Pain relief is always the first focus in Veterinary Medicine. Patients with poorly managed pain don’t heal as quickly or as well as patients with adequate pain management in place. Pets with effective pain relief are happier and healthier, but exclusively addressing a patient’s pain without making improvements to their strength and stamina greatly disservices that pet and their family.
Pain medication is ultimately a band aid to a more complicated problem; a VERY IMPORTANT band aid, but an incomplete solution nonetheless.
The Disuse Pain Cycle
Just like us, when your dog doesn’t exercise as much as they used to, their muscles atrophy and shrink. “Use it or lose it!” summarizes this issue well. Your dog’s joints become stiff from the lack of movement and exercise becomes more uncomfortable and more difficult, leading to further atrophy and stiffness. As they lose muscle mass, the risk of falls, slips, and other traumatic injuries greatly increases.
If this cycle is not interrupted, the result is a weak, painful dog who loses the ability to get around on their own.
When a stiff, atrophied dog needs to go outside to potty, but rising from the ground, navigating the home and then the process of using the doggie door, followed by the steps down from the patio to the grass becomes difficult and painful, that dog will choose to potty inside the house because it is easier than the alternative. Keep in mind that a dog with normal brain function has an incredibly strong instinct to keep its “den” clean, so the level of pain a dog experiences can be excruciating by the time they begin to potty inside.
Sadly, this exact scenario is one of the most common reasons that senior dogs are euthanized.
To stop the Disuse Pain Cycle, we must reintroduce movement but asking a weak and painful dog to exercise doesn’t exactly feel fair, does it? This is where pain medication, quality nutrition/supplements, and Physical Rehabilitation Therapy make their biggest impact.
Pain Management
Many owners come to us seeking to avoid pain medications, some even seem upset that their Veterinarian recommended pain medications at all. While we certainly agree that unnecessary medications should be avoided, the right pain medications at the right dosages are crucial for your pet’s comfort and quality of life.
We should not exercise a patient that is experiencing moderate to severe levels of pain as it is considered cruel.
Pain medications can help dampen the discomfort your pet feels during certain movements or activities while we work to enhance their mobility. Exercise is necessary to reduce pain and therefore reduce medications. Without exercise there is no muscle building. Continued lack of movement will result in further weakening and muscle loss and continued weakness and muscle loss causes further pain and immobility.
It may take some trial and error to find which medication and dosage is right for your pet, but prescription pain medications are a valuable tool that should be used when appropriate. It is rare that a Veterinarian will recommend pain medications without valid evidence from your pet’s exam. Some of these medications may cause sedation or gastrointestinal upset in some patients, and this is where some trial and error may come in. We can help you assess if your pet’s pain management plan is working and as long as you are in good communication with your Veterinarian, side effects should be minimal. Regular lab work is also essential to avoid any negative effects to the liver or kidneys.
Senior pets should have lab work on a regular basis to catch any age-related conditions, so your Veterinarian should already have the information needed to select the safest medications for your pet.
Where does nutrition come in?
If your pet is on the chunky side, their weakened muscles will struggle even more than those of a lean dog.
On average, lean dogs live 2 years longer than overweight dogs.
But it’s not as simple as getting them to lose weight either. Complete nutrition for an overweight and weakened pet is a delicate balance of losing weight while ensuring that the body has what it needs to build muscle. Your primary Veterinarian or the CROC Medical Team can help you choose the right diet and caloric intake for your pet so that they are getting the vital nutrients they need while helping them shed the excess fat. If your pet is already on an appropriate diet, they may benefit from supplements to provide the ‘extra kick’ needed for muscle building and joint health. We’re big fans of Myos Muscle Formula and Dasuquin Advanced for many of our patients but you should consult with your Veterinarian before starting any supplement.
Getting Started
If your goal is to minimize use of pain medications and help your dog improve their mobility and quality of life, Physical Rehabilitation Therapy should be your next step! It is usually best to start therapy while your pet is still on their current Pain Management regimen and then as your pet improves, we can try reducing medications and their potential side effects. How do we provide enough relief to replace those medications?
We offer clinically proven therapies and use as many of them as needed to find the best combination for your pet’s comfort.
We often begin with Thermotherapy to soothe achy joints and muscles, then move onto Therapeutic Massage. We all know how good it feels to get an excellent massage that hits all the right spots; You go home feeling like a new person. This is true for your dog too! Therapeutic Laser Therapy and Therapeutic Ultrasound help to reduce inflammation by increasing blood flow to the area and encouraging cellular healing. Veterinary Medical Acupuncture has been shown to enhance the release of corticosteroids and endorphins, helping to ease spasm pain associated with nerve tissue. As we track your pet’s response to these treatments, we monitor their progress and make any necessary adjustments to their prescribed therapy plan.
Keeping Your Dog in Motion
Like humans, dogs move more easily once they’ve been up and about. As the tight muscles and stiff joints begin to warm up and loosen with the dog’s movement and increased circulation, motion then becomes easier and more comfortable. This is why many pet owners report that their pets seem the most stiff first thing in the morning or after periods of rest but can “warm up out of it” with light activity.
Pain relief in the form of medication, thermo/cryotherapy, and massage can help them get through that initial discomfort.
Mobility is always easier to maintain than it is to regain and your dog will find it easier to get up and moving if they do so more frequently.
If they are up and moving, their muscles are in action (and therefore less likely to atrophy) and their joints don’t have the chance to get stiff and creaky. Dogs that can move more comfortably are more likely to stay in motion. Motion helps keep them strong and limber. Motion really is the Lotion of the joint!!!
The Weekend Warrior
A theoretical situation – think of a professional athlete. They’re constantly training to stay in peak shape for their next competitive event. This helps them maintain strength, stamina, and flexibility which also helps them avoid injury as they push their body to the limit. Now imagine that athlete taking a few months off from their training regimen. They take it easy and don’t make any dietary adjustments despite their decrease in activity. They stop stretching and exercising daily. Then, after a few months of this laid-back life, they are suddenly asked to perform at the level they previously did when they were training daily.
Not only will they struggle to achieve that level of performance, but they are also extremely likely to injure themselves trying.
During their break from daily training, their muscles began to atrophy, they gained weight from the excess calories, and they are no longer as limber as they once were. At best, they will be sore the next day but in the worst-case scenario, they could be facing injuries such as muscle strain, ligament tears, or sprains. An athlete that experiences an injury like these must then rest and undergo very careful physical rehabilitation before attempting to resume their previous training regimen. They might not ever be able to perform at the level they once did. How does this relate to your dog?
Many dogs spend their time hanging out at home, getting walked around the neighborhood and maybe playing with a housemate in the backyard or a game of fetch here and there. As beloved family members, we want to include our pups in all our activities and this often includes hiking, running, camping, beach days, etc, all of which are more physically demanding than a walk around the neighborhood. The sudden increase in activity or participating in an activity they normally wouldn’t, especially for a senior dog, will almost always lead to some kind of painful consequence. And as we learned earlier in this article, a painful dog does not want to be active, further contributing to atrophy and stiffness.
Sadly, it only takes 72 hours of inactivity to result in measurable muscle loss.
One outing of significantly increased exercise could mean days of pain for your dog and several weeks of recovery to return to their previous level of fitness.
This doesn’t mean that your dog can never participate in these activities with you. But it does mean that they need to be physically conditioned before doing so. Just like you would train for a marathon, your dog’s body needs training before a big outing. And wouldn’t you know it?
Keeping their muscles and joints in motion on a consistent basis will also aid in maintaining their mobility and comfort well into their golden years.
To Change the Body, We Must Challenge the Body
There are a million ways to move the body with some movements being better than others, but all exercise has some benefit.
Even a bad workout is better than no workout.
Many pet owners get excited when they learn of Hydrotherapy and while it’s true that this modality is helpful for many patients, most clients, and even Veterinarians, are surprised to learn that Target Exercises are the most transformative modality. They may not be as flashy as an Underwater Treadmill, but they’re the most important part of increasing a patient’s physical ability and therefore their comfort. Ultimately, if you’re only using one modality, you are not going to achieve the results you seek. Veterinary Physical Rehabilitation is about using everything in our toolbox to get maximum benefit for every patient. Massage and Stretching alone will not fix a patient. Hydrotherapy alone will not fix a patient and can even hurt a patient that has not been warmed up beforehand. Laser therapy, therapeutic massage, and acupuncture are great for pain relief, but will not restore a patient’s mobility since they do not challenge the body.
There is no magic treatment that will make muscle stronger, stamina longer, or cardiovascular tolerances larger. Exercise alone will do this.
What Other Factors Are at Play?
The most obvious is your pet’s demeanor. A calm and friendly dog will live longer because they get better medical care.
Good pets have a closer bond with their families and health issues are noted sooner, allowing for earlier medical intervention.
Dogs with behavioral issues are euthanized earlier than those without because their medical conditions or loss of mobility cannot be as well-managed as a friendly pet. Dogs that dislike being around other dogs may not have as much access to certain activities or exercises. Our couch potato pals often fail to achieve desired results because they lack the motivation to participate in prescribed exercises. Dogs with higher energy levels or those that are eager to do as their two-legged best friends have asked will achieve better outcomes than their couch potato brethren.
Your demeanor also plays a large role. It’s easy to feel overwhelmed as your best friend loses their mobility or struggles with painful conditions, but maintaining a positive, “can do” attitude will help you both! Our team is there to encourage and support you through your dog’s Rehabilitation Treatment Plan by giving you simple, but impactful changes you can make to your pet’s routine. On the flipside, overly enthusiastic owners are more likely to overdo things and cause harm to their pet. There’s a balancing act to your pet’s recovery and rest is vital to recovery because almost all of the body’s healing hormones are active when the body is asleep.
Pets must be allowed to rest, recover, and heal throughout their healing journey while interspersing periods of structured activity.
Your own physical fitness will directly influence your pet’s recovery. If your dog requires assistance to perform certain prescribed exercises but you are unable to provide that assistance, your pet will not achieve the desired results. If you are unable to get down on the ground to massage and stretch your dog, those muscles and joints will remain stiff and painful, making the prescribed exercises uncomfortable to perform. They may even refuse to participate at all. Of course, us humans are often dealing with our own medical challenges as well so in this situation, it is best to schedule more frequent in-clinic therapy sessions so that your pet gets the treatment they need to restore comfort and/or mobility. For the most part, our team is young, spry, and able-bodied Rehab Specialists who are ready to squat, lift, carry, kneel, and otherwise hoist your pet into the proper ergonomics to resculpt their body through exercise.
Weather often influences your pet’s ability to exercise.
When it’s cold and rainy out, arthritic joints tend to ache and swell, making exercise painful. When it’s hot and sunny, every dog is at risk for heat exhaustion, heat stroke, sunburns and burnt paws.
Both extremes will limit your pet’s exercise, thus causing them to lose comfort and mobility. More frequent in-clinic therapy sessions will help with combatting the weather since our building is temperature controlled and on the colder days, our pain-relieving modalities can help get your pet comfortable enough to resume much needed exercise.
Rehab is a Journey
There are some things we can control and some we cannot. We cannot undo osteoarthritis formation and we cannot rewind a patient’s aging process. We can control their environment, exercise routine, nutrition, and medical treatment. You can work together with your pet’s Rehabilitation specialist to form the optimal conditions for your pet’s continued comfort and mobility, keeping them in motion for as long and as pain-free as possible.
Frequency of therapy sessions, modalities used, exercises prescribed, medications and supplements recommended; these things will likely change as your pet progresses through their Treatment Plan.
If they’re expected to improve, exercises may become more challenging, supportive devices may be removed, or your pet may be asked to participate for longer periods of time. If your aim is to keep your pet comfortable as they approach their last days, pain relieving modalities may begin to be the primary focus and rather than challenging the body, we may look to maintain its current status. Quality of life should always be prioritized over length of life.
No matter which direction you and your pet are headed, the professionals at CROC will help you and your pet avoid the disuse cycle and restore your pet’s mobility to the greatest extent possible.
After all, motion is the lotion your dog’s joints need to stay active and enhancing your pet’s strength, stamina, and mobility to reduce their pain and maximize their life’s quality is what drives us.