and where to look for it. Lameness is a clinical sign relative to a physiological or mechanical change in the body, resulting in an impact on their gait and the dog’s ability to move its body. It can be due to an injury, pain, or abnormal anatomy.

Evaluating lameness can be subjective and a challenge to quantify. With a stance analyzer, a vet has data with which to do so.

It can be used as an early warning system of sorts to identify an issue before an owner even realizes it. Just like people, dogs can learn to compensate for a feeling of discomfort or pain. Mild lameness can often unnoticed, even by a vet.

By identifying lameness early on, the vet and owner have the means to proactively address the issue, before it becomes severe. A vet may recommend additional diagnostics, other treatment options, supplements, or prescriptions to help.

Who Uses a Stance Analyzer?
Rehab vets generally use stance analyzers during an initial evaluation of a dog. And, they also use it for re-checks to objectively determine progress from a prescribed treatment plan. And, if the stance analyzer doesn’t show progress, the data may suggest an alternative treatment is needed.

Primary vets may also use them during wellness exams, limping evaluations, and re-checks.

What's a Normal Reading on Stance Analyzer?
As you might expect, readings on a stance analyzer will vary. And most dogs don’t hold perfectly still, so rehab vets expect a range in the reading.

A normal reading is 30%/30% in the front and 20%/20% in the back. However, this can vary plus or minus by one or even two percent given a dog’s movement on the tool. This is why it’s important to take three to five “readings,” and each is an average of a dozen or so individual single readings.

What to Do if You Think Your Dog Has a Mobility Issue
If your dog is limping or seems to have a mobility issue, it’s a good idea to make an appointment with your primary vet right away. They are able to evaluate your dog to determine an appropriate course of action.

Of course, if your dog is currently seeing me, please bring it up at your next appointment. Or contact me and I can try to fit you in sooner. I do tend to book out a couple of months for new patients, and it’s often a good idea to not wait.

A stance analyzer is a useful tool for proactively identifying potential mobility issues, objectively securing data to quantify an issue, and determining the effectiveness of a mobility treatment plan. It’s one of many tools rehab vets use to help your dog live the best life possible.

Arthritis in Dogs and What You Can Do to Help

8/21/2022

An estimated twenty percent of all dogs will develop osteoarthritis. Since it’s a degenerative and progressive disease without a cure, this diagnosis can be quite upsetting to owners. However, you do have options!

If your dog does develop osteoarthritis, there are ways to improve quality of life by decreasing inflammation, controlling pain, and slowing the progression of the disease. The best outcomes are often found using multiple therapies simultaneously. Here’s how to know if your dog may be at risk, how you can help delay the onset of osteoarthritis, and what to do if your dog is diagnosed.

What is Canine Osteoarthritis?
Osteoarthritis (OA) is commonly simply called arthritis, and it’s also referred to as degenerative joint disease (DJD). This disease is a progressively worsening inflammation of a joint caused by the deterioration of cartilage. The cartilage may break down due to repetitive stress, injury, age, or disease.

When the joint loses the cushion of cartilage, the result is inflammation, pain, and decreased range of motion. Any joint in the body can develop arthritis, though it’s most often the limbs and lower spine that are impacted.

Osteoarthritis in Dogs: Is My Dog at Risk?
Osteoarthritis is typically found in older dogs. However, dogs at any age may develop it. There are a number of factors that may predispose your dog to osteoarthritis, including:

Age
Obesity
Breed—large or giant breeds
Poor nutrition
Genetics
Injuries like a torn ligament or fracture
Hip or elbow dysplasia
Pooconformationon
Highly repetitive athletic activities like agility and flyball
Bacterial or fungal infection and tick-borne diseases like Lyme disease, Rocky Mountain spotted fever, or others

If your dog has a predisposition to osteoarthritis, you’ll want to be sure to implement the preventive methods mentioned below. It’s also important to have regular vet visits and to be aware of the signs of pain in your dog.

Signs of Arthritis in a Dog
Osteoarthritis isn’t always easy to detect, especially in the beginning. Dogs often hide their pain until it becomes more severe when there is more damage to the joint(s). If you notice any of the following signs in your dog at any age, schedule an appointment with your vet.

Unwilling to play, lay down, or jump
Restlessness
Sensitive to touch
Trembling
Panting or excessive licking
Barking or whining with no explanation
Lethargy
Weight gain
Difficulty pottying or having accidents in the house

Pain can be very subtle, so keep a close eye on your dog. If you notice any of these signs, and especially more than one, it’s a good idea to schedule an appointment with your vet right away.

What Can I Do If My Dog Has Osteoarthritis?
To diagnose your dog, your vet will perform a full examination and will assess your dog’s range of motion. Your vet may also suggest x-rays as they show the degree of damage in a joint.

There are a number of things you can do around your home to make it easier for your dog. First, consider slip-free flooring if you can, like carpeting or even area rugs and runners. Keep your dog’s nails trimmed and trim any fur on their paws to help keep them from slipping.

Invest in an orthopedic bed if you can, and provide raised dishes so your dog doesn’t have to bed so far to eat and drink. You might need a ramp or steps to help your dog access their favorite spots and get into the car.

And speaking of steps, you might want to prevent access to stairs as the osteoarthritis progresses unless you’re around to assist. A baby gate can work well for this.

Treatments for Osteoarthritis
There are many different treatments for osteoarthritis. Some of them are beneficial as a preventive, and all can be used following diagnosis. Here are the top options.

Joint Supplements
Supplements are safe and effective ways to help reduce inflammation and slow joint damage progression. Two of the most common supplements are glucosamine and chondroitin. MSM (methylsulfonylmethane) is also used, and commonly combined with glucosamine and/or chondroitin.

Omega-3 fatty acids found in fish oil and green-lipped mussel are also recommended, which are good for the skin and joints. They can be used at any age and are often considered a helpful preventive.

NSAIDs
Non-steroidal anti-inflammatory drugs (like Rimadyl, Metacam, and others) are commonly prescribed for dogs with osteoarthritis. They help to reduce inflammation as well as pain, making them very effective with this disease.

These drugs can have significant side effects, though. If you decide to give them to your dog, your vet will discuss the risks and will recommend regular blood work to monitor.

Please never give human pain medications to your dog unless directed by a veterinarian, as they can cause life-threatening side effects. NSAIDs will be prescribed specifically for your dog and human NSAIDs are generally not used.

Weight Management
Maintaining a healthy weight is a good idea for all dogs of any age, whether they have osteoarthritis or not. For dogs with the disease, it’s especially critical to not carry excess weight on their already damaged joints. Not only will extra weight cause additional pain, but it can cause the cartilage to break down faster. Obesity can also cause other diseases, so keep your dog healthy and trim.

Physical Rehab
Physical rehab is another great way to help your dog with osteoarthritis before and after the diagnosis. Canine rehab vets are trained on proper weight management and implementing an exercise plan to help your dog maintain muscle, important for arthritis.

Many rehab vets also use alternative therapies to help your dog by promoting healing and managing pain. Cold laser therapy and an Assisi Loop can be beneficial, as well as acupuncture, massage, and exercise.

Osteoarthritis in Dogs Can Be Manageable With Help
No owner wants their dog to develop osteoarthritis. However, there are a lot of effective options to help most dogs maintain a great quality of life. It’s all about mobility and effectively managing pain to maintain a good quality of life.

How to Care for a Three-Legged Dog

6/22/2022

Some links in this article may be affiliate links, which means that if you purchase through them, I receive a small commission. This will never cost you extra.

You might expect a dog with three legs, often called a tripod or tripawd dog, to have a lot of special needs. However, your dog likely doesn’t agree with your assessment that he’s disabled!

Generally speaking, dogs do incredibly well on three legs and don’t have ongoing health issues. Unlike humans, they don’t have any stigma associated with losing a limb, so they go about figuring out the physical aspects of navigating on three limbs.

Once they adapt to it, which generally happens pretty quickly, they are usually “off to the races,” so to speak. Here’s what you should know about tripod dogs and some effective ways to help them adjust.

How Does a Dog Become a Tripod?
Dogs can have three legs for a number of reasons. It could be due to a congenital deformity, where they are born with a malformed or unusable fourth leg that may require amputation.

Dogs can also lose a leg due to trauma, like a severe break that can’t be fixed or due to a car accident. Or, a dog can lose a leg due to some types of cancer, where either a mass cannot be safely and fully removed, or they have cancer in the bone of a paw or leg, necessitating amputation.

Some dogs become amputees at a young age and others when they are older. Though it can sometimes be more difficult for older dogs physically, dogs of all ages usually adjust well to this change.

How to Care for a Dog Following Amputation
Amputation is a big decision and one you’ll discuss with your vet. If it’s recommended, they have weighed the options and determined amputation offers your dog the best chance for a high-quality life.

As traumatic as the surgery may feel to you, it’s likely your dog will feel better than before the surgery in just a few days. Amputation can enable your dog to live a long and healthy life without pain.

Following an amputation, your dog’s activity will be restricted for a period of time to allow them to heal. Be sure to give any pain medications and antibiotics as prescribed by your vet, and follow their guidance for care closely.

Consult your vet before discontinuing any medications or initiating activity with your dog.

It may be helpful while your dog is healing to keep them in a carpeted area or to add small area rugs for traction as they get acclimated to life on three legs. And they may need some help getting around at first.

Consider gating off a section of your house to limit their ability to move around, especially around stairs. Your dog will need to re-learn how to navigate them on three legs, so be especially careful until you’re sure they can do it unaided.

Tripod Dog Care
Your main objective in keeping your dog healthy, as a tripawd or not, is maintaining their general wellness. There are three things you can do to help your dog to stay happy and healthy. These are important for all dogs and especially important for a tripod dog.

1. Exercise
Tripods, like any other dog, need exercise to keep their joints in good working shape and to prevent injury. It’s especially important to exercise dogs with three legs. Strong muscles help support the remaining limbs.

But make sure to monitor the level of exercise and let your dog set the pace. Pay special attention to your dog’s body language. Tripods can sometimes need a little more rest given the extra work the remaining legs are taking to support his body.

2. Weight Management
Maintaining a healthy weight is also important for tripod dogs. More weight provides more strain on the joints, so it’s essential to keep your dog at a healthy weight.

Not only does excess body fat cause inflammation, putting them at risk for conditions like osteoarthritis, but the added weight can cause strain to the remaining three legs. It’s often beneficial to keep tripod dogs on the thin side, so talk with your vet about the ideal weight target for your dog.

3. Supplements
The only real physical concern for a tripawd dog is the risk of osteoarthritis as it can impact the effectiveness of their remaining limbs and cause an increase in pain. Your dog may be at increased risk due to the alterations in its posture from the missing limb.

Owners can try to proactively delay the onset of osteoarthritis by offering supplements like glucosamine, chondroitin, and MSM to support joint health along with a fish oil supplement with omega-3 fatty acids.

Tools that Can Help Tripods
Though owners aren’t really required to get any special equipment for tripod dogs, it can sometimes come in handy. Some beneficial things to consider are no-slip booties or socks if you have hard floors in the house. Here’s a second bootie option as well.

You might also consider installing carpets or runners for traction and padding. For dogs with difficulty jumping, a ramp or even steps may help them get to their favorite spots.

Getting up from a seated or prone position can sometimes be a challenge for dogs learning to walk on three legs as well. A support sling or harness can be really helpful.

My favorite tool that I recommend is the Help’Em Up Harness. It’s the best for all-day wear and uses support under the pelvic bone to lift the back end so it doesn’t put pressure on any of the organs. Some alternatives that you can get on Amazon are this one and this one.

This book on helping your dog with mobility challenges is one I recommend.

How Physical Rehab Can Help a Three-Legged Dog
Physical rehab isn’t required for tri-legged dogs, but it can be beneficial. First, rehab can be really helpful for dogs post-surgery to adapt to their new situation.

A rehab vet is specially trained to work with dogs after surgery to help them heal effectively and regain mobility. This includes a thorough evaluation, an exercise plan, therapeutic treatments like cold laser therapy, and others, as well as pain management.

Physical rehab can also help you determine the most effective exercise regime to help your dog maintain a good level of fitness. A physical rehab vet can help you determine the right amount of exercise and the best method(s) for your dog. This is helpful following surgery and as your dog ages.

A rehab vet can also help you determine a healthy weight for your dog to ensure they aren’t carrying any more than they should on their joints.

Seeing a specialist like a rehab vet, even for an appointment or two, is really helpful for a three-legged dog. They can detect even subtle gait or posture problems and prescribe strengthening exercises for your dog.

Caring for a Three-Legged Dog
Though caring for a tripod dog isn’t all that different from a dog with four legs, you can certainly give them an advantage when healing from amputation surgery or as they age. Consider supplements, regular exercise, healthy weight maintenance, and adapting your house to make mobility a little easier.

Hip Dysplasia in Dogs

4/29/2022

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.

How to Cope When You’re Losing Your Dog

2/28/2022

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.

Toxic Foods for Dogs

12/20/2021

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.

Degenerative Myelopathy

10/10/2021

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.

What is Electrical Stimulation Therapy and How Can It Help My Dog?

7/22/2021

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.

Common Conditions That Benefit from Canine Physical Rehab

6/20/2021

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.

<<Previous