Veterinary Articles and Case Examples

Exercise for old dogs – how much is too much?

Posted on in Geriatric care, Non-surgical Therapy, Prevention, weight control 1 Comment

 

Exercise for Old Dogs:

The longer they keep moving, the longer they will last

 

A common question is “How much is too much exercise for an old dog?”  We know that too much exercise has the potential to flare arthritic joints, that older dogs tire sooner, that they are more prone to injury, and all this needs to be respected.

But as much as we don’t want to over exercise an older dog, under exercising them is even worse.  Once a dog becomes inactive, their health and quality of life quickly drops.  Better to have an older dog take anti-inflammatory medication and lead an active life, than have it remain drug free but spend its time sleeping on the couch, too sore to enjoy the simplest outing.

There are many reasons why the health of under exercised patients declines so quickly, too many to cover in one blog, but here is a partial list:

Fiver might not be a geriatric, but she definitely needs regular exercise, not only to keep her sanity but also to keep her gluteals tone (she has had bilateral knee surgery).

Dysafferentation: This will get explained in more detail in a later blog, but the bottom line is that if the brain receives signals about body movement, it becomes less aware of pain.  Active dogs feel less pain.

Muscle mass/tone: Geriatrics tend to lose muscle tone and bulk. Inactive pets also lose muscle tone and bulk. Inactive geriatrics lose muscling the fastest of all. Exercise is the best way to maintain muscle mass (use it or lose it).  Good muscling reduces arthritic pain by providing stability to the joint.

Feeding the Cartilage:  Nutrients are transferred from the blood stream into the joint fluid.  Circulating joint fluid carries these nutrients to the joint cartilage.  Joint fluid is circulated every time the joint bears weight.  Lying around results in reduced nutrition reaching the cartilage, which accelerates cartilage degeneration and secondary arthritic change.

Neurologic benefits:  Again, the notion of “use it or lose it” applies.  Nerves need regular stimulation in order to remain healthy, the sort of stimulation that exercise provides.  Exercise helps maintain co-ordination and strength in the limbs, as well as the mental stimulation needed to combat dementia.

Weight control: As we’ve already seen (click here), increased fat results in increased pain.  The more active a geriatric is, the easier it is to prevent excessive weight gain.

 But how much exercise is too much?

 

The answer to that question varies from patient to patient but here are a few thumb rules that you can apply:

  • Keep sessions short and frequent – older dogs tire easily.
  • If the exercise session doesn’t contribute to stiffness afterward, then it was good for your dog’s health.
  • If the stiffness gets worse with certain types of exercise, avoid those types of exercise.
  • Casual walk on level or mildly challenging ground are best.  Rough-housing and sudden exertional activities (e.g. jumping down, hard braking etc.) are not as good.
  • Have your pet examined by someone experienced in detecting musculoskeletal pain, and let them help you devise an exercise program.

 

Again, too little exercise can do as much if not more harm than too much.  Any exercise that doesn’t increase pain and stiffness afterward was a good thing.


X-rays of a normal knee vs a ruptured canine cruciate ligament knee

Posted on in Canine Cruciate Ligament Rupture, Case Reports, Radiographs Comments Off on X-rays of a normal knee vs a ruptured canine cruciate ligament knee

Comparing X-rays of a normal knee vs an arthritic knee with a ruptured canine cruciate ligament

(A.K.A. the answer to last week’s “quiz”)

 

Spoiler alert! – If you haven’t read last week’s blog, click here

 

Weak Stomach Alert! – The blog below contains graphic intra-operative pictures

 

Normal, happy knee

 

 

Most of you were correct in thinking that the top/first x-ray was the normal one.  Here it is again.

 

 

 

Blue lines are traces of joint surfaces, and the red represents joint fluid

 

 

 

Here it is yet again, but now with fancy graphics that represent my 1st attempt to utilize photoshop.  I highlighted the nice, smooth regular lines in blue (any irregularities are purely due to my poor graphic arts skills).  I coloured the joint fluid red.  Once again, this is a normal knee with a normal amount of joint fluid.

 

Arthritic, unhappy knee

 

 

 

This is the bottom/second x-ray from last week’s blog, the one of the badly arthritic knee.  It has extra bone growth, increased joint fluid, and a free floating joint “mouse”.

 

Blue lines represent bone margins, red area represents joint fluid, and yellow represents areas of abnormal intra-articular calcification.

 

 

 

This is the same x-ray of the abnormal knee again, but with fancy graphics added.  The blue lines hopefully highlight the various irregular surfaces, and the red area represents the amount of fluid in the joint.  Notice how much more joint fluid there is in this knee.  Increased joint fluid is a reflection of active inflammation.  I coloured the free floating joint mouse yellow, and chose the same colour for the calcified tibial attachment of the canine cruciate ligament.

 

Intra-operative picture of a mildly arthritic knee.

 

 

 

This is an intra-operative picture of a mildly arthritic knee (I did not post a corresponding x-ray for this knee).  The bony ridge along the side is a lesser version of the irregular blue lines in the arthritic knee pictured above.  Although there is some pitting of the cartilage, most of it is in an area that doesn’t see bone-on-bone contact, so it shouldn’t cause a problem.

 

 

Intra-operative picture of a severely arthritic knee

 

 

This is an intra-operative picture of the knee from the badly arthritic x-ray example above.  There was so much scar tissue in the joint that I couldn’t fully expose the roughening along the side of the bone, but you can see how pitted and unhealthy the cartilage is compared to the only mildly affected knee.

 

 

 

This is the joint mouse that I highlighted yellow in the x-ray example above.  Before surgery, I had assumed that it was a portion of torn canine cruciate ligament, but after being in the joint and seeing how badly eroded the cartilage was, I am more suspicious that it is a calcified cartilage flap from an OCD lesion.  What’s an OCD lesion you ask?  Perhaps that’s a topic for a future blog.

 


X-rays of a ruptured canine cruciate ligament with secondary arthritis

Posted on in Canine Cruciate Ligament Rupture, Case Reports, Radiographs 2 Comments

Sometimes you don’t need to be a doctor

in order to read an x-ray.

Here’s a chance to test your own medical skills…

 

Is this a normal knee, or is it the one with a ruptured canine cruciate ligament and secondary arthritic change?

 

 

Attached are two x-rays, side views of the stifle (knee) joint.  Both were taken from the same dog on the same day, one of the left knee, one of the right.

 

 

 

 

 

Is this a normal knee, or is it the one with a ruptured canine cruciate ligament and secondary arthritic change?

 

 

One of the knees is happy and normal, the other is severely arthritic due to rupture of the canine cruciate ligament.  Changes that can be seen include roughening of bone surfaces*, increased joint fluid, and calcification of the ruptured canine cruciate ligament.

 

 

 

Can you determine which knee is happy and which knee is not so happy?

Click here for the answer.

*When bone senses inflammation, it responds by growing new bone.  This is how fractures are healed.  When bone senses the inflammation of arthritis, it grows unproductive boney spurs called osteophytes.  Osteophytes appear on x-ray as irregular roughening of the bone surface.  In severe cases such as this, you can feel a grinding sensation of joint capsule dragging over this surface when you move the knee.

For more information of canine cruciate ligament rupture, visit our cruciate surgery page.