September is Arthritis Awareness Month and there have been lots of posts about it. I thought I’d take a different line and go through a couple of the dogs I’d worked with over the years showing how a multi-modal approach can work better than just medication or single therapy alone. 

First is Luther. My big handsome wonderful Luther. I’ve been visiting Luther the Weimaraner since November 2015. He had been diagnosed with arthritis but suddenly he had gone off his back legs and his Dads just did not know what to do anymore. He also had a very stiff top line, he had gone off his food (which is NOT like Luther at all) and he generally looked sad. His vet referred him to me, and despite some initial scepticism from his Dads, I started to work with him. Luther, being a big boy, can be quite intimidating but is really a big softie when you get to know, and love, him. He was rather suspicious at first but allowed me to perform an almost classic massage routine on him. 

The techniques that turned the corner for Luther were Myofascial Release. His discomfort from arthritis had made him concertina into a shorter dog. He was tight all over. Once we got that tightness released and stretched him back out, we could work with his muscle tone, building his wasted thigh muscles back up again to support his weight. 

Two years on and his Dads are my best advocates so much so that they now give Luther’s new brother, Hugo, a massage every week when I’m working with Luther. Luther is now off Tramadol, and has added Rimadil to the medication mix as well as weekly physical therapy from me, hydrotherapy from Mia at the House of Hugo and laser therapy. He has his bad days, but don’t we all, and he is now 12 years old. Currently, though, he is walking three times a day in his steady plodding but comfortable way. And his loves his massage sessions regularly snoring his way through the hour. 

Then there is Stanley the Shih Tzu. He is 12 now and I’ve been visiting him for 18 months. He was diagnosed with osteoarthritis in the hips. He was treated with Metacam which was easing his discomfort but was not really helping with his wasted rear leg muscles. Stanley is a character and has to be massaged on the sofa so he can look down at his brother Freddy who is desperate to join in. His arthritis had caused his whole body to be wrong, which is a non-technical term but describes perfectly the way he stood. He had a very high rear end so the spine dips at the shoulders which were over developed. He did not walk but waddled with one or both rear legs crumbling under him as he progressed forward. He did not seem in the least bit perturbed by his legs giving way. He simply got up and continued to waddle on. 

With Stanley, he benefitted from as much kneading as I could give him before his attention span ran out (usually between 30 to 45 minutes) and he asked to get off the sofa. In the last couple of months, the physical therapy was really only holding him stable but not helping his muscle tone to improve. His Mum even bought a buggy so he could go out but Stanley was having none of that. A few weeks back we added hydrotherapy to the mix. This was the addition that brought about his turning point. After a few sessions, he had muscles. Big muscles. And he stood without falling. For a long time. And he walked, actually walked. It was an emotional session the first time and such a joy to be able to work with his muscles again, helping to build them up further to maintain his mobility. And today his Mum is off to IKEA to buy some carpet runners for the hall and kitchen so Stanley can continue his progress without fear of slipping. Add ‘environmental changes’ to the mix of therapies. 

Duffy the Old English Sheepdog sadly passed away a few months ago from a heart condition, but I had been visiting him every four weeks for 18 months. He was referred with Ankylosing Spondylosis in his upper back resulting in forelimb arthritis. He was already on a regime of Rimadyl and Cartrophen with monthly acupuncture from vet Guy Liebenberg of Coastway Vets. During the physical therapy sessions, his Mum added Holistic Veterinary Medicine to his mix from Tim Couzens. This took the form of daily herbal medication which included things like Turmeric and Ginger for the arthritis. He also had laser therapy. 

As well as massage, he loved his stretching exercises and passive joint stretches. His Mum took on board the need to do a few massage moves and exercises daily to keep him mobile in between my visits. Another couple of additions to complement his multi-modal therapy. 

For the first few sessions treatments, he just could not keep still and was very vocal. But by the 4th and 5th session, the problem with him was getting him to leave the massage mat at the end of the hour. He wanted more, and when I left, he always went into a deep relaxed sleep – a perfect result from a session. 

Last, but not least, is our Sarah. My inspiration. We took her on a basic introductory massage workshop many years ago and one move we learned from the wonderful Pia Campbell was what inspired me want to start AchyPaw. Simple skin rolling released so much anxiety and discomfort from her that she turned from a grumpy old woman to the 5 year old she should have been within days. 

She has now been diagnosed with arthritis in her hips and, 6 years on from that basic workshop, she has daily massage and acupressure from us, weekly hydrotherapy with Mia, holistic medicine from Tim, a raw food diet to help with weight control, environmental changes (such as our new ramp to the back door and half steps all over the house), daily activity changes (frequent but shorted walks daily so she exercises but doesn’t overdo it), nutritional supplements, a Bioflow collar, energy healing from her Auntie Lou and recently Regenerative Medicine. A truly multi-modal girl. 

Which treatment is the one that is working? Don’t know. It may not just be ONE, but a combination of all. This is complementary therapy after all. What I do know is that she is currently fitter, happier and more comfortable than she has been in a long time. And I can’t ask for a better result than that. 

Check out all the options open to an arthritic dog. It doesn’t have to be ‘just arthritis’.

Subluxation of the canine hip - meet Ronnie

Ronnie is a 2 and a half year old Golden Doodle – Golden Retriever / Poodle cross. He is a big boy with stunning eyes. 

Some months ago he started to display issues with his mobility. He lives in a house where there are quite a few steps to climb to get indoors. He started to look painfully at these steps up to their house. His Mum said it was like an old man who was reluctant to try them. He also became stiff and hyperextended his back end. His gait was definitely way off balance. This was not due to overwalking as, when his exercise regime was severely cut down, he still displayed these issues 

His local vet could not determine what was going on with him and referred him to a specialist vets. They took CT scans of his elbows and X-rays of his hips. The good news was his elbows were fine but his left hip showed mild subluxation. His right hip was also fine. 

When a joint completely dislocates or separates between the joint and the bone, this is commonly described as luxation. This is often what happens in dysplasia. But when the joint is only partially separated, this is referred to as subluxation although it can be equally painful. The signs for both are similar with limping, lameness, pain, licking or change of mood although subluxation can come on quite quickly as it is typically due to a recent trauma. 

There are a number of ways to treat this, depending on the severity, including surgery. In Ronnie’s case, his was mild and the surgeon recommended that he started with physical therapy. This included massage, exercise and hydrotherapy. If this did not resolve the issue, then surgical interventions might be necessary. He was given some medication although the Gabapentin he was given, did not agree with him. He is now just on NSAIDs 

He has already started hydrotherapy and I was asked to fill in the multi-modal therapy of physical therapy and exercise. Although he is a large boy, he is very soft with a stubborn and a “I-don’t-think-you-should-be-touching-there” glare given when he is not happy. 

He was perfectly fine with 30 minutes work on his right hand side but was not happy with his left – the side of the issue. In fact, he walked out into the garden, under the tree. I sat with him chatting away and eventually he let me rest my hand on his hip. Luckily, we found his Go-To muscles were his left shoulder and his hip. Any amount of massage there sent him straight to sleep. Alternating between the lovely muscle and the iffy muscle seemed to work. He gave up trying to out stare me and rested under the tree. 

 His Mum is now armed with homework and exercises plus a quick warm-up and cool-down routine as Ronnie struggled more after exercise. Hopefully the physical therapy, exercise and hydrotherapy should start him on his road to recovery and may prevent any surgical interventions. 

Benefit of having your own Personal Massage Therapist

“Hi I’m JC. I’m a little bit of a canine athlete, competing in shows most weekends during the season. I have the edge on my competition though. I have my own Personal Massage Therapist called Dr Les. 

My Personal Massage Therapist came to see me just over a year ago when I started to fail at a couple of events during a show. My Mum was told about Dr Les who came along to see if he could help. I’m not always the best of friends with everyone who comes into my house. When Dr Les walked in holding what looked like a big fluffy red bed I thought “Hmmm…why has Mum let him into my bedroom?” so I walked around eying him up and sniffing him out. He smelt OK so I decided to plonk myself in his lap to keep him company. He then spoke to me and asked if he could touch me. Well….Ok…..I guess so. Wow…..was I happy I agreed to that. He did something to me which released a lot of heat from my skin. It felt great. I just had to lay down on the bed to get more of that. 

He said that I was rather tight in my thigh muscles. I don’t know what that meant but he made a big difference. I decided I’d had enough after 40 minutes and walked away. But he didn’t leave, he was chatting to my Mum. So I went back…for more. And more. It was really lovely. 

I didn’t see him again until the same happened. I just couldn’t do the sit properly. It hurt a bit. I had to remain standing. I know that was not what my Mum wanted but I just couldn’t get there in time. She wasn’t angry though. In fact she must still be pleased with me because, guess what,…Dr Les came back. I wasn’t going to be all standoffish this time. I bowled him over with my excitement. I felt he needed extra kisses and cuddles as he must have missed me after this time. As soon as he put that red bed down I threw myself on it and looked at him longingly. He said something about ‘flirting’…it must have worked as he started his magic again. 

He taught my Mum something called The Locomotion which she has to do before I compete. It’s great fun. She now does that every time I get out of the car and I feel all warmed up. None of the other Mums do The Locomotion to their dogs. They must feel really stiff and cold before they compete whereas I’m all warm and suppley. 

We’re reaching the end of the event season and, as you can see, I’ve won quite a few prizes. Not bad for a 10 year old girl eh? My Personal Massage Therapist has just been again and said I feel pretty good, in between me giving him kisses, licking his beard and doing that flirting thing. 

And my Mum has been doing her homework. I showed him how well by doing the stretching exercises he put me through. They make me stretch my back, which feels nice, and I get a treat while doing it. I call that a Win Win. 

I have two brothers. They don’t have a personal massage therapist. I guess that makes me special. I’m not going to tell all my mates at shows about Dr Les as he’s mine” 

Editors note : If you would like your dog to have a personal massage therapist like JC, just get in touch 

Benefits of physical therapy – and some obscure ones

There are dozens of established benefits from massage and physical therapy. There are the physical and mechanical benefits such as : 

• Rehabilitation 
• Prevention 
• For exercise and sport 
• To manage pain 
• Stimulation of the healing process 
• Increase blood, lymph and nutrient flow 
• Increase joint movement 
• To improve muscle tone and strength 

Then there are the psychological benefits including : 

• Relaxation 
• Bonding 
• Reducing anxiety, stress and other emotional issues 

And then added benefits such as : 

• Give the owner peace of mind 
• Education 
• Beacuse it feels nice

Every now and again I get the odd one to add to my list. For example, I was once referred a dog who really struggled to poo. When she came to see me, she hadn't been for a couple of days. Would massage help? Dunno, but stand clear and let's try. For the next few days I received multiple texts from the owner detailing quantity and quality of that dog's movements. It worked. There's a new benefit then...helps to poo. 

And yesterday I added a new benefit. Lovely anxious Whippet Sonny has been suffering from neck issues for some weeks now causing yelps and general depression. He came to see me last month and has now visited a chiropractor who put his pelvis back in alignment while making tweaks to his neck. Yesterday's massage was much easier with Sonny adopting his usual "I'll just lie here Dr Les" pose. 

When I got home I received a message and photo from his Mum saying "First cuddle we've been allowed to have in longer than I can remember! Very rare, he must be feeling better. Thanks again". So there we have it....massage benefit number 7654321 : Increases and Restores Cuddling Ability. That's going to be one of my favourites. 

Canine Regenerative Therapy : My experience part 2

8 weeks ago, we took our Sarah to Dr Stewart Halperin for Regenerative Medicine Therapy.  At that session she was treated with had Plasma Rich Platelet therapy, Arthramid, steroid injection and lubrication during the surgery.  Medication wise, we added Amantadine to her regime.

I really didn't know what to expect.  Would the effects be instant?  Would we start to see improvement in a few days or weeks or months?  Would it work at all?

She regained her mobility quite quickly but still stumbled on her right hind leg for a while.  When that sorted itself out, she decided to stumble on her left hind leg.  A week after surgery we also added twice weekly hydrotherapy to her physiotherapy routine using the 10 metre pool at the House of Hugo. 

As I walk behind my girl at least 3 times a day, I constantly took videos of her walking which I could refer to for changes.  For five weeks, it seemed that not a lot was happening.  But then she started to walk symmetrically, balanced and with more confidence. And her thigh muscles began to appear.  This was quite evident as she developed alopecia over her operation area - meaning she has two baldy patches over her thighs.   You could see through to the muscles - not good for her but good for me to judge progression.  You can see in the video here, when she stops, she quickly corrects her hind leg placement.  A couple of months ago, a rapid turn like that would have sent her legs flying in different directions resulting in a fall.

Dr Halperin also removed her bad front teeth.  Now that doesn't sound a lot, but she must have been in pain from them.  Removing that discomfort seemed to help with her mobility recovery.  

Yesterday we had our 8 week review back at his Chiswick surgery.  I was looking forward to a fresh pair of eyes assessing the outcome.  Encouragingly, he was pleased at the change.  He agreed with us that a major improvement is how she stands up from a sit with less effort.  He followed us walking down Chiswick High Street while taking a video for his records and agreed with my opinion, which is that she is clearly pushing from her rear legs now rather than pulling with her front.  Meaning she is regaining strength and confidence from her hips and thighs.

He performed a physical examination.  Her wrists no longer crackled when moved, her elbows and shoulders felt more solid and her right hip had considerably more movement.  She still showed some reluctance in her left hip, but hey, any relief to her discomfort of bone rubbing on bone has to be a benefit and a result.

It was decided she did not need a top-up this time.  The plan now is to continue with the medication and physical therapy routine with a review around Christmas time. 

As I said a month ago in my first post about her surgery, "it's just arthritis" doesn't have to mean the end. There are options for relief including physical therapy, hydrotherapy, acupuncture, medication reviews with your Vet, laser therapy, making simple but effective dog friendly changes inside your house (we’ve just added ramps everywhere) plus all the new innovations coming along which can give us dog Dads and Mums, more hope now.