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

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.

Options for Knee Injuries In Dogs — CCL Ruptures

5/23/2021

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.

Safe and Effective Ways to Manage Pain in Dogs

4/4/2021

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.

Psychological and Emotional Aspects of Pain in Dogs

2/22/2021

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.

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

1/24/2021

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.

Chronic Pain vs. Acute Pain in Dogs

12/21/2020

It can be hard to determine if your dog may be in pain as they can be masters of hiding it. Sure, if your dog is limping, chances are you will know something is wrong. However, it’s not always so clear. Owners don’t want to miss the signs of pain as it can lead to prolonging their dog’s discomfort. In this four-part series, we’re going to dive into pain in dogs. In the first article, you’ll learn about the two primary types of pain that may impact your dog and some helpful hints to distinguish them.

Do Dogs Feel Pain?
Pain is a feeling of discomfort that indicates (usually) something may be wrong. It’s our body’s way of signaling that an area needs to be protected to allow it to heal. Pain can range from mild discomfort, like an ache, to sharp pain. It can be a nuisance, like a mild headache, or it can be more significant, like a sharp pain that is so bad that you’re unable to walk. Some descriptions of pain include throbbing, stabbing, pinching, aching, piercing and there can be many others.

Some people believe dogs don’t feel pain, or if they do, that they have a much higher threshold for pain than people do. In truth, dogs feel pain in the same way humans do, though they don’t always show it in the same way.

Think about it—a human can express their feelings through words. “Ouch!” Whereas a dog can’t be that specific in its communication. If a dog barks or growls, you might not know what it means. As a result, dogs often rely on owners to pick up the cues- or suffer in silence.

These indications of pain in dogs can be expressed through physical symptoms, mobility issues, and behavioral changes. They may be obvious, like if your dog is limping or whining. Or, they can be much more subtle, like if your dog pulls away when you pet him in certain areas.

Types of Pain
There are two primary types of pain in dogs—acute pain and chronic pain. Knowing which type of pain your dog may be dealing with can help you to understand potential causes.
Acute Pain in DogsWhen your dog is suffering from acute pain, it is due to some recent event or trauma that has been present for a short period of time. This pain is usually associated with things like injury, surgery, or even illness. It generally improves within the first few days after the event that caused it. However, it can last as long as it takes for the issue causing the pain to heal.

Acute pain in dogs often causes behavioral changes. When dogs feel this kind of pain, you may notice that they may not want to be touched. They may also do things like hiding or not putting weight on an injured leg. If you notice these kinds of behaviors in your dog, he may be dealing with acute pain.

Acute pain is sometimes known as adaptive pain as it’s pain that heals with a return to function. It serves a purpose to protect the dog. If a dog breaks a bone, for example, the pain goes away as the bone heals. However, if the bone isn’t treated properly and remains out of alignment it can get worse, leading to chronic pain.

Treatment of Acute Pain in Dogs
Acute pain often requires a visit to the vet and treatment will depend on the cause and the severity of pain. Treatment may require prescribed pain medication and rest or it could require more. It generally lasts for a short period of time—days or even months, depending on the issue. Pain lasting for a longer period of time becomes chronic pain.

Chronic Pain in Dogs
Chronic pain persists longer than the period of time expected for healing. Or, it can also be associated with certain conditions. Osteoarthritis is one of the most common, but it can also include pain caused by cancer, neuropathy or myopathy, and conditions like intervertebral disk disease and others. Acute pain can also become chronic pain as mentioned earlier.

Chronic pain is often called maladaptive pain as it doesn’t seem to serve any purpose to protect the area in pain. In the case of arthritis, for example, it’s not a condition that can be cured. So, the pain remains present along with the osteoarthritis.

With chronic pain, you may see your dog limping, or you may see more subtle behavioral changes. Some dogs may be less willing to do things they used to do before. This could be activities like running, or perhaps they are less willing to jump or climb stairs. You may notice they are generally less active than usual. These signs may be much more subtle and can be easily overlooked or dismissed as “aging” but they are often still there.

Treatment of Chronic Pain in Dogs
Chronic pain in dogs is often not curable, but it can be managed. Pain medications given at the right dosage can ease it, reducing the pain signals to the brain to give the nervous system a chance to recover. There are also some holistic treatments that can help manage chronic pain as well as therapies like physical rehabilitation.

Treating chronic pain helps to reduce your dog’s stress while keeping him comfortable. And, it enables dogs to engage in the activities they love giving them an improved quality of life. It may take some time to determine that the behavioral changes you are seeing are related to chronic pain. When you do realize, or if you’re unsure, it’s a good idea to go to your primary vet for an exam. Share the changes you’re experiencing to help your vet determine the cause of the pain.

Understanding Chronic Pain vs. Acute Pain in Dogs
Dogs feel pain just like humans. However, their inability to directly express that they are in pain and the site of their pain can be challenging for owners. Knowing the difference between acute and chronic pain can help you to know what to look for so you can help your dog feel better.

The Benefits of Cold Laser Therapy for Dogs

10/22/2020

There are many tools a Canine Physical Rehabilitation Vet uses, and one of them is cold-laser therapy. Most people have heard of it, however, fewer people know what it is and how it may help your dog. Here’s what you may want to know about cold laser therapy for dogs to help you determine if it may be right for your dog.

What is Cold Laser Therapy?
Cold laser therapy can be an effective treatment for reducing inflammation and pain and promoting healing in dogs. And it’s not just for dogs—cold laser is used on other animals and humans. It goes by several names, including low-level laser therapy (LLLT), red-light therapy, and photobiomodulation therapy (PBMT).

Cold laser therapy uses beams of light (photons) to increase blood circulation and to stimulate cell generation. This physiological change at a cellular level can help to replenish adenosine triphosphate (ATP), the molecule in cells that carries energy. This, in turn, helps to reduce pain and inflammation.

In simple terms, the cold laser provides a “jump-start” for healing at a cellular level. They are “colder” and shorter in length than the laser beams you might think of that can cut through objects. As a result, they are therapeutic and safe to use.

Some advantages of cold laser therapy include that it is not invasive, so benefits are seen without surgery. It’s also drug-free, and there is no pain with its use. Because of this, cold laser therapy is effective, especially when used with other treatment modalities, like physical rehab.

After a treatment, dogs usually have less swelling and pain, which provides an increase in range of motion and mobility. Cold laser has been found to promote healing effectively and the benefits increase with regular use.

What Medical Conditions Can Cold Laser Help?

Cold laser therapy can be used effectively for many medical issues. Some typical uses in my rehab practice include:

Reducing osteoarthritic pain from hip dysplasia
Wound healing—post-surgical or soft-tissue trauma
Improving nerve function and nerve regeneration
Supporting degenerative disc disease
Healing muscle, joint, or ligament injuries
Reducing the formation of scar tissue
Improving infections

When used correctly, there are no known risks or side effects of cold laser therapy. You should use a reputable veterinarian to ensure that it is used appropriately. It is also important to wear protective eyeglasses and not shine the laser directly in the dog’s or owner’s eyes or it could potentially burn the retinas and impact vision.

There are a few situations when cold laser should not be used. Because it stimulates cell growth, it should not be used at the site of a tumor or in a dog with metastatic cancer that has spread to multiple areas as it could accelerate cancer growth. Additionally, it should not be used over the uterus of a pregnant dog.

What to Expect During a Session

You and your dog will get your special protective glasses to wear during the entire time the laser is used. There is seriously nothing cuter than a dog wearing Doggles©️.

I hold the laser in my hand and aim the light directly at the dog in the area I want to treat. (In the case of a wound, I would position it above). Treatments usually last between ten and twenty minutes.

Your dog may be a little unsure initially as there can be a slight tingling sensation from the laser. Usually, though, the dogs settle right down and often will nap during the session. You can sit right next to your dog and pet them during the treatment.

If you have any interest, please ask me what it feels like. I’m happy to demonstrate.

How Many Treatments Will My Dog Need?

The recommended number and frequency with cold laser therapy treatments will depend on your dog’s needs. If your dog has an acute condition, like post-surgery, we may discuss weekly treatments for a few months. For chronic conditions like osteoarthritis, your dog may benefit from prolonged weekly treatments (or the frequency you can do). As your dog heals, depending on the medical issue, treatments may be spaced out further based on the level of healing and pain.

Many dogs show improvement after the first visit, though the speed and level will vary by the dog. For some, it may take a few visits. I have seen cases where a dog shows marked improvement after leaving my gym, and other times, it can be much more subtle.

Does Pet Insurance Cover Cold-Laser Therapy?

One question many people have is whether pet insurance covers cold-laser therapy. And the answer is generally speaking, yes. Since cold laser is used for dogs with a medical issue, most pet insurance policies will cover it. However, you do need to check the specific terms of your policy to make sure.

At Arizona Veterinary Physical Rehabilitation, cold-laser therapy is included in multi-visit packages. So, if your pet insurance does cover the physical rehab visits (and most do), then cold laser would be covered. Physical rehab is typically covered by pet insurance, but again, check your policy to make sure you understand the coverage.

Cold laser therapy can be a helpful and effective way to improve your dog’s mobility, reduce pain, and decrease inflammation. It’s especially useful when used in combination with other therapies, which is why I offer it in my practice. If you’re interested in learning more, please ask and I’m happy to discuss if it may be helpful for your dog.

How Does an Assissi Loop Help My Dog?

9/16/2020

Your vets have a number of great tools and therapies to help your dog heal from acute trauma and to reduce the impacts of chronic conditions. One of the effective ways to manage and reduce pain and inflammation and to promote healing is with a tool called an Assissi Loop. I am a huge proponent of these devices and I use them effectively on many patients in my practice with positive results. Read more about what an Assissi Loop is and how it may benefit your dog.

How Does an Assissi Loop Work?
An Assissi Loop emits bursts of microcurrent electricity that evenly penetrates body tissue around the area where the loop is placed. This electromagnetic energy causes a chemical process that increases nitric oxide production, known to promote healing in humans and animals. This compound is released naturally in the body when we are injured, and even when we exercise to signal the body to repair itself.

The loop is effective on both hard and soft tissue including skin, bones, ligaments, tendons, and even organs. It was designed to use a specific ratio of frequency-to-burst width that has been proven to be effective at delivering the optimal amount of electromagnetic energy needed to stimulate nitric oxide production. Too little isn’t as effective and too much can actually slow the healing process. In this case, more power does not mean more effective.

Assisi loops are pulsed electromagnetic field (PEMF) devices offering non-invasive therapeutic benefits. This FDA-approved therapy can be used on dogs, cats, and horses as well as on humans. The 15-minute timed treatments promote blood flow and have no known side effects. The Assissi Loop has been found to not only speed the healing process but also to reduce inflammation and reduce pain levels. It penetrates fur, casts, and bandages to reach body tissue for powerful relief with only a minimal tingling sensation in some people and animals.

Medical Conditions the Assissi Loop May Treat
The Assissi loop can be beneficial with medical conditions that cause pain and swelling, inflammatory conditions, some neurological and degenerative conditions, as well as post-surgical care and wound healing. This includes:

Arthritis
Fractures and broken bones
Degenerative joint disease
Cruciate tear (CCL)
Broken bones and fractures
Lumbar stenosis
Intervertebral Disk Disease ( IVDD)
Hip dysplasia
Muscle strains
Amputation healing
Degenerative myelopathy
Neuropathy
Wobbler’s syndrome

It may also help with irritable bowel syndrome (IBS), pancreatitis, cystitis, granulomas, tumor removal, tooth extraction, and other medical issues. If you’re unsure if it may be useful for your dog, please ask.

How Do I Use an Assissi Loop?
An Assissi Loop is a prescription item that must be prescribed by a doctor or veterinary professional. When you bring your pet to a vet, we will do a thorough evaluation and then will discuss treatment options with you which may include an Assissi Loop. If it is not mentioned and your dog has one of the medical issues noted above, it is worth asking.

To use the Assissi Loop, simply hold it over the area you wish to treat and press the button to turn it on. You will see a flashing light to indicate that it is working. Each treatment is timed for 15 minutes, so when the light stops flashing, you know the treatment is done.

Your vet will tell you the treatment recommendations for use. Typically it will be in the range of two-to-four 15-minute treatments per day. For acute conditions, like a fracture or post-surgery, you may use it at a higher level for the first week and then taper off treatment. For chronic conditions or degenerative issues, you may continue treatment until there is a significant improvement or possibly indefinitely. You may be able to taper treatments down in time even if continues for a long period of time.

What Does My Dog Feel with an Assissi Loop?
Using the loop can significantly increase tissue oxygenation and blood flow. This reduces pain associated with a lack of sufficient oxygen and improves overall tissue health. As a result, some animals will notice a warming or tingling sensation though it is subtle and many animals won’t notice any differences at all. Some animals will relax as soon as the treatment begins. Others may move away from it initially due to the increased sensation.

It’s possible you may see some mild twitching, particularly in animals with certain long-term degenerative or chronic conditions. This is very rare, and it is caused by the increase in blood flow to the area. If you do see this, contact your vet and they will likely recommend you reduce the duration of the treatment until the twitching subsides and the area is assimilated to the increase in blood flow.

If you’re concerned, try it on yourself! You can absolutely put it over an area on your own body to see what it feels like before using it on your pet.

When Can I Expect to See Results?
Like with so many medical issues, the answer is: it depends. For acute inflammation like post-surgery or trauma, you will likely see a noticeable difference after the first or second treatment. It can take longer, and up to 2 to 4 weeks, for chronic or degenerative issues. Stick with it, though, and you should see results from the long-term healing process.

The Assissi Loop provides a minimum of 150 treatments that are 15 minutes each. Generally, it is covered if you have pet insurance though you will want to check first if that is a concern.

If you’re looking for ways to help reduce pain and inflammation and to promote healing, an Assissi Loop is an effective, FDA-approved treatment option for your dog. I have been using them for years in my practice with positive results and would be happy to answer any questions. If you’re curious, please ask as we can try it out in the gym!

How to Deal with Caregiver Fatigue

8/10/2020

Caregiver fatigue and burnout is a real thing. Ask anyone with a terminally-ill dog or one with a serious health condition, particularly one that affects mobility. The heavy emotional challenge often accompanied by a physical burden can really take a toll on your mental and physical health.

This isn’t something we like to talk about as it can be an uncomfortable feeling that we can’t always do everything we feel we should for our beloved pet, but it’s something we really need to talk about. This post will help you to identify the signs, understand the causes, and includes some practical tips for dealing with caregiver fatigue.

What is Caregiver Fatigue
First of all, if you are feeling exhausted, frustrated, sore, and isolated while trying to support your beloved dog who is dealing with a significant medical issue, you are not alone. Most of us go through it at one point or another and it’s a really tough time. Not only are our hearts and bodies taking a beating but our minds are as well as we have a tendency to load on guilt when we’re in this situation. We feel guilty for what we can’t do or perhaps that we feel we may not be doing enough.

It’s no different from caregiver fatigue when caring for our human loved ones. When the symptoms aren’t managed, caregiver fatigue becomes caregiver burnout: a state of emotional, mental, and physical exhaustion.

What Causes It?
Caregiver fatigue and burnout are typically reported with extreme fatigue, stress, anxiety, hopelessness, and sometimes depression. The caregivers are often so busy caring for their loved ones that they often neglect their own health and it takes a toll.

Here are some causes of caregiver fatigue and burnout:

Lack of control — Unfortunately, we’re not always able to control the medical situation of our dog. That may be due to a deteriorating condition and aging, or it may be a financial challenge to provide care. It may be a lack of time or not having the right skills to manage the situation.

Unrealistic demands — Sometimes we take on too much responsibility that could possibly be shared with other family members. Other times, this burden is placed on us. Additionally, we sometimes place unrealistic burdens on ourselves as to what we can actually do.

Unreasonable expectations — Sadly, no matter how much we may be willing and able to do, we simply can’t stave off the inevitable. We hope to have a positive effect on our dog’s health and happiness but that’s not always possible. It can feel very personal when this happens when we are giving so much.

What often happens when people suffer from caregiver fatigue is that they lose the ability to assess their own situation as they are so focused on who they are caring for. This leads to burnout and eventually to an inability to function effectively. Though this is understandable, it does no one any good, particularly the patient.

How to Know if You Have Caregiver Fatigue?
The symptoms of caregiver fatigue are often similar to those for stress and depression. They may include:

Exhaustion, both emotional and physical
Loss of interest in activities the person used to enjoy
Irritability, hopelessness, and helplessness
Changes in weight, appetite, or both
Isolation and withdrawal from loved ones and socializing
Increased illness or possibly physical injuries
Changes in sleeping, either too much or too little

As fatigue evolves into burnout, the severity of symptoms may increase and more serious symptoms may evolve like feelings of self-harm or aggression.

Tips for Managing Caregiver Fatigue
Though it may not feel like it sometimes, there are a lot of things you can do to manage caregiver fatigue and to try to keep it from progressing.

Talk to Someone
Find a person you trust that you can share your feelings with. It may be a family member, a friend, or a coworker. Whomever it is, just make sure you can have an open and supportive dialogue. Sometimes just sharing your feelings will help you feel better.

Consult with a Vet
If you’re feeling burned out by caring for your dog, talk with me or your primary care vet about it. We understand what you’re going through and maybe there are changes you can make or something we can recommend to help you manage the situation better. For example, if you’re having to carry your dog around on bad days, maybe a cart would help ease your back while still helping your dog. It’s important to educate yourself to be sure you understand what to expect and talking with your vet is a great way to do that.

Set Realistic Expectations
Fear of the unknown, or even an unpleasant future, can weigh heavily on you. However, it’s important for you to prepare yourself for what the future may bring. Make sure when you talk with your vet, you get a clear picture so you can set your expectations accordingly. You don’t want to set yourself up for failure by expecting that your assistance will cause dramatic improvement if that isn’t possible.

Ask for Help
You may feel you need to do it all for one reason or another, but that’s not entirely true. It’s important to ask for help when you need it. Maybe it’s a family member or a friend or perhaps it’s paying for a temporary caregiver to help. Know your limits and be honest with yourself.

Take a Break
We all need to get away sometimes and it’s especially important when you’re feeling burned out. See if someone can care for your dog for a couple of days. Or check with your primary vet. Vet techs often offer pet-sitting services and they have medical experience, are familiar with your dog’s issue, and your vet’s cell number!

Take Care of Yourself, Too
Your focus may be on your dog and that’s understandable, but you need some “me time” too. This includes mental, emotional, and physical self-care. Take time to go for a walk or to the gym. Get a massage if your back is hurting or take a hot bath. Do some things you enjoy too so it’s not all about your dog, at least for a little while. And make sure to get plenty of sleep, exercise, and eat well. Make sure to fill your own cup first. Especially when you are taking care of two, it’s important.

Talk with a Professional When You Need
Sometimes we need a little extra help from a professional. That may be a therapist, social worker, or even a clergy member that is trained to counsel people dealing with similar issues. You can also look for groups, either in-person or online, that may be able to provide you with some support when you need it.

Above all, be kind to yourself and accept how you are feeling. This can be a really tough time emotionally and it’s okay to not be okay. It’s okay to feel negative, frustrated, overwhelmed, or angry. It doesn’t mean you’re a bad person or that you’re doing a bad job caring for your dog.

Taking care of your dog when they are injured or unwell is hard work! It’s tough enough when it’s short-term but when longer-term care is required, it can be really challenging. Try to be positive but realistic as well, and make sure you make it onto your list for care. After all, we can care for others better when we are taking care of ourselves, first. Don’t wait until you are completely burned out and above all, make sure to communicate and ask for help when you need it.

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