Vet Blog
08/06/09
 Everywhere I read about hip dysplasia suggests exercise, but nowhere does it list what exercises to do except for swimming. Please list what exercises and for what time period one should proceed with the dog’s excerise. [My vet did not have any info on this.]
K
Youngstown,OH
The type, intensity, and quantity of exercise that is beneficial for hip dysplasia depends upon your dog’s age, condition, and weight.
Hip dysplasia is a syndrome that most often occurs in large breeds of dogs such as Labrador Retrievers, Golden Retrievers, and German Shepherds. The hips of dogs with the syndrome do not develop properly. This leads to early onset of arthritis. Hip dysplasia should not be confused with natural pelvic arthritis that commonly occurs in older dogs. True hip dysplasia has the potential to cause mobility problems in young dogs.
Hip dysplasia has a strong genetic link. Careful breeding has reduced the incidence of the syndrome in recent years.
All activity helps keep weight down. Obesity is a leading contributor to complications from hip dysplasia. In dogs that are not suffering from symptoms of arthritis or mobility problems, any exercises that are enjoyable for pet and owner will build strength and keep weight down.
Dogs with mobility problems due to hip dysplasia should engage in moderate, low contact activities. Swimming is one such activity. So are leashed walks on level surfaces. I recommend that dogs engage in the maximum amount of activity that does not lead to exacerbation of symptoms during the following 24 hours. In other words, activities that don’t make your dog sore generally are good ones.
Dogs with severe mobility problems will benefit from forms of physical therapy that help to strengthen the muscles of the hind legs and the back (these muscles help support the hips). Examples include sit-to-stand exercises (have the dog sit, then have him rise–this is similar to a human being performing squats) and walking under obstacles such as chairs that require the dog to lower and raise his body. Other forms of physical therapy include tissue massage and range of motion exercises that help to keep the joints in the legs fluid.
Severely disabled dogs should undergo physical therapy regimens only under the supervision of a qualified veterinarian or animal rehabilitation expert. The field of animal rehabilitation is growing, and special rehabilitation centers are now available for dogs and cats with all types of disabilities. In addition to specially trained staff, the centers have special equipment such as underwater tredmills that help improve mobility and function in disabled animals.
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02/21/09
Much has been said online to malign non-steroidal anti-inflammatory drugs, or NSAIDs.
NSAIDs are commonly prescribed for arthritis, postoperative pain, and syndromes caused by inflammation. Rimadyl, Deramaxx, and Previcoxx are commonly used NSAIDs.
All NSAIDs are metabolized by the liver and excreted by the kidneys. Therefore, all NSAIDs can exacerbate or cause liver or kidney problems. Also, all NSAIDs have the potential to cause upset stomach and gastrointestinal ulcers.
To be sure, pets can suffer from severe adverse reactions to NSAIDs that may be fatal. Every drug in the class has the potential to cause these events.
Veterinarians have a duty to discuss side effects and adverse events before prescribing NSAIDs. Pets who receive NSAIDs should undergo regular testing of liver and kidney function. Pet owners should make informed decisions about NSAIDs.
If you google any NSAID, you will find web pages detailing heartbreaking experiences of pet loss after NSAID use. People very reasonably want to share this information after suffering a tragedy, so that others might avoid the same fate.
But this leads to a skewed perception on the internet. In fact, the vast majority of pets who receive NSAIDs do not suffer any adverse reactions or side effects. NSAIDs have helped millions of pets.
In fact, NSAIDs often save pets’ lives. A patient I saw yesterday drove this point home to me. He was a 13 year old Labrador who had received Previcox for years to treat arthritis. The owner ran out of the medication, and he did not receive it for three days. The dog was miserable. He could not stand or walk. The owner told me that he thought he “was going to lose” his dog.
A few hours after receiving Previcox, the dog was up, walking, and acting like himself. Previcox saved the dog’s life.
If you google Previcox you won’t see stories like this. People who have good experiences with NSAIDs aren’t motivated to create web pages. But don’t forget the message of the story: NSAIDs aren’t always bad.
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01/27/09
 Dear Dr. Barchas,
My six-year-old Labrador had hip surgery
when he was two and on some days he has a hard time
getting up or just may be having a bad day pain
wise. Of the OTC pain remedies can you recommend
the best one? Do they really do any good?
David
Gilbert, Az.
There are a few reasons why two-year-old dogs undergo hip surgery. Developmental problems such as hip dysplasia sometimes require surgery at two years. Trauma to the hip may lead to broken bones in or near the joint. Dislocation of the hip may occur when dogs are injured, and may require corrective surgery.
All of the problems that can lead to hip surgery have one thing in common. In many cases they also lead to arthritis in the affected joint.
Arthritis of the hips can lead to limping, difficulty rising, and reluctance to walk, run or play. I suspect that your dog has a hard time getting up because of arthritis in his hip.
There are several treatments for canine arthritis. The simplest, and most effective, do no require medications. I recommend that you keep your pet thin, provide regular mild or moderate exercise, and perform basic physical therapy to maintain flexibility and strengthen the muscles in his legs. Talk to your vet for tips on physical therapy.
Dietary supplements containing glucosamine, chondroitin sulfate and omega-3 fatty acids may help ease the symptoms and progression of arthritis. These sorts of supplements are available over the counter.
Aspirin is the only canine arthritis medicine that is available over the counter. It belongs to a class of drugs called non-steroidal anti-inflammatories (NSAIDs). Although aspirin is very helpful for some dogs, you should be aware that all NSAIDs, including aspirin, can cause serious side effects. Prescription NSAIDs may be safer and more effective. Do not administer aspirin to your dog without first talking to your vet.
Finally, before you resort to medications, I recommend that you talk to your vet about advanced non-drug treatments for your dog. Such treatments include professional physical therapy (available through special facilities), extracorporeal shockwave therapy, therapeutic laser treatments and stem cell therapies. Your dog may not yet be a candidate for such cutting-edge protocols, but it never hurts to ask.
For more information on arthritis in dogs, check out my website:
http://drbarchas.com/canine_arthritis
Photo credit. Photo license.
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01/23/09
 I have an 11-year-old dog, half Australian Shepherd/half
German Short Haired Pointer. Sometimes when he
walks one of his front legs will give out. It’s almost
like he’s tripping over himself or like he’s
kind of dragging one front paw. It happens maybe
a couple times a week that I notice. He weighs 55
pounds, is not overweight, and is in very good
health. Any thoughts on what could cause this?
Doreen
Bothell, WA
As everyone who is lucky enough to become elderly knows, getting older can be hard on the body.
An eleven-year-old dog who weighs 55 pounds is elderly. And even when they age gracefully, elderly dogs are prone to a number of syndromes that can interfere with walking.
Older animals have decreased muscle mass relative to younger pets. Their joints are not as flexible. This combination often contributes to incoordination when older pets have trouble properly moving their legs into position as they walk.
Also, older pets sometimes suffer from mild neurological deterioration. This can make it hard to place their feet properly while moving.
Arthritis is extremely common in older pets. Arthritis can lead to soreness and weakness in one or multiple legs.
Other, rare causes of trouble walking in older pets include slipped discs, degenerative diseases of the spinal cord or brain, metabolic problems, and certain tumors.
Doreen, based on your description I doubt that your dog is suffering from a serious illness. However, I’d recommend that you have your vet check your dog. The vet may be able to recommend exercises, dietary supplements, or medications that can help the problem. However, it would be unrealistic to expect your dog’s mobility issues to resolve completely. The march of time ultimately affects all of us.
Photo: Eshu is moving well!
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08/15/08
What are some of the things we as dog owners can
do to help a dog with hip dysplasia?
Rosie
Humble, TX
 Hip dysplasia is a syndrome in which a dog’s (or less often, a cat’s) hip joints do not develop properly. This causes premature arthritis in the hips. Hip dysplasia is most common in large breeds of dogs. It has a hereditary component. Careful breeding has reduced the incidence of hip dysplasia over the last several years.
Hip dysplasia is sometimes confused with age-related arthritis. Many older animals suffer arthritis in their hips that is not related to abnormal development of the joints. However, in either instance the outcome is the same–arthritis that causes pain, stiffness, decreased mobility and a lower quality of life.
There are several techniques (some old, some new) for managing hip displasia and arthritis in pets.
Preventing hip dysplasia is by far the best option. Careful breeding is the most important aspect of hip dysplasia prevention. Less effective, but still important, is to feed at-risk puppies (Labrador Retrievers, German Shepherds, Golden Retrievers and other large breeds) a diet that promotes slower growth. Talk to your vet about this.
For pets diagnosed with hip dysplasia by a veterinarian, several techniques may delay the onset of arthritis. The most effective of these is weight management. Carrying extra weight puts tremendous strain on the hip joints.
Other techniques that can delay the onset of arthritis (or help to ameliorate the symptoms of arthritis after it develops) include administration of oral or injectable glucosamine, oral omega-3 supplementation, and physical therapy (mild exercise, swimming, hydrotherapy, and range of motion exercises). Young dogs diagnosed with severe hip dysplasia may benefit from a surgical technique known as triple pelvic osteotomy.
For the unfortunate individuals that are suffering from arthritis, all of the techniques listed in the preceding two paragraphs (except for triple pelvic osteotomy) can be beneficial. Additionally, treatment with the much maligned NSAID medicines can lead to a dramatic improvement in quality of life. Other, newer pain medicines such as amantadine are emerging as well that may be highly beneficial when used in conjunction with NSAIDs. Some prescription diets may lead to clinical improvement in arthritic pets.
A new generation of treatments for arthritis in the hips is also entering use in clinical practice. These treatments include stem cell injections, stimulation with certain types of lasers, and a technique known as extracorporeal shock wave therapy (it sounds scary, but it’s quite benign).
The treatment of last resort for arthritis of the hips is surgical hip replacement. Recent clinical advances have made this option more attractive than it was in the past.
The long and short of it is that there is a wide array of treatments for hip dysplasia and arthritis in pets. Many of them are new and not widely known. Your best bet is to find a vet who is passionate about comprehensive management of the syndromes. Sit down with this vet and develop a treatment plan that is right for you and your pet.
Image credit: Joel Mills. Licensing information: CC.
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Categorized Vet Question and Answer.Tagged arthritis, askavet, cats, dogs, germanshepherds, glucosamine, goldenretrievers, hipdysplasia, labradorretrievers, limping, nsaids, physicaltherapy.
08/13/08
 Stem cells have been in the news a great deal. They are a source of much excitement in the medical community.
Stem cells are special because they have the potential to turn into many different types of tissue. In the future, stem cells may help to treat a number of human and animal diseases.
A recent study has shown that routine therapeutic use of stem cells may not be far off for dogs afflicted with a common and debilitating problem: arthritis of the hips.
Researchers in the study collected stem cells from fat tissue of dogs with arthritis. The stem cells were then injected into the donors’ hip joints. Dogs that underwent this therapy showed a significant improvement in clinical signs. A quote from the study is below.
Dogs treated with adipose-derived stem cell therapy had significantly improved scores for lameness and the compiled scores for lameness, pain, and range of motion compared with control dogs. This is the first randomized, blinded, placebo-controlled clinical trial reporting on the effectiveness of stem cell therapy in dogs.
Arthritis of the hips causes a great deal of suffering in older dogs. It is sometimes a cause of euthanasia. I, for one, am very happy about the development of a new treatment for the syndrome.
However, one aspect of the study has tempered my enthusiasm slightly. Another quote is below.
*This study was sponsored by Vet-Stem, Inc., Poway, California.
Vet-Stem, Incorporated markets stem cell therapies to veterinarians. The study appears to have been well-run. But I am always suspicious of research that is funded by organizations with conflicts of interest.
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08/01/08
I was perusing an article in the most recent issue of Veterinary Practice News when I came upon a quote that really surprised me.
 The article discussed the growing issue of mobility problems in older pets. As they age many pets develop arthritis, muscle weakness and neurological problems that lead to decreased ability to walk and engage in normal activities. Many humans experience similar problems. People often use walkers or wheelchairs when mobility problems become disabling. Although wheelchair-like devices exist for dogs (and they generally work very well), sadly some pets are euthanized when they can no longer stand up or walk.
Several tactics can help to prevent mobility problems in pets. The article mentions weight management and muscle strengthening exercises. As well, physical therapy, range-of-motion exercises and certain dietary supplements (omega-3 fatty acids and glucosamine) may help pets to remain agile.
However, one paragraph of the article really caught my eye. It wasn’t related to animal mobility. Rather, it was related to animal life spans. Here is the paragraph:
According to the American Veterinary Medical Assn., pets are increasingly living longer. In 1987, 31.7 percent of owned U.S. dogs lived past the age of 6. In 2006, 44 percent of the surveyed population lived past age 6. The feline population experienced an increase as well, from 15.3 percent living past age 6 in 1986 to 31.9 percent in 2006.
I was aware that life expectancies of pets were increasing. But I was stunned to find out that only 32 percent of cats were living past the age of six in 2006! For cats and most breeds of dogs, six years represents middle age. The vast majority of well cared for pets can expect to live past six.
My hunch is that the key phrase in the sentence above is well cared for. If the article is not mistaken, then I am afraid that there may be a simple explanation for this surprising statistic. Too many cats and dogs are not well cared for.
About the photo: Patches, who appears in a canine wheelchair (photo courtesy of doggon.com) clearly is well cared for! Patches is proof that pets can lead long, happy lives despite mobility problems.
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07/25/08
Lately when I take my three-year-old dog Riley for a
bike ride, he is limping on one of his front legs
the next day. We took him to the vet and she gave
him some pain medicine.
He has nothing stuck in his paws and the vet said it was
in one of the muscles in his ‘arm’. He has long
legs that are supposed to run ‘ground
breaking speeds’,but he is very slow and lags
behind when I ride my bike with him. Our other
little dog will run by my bike all day long and
she won’t limp at all.
When Riley appears to not be limping anymore,I’ll
take him for a ride and again,he will be limping
the next day. I tried waiting a couple of weeks to
ride him and he still limped when I took him
for a ride again. Should I just not take him for
bike rides and do walks instead?
What’s wrong and what can I do?
Thanks!
Lydia
North East Texas
 Your situation sounds familiar to that of the three-year-old lab whose mother wrote to me on June 30. The symptoms are slightly different. However, the problem seems to be essentially the same: you have a young dog who is suffering from chronic pain after exercise.
I decided to answer your question because I strongly feel that you should not simply stop taking Riley for bike rides. I suspect that Riley has a problem, such as elbow dysplasia, panosteitis, Osteochondritis Dissecans or early-onset arthritis that is interfering with his ability to run.
Although the syndromes I have listed may sound intimidating, many of them are treatable. I would hate for Riley’s lifestyle to be curtailed permanently if it is not necessary.
I recommend that you go back to the vet. Consider taking Riley for a bike ride before the visit (but talk to your vet about this first), so that he will be limping. This may make it easier for the vet to identify the joint, bone, or muscle that is causing the problem. The next step will be to take an X-ray of the problem area.
If you are able to determine exactly what is causing the problem, you may be able to fix it. And then you and Riley could enjoy the lifestyle together that you would like.
A note about the image: yes, it is a human humerus, and I realize that I have used human images two days in a row. But it is remarkably difficult to find non-copyrighted images of canine body parts!
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06/11/08
Hello, I have a Yellow Lab that is 13 years old.
In the past year his back legs have been acting
goofy. They will just give out on him once in a
while. He doesn’t go up stairs anymore either but
he can go down them. I understand that he is a
rather old dog but is there any way to boost his
legs back to normal? He has the heart of a puppy
and we would like him around for as long as
possible.
Dani
MN
Weak rear legs are common in older large dogs such as Labrador Retrievers. Dogs with weak rear legs may have trouble standing up. Their hind legs may suddenly give out, causing the hindquarters to collapse. Because the rear legs do most of the work when climbing stairs (the front legs exert more effort when descending), dogs with weak rear legs may have difficulty going up stairs but no problems going down.
In my experience, two factors play a role in causing the symptoms you describe.
First, all individuals become weaker and less agile as they grow older. Joints become less flexible. Muscle strength deteriorates. Neurological control of the limbs becomes less precise. Most people who make it to 80 are familiar with these issues.
Second, arthritis is extremely common in older pets. I discussed treatment of arthritis relatively extensively in a previous post.
You may be able to help your dog by managing his weight (if he is overweight), performing physical therapy (such as gentle range of motion exercises), and feeding dietary supplements including glucosamine and omega-3s.
Regularly walking your dog will help to build strength, maintain flexibility, and keep his weight down. And it’s fun! I recommend that he get as much mild or moderate exercise as possible. Avoid any activities that seem to make him sore the next day.
Finally, talk to your vet about trying a prescription arthritis medication. One of these medicines may make your dog feel dramatically better.
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03/26/08
Hello doc, my name is Jim. I have a 12-year-old
yellow Lab named Buster. My vet is giving him
Zubrin to help ease is pain. Is there anything
else we can do?
Jim
West Palm Beach Florida
Zubrin is a non-steroidal anti-inflammatory drug (NSAID). I touched upon these drugs in a recent post.
NSAIDs are commonly prescribed for pain from surgery or arthritis. Since Buster is a 12-year-old yellow Labrador, I am guessing that he has arthritis. Sadly, most 12-year-old Labs do.
In most cases, NSAIDs are the most powerful treatments for arthritis. But there are many other steps you can take to help reduce Buster’s pain and improve his quality of life.
First, manage his weight. Excessive weight causes severe stress on arthritic joints. If Buster is overweight, getting a few pounds off of him may significantly improve his situation.
Also, I recommend physical therapy. The simplest form of physical therapy is mild exercise. Leashed walks are enjoyable for both the dog and the person walking the dog, and they help to keep joints limber and flexible. They also help to keep weight down. Do not engage in any physical activities that cause Buster to be sore or in pain the next day. But do allow him to enjoy activities that are fun and that don’t cause follow-up repercussions.
Another form of physical therapy you can perform at home is passive range of motion exercises. With Buster at rest, gently take each joint in each of his legs trough its normal range of motion. If he shows any sign of discomfort, be more gentle. This helps to maintain flexibility. It should be done several times each day.
As well, consider a nutritional supplements containing glucosamine and chondroitin sulfate. Many clients report that their pets’ (and their own) symptoms of arthritis are less pronounced when these supplements are offered. As well, omega-3 supplements may help to ease arthritis pain. There is still some debate among experts about the efficacy of oral administration of both of these supplements, but neither is likely to cause any harm.
Finally, you can talk to your vet about advanced physical therapy (such as underwater treadmill walking), or injectable forms of glucosamine. These therapies are more involved and more expensive, but are often remarkably effective.
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Everywhere I read about hip dysplasia suggests exercise, but nowhere does it list what exercises to do except for swimming. Please list what exercises and for what time period one should proceed with the dog’s excerise. [My vet did not have any info on this.]
You have questions. 