Geriatric Care: Exercise/Pain Management

A very delayed part two in my Geriatric Care series.

Exercise is important for cardiac health, muscle strength, and mental health. Many older dogs struggle to maintain the amount of muscle that was easily built in younger years. At work we tend to see older dogs losing muscle as a result of pain because exercising becomes increasingly difficult.

Step one has to be pain management. Talk to your veterinarian (or a rehabilitation veterinarian if you are lucky enough to have one nearby) about diagnosing and managing pain. A general place to start is finding a high quality joint supplement. Dasuquin is recommended by many veterinary professionals as the go-to joint supplement. In addition to that, the International Veterinary Academy of Pain Management is an organization devoted wholly to the management of pain. There is a "search for member" tab at the top to assist in finding a local veterinarian experienced in pain management. In Minnesota alone, there are 51 members!

An alternative complimentary approach is using Low-Level Laser Therapy (therapeutic laser) as an anti-inflammatory and pain reliever. Buzz benefited greatly from regular laser therapy. His overall comfort level improved, his mobility was better, and he certainly didn't mind spending quality time alone with me. Not all lasers are created equally, so it is definitely a treatment that should be prescribed and overseen by a professional.

Once pain is under control there are so many options for strengthening. At work we utilize underwater treadmill therapy in conjunction with specific exercises tailored to each dog. We have exercises that target specific muscle groups to engage them, or relax them, based on the needs of the dog. 

An example of Buzz's exercises at home included a chest elevation stretch, weight shifting, and front limb range of motion. The exercises were prescribed twice daily, and I was pretty good about getting them done at least once daily. Doing his exercises took about 10 minutes start to finish. His exercises changed frequently based on how he seemed to feel while I was doing them, and after. A few exercises he really enjoyed, I made a point of doing regularly (chest elevation stretch and spinal traction). Before I started working at TC Rehab, Buzz saw Dr. Julia every month or two for re-evaluation. 

Structured exercise is very important in keeping a geriatric dog happy and healthy. While enjoying smells in the backyard and interacting with other dogs is still considered exercise (and can be great mental stimulation), an exercise regimen can help to keep your dog more comfortable and active as they age. It is very important to remember that we want to give them enough exercise erring on the side of too little rather than over tax their bodies and make exercise painful.


How to make a Happy Gabby!

I picked Gabby up on 5/4/13. She did a lot of lying around. Her previous owners described her as a turtle. 
exhibit A: lying in the kitchen
Well, we discovered she moved like a turtle because a) her vision is poor, b) she has hip and elbow dysplasia, c) she is hypothyroid, d) she was obese, e) had a bladder infection, and f) she had broken/infected/painful teeth.

she was just a little "thick"

Over the last 12 months Gabby has:
a) gotten a diagnosis of PRA 
b) had her hips and elbows xrayed to confirm arthritis and dysplasia
c) confirmed hypothyroidism with bloodwork and she started Soloxine last fall
d) lost 20 pounds -- TWENTY POUNDS
e) treated the bladder infection with antibiotics
f) had a dental last summer and very obviously felt so much better after

she frequently looked angry
I have a lot of photos of her that I never shared publicly, because they really aren't flattering, but because of how far she's come... I'm sharing them today!

tubby lumpkins

exhibit B: she looked like a pregnant pig
As she started to feel better, she started doing more. Like playing with toys, and playing tug with me!

She enjoyed going for walks where she could just putter around at her own pace.

I took this picture the day I announced to the world I'd decided to keep her!

A few people have asked what I've done and continue to do for Gabby. Some people even asked if we were going to do surgery on her hips. The answer to surgery is more than likely, no. As she continues to lose weight and build muscle, we have only noticed decreasing pain, not increasing. That's very promising for us to be able to manage her well with all the things we've been doing, for many years to come.

This is what we've done for Gabby:
  • I started her on Cosequin as soon as I got her. It is my go-to joint health supplement, because they've done the research. A couple months later, she was switched to Dasuquin (the next level). Just like everyone in the family, she continues to take her Dasuquin every morning.
  • The first week I had her, she went to the vet for a general health check up where we discovered she had a UTI and an ear infection. She was put on medication to treat both conditions.
  • I added in a Vitamin B complex. B vitamins are great for everyone and they seemed to put a pep in her step. She continues to get this on a regular basis (we both take it every morning).
  • In early July, she had a dental with four extractions. She felt SO MUCH BETTER getting those teeth out of her mouth!
  • By August, her vet and I determined there was likely an underlying cause for her to be losing weight so slowly despite a very strict diet and exercise plan. So a thyroid panel was run. She is hypothyroid and was started on Soloxine.
  • At some point around here, it was decided she should be on an omega 3 supplement. She has been on Grizzly Pollock Oil and Solid Gold SeaMeal since then.
  • On October 6, 2013 I announced I'd decided to keep her!
  • In November, Gabby had an eye exam with Dr. Larocca. It was determined she is afflicted with PRA. She had been taking an eye supplement for some time, but the supplement was changed to Opti-Vue with Floraglo Lutein. So far, her eyes seem to be holding steady!
  • This winter was a little tough for all of us with it being so cold but I continued to monitor her caloric intake and she really enjoyed playing in the snow. She learned to wear boots and a coat so we could be outside for longer than to just potty.
In the last couple of months, she's had a full functional exam at work. This entails taking range of motion measurements of all four limbs, checking for pain, measuring muscle mass, assessing gait, and determining core strength. She has started Adequan (an injectable chondroprotective). She's had her four-doses-every-four-days already and now we're at the four-doses-once-a-week before we go to once every 3-4 weeks. She has also started working out in the treadmill at work regularly as well as doing exercises at home! Last, but certainly not least, regular veterinary spinal manipulation therapy (chiropractic) rounds out her "get fit, feel great" health care plan. 

Gabby's current medication/supplement list:
So, even though her xrays look pretty terrible...

With weight loss, joint support, and rehab... Gabby is having a blast in life.

**Disclaimer, I am not a veterinarian. Gabby's protocol has been developed and adjusted as needed by a veterinarian!