Quality of Life of Obese Dogs Improves –

Quality of Life of Obese Dogs Improves When They Lose Weight –

This is recent research conducted in the UK, where they estimate 1/3 of the dog population is obese. Study conducted by Waltham/Royal Canin.

Feb. 21, 2012 –

Researchers at the University of Liverpool have found that obese dogs that lose weight have an improved quality of life compared to those that don’t.

A study of 50 overweight dogs, comprising a mix of breeds and genders was undertaken by scientists at the University in collaboration with the University of Glasgow, Royal Canin and the WALTHAM Centre for Pet Nutrition.

How?

Owners completed a questionnaire to decide the health-related quality of life of their dog prior to weight loss. A follow-up questionnaire was completed by the owners of 30 dogs that successfully completed the weight loss programme, enabling changes in quality of life to be assessed.

A range of life quality factors were scored, including vitality, emotional disturbance, and pain. Quality of life of dogs which succeeded with their weight loss programme was also compared with those dogs that failed to lose weight successfully.

Results –

The results showed that quality of life improved in the dogs that had successfully lost weight. In particular, their vitality scores increased and the score for emotional disturbance and pain decreased. Moreover, the more body fat that the dog lost, the greater the improvement in vitality.

The research also found that dogs that failed to complete their weight loss programme had worse quality of life at the outset than those successfully losing weight, most notably worse vitality and greater emotional disturbance.

Dr Alex German, Director of the Royal Canin Weight Management Clinic at the University, said: “Obesity is a risk for many dogs, affecting not only their health but also their quality of life. This research indicates that weight loss can play an important role in keeping your dog both healthy and happy.”

Strategies for Combating Obesity –

Dr Penelope Morris, from the WALTHAM Centre for Pet Nutrition, added: “Strategies for combating obesity and keeping dogs fit and healthy include portion control, increased exercise, and diets specifically formulated for overweight pets.”

Established in 2004, the Royal Canin Weight Management Clinic at the University’s Small Animal Hospital, UK is the world’s first animal weight management referral clinic. It was set up to help tackle and prevent weight problems in animals such as dogs and cats.

Veterinary surgeons from any general practice in the UK can refer overweight animals to the clinic. The patients receive a thorough medical examination. Then they receive a specific dietary plan and exercise regimen to follow over several weeks.

Taken from ScienceDaily.com

Thoughts to Ponder –

The results showed that quality of life improved in the dogs that had successfully lost weight. In particular vitality scores increased and the score for emotional disturbance and pain decreased. Moreover, the more body fat that the dog lost, the greater the improvement in vitality.

And, interestingly, the study notes this: “The research also found that dogs that failed to complete their weight loss programme had worse quality of life at the outset than those successfully losing weight, most notably worse vitality and greater emotional disturbance.” …sort of as if the dogs failed the program and not that the owners were partners in this endeavor.

The dogs didn’t fail to complete the program, in reality. The study finding here denotes the close connection and potential issues within the human/animal psychology bond.

Pet Moods –

Lizzie the Golden is a lean and fit elderly dog in this photo. Calvin is working on becoming a dirigible, and he would eat until he passed out if someone let him!

If the lower-vitality dogs came into the study with possible lower quality of life, then I recommend evaluation of the home life of the human, too. Our pets reflect our moods. You may also look for mood changes in a pet to alert you to possible mood changes in their people!

The failed dogs notably had “worse quality of life at the outset” than the ones who ended up succeeding. Most compromised were their vitality and emotional status. We definitely pass our moods, demeanor, and worry onto our animals. Breathe peacefully with your pets 🙂

Contact me if you need a progressive and defined program to follow in order to lose fat and build supportive muscle. Or if you think you are dragging your pet into a dark mood abyss due to lifestyle changes and difficulties.

 

(Published February, 2012. Updated April 19, 2018)

Torn CCL/ACL on 10 yr. Old Lab, Been Torn a Year…

Torn CCL/ACL on 10 yr. Old Lab, Been Torn a Year…

Hi Deborah – I’m so glad I found your blog/website after researching for hours. I am at a total loss of what to do for my beloved yellow lab, Sam. Sam is 10 years old, weighs 98 pounds (vet said he had a large girth) and that his weight was fine. A year ago this vet said he had a pulled or torn ligament in his left leg. She said he could have surgery even though he was old, or prescribe adequan (very expensive) or keep him inactive. There was no guarantee of either treatment. I kept Sam inactive for quite a few months, with limited leash walks. I thought he was getting better but he’s not. There have been a few times; he took off running across our yard, which I know was bad. But I’m more careful now about opening the door and him on the leash. I took Sam for a 2nd opinion yesterday (1 year later), this vet said he had a torn cruciate ligament and needed surgery. He gave no medication for pain or recommendation of using anti-inflammatories. Neither vet recommended Xrays or other tests. They just did the manually testing of his leg. He is slow to get up, limps for a minute but then walks on that leg, but does not put full pressure on it. He doesn’t limp when he’s walking. It’s mostly after he’s been lying down, he struggles to get up, limps for a minute or two, then he seems fine. I limit his walking to about 5 minutes 4 times a day. He never seems like he’s in pain. He’s always wagging his tail even when he’s lying down. The only thing I’ve really noticed is at night while we are watching TV, he normally sleeps; now he seems to stay awake and look around, which maybe that means he’s in pain, I just don’t know. I really don’t want to do surgery on Sam, not at his age. I’ve read quite a bit on your site, and it looks like there may be a nonsurgical route for ACL injuries…. I thought you might allow me to ask you a few questions: Deborah, I live in Foley Alabama, is there anybody like you my area that you know of? Anybody you can recommend? Can you give me any kind of advice of what I should be doing for Sam? Should I let the Vet give Sam Adequan? I will do it if you think it will help. When is surgery really necessary and should it be done on a 10 year old lab? I don’t know who else to turn to, please help. Thanks Lisa from Alabama

Here is the first answer I sent you via Facebook-

Hi-
Here is my FB rehab page, and you may already be a fan, since we have at least one friend in common, but there is no easy way for me to search and sort who follows this page
I will get to answer your post on my website as soon as I can. Otherwise, I do know the answers to all of your questions are on one or both of my sites…it just takes a lot of reading ! So while you wait for me to be able to answer, check out the homework and other related posts if you haven’t already.
Sam does need pain meds of some sort and he does not need to rush into surgery based on what you have told me. X rays won’t show torn ligaments, however they will show clouding in the joint which just tells us what we already know, that there is joint disruption and damage.
See the post I just made on the wordpress blog regarding Clark, the hip dog.
Blessings-

And here are more answers now that I have some time:

I will always do a paid phone consult, so if you are interested, let me know and we will set that up.

I do not know of anyone else that practices the way I do, with standard therapy interventions and certification within veterinary medicine (CCRP) yet using the tried and true, long-standing principles of athletic training and strength training protocol. There are a few people in the U.S. that I know of who also carry the strength and conditioning certification that I do, the CSCS®.

The protocol for dealing with this situation did not exist that I could find when I first came into companion animal practice, in 2004-05. I began writing simple programs based on my background and experience. These have been refined and honed and proved to be beneficial.

Additionally I was blessed with a Great Dane companion for 10.5 years who was bone-on-bone in both knees, had all three ligaments torn in the right knee and two torn in the left. She had a genetic bone disorder called OCD (for short), and had two TPLO’s that didn’t work out, or, the end result was not what we would have aimed to accomplish. I am not anti-surgery and not because of her situation. It is through her situation that I learned even more about improving function non-surgically or in the face of very complicated circumstances.

At the least, I have substantiated with some vets in this area and around about (who have inquired and followed my simple homework) the beneficial effect of slow, weight-bearing, pain-controlled return to function after surgery. I built my Grace’s thigh muscles to better support her joints, and I had plenty of opportunity to see the benefits of increased muscle mass in her case. I have also appreciated the benefits in other cases.

I hope that you have found many of the other answers you were seeking elsewhere in this blog.  I suggest pretending like it all just happened and start at the beginning of my homework suggestions (under “homework”) and I strongly suggest, as I said previously, that you obtain an anti-inflammatory if Sam’s system will support it (your vet will do blood work to substantiate this), and if not an nsaid, then use Tramadol or Gabapentin. There are lots of options for pain control (see my Q&A post regarding limping after surgery), and if you just pretend like it happened recently and really start again at the beginning, building up from there, I really think you will realise great benefit for Sam.

Adequan seems to work really well on relatively few dogs (animals). I tried it a lot in my Grace, and I was working with a surgeon friend, so we tried it three different ways (IM, IA, SQ)on three different trials, to no effect for her. Some of my clients say it has helped their dogs substantially. A surgeon on the East Coast told me in 2005 that he didn’t think it would work for my Grace and that they had stopped using it in horses due to little effect. It’s expensive, yes, and it’s great if it works on your dog.

In the meantime use fish oil and a glucosamine/chondroitin/msm combo for joint health. Your vet may carry these products. I have info posted elsewhere regarding these supplements. If Sam takes off running and injures the joint, then make him rest for the remainder of the day and he has to go back to slow leash walks until he is no longer lame. You may also use ice, right on his knee, 20 min, when he has a limping/lameness episode. Hopefully you will be able to have a veterinary relationship where more pain medicines are utilised for greater overall benefit. Check out www.ivapm.org for more pain management info. I’m with you in that he is probably uncomfortable at night. Pain meds will help this, and the other options I gave you will help it some.

If he were my dog, I would definitely follow my homework and the supplement advice, the pain med advice, and I’d recheck with me when the first four weeks of homework are completed. I would not have surgery on him right now based on what you have told me, however I also have seen older dogs do well in surgery…so it’s not the surgery that is offputting; it’s just that I think he can thrive, based on what you have told me, without surgery. You have opportunity to find out if you get strict with the restrictions and homework again. He will have difficulty every time he spazzes out until he builds more thigh muscle. Then the joint should suffer less impact. At the least, if you follow this simple homework, it could serve as pre-hab, and if you decide on surgery, he will be in better shape and presumably recover better after surgery.

That is all I have time for right now.

Our next consult should be a paid phone consult if you’d like to go further. Thanks for presenting Sam to us-

Blessings-

Deborah

Pain – 3 Articles

New Understanding of Chronic Pain

Jan. 23, 2012 — Millions of people worldwide suffer from a type of chronic pain called neuropathic pain, which is triggered by nerve damage. Precisely how this pain persists has been a mystery, and current treatments are largely ineffective. But a team led by scientists from The Scripps Research Institute, using a new approach known as metabolomics, has now discovered a major clue: dimethylsphingosine (DMS), a small-molecule byproduct of cellular membranes in the nervous system. In their new study, the scientists found that DMS is produced at abnormally high levels in the spinal cords of rats with neuropathic pain and appears to cause pain when injected. The findings suggest inhibiting this molecule may be a fruitful target for drug development.

“We think that this is a big step forward in understanding and treating neuropathic pain, and also a solid demonstration of the power of metabolomics,” said Gary J. Patti, a research associate at Scripps Research during the study, and now an assistant professor of genetics, chemistry, and medicine at Washington University in St. Louis. Patti is a lead author of the report on the study, which appeared online in the journal Nature Chemical Biology on January 22, 2012.

Scientists who want to understand what makes diseased cells different from healthy cells have often looked for differences in levels of gene expression or cellular proteins — approaches known respectively as genomics and proteomics. Metabolomics, by contrast, concerns differences in the levels of small-molecule metabolites, such as sugars, vitamins, and amino acids, that serve as the building blocks of basic cellular processes. “These are the molecules that are actually being transformed during cellular activity, and tracking them provides more direct information on what’s happening at a biochemical level,” Patti said.
Metabolomics is increasingly used to find biochemical markers or signatures of diseases. One of the most relied-upon “metabolome” databases, METLIN, was set up at Scripps Research in 2005, and now contains data on thousands of metabolites found in humans and other organisms. However, in this case the research team hoped to do more than find a metabolic marker of neuropathic pain.

“The idea was to apply metabolomic analysis to understand the biochemical basis of the neuropathic pain condition and reveal potential therapeutic targets,” said Gary Siuzdak, a senior investigator in the study, who is professor of chemistry and molecular biology and director of the Scripps Research Center for Metabolomics. “We call this approach ‘therapeutic metabolomics’.”

The scientists began with a standard model of neuropathic pain in lab rats. Patti, Siuzdak, and their colleagues sampled segments of a previously injured tibial leg nerve triggering neuropathic pain, as well as the rats’ blood plasma and tissue from the rats’ spinal cords. The scientists then determined the levels of metabolites in these tissues, and compared them to levels from control animals.

Unexpectedly, the scientists found that nearly all the major abnormalities in metabolite levels were present not in the injured leg nerve fiber, nor in blood plasma, but in tissue from the “dorsal horn” region of the spinal cord which normally receives signals from the tibial nerve and relays them to the brain. “After the nerve is damaged, it degrades and rebuilds itself at the site of the injury, but remodeling also occurs, possibly over a longer period, at the terminus of the nerve where it connects to dorsal horn neurons,” Patti said.

Next, the researchers set up a test to see which of the abnormally altered metabolites in dorsal horn tissue could evoke signs of pain signaling in cultures of rat spinal cord tissue. One metabolite stood out — a small molecule that didn’t appear in any of the metabolome databases. Patti eventually determined that the molecule was DMS, an apparent byproduct of cellular reactions involving sphingomyelin, a major building block for the insulating sheaths of nerve fibers. “This is the first characterization and quantitation of DMS as a naturally occurring compound,” Patti noted. When the scientists injected it into healthy rats, at a dose similar to that found in the nerve-injured rats, it induced pain.

DMS seems to cause pain at least in part by stimulating the release of pro-inflammatory molecules from neuron-supporting cells called astrocytes. Patti, Siuzdak, and their colleagues are now trying to find out more about DMS’s pain-inducing mechanisms — and are testing inhibitors of DMS production that may prove to be effective treatments or preventives of neuropathic pain.

“We’re very excited about this therapeutic metabolomics approach,” said Siuzdak. “In fact, we’re already involved in several other projects in which metabolites are giving us a direct indication of disease biochemistry and potential treatments.”

Oscar Yanes, a postdoctoral fellow in the Siuzdak laboratory, was Patti’s co-lead author of the study, “Metabolomics Implicates Dysregulated Sphingomyelin Metabolism in the Central Nervous System During Neuropathic Pain.” The other contributors were Leah Shriver and Marianne Manchester of the University of California, San Diego (or UC San Diego) Skaggs School of Pharmacy and Pharmaceutical Sciences; Jean-Phillipe Courade, then at Pfizer, now at UCB Pharma in Belgium; and Ralf Tautenhahn of the Siuzdak laboratory.
Funding for the research was provided in part by the U.S. National Institutes of Health and the California Institute of Regenerative Medicine.

 

The effect of 300 mW, 830 nm laser on chronic neck pain: a double-blind, randomized, placebo-controlled study.

Pain. 2006 Sep;124(1-2):201-10. Epub 2006 Jun 27.

Source

Castle Hill Medical Centre, 269-271 Old Northern Road, Castle Hill, NSW 2154, Australia. rtchow@bigpond.net.au

Abstract

A randomized, double-blind, placebo-controlled study of low-level laser therapy (LLLT) in 90 subjects with chronic neck pain was conducted with the aim of determining the efficacy of 300 mW, 830 nm laser in the management of chronic neck pain. Subjects were randomized to receive a course of 14 treatments over 7 weeks with either active or sham laser to tender areas in the neck. The primary outcome measure was change in a 10 cm Visual Analogue Scale (VAS) for pain. Secondary outcome measures included Short-Form 36 Quality-of-Life questionnaire (SF-36), Northwick Park Neck Pain Questionnaire (NPNQ), Neck Pain and Disability Scale (NPAD), the McGill Pain Questionnaire (MPQ) and Self-Assessed Improvement (SAI) in pain measured by VAS. Measurements were taken at baseline, at the end of 7 weeks’ treatment and 12 weeks from baseline. The mean VAS pain scores improved by 2.7 in the treated group and worsened by 0.3 in the control group (difference 3.0, 95% CI 3.8-2.1). Significant improvements were seen in the active group compared to placebo for SF-36-Physical Score (SF36 PCS), NPNQ, NPAD, MPQVAS and SAI. The results of the SF-36 – Mental Score (SF36 MCS) and other MPQ component scores (afferent and sensory) did not differ significantly between the two groups. Low-level laser therapy (LLLT), at the parameters used in this study, was efficacious in providing pain relief for patients with chronic neck pain over a period of 3 months.

PMID:

16806710 [PubMed – indexed for MEDLINE]

 

Surgeons Report Two New Approaches to Lessen Postoperative Pain

(Taken from ScienceDaily.com, intended for human medicine audience, however the principles are good and some are interchangeable. Italics mine)

Oct. 8, 2013 — New combinations of postoperative pain treatment decreased both pain and the use of narcotic pain relievers according to two studies presented this week at the 2013 Clinical Congress of the American College of Surgeons. One pain treatment utilized the simple but nonstandard application of ice packs after major abdominal operations in patients, and the other treatment was a prolonged drug delivery method using nanotechnology in animals.

Past research has shown that postoperative pain is often under-treated  The standard pain treatment after most major (human) operations is narcotics, also called opioids, such as morphine. However, these medicines have many possible side effects, including sleepiness, constipation, and — when used long term — the risk of drug dependence. (we don’t see this issue in veterinary medicine, not in the same way, so  for now don’t worry about your pet becoming an addict!)

“A growing body of scientific evidence shows that narcotics may not be the best way to control pain,” said the principal investigator of the ice pack study, Viraj A. Master, MD, PhD, FACS, associate professor of urology at Emory University School of Medicine, Atlanta. “We now know that it is more effective to use combination treatments that reduce the amount of narcotics needed.

New use for ice following open abdominal procedures

Multiple studies have found that cryotherapy — application of ice to the surgical wound — is safe and effective at reducing pain after some types of operations, such as orthopedic procedures. However, researchers have not studied the use of cryotherapy in patients undergoing major, “open” (large-incision) abdominal operations, Dr. Master explained.

For the Emory study, Dr. Master and his colleagues compared the effect on postoperative pain of applying soft ice packs to the incision area after open abdominal operations (27 patients), versus no ice application (28 patients).

Patients in the cryotherapy group applied ice packs to the wound at desired intervals for at least 24 hours. They also had the option of taking prescribed opioids, whereas the other group received only opioids for pain relief. Twice a day the patients rated their pain intensity on a line indicating a range from no pain (zero) to severe pain (100).

The results showed that patients who used ice packs reported significantly less pain than those who did not ice their surgical wounds. On average, the cryotherapy group had about 50 percent less pain on the first and third days after the operation compared with the no-ice control group, according to the investigators. In addition, on the first postoperative day, the cryotherapy group used 22.5 percent less opioid pain medication than controls, while some patients who iced reportedly used no narcotics.

According to Dr. Master, surgeons should recommend that their patients who have open abdominal operations intermittently apply ice packs to the surgical wound, removing the ice when it becomes too cold. “An ice pack,” he said, “is safe and inexpensive, gives the patient a sense of empowerment because it is self-care, and doesn’t require high-tech devices.”

Prolonged delivery of lidocaine effective in animals

The pain treatment utilized in the second study used a high-tech device — nanoparticles — to create a controlled-release delivery system for the nonopioid numbing medication lidocaine. Although the effects of lidocaine injections usually are short-lived, nanotechnology allowed researchers at Houston Methodist Research Institute to extend the drug’s delivery time so that pain relief lasted all seven days of the study.

Led by Jeffrey L. Van Eps, MD, a research associate at the institute and general surgery resident at Houston Methodist Hospital, the research team developed an injectable hydrogel containing lidocaine. The gel also held microscopic spheres of a biodegradable polymer called polylactic-co-glycolic acid (PLGA), which the U.S. Food and Drug Administration has approved for drug delivery. This polymer acts as an “envelope” for nanoparticles — molecular-sized structures — of the mineral silica, whose spongelike holes take up the lidocaine gel, Dr. Van Eps explained.

“Nanotechnology with PLGA makes an ideal drug delivery system because we can tailor the nanoparticles to allow prolonged delivery,” Dr. Van Eps said. He said that this method re-duces or avoids side effects.
After first testing their lidocaine delivery system in the laboratory, Dr. Van Eps’ team obtained results in an animal model of postoperative pain. In groups of rats under different experimental conditions, the investigators rated the animals’ pain by measuring their withdrawal response to mechanical force applied around the surgical wound.

Rats that received lidocaine gel through the novel delivery system needed twice the amount of force to elicit a pain response compared with control rats that received no pain medication after the incision, the researchers reported. Using this same technique of measuring the pain response, the investigators reported that the lidocaine gel also was superior to daily treatment with nonsteroidal anti-inflammatory drugs (NSAIDs) alone.

The best study results were seen with combination therapy using lidocaine gel and daily NSAIDs. This combination therapy reportedly showed equivalent effect to daily opioid narcotic treatment by mechanical-force withdrawal testing and superior results by daily scoring of pain-related adaptive behaviors. This finding is important because it shows that the experimental drug delivery system is not inferior to standard opioid treatment of pain, according to Dr. Van Eps.

Studies in larger animals will take place before the research team can test this therapy in patients, he said. Yet he called the new technology an “exciting potential treatment of post-surgical pain, the largest barrier to successful postoperative care.”

The research team developed and is testing the drug delivery system in the Houston Methodist Research Institute’s Surgical Advanced Technology Lab, which was created to accelerate transition of new products to the clinic.

The above story is based on materials provided by American College of Surgeons, via EurekAlert!, a service of AAAS.

Massage is Promising for Muscle Recovery

Massage Muscle Inflammation –

Feb. 1, 2012 — Researchers at McMaster University have discovered a brief 10-minute massage helps reduce inflammation in muscle.

Massage muscle inflammation! “As a non-drug therapy, massage holds the potential to help not just bone-weary athletes but those with inflammation-related chronic conditions, such as arthritis or muscular dystrophy”, says Justin Crane, a doctoral student in the Department of Kinesiology at McMaster.

While massage is well accepted as a therapy for relieving muscle tension and pain, the researchers delved deeper to find it also triggers biochemical sensors that can send inflammation-reducing signals to muscle cells. In addition, massage signals muscle to build more mitochondria, the power centres of cells which play an important role in healing.

What Happens to the Muscles During Massage?

“The main thing is that no one has ever looked inside the muscle to see what is happening with massage. This is what is novel about our study. No one has looked at the biochemical effects or what might be going on in the muscle itself,” said Crane.

“We have shown the muscle senses that it is being stretched and this appears to reduce the cells’ inflammatory response. “As a consequence, massage may be beneficial for recovery from injury.”

Crane said the McMaster researchers are the first to take a manual therapy, like massage, and subsequently test the effect using a muscle biopsy. They did this to show massage reduces inflammation, which is an underlying factor in many chronic diseases.

Crane admits his surprise that just 10 minutes of massage had such a profound effect. “I didn’t think that little bit of massage could produce that remarkable of a change. This was especially since the exercise was so robust. Seventy minutes of exercise compared to 10 of massage, it is clearly potent.”

The results hint that massage therapy blunts muscle pain by the same biological mechanisms as most pain medications. Massage therapy, therefore, could be an effective alternative.

Mitochondrial Dysfunction and Muscle Atrophy –

Dr. Mark Tarnopolsky, professor of medicine for the Michael G. DeGroote School of Medicine, oversaw the study.

Given that mitochondrial dysfunction is associated with muscle atrophy and other processes such as insulin resistance, any therapy that can improve mitochondrial function may be beneficial,” he said.

Crane said this study is only a first step in determining the best therapies for promoting recovery from a variety of muscle injuries.

He said that surprisingly the research proved one oft-repeated idea false! Massage did not help clear lactic acid from tired muscles.

The research appears in the Feb. 1 issue of Science Translational Medicine.

From ScienceDaily.com

 

Questions About Dog Hip Surgery

 

Questions About Hip Surgery

About Clark

From the client:

You are so awesome!!! We took him to the vet yesterday and he gave me Rimadyl and Tramadol to help with pain and inflammation. I haven’t had him in for x-rays yet, would that be helpful for you? The vet said he didn’t see any signs of being hit by a car recently that would tell him that there was something broken. I was going to have him fixed this weekend, but I can wait if you think it would be best to see you first. You are worth every penny + some and I will be prepared to pay you for the time you spend with him. ;0) He is a shepherd mix about 14 months old. Just a baby with a sweet, sweet heart and a crappy start. Let me know if you want x-rays and if I should wait on having his boys removed and I can be available anytime Wednesday on next week.

Me:

I’ve been thinking about it, and I think it would be a good idea to get the manly-man surgery out of the way first.
When he gets pain meds for that, you may be able to see a difference in his demeanor or comfort, regarding his hips/legs, so take note of that.
Yes, and it may be hard to tell ;))
I can tell a lot without xrays, and often they get in the way in part of our brains regarding a better clinical evaluation. On the other hand, since he will be sedated, it will be a great time for x-rays, so go ahead if your vet is on board (which I’m pretty sure he will be!)
If he gets surgerized this weekend, I could see him next Thurs or Fri or when ever your schedule allows after that…
What do you think?
:)) Blessings-

Me:

After our first evaluation, my bullet point recommendations were to

1) restrict and crate when not at home for the next 2 weeks.

2) Begin exercise protocol noted on my FHO homework sheet, beginning with week 2, 2-4×10 min walks daily, very slowly (wedding march).

3) Use medications as per label, giving the Tramadol 30 minutes to 2 hrs. prior to walking if possible. Regarding your dosing question and the variability noted on the label, give the larger dose in the morning if you will be walking him in the morning, otherwise just give the smaller dose. Give the larger dose when you get home in the afternoon/evening, in prep for 1-2 pm walks. Give 2 hrs. rest period in-between walks (as per homework sheet).

4) Feed grain-free kibble (no barley or oats or rice, either, right now), Omega 3 in fish oil capsules as discussed, and joint formula that contains at least two of the following: glucosamine, chondroitin, msm.

Client:

(after having some problems with Clark, a rescue, and other dogs adjusting)

Hi!

We still have our friend. We made some adjustments and he seems to have settled a little bit. He has the sunroom to himself at night and during the day…we call it his puppy apartment. ;0) Everyone seems happy.
We took him off the Rymadal (SP?) because he was getting sick. And I’ve scaled back on the pain meds and give them when he is looking a little stiff. We are trying REALLY hard to stick to the directions, but I’m afraid it’s a modified version. He is still during the day and at night and we have shortened his time outside with the girls and I’ve been good at at least one walk a day…sometimes I get lucky and can get two. We will get it fine tuned…it’s just going to take a little time.
The vet is REALLY, REALLY pushing the surgery…I’m not doing Clark long term harm by not opting for surgery…right? You would think it by talking to him.

Anywho, thanks for checking in and the great direction. You idea to crate him at night helped everyone out!! ;0)

I will keep you posted on progress…just might be a little longer than 4 weeks.

Have a wonderful week!

Me:

Ok, so, I’m going to tie in our texts here and I think we should have a recheck to keep you guys on task…so that you see the improvements, and Clark improves, and others may see and reevaluate their insistance on surgery.

In Clark’s case, I don’t hear that anyone is concerned about gross malformation of the pelvis or a femur that is deformed beyond function, so there is no clinical reason to not employ muscle-building & joint strengthening techniques to appreciate improvement. The reports you have given me, verbal from the vet and the view of the x-rays, don’t indicate “horrible hips” and don’t indicate hips beyond the level at which others have improved without surgery. Clark is young. Perhaps your intervention staves off the need for surgery for the remainder of his life or perhaps it serves him well until he is older and then you may re-evaluate.

Usually in a case like this pain control plus the right type of exercise slowly improves the body and therefore the situation.
Some dogs improve, some don’t. The ones that don’t usually have owners who don’t do much of the protocol. So, if they keep doing the same thing as before, they get the same result, yes?

I don’t think you are in that catagory.

You guys represent a lot of families I see in my practice, in that you have two working adults, small child(ren), other dogs, etc…and several variations of this norm exist, of course. This norm is perfect for my home-based protocol because it only causes home-based disruption, in that you only have to sacrifice a little time, and my recommendations are based on 30+ years of my understanding of program design for improved function. This combo brings the biggest benefit, greater results, when all factors are weighed. And there is always the option to pay me to come do the exercise and drill work.
I know you get that

And of course my perspective is a little more broad, because I have seen a lot of what happens to animals in a wide variety of circumstances.

The most predominant point I make to clients is that the protocol does not get easier if the animal has surgery; in fact, it becomes an absolute necessity in order for the healing to occur and for the desired outcome from surgery. Without surgery, using my protocol, there is more room for letting something slip with less immediate ramifications, the main two of which post-surgically would be great damage to the surgery and money down the drain, since re-dos aren’t free (in most cases).

More than that is the additional stress and pain for the animal.

I am writing more here than need be to address you guys directly because I plan to share some of this discourse on my blog and giving more info helps a wider range of readers.

You said you stopped the Rimadyl because it was causing gastro distress…GOOD! And I presume from something you said in your texts that you let the vet know. You were not using the Tramadol as consistently, and I recommended you return to dosing as per the label for adequate pain control and especially since it’s all the pharmaceutical pain control you are using. Don’t forget the fish oil, grain-free food, and the glucosamine/chondroitin/msm…and I think you’re doing all that.

And you wondered if you were doing some sort of long-term harm by not having the hip surgery since the vet and staff seem so insistent on Clark having surgery. I covered this answer in part above. Additionally I will say that the exercise physiology and functional rehabilitation protocol I bring to veterinary rehab are not necessarily new to vet med, since race horses have been using protocol similar to that derived from human sport science for decades. These are, however, new concepts in small animal medicine, it seems. I came into vet rehab after 25 years experience in human sport science and nutrition protocol covering the gamut. These principles were novel where I began rehab practice, and I find the programs I have been designing for humans, based on much research performed by people living long before I came around, also are the most beneficial programs and protocol for animals for pre-hab, re-hab, and instead-of-surgery in many cases. No, you can’t just copy a program from Muscle and Fitness magazine…but you can pay attention and learn what actions produce what results. That will take time. The paying attention and learning…

There are some cases that really may need hip surgery, and when the clients have contacted me for pre or non-surgical intervention, at the very least we may say we are doing pre-hab. In the case of luxating hips, even though keeping the dog in a tight sling for weeks will/should work, as per science and experience, it seems almost impossible for most people to maintain the restrictions necessary for the sling to do its work. Disruption too soon=ligament laxity, again, and the ball of the femur keeps popping out. At any rate, it stands to reason that a body realising better function prior to surgery will improve easier post-surgically. That is also proved in research. Dynamic exercise improves every body system, from strengthening bones to improving the health of soft tissue.

I know for a fact, from years of study, evaluation, and observation, that cross-training rehab specialists in sport physiology and program design for dynamic function would elevate overall rehabilitation outcomes across the board. This has actually been an extreme discussion in Europe for the past yea-many years, that of the need for physiotherapists to have a deep(er) foundation in sports physiology and program design. I haven’t seen it hit here as forcefully yet (and we’re talking human medicine, which is paving the way in this arena). Europe is quite a bit more progressive regarding body wellness treatment and sport program design and a variety of similar topics.

Simply put, these exercises will not change noted gross malformations of the femur in an animal with hip problems, however, to note, any gravity-based exercise, weight-bearing exercise, will improve bone density, so changes along those lines will accrue. These exercises, performed as per a program designed for Clark, should improve tendon, ligament, and muscle strength, muscle size, and neuro-muscular signaling, simply put.

Other beneficial things will happen as well, as always do with exercise of the right type for a particular entity. The changes I noted should improve his overall function. To my knowledge, the surgical protocol is to not operate on hips based solely on x-rays and is to operate based on severity of clinical signs. That is what the surgeons say, and that is what the literature says. Vet surgeons in other parts of the U.S. will not operate on dog hips without having the clients do 4-6 weeks of pre-hab first, with the intent of gaining owner compliance and improving the dog’s health, most especially in cases of obesity.

So, the catch here is to have enough of the right variety(ies) of pain control on board while the dog is performing the best exercises for his/her situation and thereby learning to use the affected limb more freely again. With that increased use come the improvements I mentioned. With the improvements comes the need for less medicine, since increased muscle mass and supportive tissue strength will better support the joint.

That’s all I have time for right now, and I think this will help you guys.

Blessings-