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Amputations are never a pleasant option and obviously we’d all prefer to keep our legs but, there are situations where this is the best option for a patient to live longer or more comfortably. We often see dogs that required amputation due to trauma, cancer, or congenital defects and each of these situations need unique approaches for optimal recovery. Generally speaking, most dogs do quite well post-operatively, but all of them can benefit from rehabilitation therapy. While dogs still have the 3 remaining legs, they’re not much different from human amputees in that there are significant changes to how they do even the most basic things and it is of utmost importance to keep the functioning legs at their best. How did your dog become a Tri-Pawd? Birth Defects Dogs with congenital defects have spent their entire life up until amputation compensating for the affected limb. While their body still has to make up for this limb, its also had time to build muscle in the functional limbs and to adjust balance to remain upright and mobile. Dogs in this situation often arrive at amputation when prosthetics are not appropriate or not financially possible and the leg has become more of a hindrance than a help. The musculature of the affected limb is often atrophied and depending if and how the dog uses the limb, wounds and infection are a chronic problem. Rehab helps these cases keep the three remaining legs as strong and sound as possible, as they are likely to have compensatory repercussions like arthritis or muscle fatigue from having to make up for the lost leg. These patients usually recover from amputation quite well since they’re already accustomed to relying on their stronger legs and now they are free from the dead weight and chronic wounds associated with the deformed leg. Traumatic Injuries Dogs that lose a limb due to trauma are a bit more complicated. Up until that point, they have been fully mobile with all four legs but now they’re suddenly depending on three to get the same job done. There is usually little to no preparation for these patients and it is crucial to get them into rehab therapy as soon as they are healed enough to participate. Therapy for these patients usually entails teaching them how to correctly stand and walk as well as overall strengthening while soothing the now overworked muscles and joints. Just like us, poor posture can significantly affect how the body feels and operates. Cancer Dogs that lose a limb to cancer are often at the greatest disadvantage. Not only are they suddenly having to depend on three legs, but more often than not, they are senior pets with decreased muscle mass, likely arthritis, and overall poorer body condition from cancer and/or chemo as well as any other medical conditions they might have developed over their lifetime. Again, getting them into rehab right away can give them a better chance, but these patients have the longest road ahead of them. Goals are similar to the other cases in that we are focused on building muscle and soothing the overworked remaining legs, but special care is given to ensure these patients aren’t over-exerted. Too much too soon can quickly wear them out and make their creaky joints even more painful. Variables Affecting Successful Recovery For all amputees, the leg in need of amputation is a significant variable. Dogs carry approximately 70% of their weight on their front legs, so patients that require a front limb amputation are most at risk for compensatory injury. However, since dogs come in all shapes and sizes, sometimes the leg in question isn’t the problem. For example, heavier bodied dogs like English Bulldogs or longer bodied dogs like Dachshunds can have a particularly difficult time recovering from an amputation, and even more so if it’s a front leg. Dogs that are long and heavier bodied, like a Bassett Hound, are essentially twice as disadvantaged. Cases like this can be ethically challenging for all involved and thorough consideration for Quality of Life post-operatively is a must. Whether there is time to prepare for amputation or not, weight management is the other huge variable for how these patients recover. Your dog’s skeletal and muscular systems are only built to carry and propel their lean weight. Now we’ve removed a leg and the remaining three are operating at 133% of their normal workload so any additional weight is even more of a burden than it would be for a normal dog. Factor in front vs rear limb and if there are any other comorbidities like osteoarthritis , and your dog could be set up for failure. Even a perfectly healthy, younger dog that undergoes a leg amputation will be putting extra wear and tear on their remaining legs, so as your Tri-pawd ages, it will become even more important to manage their weight, treat their pain, and keep them as strong as possible. Rehabbing the Tri-Pawd For our amputee patients, we focus on making sure they are at a healthy weight, that any sources of pain are well managed, and that the remaining legs are well equipped to take on the extra strain of Tri-pawd life by teaching them better ergonomics and improving overall strength and stamina. Generally speaking, once sutures are removed, therapy can begin but if your pet has other injuries or conditions, they may need further care before it’s safe to begin treatment. Thermotherapy and Therapeutic Massage helps to improve blood flow to overly strained muscles, helping to reduce tension and pain. Stretching is extremely important for the Tri-Pawd to retain full Range of Motion of their remaining limbs but should only be done as prescribed and after Thermotherapy and Massage. Laser Therapy and Acupuncture are excellent tools for pain relief and improved circulation. Pain relief is important but the body will not improve without exercise! Hydrotherapy using an Underwater Treadmill is particularly effective to help teach better ergonomics since their speed is controlled by both the treadmill belt settings and the resistance of the water. The buoyancy and warmth of the water helps reduce strain on sore joints and muscles. Take note that Hydrotherapy in an Underwater Treadmill is recommended, but due to less benefit and higher risks, swimming is not. Our article The Deep Dive Into Swimming  provides a visual and more detailed explanation for this, but we’ll briefly explain here too. When dogs swim, they generally paddle fiercely with their front legs while keeping their back legs tucked up alongside their body. This type of movement means they are over-working their front legs and barely working the back legs. If they do kick their back legs, it is generally in a quick, spastic movement that does not encourage muscle building but does apply more stress to the limb. Since the Tri-pawd is already experiencing extra strain on their 3 remaining limbs, they should not be subjected to the additional stress from swimming. Target Exercises also provide an incredible impact on their recovery since we are improving their strength, stamina, and balance while also teaching them how to safely navigate obstacles common to daily life. Things to Do at Home Changes to their home environment are in order as well. Stairs and slick floors are especially dangerous for your pup, especially in the early stages of recovery. It is best to avoid these at first, then slowly introduce them in a controlled manner where you can slow them down and support them using a harness. Remember that a slip and fall on stairs or hard floors could seriously injure your already compromised pet. If your dog enjoys high impact exercise or wrestling with other dogs, these activities will also need to be restricted until your pet has been cleared to resume. Unfortunately, there are some cases where these activities will never be safe to resume. Extra supportive orthopedic foam beds (Big Barker is our favorite!) ensures a comfortable resting place that also avoids any undo pressure on overworked joints and insulates from cold flooring that can cause stiff muscles and joints. The addition of rugs or yoga mats around the house makes a huge difference in your pet’s ability to safely traverse their home. Even after they have learned to use stairs or traverse slick floors, it’s still a good idea to use a harness ( Help ‘Em Up is our top pick) to provide support as needed. Your pet is at higher risk to trip or slip and injure themselves but you can safely offer assistance with a harness whereas a collar will provide zero support and is more likely to cause additional injury. Special Considerations for Tri-pawds Because the leg opposite from the amputation is now the only one supporting that half of the body, you'll want to take great care to avoid any unnecessary risks that could cause injury or infection to that leg. If your Tri-pawd needs injections or an IV catheter placed, you may need to ask your veterinary team to use a different leg since this one doesn't have back up. This is particularly true for intravenous chemotherapy treatments. If you notice anything off with the remaining leg, even if it seems small, make sure to have your primary veterinarian check it out right away! Some Tri-pawds may require long term pain medications to address compensatory pain. Many benefit from dietary supplements to support muscle growth and joint health. To learn more about commonly prescribed pain medications and how to choose quality supplements, check out our article Pain Meds & Supplements . To Summarize Many Tri-pawds go on to live fulfilling lives with their families and yours can too! It’s likely to be a big adjustment at the beginning but once the basic activities of daily life are mastered and your pet’s body condition maximized, you and your pet can still enjoy good quality time together. Rehab is particularly helpful in the beginning but remember that your dog’s body will now be experiencing more wear and tear than a dog with four legs. For this reason, we recommend circling back to Rehab as your Tri-Pawd ages to help keep them strong and comfortable for as long as possible. We’re here for you and your Tri-Pawd now and in the future, so don’t ever hesitate to reach out to us!

While this article was originally written in the context of working and sporting dogs, it does apply to all dogs and we hope that it can help every dog to have a better experience and get higher quality medical care. Visits to the vet can be stressful but they don’t have to be! Couple this with the stress and anxiety you are feeling during the entire process and we now have the perfect storm brewing. Sadly, this scenario is very common amongst all dogs, but as highly trained, intelligent, and powerful animals, Canine Athletes have the potential to make this situation particularly dangerous for all involved.  When dogs have not been socialized with strangers, conditioned to relax in new environments, or taught to allow touching of their body, we’re going to have a bad time at the vet. What Constitutes a “Bad Dog”? Inability to sit, lay down, or stay on command Growling Barking, whining, or howling Biting Jumping Refusing to be leash walked by a person other than their owner Refusing to be touched by a person other than their owner Refusing to be picked up by a person other than their owner Inability to rest quietly in a kennel Leash chewing Reactivity towards other animals How These Behaviors Affect Vet Visits When a patient comes in that is growling, lunging, barking, or trying to bite at the veterinary staff, the veterinary team is now tasked with giving that dog the best examination, diagnostics, and treatments possible while making sure that they, the client, and the patient don’t get hurt. Great example of a very good pupper calmly allowing close inspection of their feet! That’s a lot of pressure! An injured veterinary professional means many patients not getting the care they need or potentially the end of that veterinary professional’s career. All veterinary professionals are dedicated to the health and safety of their patients and clients, so if a client or patient has been injured on their watch, it is devastating for all involved.   If the veterinary team cannot safely approach or touch a dog without risking bodily injury, how are they supposed to provide good medical care? Examples include: If the veterinary team cannot touch your dog’s face, they cannot examine or treat your dog’s ears, eyes, nose, or teeth. If your dog cannot lay down and stay on command, performing radiographs will be significantly more difficult and potentially dangerous. If your dog is flailing or trying to bite, the radiographs may need to be reshot in order to get a diagnostic image, thus exposing your dog and the technicians to additional radiation. If your dog bites when its feet are touched, how will a veterinary team help them with a broken nail or avulsed paw pad?  If your dog will not cooperate for a blood draw, the results of that bloodwork may be inaccurate due to poor sample quality or stress-related changes in the body.   Dogs who can calmly and comfortably participate in their vet visit will get a more detailed examination, receive higher quality treatment, and heal better than a dog that cannot. When a dog cannot be handled safely, their exam and treatment is often rushed and/or shortened, skipping over things that have to be assumed to be okay and focusing only on the primary reason for the visit. For the Canine Athlete, this could mean that a career-ending condition isn’t diagnosed until it’s too late! It should be noted that friendly but overly excited dogs can also experience barriers to care. If they can't sit still long enough for examination and treatment, their quality of care will suffer the same limitations as a dog that bites.   How Do These Behaviors Affect CROC Visits? Bad behavior isn't limited to biting. This cutie pie is singing the song of his people while we're trying to treat his pain. His inability to calmly receive treatment ultimately reduces how much benefit he gets out of therapy. When it comes to your Canine Athlete’s visit with the CROC Team, the ability to run our hands over all areas of the body is integral to maximizing their evaluation and follow-up sessions. Palpation is the most effective examination tool we have as professionals, especially for dogs with thick coats. We are frequently feeling all over every patient’s body to assess for any subtle changes because reduced range of motion, swelling, or muscle atrophy can be identified before a patient shows any obvious limping or pain. Please note: Limping IS a sign of pain! Do not ignore this crucial signal that your dog needs help! If a patient will not allow us to palpate a relaxed muscle, that will significantly reduce our ability to evaluate and treat that patient. In our earlier article, Canine Sports Medicine Part 1: Peak Performance & Injury Prevention , we discuss how vital massage and stretching is to restore lost range of motion and alleviate pain. If your dog is unhandleable or cannot relax and allow gentle touching, they are limiting the healing benefits of our touch. The CROC Team works with some of the most conditioned and capable Canine Athletes around and it is because those patients are happy to cooperate with us. Without their voluntary participation, our efforts to repair and recondition an injured working or sporting dog is severely inhibited. Make Vet Visits Easy Beginning as early in life as possible, your dog needs to be taught to tolerate handling and be comfortable around new people and situations. Anyone should be able to touch any part of your dog’s body, especially their mouth, eyes, ears, and paws. Reina might look like a scary Malinois, but she is an excellent patient and allows us to do whatever we need to help as long as she also gets pets. Practicing nail trims early on will make it easier to maintain your dog’s feet and help prevent torn or broken nails. Teach your dog to walk on a leash, sit, lay down, and stay regardless of who is handling them. You should be able to hand over the leash to a new person and know that your dog’s behavior will remain consistent. Even if you do not plan to use a crate at home, crate training is still super important! Your dog is likely to find themselves in a kennel at some point in their lives, so conditioning for this situation at a young age means it won’t be a big deal later. Train your dog to calmly ignore other dogs walking by rather than getting excited or aggressive. Vet visit stress can begin as soon as you get in the car, so practice loading your dog in the car, making sure that it’s a positive experience and that they go on car rides to go to many places, not just vet visits. Crates can be particularly helpful here since they give your dog their own comfy place to be in while preventing them from jumping all over the car or potentially interfering with your driving. Using a crate in the car can even save a dog’s life in the event of a car accident! If your dog gets car sick, ask your veterinarian about medications to help prevent nausea. If your dog only goes to the vet for vaccines, they learn that they get poked by needles every time they go there. Many veterinary hospitals are embracing “fear-free” techniques and suggest “happy visits”, where your dog visits the clinic to get a treat and some snuggles, then goes home. This exposure to the veterinary clinic and the people in it helps your dog remain calm and comfortable when visiting the clinic. If there is a special treat that your dog loves, try to reserve it specifically for important situations like vet visits so that you can provide extra motivation to be on their best behavior. Helping Adult Dogs with Fear Aggression & Anxiety It can be more difficult for adult dogs to create positive associations with vet visits, but it’s not impossible and there are other tools to make things safer for everyone. You should still be working on calm, cooperative behavior and socializing regardless of your dog’s age , but anti-anxiety or sedating medications can make a world of difference for fearful or aggressive dogs. It can take some trial and error to find the right medication(s) and administration methods, but once you do, these medications can help reduce those feelings of fear and stress, thus resulting in a better, more willing patient that can be examined more closely and ultimately culminating in higher quality care. Some dogs do best with medications that start the day before a vet visit, while others benefit from injectable sedatives immediately upon arrival at the clinic. Oral medications are generally preferred over injectables so that the patient can be aware of their experience without feeling so afraid and because it can be risky to give injectable sedatives to a patient with an unknown medical status. For safety reasons, muzzles are often required but trying to put a muzzle on a dog that wants to bite you is dangerous and that dog is likely to be terrified, further reinforcing the idea that going to the vet is bad. But don’t let the negative stigma dissuade you! When introduced correctly, a muzzle can be a huge asset and make calmer, safer interactions possible. There are many types of muzzles so you will need to research which type and size would be best for your dog, with a wider variety of options available online than in your typical pet store. Many muzzles, if correctly fitted, allow the dog to pant and drink water while wearing them. Nemo's muzzle allowed us to start treatment and once he learned that we're there to help him feel better and NOT to hurt him, he was much more tolerant of therapy! The key to success is to train your dog to willingly wear the muzzle by creating a positive association and having them wear it in non-stressful situations. It’s often easiest to start by feeding high reward treats from within the muzzle (as if the muzzle was a cup) and slowly working towards putting the muzzle over the nose for a few seconds followed by a treat, and eventually getting to the point where your dog will wear the muzzle just as comfortably as a collar or harness. Once your dog is comfortable wearing the muzzle during their usual day to day activities, you can also put it on them before you step foot into the veterinary clinic. Set Your Dog Up for Success! Being a tough, strong, impressive specimen of athleticism does not mean that your Canine Athlete should be a scared, reactive, or angry dog. Canine Athletes have so much time and effort invested in them to perform at their best, it behooves you both to ensure that they get the very best medical care possible so that they can continue their work or sport. Failure to thoroughly train and socialize your dog will negatively impact the quality of their medical care and life experiences for you both. Canine Rehab OC offers custom Fitness Plans by appointment. If you are interested in a comprehensive exam, clinically-proven therapies, and prescribed exercises for your Canine Athlete, check out the New Patient  section of our website to learn how to get started. Want to learn more about how to support your Athlete? Canine Sports Medicine events are coming to Canine Rehab OC soon and we'd love to see you there! These events include demonstrations courtesy of Dogtor Wilbur and a 30+ page Canine Sports Medicine booklet for each attendee. If you are part of a local Dog Sports group and interested in setting up an event, reach out to us ! We love getting involved in the dog community and helping as many families as possible. This article is Part 5 of our 5 part Canine Sports Medicine series! Other articles include: Part 1: Peak Performance & Injury Prevention Part 2: Cross-Training Part 3: Common Conditions & Injuries Part 4: Nutrition for the Canine Athlete

*** The tips and recommendations within this article are made for dogs that are free from any health concerns and may not be right for your dog. As all dogs are unique individuals, we recommend that you consult with your Veterinarian or schedule a Fitness Consultation with the Physical Rehabilitation Specialists at Canine Rehabilitation of Orange County to discuss what is right for your dog.*** What does weight lifting have to do with playing tennis? Human athletes cross-train to ensure they are in peak physical condition and ready to perform at their best. They know that weight training and targeted exercises translate to bigger wins and reduced chances of injury. That’s why olympic swimmers can be found cycling and basketball players will practice pilates. Using low-impact, targeted exercises, cross-training will improve your Canine Athlete’s balance, endurance, flexibility, and strength in the same way as their human counterparts.  Balance Balance is the ability to maintain uprightness and avoid falling, so we begin our work here before moving our focus to coordination and strength. You can’t focus on getting stronger if you keep falling over! Balance work also increases core strength; a weak core can cause hyper-mobility of the spine and predispose your dog to significant back injuries and chronic pain. Poor core strength will also put excess force onto the limbs, increasing risk of compensatory injury. The goal with balance work is to gradually increase the challenge of each movement. If your dog is unsteady at a certain level and cannot hold a balance pose for extended periods of time, continue to train and repeat the exercise until it is no longer difficult for at least 5 sets of 15 seconds.  Proprioception The foundation of good agility, proprioception is the brain’s awareness of the body’s position in space. Improving proprioception enhances your dog’s speed and precision of limb movement. Poor proprioception can mean the difference between 1st and 2nd place, but it might also be the variable saving your dog from serious injury. One paw in the wrong spot could lead to a nasty fall off an obstacle and potentially months to recover before they can resume their favorite activity. Strength In order to gain strength, exercises must be challenging enough to require cellular adaptation but not so difficult that the body has to modify or compensate in a counterproductive way. It takes an average of 8-12 weeks of strength training to achieve measurable outcomes. Remember that rest & recovery is vital as strength training too frequently can result in overly fatigued muscles, followed by catabolizing (breaking down) of the muscle tissue. At least 48 hours between strength training sessions is necessary for recovery , with the average Canine Athlete strength training just 1-2 times weekly. It’s also important to keep in mind that fast movements do not enhance muscle mass but slow, controlled movements do! A Quick Word on Overtraining The buildup of lactic acid is proof of muscle strengthening occurring but it can also result in Delayed Onset Muscle Soreness (DOMS). Sore and tight muscles can delay performance reaction times, so cross-training should be avoided in the two days prior to a competition or performance. Varied training will help decrease the risk of exhaustion and soreness, but it’s important not to overtrain your Canine Athlete. An example workout week might look like 1-2 days of cardio, 1-2 days of strength training, and 3 days of target training for the sport or job your dog participates in.   If you note that your Canine Athlete stretches a lot the day after a workout or event, they are likely experiencing DOMS and would benefit from a good massage and stretching session. The application of Cryotherapy can help reduce inflammation and swelling in acute phases of tissue trauma (occurring immediately after an activity/injury) by reducing blood flow to the area, therefore reducing pain. Cold packs can be made at home using a sealable bag with three parts water to one part running alcohol. Wrap the cold pack in a thin towel and apply to your dog for 15 minutes, but no longer than 20 minutes. Target Exercises for the Canine Athlete The following target exercises can be helpful for working and sporting dogs, but please use your best judgement before attempting them with your Canine Athlete as these exercises may not be right for them. For a comprehensive and customized Fitness Plan, schedule a Fitness Consultation with our Veterinary Physical Rehabilitation team. We always recommend checking with your Rehab Team or Primary Veterinarian before beginning any new exercise regimen with your dog. We strongly recommend using a harness during exercise so you have better control of your dog and can catch them more easily if they stumble. If your dog has not been properly warmed up for exercise, check out Part ONE of our Canine Sports Medicine series first! Step Up & Step Down Your dog will be standing still for this exercise. Have your dog step up a single stair, curb, or other raised surface & leave their back legs on the lower surface. While in this position, gently push one area of the body & then another. Vary the speed & direction of each push. Push enough to challenge your dog’s balance but not enough to make them take a step or fall. For a Step Down, have your dog stand with their back legs on the higher surface & their front legs on the lower surface, then repeat gentle pushing to challenge balance. For increased challenge, add a three legged stand or an unstable surface like a fitbone, or wobble board. Three Legged Stand Your dog will be standing still for this exercise. Lift one of their legs off the ground. When holding a front leg, bring the leg forward, holding the underside of the paw above the big pad. When holding a back leg, bring the leg backward by holding it at the ankle & pulling up & back so that the paw pads face up. Support the paw lightly so that your dog cannot use your hand to support their weight. For increased challenge, combine this exercise with a Step Up or Step Down, add an unstable surface, or for even more challenge, lift up a front leg on one side & a back leg on the other. Figure 8's Using a leash and harness, slowly walk your dog in a large, wide figure 8 pattern. It can be helpful to have objects for your dog to walk around. This exercise can be included as part of your dog's regular walks. Canine Rehab OC offers custom Fitness Plans by appointment. If you are interested in a comprehensive exam, clinically-proven therapies, and prescribed exercises for your Canine Athlete, check out the New Patient  section of our website to learn how to get started. Want to learn more about how to support your Athlete? Canine Sports Medicine events are coming to Canine Rehab OC soon and we'd love to see you there! These events include demonstrations courtesy of Dogtor Wilbur and a 30+ page Canine Sports Medicine booklet for each attendee. If you are part of a local Dog Sports group and interested in setting up an event, reach out to us ! We love getting involved in the dog community and helping as many families as possible. This article is Part 2 of our 5 part Canine Sports Medicine series! Other articles include: Part 1: Peak Performance & Injury Prevention Part 3: Common Conditions & Injuries Part 4: Nutrition for the Canine Athlete Part 5: Bad Dogs, Bad Medicine  (Effects of Behavior on Quality of Care)

Congratulations on ordering your pet’s new, custom-built cart! There’s some pretty important details you’ll need to familiarize yourself with in order for your dog to get years of safe and comfortable use out of their cart. Most importantly, this is not a process that can be rushed! Jumping ahead too quickly can cause serious injury to your dog or make them too afraid of their cart to continue using it. Preparing Your Dog & Your Home Ideally, dogs who will be needing a cart will have Physical Rehabilitation Therapy beforehand to prepare their body for the physical demands of cart use. This is not a passive device like a human wheelchair. A human can pause and just sit and rest when they get tired. Your dog cannot and is stuck in a standing position as long as they are in their cart. Building up their strength and stamina before cart use can help them adjust to this new activity more quickly and ultimately set them up for better success long term. Dogs that are unable to participate in Physical Rehabilitation Therapy before getting their cart can still do well, but they will need much smaller increments of time and distance as they become accustomed to exercising in their cart. In addition, you may want to prepare your home for your dog’s new cart. Obstacles like furniture, doorways, and even small bumps on the floor are likely to be challenging for your dog to navigate at first.  As they are learning to use their cart, hitting obstacles that cause sudden stops can be scary and obstacles that cause them to feel trapped can be frustrating. Dogs are emotional creatures so creating a positive environment for them to learn in is a huge contributing factor for your dog’s success. Flat open areas, free of furniture and tight spaces, are the perfect environment for practicing in the cart. Hard, smooth floors like tile, laminate, or concrete are the easiest to roll on with textured flooring like carpet being more difficult especially as your dog is still adjusting to their new device. It may also be helpful to be able to temporarily put other pets away while they’re practicing in their cart, so having a safe space for other pets is optimal. Without a careful introduction, some animals can view the cart as something terrifying or dangerous attached to their housemate and may act aggressively towards your wheeled pet out of fear. Good Vibes Only! As mentioned above, dogs are emotional creatures and positive reinforcement is the most effective training tool. We’re working together to train your dog to properly use their cart. We are asking them to be strapped into a moving, metal contraption that is going to “chase” them everywhere they go; some calm confidence is definitely needed here! To assist with this first introduction (and to make any remaining adjustments), we will have you schedule one last Cart Fitting appointment at CROC at no charge. During this appointment, we will introduce your pet to their new cart in a calm and positive environment. We teach them that the cart is not scary, what it’s like to get in/out, and how to make it move with them. We let them make their first, sometimes awkward, steps in the clinic where we can help them learn how to maneuver it where they want to go and what it’s like when they inevitably hit an obstacle. Some dogs are chomping at the bit to run right from the get-go and couldn’t care less about any speed bumps. Others are more reserved and need a lot of encouragement to take even a few steps. The shy pups can quickly shut down out of anxiety and refuse to walk any further, especially if they hit an obstacle. By having them go through this initial experience at CROC, we can ensure that their first time in their wheels is a positive experience , making your first time using the cart at home a smoother, easier process. While you might feel excited or even anxious about your dog’s first few times in the cart, you must focus on the task at hand. If you are anxious about the cart, your dog will be too! You want to start the training session in a calm, but encouraging energy so that your dog feels relaxed and confident. Even just having the cart nearby for them to inspect and do normal daily activities next to can help desensitize your pet and any housemates, so they feel that it is a safe thing to have near. Your confidence truly rubs off on them! Even if they show some initial signs of being nervous or fearful, it’s super important that you reassure them and calmly continue. When you’re ready to get started, be sure you have any and all tools you might need close at hand. You will want to have your dog harnessed and leash and you may want a bag of treats to encourage them with. Make sure you read the instructions included with your dog’s cart and are familiar with how to load/unload your dog into the cart so you can make your dog’s experience smooth and fear-free. You don’t want to panic or become frustrated. Move too quickly and your dog may become scared. Move too slowly, and they may be too excited or frustrated to stay still long enough for you to finish loading them in. It’s okay if you’re nervous! Sometimes you just have to “fake it until you make it” for your dog’s sake. Listen to Your Dog These first few sessions in their cart should only last about 5 minutes (unless directed otherwise by CROC) each and happen a few times each day, with plenty of time to rest in between sessions. Be sure to monitor for signs of fatigue. Dogs that lower down onto their front legs are trying to lay down, so it’s important to give them a break when they ask for it. If your dog hesitates to walk, try to encourage them to take a few more steps before calling it quits. If the session has come to a complete halt, it may be best to recognize that your dog needs a break and try again later, keeping things positive and light the entire time. Over time, you can start increasing their cart sessions by 5 minute increments every few days to a week, as long as they are able to finish the session without being exhausted. If you increased your dog’s cart session and they are totally wiped out exhausted at the end, it’s recommended to revert to shorter sessions for a bit longer before attempting to increase again. If you find that your dog is only wanting to move backwards, this is often a sign that your dog is not strong enough to pull their cart forward as pushing backwards is much easier. For the best chance of successful cart use in this situation, your dog will need additional physical conditioning to become strong enough to pull themselves and the weight of the cart forward. If this is happening with your dog, follow up with the CROC team so that we can work together to create a plan to help your dog get rolling. Suggested Safety Measures Use extreme caution around stairs and pools A fall down the stairs or into a pool can cause serious injury or death. Ideally, these risky areas would have a physical barrier preventing your dog from getting to them. Use caution around other animals Not all animals are comfortable around carts and may even be terrified, making your dog a target for attack. You dog cannot defend themselves in the way that a fully ambulatory dog can, so please be very careful about which animals are allowed to interact with your wheeled dog. When allowing your wheeled dog to play with other animals, it is best to prevent overly rough play, as most wheeled pets have conditions that can be worsened by the impact and twisting of rough play. Practice good hygiene Keeping your dog’s cart clean and well maintained is imperative for comfortable, long term use. Your dog is able to urinate and defecate while in their cart and while it’s not common that the cart becomes soiled, be sure to watch for it and wipe down as needed. The pelvic support area can get dirty just from regular use, so make a good habit of cleaning it regularly and allowing it to dry fully before resuming use. Abrasions and worn nails are frequently seen when a dog's feet are not adequately protected. Protect those paws Depending on your dog’s condition, they may or may not have some use of their affected limbs. We always want to encourage whatever independent movement your dog can manage, so if they are able to move their legs with the support of the cart, you should let them do so. Either way, you will need to protect their paws from scuffing or dragging on the ground. If they are able to move their legs in any meaningful way, you may want to keep some booties on hand, such as Pawz, or keep them on soft surfaces like grass. Please note that even carpet can cause burns from frequent rubbing. If your dog does not have the ability to move their legs, please take care to use the included supportive pieces on your cart to hold their paws up off the ground. Some carts will have a padded bar along the back for the legs to rest on and others will have dedicated stirrups to secure their feet safely up and away from dragging. Visit our Gear & Resources page for examples and links to booties we like. When in Doubt, Call CROC! When we suggest a cart for your pet and begin preparing them, we use our Veterinary Physical Rehabilitation experience to ensure that your pet is a good candidate, that they get the right cart and the right fit and we stand behind our work. Therefore, patients who have undergone CROC’s Cart Fitting process are extended long-term support for their cart. You are welcome to call with questions any time or even schedule a follow up fitting if something seems off down the line. Some pets will need minor adjustments to their cart as they age or as their condition changes to ensure that the cart remains ergonomic and comfortable. On a regular basis, you will need to check that all screws and bolts are secure and that the wheels are spinning easily and evenly. More frequent maintenance checks should be performed for dogs that are particularly active in their carts. Unfortunately, CROC cannot offer any support for carts obtained outside of our guidance, even if they are obtained through Eddie’s Wheels. We know that the circumstances leading up to needing a cart are typically challenging and exhausting, but now that you've got some wheels, we hope that you and your dog get as much joy and freedom from your new cart as possible!

You might have seen the abbreviation BCS on your pet's medical records or seen the charts on the wall at your Veterinarian's office, but what does it mean and where does your dog need to be? The Body Condition Score (BCS) is a scale used to describe body fat level and determine proper body condition in animals. The BCS is often used on a scale of 1 to 9 or 1 to 5. To provide as much information as possible, CROC utilizes a scale of 1 to 9, with 1 being extremely underweight and 9 being extremely obese. Since dogs come in all shapes and sizes, determining their BCS is more about evaluating certain parameters of their body condition instead of focusing on just the numbers on the scale. Some quick ways to assess your dog's BCS include: Does your dog have an hourglass shape when you stand behind/over them and look down at them? Do they have a tuck at their waist? Can you easily feel their ribs? If any of your answers to the above questions are “no”, there’s a good chance your dog needs to lose weight. Dog owners don’t always recognize when their dog is out of shape. Maybe that’s why approximately HALF of all dogs in the United States are overweight or obese ! An overweight dog is at severely increased risk for serious health concerns, with even just a few extra pounds contributing to: Shortened Life Span Diabetes Cancer Arthritis Heart & Respiratory Conditions Skin Infections Pancreatitis Increased Surgical & Anesthetic Risk and many more scary things! So my dog needs to lose weight.... Now what? Just like humans, weight loss for dogs really comes down to two things: food and exercise, with food being the easiest and quickest thing to change. For successful weight loss, a reduction of caloric intake is not optional. We know. We wish it worked differently too! Get Specific With What You’re Feeding Here’s where things can go sideways. Humans may or may not choose to count calories as a guide for what they’re eating, with some opting for other methods of keeping to a healthy regime (Do my pants fit? Cool or Yikes!). But when it comes to the long term management of your dog’s weight, it’s essential to establish a concrete benchmark for how much to feed, meaning we need to determine the number of calories your dog needs each day. Unfortunately, feeding guidelines on the average pet food package are generally too broad or vague and many owners end up over feeding. The feeding guidelines on pet food packages are loosely based on active adult dogs of all ages, breeds, and sexes. Spaying or neutering, as an example, reduces energy requirements by 20-30%, so if your pet is spayed or neutered, you can already be overfeeding by 20-30% or more. To determine the ideal caloric intake, we need to consider your dog’s Body Condition Score, muscle mass, lifestyle and any medical conditions. For at home calculating, you can use the Resting Energy Requirement (RER) Formula (or just ask us and we'll calculate for you!) . RER Formula Example Equation Using a 30lb Dog a. Start by taking your dog's weight in pounds and dividing by 2.2 to get your dog's weight in kilograms. 30lb divided by 2.2 = about 13.6kg Multiply weight in kilograms by 30. 13.6kg X 30 = 408 c. Add 70 408 + 70 = 478 d. You can then factor in Metabolic Energy Requirements (MER) based on things like weight loss or spayed/neutered. ​ For healthy, intact (not spayed/neutered) adult: Multiply the RER by 1.8 478 X 1.8 = 860.4 calories per day For healthy, spayed/neutered adult: Multiply the RER by 1.6 478 X 1.6 = 764.8 calories per day For an overweight adult to lose weight: Multiply the RER by 1.0 478 X 1.0 = 478 calories per day These formulas provide an estimate, but every dog’s metabolism is different so be sure to monitor your dog’s weight as you adjust their diet. CROC weighs our overweight patients approximately every 2 weeks to make sure they are safely losing weight and if we need to make any changes to their weight loss plan. Another easy change is to start utilizing a diet formulated for weight loss. Many diets exist to help dogs feel fuller while eating less calories. Some even have extra benefits like joint support! Trick or Treat? Our bond with our dogs is priceless and every dog owner wants to see the joy and excitement a treat brings to their best friend. However, it’s easy to forget that those treats are also part of your dog’s daily caloric intake. Even if you’re following the above formula perfectly at meal times, any treats your dog gets throughout the day are adding to their caloric excess. This doesn’t mean that you can’t give any treats! What it does mean is that you must calculate the additional calories of the treats you are giving and feed that much less of your dog’s regular meal. While commercially prepared, AAFCO approved diets are nutritionally balanced to provide your dog with everything they need, treats are not! The majority of your dog’s daily calories needs to come from a balanced diet to avoid any nutritional deficits that could then cause serious illness. Dogs also get the same joy and excitement from healthier or smaller treats. Many of our clients report success switching to fruits or veggies as treats. There are also commercially prepared low calorie treats readily available, some as low as 2-3 calories per treat. At the end of the day, there are many ways besides food to show our pups that we love them. Safely Increase Exercise Now that your dog’s diet has been addressed, it’s time to start adjusting their exercise routine. The most obvious and important activity for your dog’s weight loss is walking. The amount of walking your dog needs depends on their breed and general health, but unless recovering from life threatening trauma, all dogs need to move regularly. Our article Motion is the Lotion  discusses the importance of regular movement in maintaining your dog's musculature, range of motion, and comfort. Regular walks exercise your dog’s body and provide mental stimulation like the vital opportunity to sniff! If you’re already doing regular walks, try lengthening your walk by 10-20%. Remember to work in your Home Care exercises to improve coordination, stamina, and strength. Muscle burns more calories! Unless your dog has been trained and physically conditioned for sports or other vigorous exercise, you’ll need to avoid overly strenuous or repetitive exercise, or you will risk injury. Weather conditions, such as high heat, will also need to be kept in mind to avoid paw pad burns or heat stroke. Physical Rehabilitation is an excellent tool to safely exercise your dog and speed up their return to health. Our Rehab Practitioners and Veterinarians will prescribe a weight loss exercise plan specifically for your dog to achieve maximum results while making sure your dog isn’t overworked or injured. Hydrotherapy in an Underwater Treadmill Therapy is a great option for overweight pets since the buoyancy of the water reduces strain on their already overworked joints while providing resistance to build their muscle mass and improve their stamina. While swimming is often touted as a good low-impact exercise, it is not recommended for most compromised pets as it does not build muscle as effectively and puts excess strain on overworked joints. Read the Deep Dive into Swimming to learn more. On the topic of overworked joints, overweight pets often experience accelerated  osteoarthritis  formation and considerable joint pain due to the extra force applied to them daily. Rehab treatments like Laser Therapy can help reduce that pain and inflammation, therefore keeping your pet more comfortable as they work through their weight loss plan. Rule Out Medical Conditions If caloric boundaries have been established and strictly followed, your dog is getting regular and balanced exercise, but you’re still not seeing results, a visit to the vet could be in order to rule out medical reasons for your dog’s weight. Weight gain and lethargy can be symptoms of conditions like Hypothyroidism or Cushing’s, among many others. These conditions often occur in middle-age to older dogs and can be treated with medication once properly diagnosed. Other symptoms to watch for include frequent urination, hair loss or poor coat condition, weakness, and delayed healing. Keep Track! Sometimes, it feels like you're doing everything right, but your dog STILL isn't losing weight. Often, the devil is in the details! To help figure out the culprit, we suggest keeping a food diary to track everything your dog is eating. This goes beyond just what goes in the bowl day after day. Your food diary should include treats, table scraps, supplements, random things they found outside - literally anything that goes into their mouth! Owners of CROC patients are welcome to bring their completed food diary in for discussion any time. We are here to help get your dog to optimal body condition! Click below to download and print our food diary form.

As our four-legged friends become more and more integral parts of our lives, us humans are getting better at finding ways to keep them comfortable, mobile, and having fun despite physical limitations. Using a cart can allow an otherwise immobilized dog the chance to go on their favorite walks, play with their friends, even play fetch! Sometimes, these activities are the difference between a stimulated, happy pup and a depressed, lethargic one. Bella was given more time to be mobile and active after Degenerative Myelopathy made her rear legs too weak to walk or stand on her own. Is Your Dog a Good Candidate for a Cart? First, we have to point out that dog carts don’t function like a human wheelchair. When a human is in a wheelchair, they are usually sitting – a passive position that requires little effort to maintain. They are not holding up their own weight and depending on the type of wheelchair, they may not have to put in much physical effort to move the chair. For simplicity’s sake and since they’re the most common, we’ll be using a rear-wheel cart as the main subject of this article, though there are many configurations available. The rear-wheel cart requires the dog to be in a standing position and does not allow for them to sit or lay down. Imagine being a physically compromised human and being forced to stay on your feet all day without rest! AND The rear-wheel cart requires the dog to have the strength in the front half of their body to not only hold up their front half, but to also pull the weight of the rear half of their body AND the weight of the cart. That’s quite a lot to ask of a weakened or injured pup! Well then, what’s the point? Rear-wheel carts are usually recommended for dogs that have normal strength and ability up front but whose back legs are too weak to walk or are being dragged. Dogs with Intervertebral Disc Disease (IVDD) or Degenerative Myelopathy (DM) who have no chance at regaining the ability to walk but are otherwise in good health are commonly referred for a cart. But even the perfect cart patient needs some preparation before they start using a cart. This is where rehab comes in. We’ve heard people say, “rehab can’t fix my dog’s legs so why do I still have to bring them?”. Firstly, we’ve had numerous patients come in for a cart fitting only for us to see that the dog still has a chance at walking again if the clients want to try. This is HUGE! If you take a dog that still has potential to regain the ability to walk and put it in a cart, you have sealed their fate and taken away that chance at independent mobility. If you haven’t seen it yet, we suggest watching the video about our patient, Nalu , as he was an exact example of this situation. If we hadn’t turned down the idea of a cart for him, he likely never would have walked again. Thanks to Rehab, he went back to running on hiking trails with his mom, his favorite activity! Secondly, remember how the dog has to remain standing and pull the weight of their body plus the weight of the cart? That’s going to take some serious strength and stamina to do comfortably. Rehab sessions for these patients are aimed at getting the front legs, neck, and back as strong as possible and building your dog’s cardiovascular stamina to meet the demand of using the cart. Not only that, but this extra strain on the front causes significant compensatory pain and possibly injury. Therapy can physically prepare and maintain your dog for the strain of using the cart while also keeping those overworked muscles and joints happy and comfortable. Example of a poorly constructed and ill-fitted rear wheel cart. Purchasing Your Dog's Cart At this point, we’ve established that our patient is a good candidate for a cart and they are being physically prepared for the cart. Now, we just need a cart! This is another spot where many pet parents get caught up and their dog suffers. Carts are quite the investment. Even the cheapest carts are several hundred dollars. But much like anything else, you get what you pay for and with a medical device, you never want to cut corners. Cheaper carts are often made with cheaper materials and in only a few cookie cutter dimensions but dogs come in all shapes and sizes! We have seen lower quality carts cause significant back pain because they were not properly fitted for the dog and serious skin injuries where poor craftsmanship caused damage from regular use. A properly fitted cart should allow the dog to stand in an ergonomic position, provide good support without injuring the body, and be as easy for the dog to use as possible. Barry's low quality, poorly fitted cart Barry getting measured by the CROC Team Barry's new custom built, high quality cart What DO we recommend then? CROC exclusively recommends Eddie’s Wheels and we can perform the measurements for you so you know that when you invest in your dog’s equipment, it will be custom built for your dog to use safely and comfortably for years to come. We’re so confident in their carts, that when our clients get their dog’s cart through our Cart Fitting process, we offer continuous support for the cart long after the initial ordering process. Most of our clients never need this follow up support but sometimes a dog will need small adjustments as their condition or ability changes. We begin by meeting with our clients to make sure that their dog is a good candidate for a cart, then anywhere from 2-5 CROC team members are utilized to position, measure, photograph, and record all details required for the cart to be perfectly custom built. We send in our part and the client takes the rest and orders their pet’s cart directly through Eddie’s Wheels. Lead times vary, but it usually takes at least a couple weeks for the cart to be shipped. We don’t stop there though! Next, we have our clients bring in their cart at their dog’s next therapy session so we can put together any unassembled parts and make any small adjustments to ensure a perfect fit. Introducing a dog to a cart can be a delicate process. Dog’s generally don’t like the concept of something being stuck to them or “chasing” them and some can get spooked when a wheel hits a bump or a wall. We make sure your dog has a calm, positive introduction to the cart and then start acclimating them to being in the cart and walking with it. Then, we teach you how to use the cart at home. Unfortunately, because of how much effort is required for your dog to use their cart, they can’t just jump in and go back to their 2 mile long walks. Like any new exercise, they need to be slowly introduced to it and then gradually increase the length of time in the cart. This process starts with just a couple minutes at a time, a few times a day. Dogs that have been physically prepared in the weeks leading up to receiving their cart will move through this process much quicker. Often, dogs using carts benefit from continuing rehab therapy to keep the functioning limbs as pain-free and strong as possible. To learn more about life with a dog on wheels, check out our article The Wheel Deal Part 2: You Got the Cart; Now What? Ask the CROC Team There’s nothing quite like seeing a previously immobile dog absolutely take off in their brand new cart! They always seem so proud of themselves and their spirits instantly lifted. If you think your dog might benefit from a cart, give us a call to schedule a Cart Consult. We’ll go over all your options and give you the real facts about if your dog needs a cart, what kind, what the process will be, and how to set you both up for success.

The Iliopsoas (pronounced like ill-ee-oh-soh-az) is a grouping of muscles comprised of the Iliacus and Psoas Major, which originate in two different spots but then fuse into one common tendon way up in the groin and attach to the femur. Their job is to flex the dog's hip (bringing their knee forward and up to their belly), rotate the hip outwards, and stabilize the lower spine. Highly active or sporting dogs frequently experience Iliopsoas Injury since the activities they participate in are high intensity like jumping, sprinting, or rough play and are more likely to overstretch the Iliopsoas. Dog sports are very similar to human professional sports in that structured and staged exercises are done to work up to a certain level of ability. Human professionals also routinely warm up and stretch before exerting themselves to their full potential but this is all too often overlooked in our canine athletes. Just like us, if the dog’s body is not properly strengthened and cross-trained for these activities before attempting, they are more likely to overwork the body and incur an injury. There are some conditions that can make your dog more likely to experience an Iliopsoas injury like Hip Dysplasia , Intervertebral Disc Disease , or Cranial Cruciate Ligament Tear/Rupture  (sometimes incorrectly referred to as an ACL) but a dog’s overall fitness level and lack of preparation for high intensity activity can also be primary causes. Even if they are otherwise very well-muscled and fit, a dog that has poor flexibility and core strength will be significantly more likely to experience Iliopsoas injury than a dog that has been cross-trained and warmed up before exercise. Symptoms of Iliopsoas Injury Signs and symptoms of Iliopsoas injury vary, with some being extremely difficult for dog parents or even veterinarians to notice. Sometimes, a mild change in the dog’s gait is the only outward sign. Dogs with significant injuries/pain often stand with their lower back rounded and their hind legs brought closer to their front legs in an attempt to avoid the painful stretch their normal posture requires. This injury is usually diagnosed by palpating the dog’s groin muscles along with evaluating symptoms, though it can also be identified via Ultrasound Imaging or Magnetic Resonance Imaging (MRI). Rehabbing Iliopsoas Injury Just like human medicine, Physical Rehabilitation is the treatment of choice for muscle strain. Previously, clients were advised to keep their pets on strict crate rest, but this is no longer recommended. Instead, treatment starts by managing the dog’s pain including pain in other areas of the body caused by compensating for this injury. Pain management is key, as a painful dog will not be able or willing to participate in the exercises necessary to recover. As part of your consultation, we will discuss all current medications that your dog is on and if their pain is not adequately managed, we will refer you back to your regular veterinarian to adjust their medication as needed. We will alert you to any signs of pain seen in clinic, but make sure to keep us updated on your dog’s comfort level at home with daily routines as well. In addition to medications, Thermotherapy, Therapeutic Ultrasound, Therapeutic Laser , Massage, and Stretching are excellent modalities to relieve the pain your dog is experiencing. Once we feel that your dog is comfortable enough to start exercises, we will create a customized plan of foundation exercises to carefully reintroduce the Iliopsoas to normal movements and functions. It might seem counterintuitive to work this injury, but specific exercises are integral to bring blood flow and movement back to this tight and overstrained muscle group. As your dog starts to tolerate more of these exercises, we will introduce more challenging exercises to strengthen not only the injured muscles, but also other supporting muscle groups. This balance is essential to return to normal function. Consistent rehab sessions are best, but the custom homecare plan we create for you and your pet to do at home is also an essential part of your dog’s optimal recovery. These controlled and measured exercises will help your dog get better, but if your dog is allowed to return to normal exercise, free play, or even their sport too soon, they are likely to quickly re-injure themselves and lose any progress gained by the previous weeks or months of therapy. Sticking to the prescribed exercises and patience with the process are a necessity. Remember that every dog is different in how their body heals, so the length of time required to heal from this injury is unpredictable. The goal is always to prevent injuries like this, but once they occur, we can help get your dog feeling and moving better, faster. If left untreated, Iliopsoas injuries can become a chronic source of lameness and pain, so professional rehabilitative services started directly after diagnosis are always recommended for this type of injury. Ask the CROC Team Think your pet might have an Iliopsoas Injury? Let’s get you in for a consultation to find out! Give us a call at (949) 444-2451 to schedule with our Certified Canine Rehabilitation Practitioners and Veterinarians so we can get your best friend back to doing what they love most.

We’ve recommended a Help 'Em Up Harness for your dog. What is it, why do you need it, and why can’t you just use a regular harness? Unlike a regular harness you might buy from a pet store or online which might be comparable to clothing, the Help 'Em Up harness is a medical device , like crutches or a wheel chair. You’d want your crutches to be designed in a way that is comfortable for you to use, will withstand day to day wear and tear, and will not cause injury to other body parts during use. Using the Help 'Em Up Harness makes it much easier to help Nalu stay on his feet during an exercise meant to challenge his balance and stamina. Why This Harness? This harness is a fantastic tool to help your dog be more mobile. Whether old age and weakness is making getting in and out of the car more challenging, or they have a neurological condition requiring that they relearn how to walk again, your dog needs physical assistance. The thought behind assisting them to do normal activities rather than just carrying them everywhere is a sort of “use it or lose it” concept. They can’t ever regain strength if they’re not using those muscles. They won’t get the chance to regain neurological function if the opportunity to get those nerves firing isn’t there. The hope is, that by assisting your dog to do basic things, like walking or using the stairs, they can eventually regain the ability to do it on their own. So where does that leave you and your dog? You can physically lift and hold them in the positions, postures, and paw placements necessary for these activities – prepare for your own back pain! You can use a towel, leash, or sling to hold your pet up. These are appropriate tools for short term but they don’t disperse your dog’s weight in a comfortable way and aren’t the most comfortable for you to use every day either. There’s often too many straps to easily manage, you have to remember to grab it before any activity, they can impede your dog’s normal range of motion, and they put most if not all of your pet’s weight on their belly – ouch! The Help 'Em Up is designed to be easy for you to use and fitted for your dog’s anatomical needs. The padding is strategically placed so that your dog’s body weight is evenly dispersed under their chest and hips, instead of their neck or belly while also allowing your dog to move their legs normally. They even have pieces specifically designed for male dogs to be able to urinate while still getting the support they need to stand. No more pee covered slings or towels! But why does it have to be this harness specifically?  Over the years, we have seen countless attempted knock offs of this device. We understand; they’re not cheap and pet parents are trying to do the best they can for their pups while keeping themselves afloat; it’s a delicate balance. Unfortunately, we’ve yet to see a knock off that offers the same benefits and we’ve seen many that are dangerous to use. Some of the knock offs we have seen put the dogs at risk for a dislocated hip or a slipped disc! Yikes! While we do offer a service to custom fit a Help 'Em Up Harness for your dog, the cost of this service only covers the expense to provide it (meaning we make no money by offering it) and we do not receive any sort of kick back from the makers of the harness. We recommend this product exclusively because it is the best we have found and tested. Common Conditions that Benefit from a Help 'Em Up Intervertebral Disc Disease (IVDD) Fibrocartilaginous Embolism (FCE) Geriatric Onset Laryngeal Paralysis & Polyneuropathy (GOLPP) Degenerative Myelopathy (DM) Osteoarthritis (OA) Hip Dysplasia Post-Op Amputation Most recovering recumbent patients Proper Use of the Help 'Em Up You might ask, " why is a harness fitting appointment necessary? ". The Help 'Em Up can be a bit tricky to fit to your pet the first time and improper use can cause skin irritation or failure to support your pet as intended. There are many adjustment points and this device needs to be well-fitted to your pet. Using the size chart to pick out your pet's harness can be deceiving as well as we have found that they often need a slightly different size from what the chart indicates. These harnesses are also unable to be returned, to us or the manufacturer. By letting CROC Professionals take care of this for you, you'll know that your pet is comfortable and well supported in their new harness the first time around. It is important for the harness to be snug. You should not see huge gaps between your pet and the harness. The Help 'Em Up is designed to be worn all day, but it must still be cleaned on a regular basis. Harnesses left on 24/7 and unwashed can cause skin infections/abrasions, especially for pets with urinary or fecal incontinence. If you notice that your pet's skin is irritated from the harness, remove the harness and wash it before putting it back on your pet. It is machine washable and we recommend placing it in a garment bag or large pillow case tied up before machine washing it. Ask the CROC Team If you have questions about using a Help 'Em Up with your dog, feel free to reach out to us! We’d love to help make sure that your dog is properly outfitted with the correct components, as several different combos of the harness and accessories exist, and that they are properly sized and fitted. We also help with adjustments later on as the buckles can move a bit over a longer period of time or your pet may need different settings as their body changes.