Tuesday, 28 October 2014

Massage for Palliative Care in the Older Dog

It has been widely researched that massage and aromatherapy can help with palliative care in humans (see appendix for examples of scholarly articles). Most seem to concur that there is a statistically significant reduction in anxiety after massage, with or without essential oils, and levels of anxiety are reduced. They conclude that massage can improve physical and psychological symptoms, as well as overall quality of life. In several palliative care units massage therapy is offered as a complementary treatment for pain, discomfort, and emotional distress working in conjunction with the health care multi-disciplinary team. 

In dogs there is less scholarly research regarding massage & palliative care but it is available (see appendix for examples). Dr Jessica Pierce states that using several different therapies, drugs and complementary therapies, can create a synergistic response which is more effective than a single therapy alone. Robin Downing states most dogs find massage to be very comforting and adds that massage can be performed by a trained provider, but many massage techniques can also be taught for use at home. 

Alice Villalobos, DVM, former President of the American Association of Human Animal Bond Veterinarians (AAHABV), and founding member of the Veterinary Cancer Society, refers to hospice care in dogs as “pawspice”. 

The event that set me thinking about palliative care and dogs was that I received two referrals the other week from a vet about a couple of elderly dogs. One was terminally ill with kidney failure, the other had suddenly started to struggle to walk. They were aged 14 and 13 years respectively and long-loved members of their families. Clearly I was not going to be able to make them puppies again but my aim was to help them with any muscle and joint aches and stiffness so they could hopefully be pain free to fight any other issues going on in their body – holistically helping them to heal themselves. 

This took me back to my very first case study – an elderly dog who was also referred to me by the same vet. The dog was an old lady with progressive stiffness in her hind legs. She also had a cruciate injury on her right back leg but the veterinarian had recommended letting it heal itself rather than putting this elderly dog through potentially life-threatening surgery. Her owners had taken the dog to hydrotherapy and now wanted to try more targeted massage and myotherapy. When I first met her she was severely hunched and clearly in pain. During the first treatment the owners and I were surprised at how she simply lay down for me making ‘happy vocalisations’ with no protest at all. Effleurage around her neck, pectorals, front legs, back and hind legs resulted in the dog actually turning round and planting a big kiss on me which both the owners thought was amazing as this was the first time we had met. 

After the first session I was sent a picture of a very relaxed dog sleeping happily for the rest of the day. When I walked through the door for the second session she immediately lay on the floor ready for the massage. Her owners said she had been ‘full of beans’ all week and was really looking forward to going out for her walks. In fact she was rather over-enthusiastic so they were taking it slowly as advised. It was also encouraging to see that they had also been doing the homework I had given them and that their dog was now actually coming to them and asking for it – she had turned into another massage diva. I can’t stress enough how giving owners the tools to help their own dog in return helps them too. 

I had several sessions with this dog and her owners regularly brought her to meet us at local dog shows. 18 months later she still remembered that seeing me meant she should lie down for her massage. 

Flash forward a couple of years to my latest ‘oldie’ referrals. The first was a very poorly dog who was suffering with kidney failure. My aim for the session was, at the very least, to help reduce the stresses, strains and stiffness that had built up in his limbs due to his immobility from his illness. Massage can help maintain the circulatory system, boost the immune system and relax the tired muscles. This should also help to quieten their mind allowing them to stretch out safely and concentrate on healing internally so they can continue in a dignified way for as long as possible. There is a double bonus too as the owner can also relax during the treatment session as they give the care of their dog over to me for a while. 

As often happens on the first appointment, the dog was slightly unsure of what was happening but quickly lay down and let me perform a series of gentle warming massage strokes to his whole body and joints. In addition the dog has taken to lying in a bed that was clearly two sizes too small, possibly for security. So his hind limbs had become very shortened and bent. As he stretched for me during the session I was able to gently extend his legs ensuring his tendons did not become shortened. The owner and I also used a bit of stealth to replace his small bed with one that was more his size while he was sleeping off the massage so that the issue would not recur. There is no fooling some dogs though, even elderly ones. When he approached his new bed he looked at it suspiciously, looked at us, then flopped down in eventual resignation. But he was able to stretch out so the dirty looks from him was worth it to us. We made a plan to visit this dog every couple of days to continue with the relaxing massage. As the week went on, his eyes were becoming brighter and he bounded to the door to greet me. 

We even introduced music into the therapy session. The dog had a ‘tune’ which the owner always used to sing to him at night. I downloaded that tune onto my phone and played it while giving him his massage. I’m sure he recognised his tune but even if he didn’t, the owner and I were singing along in a relaxed way. (Listen to "Harry" by Catherine Howe and try not to shed a tear with me.  I'll be a blithering wreck when that comes on shuffle as I'm walking Sam & Sarah)

I had given the owner a short routine to use on the dog before his first walk and during the day. She felt that empowered her in the palliative care of her dog, helping him to maintain his dignity and gave her something to do rather than simply watch him fade away. 

Senior referral number two was a dog who had become lame very quickly. The vet had diagnosed neurological degeneration and there was noticeable muscle wastage over his rear end. This dear dog decided immediately that he loved massage and lay down stretched out on his huge comfy bed for me. He even rolled over after 30 minutes so I could work on his other side – no prompting needed. We made a plan to visit this dog weekly at first to ease his muscular aches and pains and once more I gave the owners a short routine that to perform daily. 

As I have stated in other articles, I would advocate that massage is not just for prevention or injury but has many uses. One being as a useful adjunct to more traditional treatments in palliative care helping to reduce pain, improve circulation and relax muscles. Psychologically it also helps to calm, and comfort the dog thus helping to relieve any anxiety. It has been shown to be of benefit in humans so should be equally effective in our dogs. Combining a regular routine from the owner with a longer maintenance session from the professional could help maintain and even improve their quality of life. The regular routine doesn’t need to be a long session - the session I gave both sets of owners would only be about 5 to 10 minutes - but enough to give both them and their cherished dog a few hours peace. 

For advice on methods for treating elderly dogs, please contact me from the achypaw.com website. 


The American Massage Therapy Association. (Sept 2009). ‘Massage Therapy Can Improve the Quality of Life for Those in Hospice and Palliative Care’. http://www.amtamassage.org/statement5.html [accessed 28th October 2014] 

Pierce. J. (2012) ‘Palliative Care for Pets’. http://www.seniorsresourceguide.com/articles/art01240.html [accessed 28th October 2014] 

Rodier. L. (March 2010). Canine Hospice Care Options : Veterinary hospice care considerations for your canine companion. http://www.whole-dog-journal.com/issues/13_3/features/Hospice-Care-For-Dogs_16206-1.html [accessed 28th October 2014] 

VCA Animal Hospital based on material written by: Robin Downing ‘Palliative Care for Dogs’. http://www.vcahospitals.com/main/pet-health-information/article/animal-health/palliative-care-for-dogs/8179 [accessed 28th October 2014] 

Wilkinson, S. et al (1999). ‘An evaluation of aromatherapy massage in palliative care’. Palliative Medicine. 5 pp 409-417

Wednesday, 1 October 2014

Firework time of year – stress, anxiety or relaxation for you dog?

Our two collie spaniel crosses, Sam and Sarah, were bred as gun dogs.  They were both from the same litter and inseparable – except around firework time of year when Sam spent much of the evenings trying to hide into the smallest place possible shivering and quaking.  He clearly never realised his initial calling as a gun dog.  His sister is totally not fazed by the bangs but gets upset to see her twin brother looking stressed.

We have tried everything over the years from CDs that have loud banging noises which you are meant to play to the dogs to get them used to the sounds (they didn’t work at all…the dogs just barked along in tune) to pheromone diffusers (which clearly we can’t smell so you never really know when they have run out).  

But before we tried sometime new last year we thought we’d have a go at introducing a relaxation massage routine.  It is well known that when a dog (or a human) feels in danger or stress, it places stress on their body systems.  This can lead to an increase in muscle tension which can cause further problems.  If we could rebuild Sam’s confidence with massage and touch, the hope was we could reduce his stress and generally help him through the firework season.   

During my time working in canine therapy with my AchyPaw Dog Massage service, I know that some forms of massage helps to calm a dog down (repetitive, predicable, slow & rhythmic strokes) while others help to revitalise them (deep fast and kneading moves).  When performing a relaxing massage session you do feel their heart rate calming and slowing down.  It can also help to calm their nervous state – again something that is evident during a massage session where you see their eyes start to go ‘googly’ in their head and you suddenly get that deep long sigh.  The ‘sigh’ helps to fully expel their breath allowing for a complete intake of fresh oxygen and nutrients.  As an ex-academic I have looked through some literature and several research studies have been performed in humans (and dogs) to show how massage can reduce blood pressure and heart rate (research examples are given in the geeky-style appendix but there are plenty more) so trying this pre-firework massage routine made sense to me.

But massage also helps the therapist.  It is such a joy to perform a relaxing holistic massage – I feel my own heart rate slowing and any tension disappearing.  This has to be a double benefit.  Again research evidence seems to back this up (more geeky appendices).  Most behaviourists say that your dog can feel your tension – either down the leash or just by looking at you.  Knowing that your dog is about to get all jumpy and agitated is stressful for the owner as well as the dog.  So anything that can calm both parties down in one hit has to be good – until they develop a calming pheromone diffuser for the stressed owner!

So last year we decided to give regular and short holistic massage sessions to our Sam to calm him naturally a few weeks before the big bangs started.  Three or four weeks before the season we started giving him 15 minute sessions ending up with wrapping him up warmly in a blanket – like a thunder shirt.  Each night the sighs came earlier into the session and his eyes got googlier and googlier.
Halloween was clearly our first test.  So he was massaged early and wrapped up while we waited for the first bangs of party nights.  This time when he heard them, instead of him running round the house, he simply looked up, still aware of the noise, but lay back down again as though the effort of being stressed was actually too much like hard work.  Yes he was aware but no he was not as nervous as he used to be before the massage routine.

So that was a success.  But as an added extra, WE were relaxed too.  Instead of us dreading the next big bang wondering what we could do to calm down our sensitive dog, we were able to get on with the normal evening things – like watching TV (which didn’t have to be on full blast to drown out the noises).  His sister was also able to sleep through the bangs without worrying about her brother.

We continued the routine through the November 5th firework season with the same result – a much calmer Sam.  

It is not just fireworks that worry Mr Sam but also thunder – he is a bit of a wuss but we wouldn't change a thing about him.  He is just a 'sensitive soul'.  We’ve had quite a few storms this year.  Sam was aware of the noise but this time came up to have his special ‘Dad Massage’ and immediately fell asleep.  It seems he is remembering that fireworks and loud bangs should be associated with massage rather than fear and anxiety.

Hopefully if we start the routines now, by Halloween we’ll have two chilled dogs.

If you want to learn more about this form of complementary therapy, feel free to contact me from my website @ achypaw.com or via our Facebook page (http://www.facebook.com/achypaw).  I can happily organise tailored training sessions to teach you how to massage your own dog.  It certainly can’t do any harm and may help you and your dog.

Appendix :

Handlin L. et al (2011) ‘Short-Term Interaction between Dogs and Their Owners: Effects on Oxytocin, Cortisol, Insulin and Heart Rate - An Exploratory Study’. Anthrozoos: A Multidisciplinary Journal of The Interactions of People & Animals. Vol 24, No. 3, pp. 301-315

Hennessey M.B. et al (1998) ‘Influence of male and female petters on plasma cortisol and behaviour: can human interaction reduce the stress of dogs in a public animal shelter?’.  Applied Animal Behaviour Science Vol 61, pp 63-77 

Kaye et al. (2008) ‘The effect of deep-tissue massage therapy on blood pressure and heart rate’ J Altern Complement Med. Mar;14(2) pp 125-8.