Pluto – the inextricable link between pain, posture and behaviour

8-year old neutered male Basset Hound Pluto, who first came to us in September 2018, has taught us so much in terms of just how connected pain, posture and behaviour are that we had to share our experience.
Pluto came with a warning of aggressive behaviour towards people and animals, and that he would snap with little warning. He was a rescue case, having been with his owners for 18 months, and a history of 7 homes and fosters, spread across the world, including South Africa!

His medical history was long, with lameness on all 4 legs, and osteoarthritis pretty much everywhere – thickened, swollen joints, crepitus, meniscus damage in his stifles, disc degeneration in his spine – the list went on. Over a period of 12 months, Pluto’s owners had been working with their vets, trying many iterations of different pain medication to find a workable combination. Attempts to reduce his pain medication had always resulted in a deterioration in his behaviour, and an increase in his aggression.

When we first met Pluto, he had a left hindlimb lameness, a sway-back (official term – lordosis) denoting poor core musculature and was very low over his forelimbs – even for a Basset! His front paws were swollen and misshapen with arthritis, with his elbows abducted away from his body, and notable carpal valgus (turned out front paws). His owners warned us that he was occasionally muzzled by the vets and can react very quickly.

We started a slow programme of therapy with Pluto and advised his owners to reduce his use of stairs, but when it was necessary, to take some of his weight to reduce impact on his forelimbs and spine. As we were unable to get our hands on him without potentially upsetting him and causing a reaction, we treated him with pulsed electromagnetic field therapy. We also knew that having a person he did not know in the treadmill with him (we get in with all our patients), was not going to work for Pluto, so his owner Stephen got in with him instead, and we instructed from the outside. We built proprioceptive track courses, to improve his proprioception, activate joint range of motion and improve gait patterning.

Over time, Pluto became more and more relaxed at our clinic. As he relaxed, and we were able to do more comprehensive treatments, including class 3b laser therapy and some alignment techniques applied from outside of the treadmill, we noticed improvements in Pluto’s posture. He became more upright on his front legs with better elbow and carpal alignment, his spinal posture improved, and his left hindlimb lameness reduced. Along with this, we also noted a difference in Pluto’s behaviour. He became more playful in clinic, pleased to see us and much less “stare-y”. However, the biggest improvement was in his home life. His owners report that he is a very different dog. They have even been able to take him to the pub for lunch – something they could never do with him before as he was so reactive.

A change in routine and reduction in therapy over Christmas saw Pluto’s mobility decline slightly, his posture reverted to the more lordotic, low over his forelimbs and carpal valgus positioning we had seen initially, and, unsurprisingly, his mood deteriorated, and he became grumpier and growly again. Luckily, this only lasted a short while, and he quickly got back on track. His owners have reiterated to us that the physiotherapy and impact-reduction have had an astounding effect on his behaviour, communication and quality of life.

Pluto has reinforced to us that pain, posture and behaviour cannot be separated. Dogs – and in fact most animals – are not naturally “grumpy”. A dog that suddenly starts growling if a certain part of them is touched, or becomes defensive around other dogs, may well have a pain issue worth investigating with your vet. Movement patterns are also significant and must be taken into account. Dogs don’t limp, or move in a compromised way, for no reason. A change in gait will generally be pain related. If your dog starts to seem grumpier, enjoy their activities less, and seems to be slowing down – don’t just accept “they are getting old”. Speak to your vet.

Pluto has also taught us what can be achieved with patience, love, understanding and a proper home care programme. Pluto was once almost on death row due to his behaviour – and to see him now is heart-warming and is why we do the job we do. We love seeing you Pluto!

Puppies – a canine physio’s perspective!

Introducing a new puppy into the household is a very exciting and indeed life-changing time. However, there are many things to consider and be aware of, both in terms of choosing a pup, and in the very formative early months of ownership. As canine physios, there are a couple of pitfalls that we feel all new puppy / dog owners should be aware of – so we thought we’d summarise the main ones!

 

What breed?

Firstly – the decision of what breed of puppy to buy, or indeed whether to go with a rescue dog – more on rescues later! Choosing breed involves a huge amount of thought, as whilst you might love the idea of a certain breed, it might not be the best fit for your circumstances! It is a good idea to research what the dog is bred to do – if it is a working breed, can you offer them the mental and physical stimulation it will require? If it is a long-haired breed, can you invest in regular grooming (which can be as much as £100 per groom potentially on a monthly basis!), or learn grooming techniques yourself, to keep that beautiful coat in top condition?  If you have your heart set on a giant breed – are you prepared for the fact that everything, well, just costs that bit more! It is also worth familiarising yourself with the conditions that your chosen breed over-indexes for – both in terms of knowing what questions to ask the breeder about the parental history, and to be prepared for what care your dog might need in later life.

 

Appropriate exercise

Another area that we get asked about a lot here is appropriate exercise for puppies. Puppies do not need much running / intensive exercise! Their joints and skeletal systems are not mature for quite a long time (actual timing is breed-dependent, but can be over 1 year), so allowing them unrestricted exercise at a young age can be very damaging. The vague rule of thumb is: 5 mins per month of age, x 2 per day. Therefore at 4 months, your puppy would need an absolute maximum of 2 x 20 min walks – in fact we would generally recommend less! For giant breeds it is recommended to toilet walk them only for the first year or so. Exercise should also be undertaken with care – too much intensive running, even for short times at a young age, can do irreparable damage to young joints. So please leave the tennis balls (and definitely any ball launchers – the devil in our eyes!) at home.

Puppies need a lot of sleep – this is so important for their physical and mental development, however much like human pups they won’t always just take themselves off for a nap! Ensure you provide a safe, warm, quiet space for your puppy, and encourage them to nap on a regular basis. Crates are often good for this but must never be used as punishment. After play time, when your puppy has had a chance to empty, is a good time for a nap, a few times a day.

Now, whereas two short walks a day might provide enough physical stimulation for your pup, as they grow they will need more mental stimulation! Training and sensory games are the best thing here – to work your dog’s brain, but not their body. There are lots of ideas for brain games etc online, and several good books available too. We have a couple of games we recommend or can point you in a good direction for books / online videos, so do get in touch if you would like further info.

 

Collar vs harness

We have previously written a blog regarding the benefits of a harness over a collar, and this applies strongly to little puppy necks! See our website for this blog and do ask us if you have any further queries.

 

Nutrition

Pups grow at a huge rate and therefore need specialist puppy nutrition to support their musculoskeletal system. Inappropriate diet at a young age can lead to developmental issues, either stunting growth, growing too quickly or becoming overweight. Your vet and vet nurse team will be able to provide more information specific to your dog’s type and development to help you get this essential factor just right!

 

Rescue

Just a little plug for the rescue dog – there are, sadly, thousands of dogs awaiting forever homes in rescue centres all over the country, of all different ages and breeds. We don’t want to get too soap- boxy on you, but we would really encourage taking a look at rescue centre websites and Facebook pages, and seeing if there is anything that would suit your circumstances. Adopting an adult dog can often be easier and smoother than taking on an 8-10-week-old pup, lots of rescue centres will give training support, and you have the lovely knowledge that you have given a dog in need a forever home!!! Puppies also end up in rescue – either being born into rescue, or sadly being surrendered to rescue very young, so this is always a good avenue to explore if you do have your heart set on a pup.

The team at Bach Canine Rehab are always on hand to help, or to chat through any issues that might concern you regarding your new dog, so do get in touch.

Home adjustments

Here at Bach Canine Rehab, we often recommend some home adjustments or changes of management for our owners and canine patients. Some of these changes are specific to the patient and their circumstances however many of these suggestions are beneficial to the majority of our canine friends so we thought we would let you know about a few easy home adjustments that could help your dog to stay comfortable and mobile!

As veterinary physiotherapists, we look at the way dogs move, their posture and how they load their limbs. A correct loading pattern for most healthy dogs is to distribute 60% of their body weight over their forelimbs and 40% of their weight over their hindlimbs. Sometimes this balance of weight distribution gets disrupted either by injury or sometimes by repetition of particular activities that encourage overloading of particular structures. For example, feeding your dog from the floor requires your dog to increase the load on the forelimbs. If your dog has any stiffness or soreness in their neck or forelimb joints this may not be comfortable. Equally, if your dog has any stiffness or discomfort in the hindlimbs they may well already be overloading the forelimbs to compensate so a stressed structure is put under more strain. By raising food and water bowls off the floor so that your dog can keep their head and back level, you will encourage more even limb loading, reducing stress on the forelimbs and encouraging correct use of the muscles in the hindlimbs.

Another situation where we often see a change in limb loading is when dogs pull on the lead. When a dog is pulling, they tend to lower their heads and increase the load on the forelimbs to pull themselves along, towing you along behind them! This can make walk times particularly uncomfortable both for you and your dog. We will often suggest trying a technique called balance lead walking using a two-point control harness. This is a training technique, not an instant fix however it works by applying forces on key points of control on the dog’s body to give the signal to slow down or stop. This means that you need much less force on the lead to give an effective signal so you and your dog can stop having a tug of war every time you go out! It also means that you can give your dog the signal to slow down without pulling them off balance, again encouraging more even limb loading. More information on balance lead walking can be found on our Collars vs Harnesses blog on our website and Facebook page, and at www.mekuti.co.uk. There are a few different 2-point control harness brands available but one of our favourites is called the Perfect Fit harness (www.dog-games-shop.co.uk).

Features of our homes can sometimes be challenging or pose an increased risk of injury to our dogs. For example, lots of dogs slip on hard floors, especially tiles or wood. This is a particular challenge for older dogs or dogs that are weak or recovering from an injury or surgery. However, it can also contribute to causing an injury in young dogs if they race around the house, slipping and sliding as they go! We often recommend using runner mats to provide a bit of a non-slip track around the house. Areas that we would prioritise with non-slip solutions are where you have changes of surface and especially if that is combined with change of level i.e. coming down carpeted stairs or jumping off a sofa on to a hard floor. Another area we would recommend thinking about is where your dog eats and drinks to ensure they can stand comfortably and confidently at this time.

Going up and down the stairs can also be a risky business. If you are going to allow your dog free access to the stairs it is worth taking the time to train them to go slowly and avoid encouraging them to race up or down. If the sound of someone coming home through the front door is always going to set your pooch off tearing down the stairs and skidding across the hallway into the front door it’s probably best that they don’t get to go up the stairs in the first place. Doing stairs well requires a strong core and good range of motion in the joints. If your dog is a bit stiff, doing the stairs may well make them more uncomfortable. If your dog is a bit weak, they are more likely to struggle and potentially fall and hurt themselves. If your dog has to do the stairs because of the set up of your home, you can support them on the way up with your hands under their seat bones, found either side of their tail. On the way down, you could use a harness to help slow them down and keep the descent controlled. If they are small enough you may well just choose to carry them, but remember to brace your own core so you don’t end up with an injury! If you have areas with a small number of stairs, such as getting in/out of the garden or up to doorways, you could consider a ramp with a non-slip surface.

So now your home is sorted, what about exercise? Going out for a walk together is one of the great joys of having a dog. However, in order to make sure this activity stays a joy, there are a couple of things to keep in mind. The length of your walk should be in line with what your dog is capable of. This can sometimes be a tricky thing to work out, particularly as many dogs will over-exercise quite happily at the time. Keep an eye out for a change of pace – does your dog slow down significantly towards the end of a walk? Do they stop and sit or lie down? Make a mental note of how long you have been out if you notice either of these changes and try keeping your next walk within that time frame. If the slowing down or resting doesn’t happen anymore with these shorter walks this probably means that they actually had a lower exercise tolerance than you thought. Keeping the walks within their tolerance will reduce the risk of muscle fatigue and, in turn, reduce the risk of injury. We also have a blog on running with your dog, and how to do so safely – see our website or Facebook page!

Many people think that limiting your walks means limiting the time you can be out and about with your dog – but this is not the case! Being out meeting people and other dogs is very stimulating for your canine friend, so on a nice day, take a picnic and a blanket to the park, or sit in a café together. Scent and stimulation games (such as hiding treats for your dog to find, or a Snufflemat) are great for engaging your dog’s brain and therefore tiring them out mentally without overloading their muscles and joints, so if you are restricted on how much walking you can do, try to think up other games and puzzles you and your dog can play together.

These are the main areas we find we discuss with our clients, to help improve your dog’s quality of life and also ensure you can still enjoy your time together. If you would like to talk through anything with us, or discuss how we could help your dog further, do get in touch!