Arthritis & Joint Pain In Dogs
Everything you need to know

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If you are a dog lover, then you know instantly and instinctively know that arthritis and joint pain in your dog is painful to both them and you.

If your dog is getting older, then you also know that lurch of the heart the first time your dog struggles to get up off her mat when you say “Walk?”.

When she doesn’t run or play like she used to. When getting up the stairs seems more and more difficult. The love we have for our dogs is so overwhelming, it makes it so much harder to watch them age, to watch them struggle with pain and discomfort.

So what can we do?

Well, first of all, it is important to know what is causing your dogs’ pain. Is it just age? Is it arthritis? Your vet is the best person to diagnose what is going on. But as an educated dog owner, you likely have a good idea already. But once you’ve got an “official” diagnosis of arthritis, is there anything you can do to help?

You bet you can!

“Dogs are not our whole life, but they make our lives whole.” – Roger Caras”

HERE ARE 7 PROVEN WAYS TO HELP RELIEVE ARTHRITIS AND JOINT PAIN IN YOUR DOG

A Comfortable Bed – A well-padded bed, away from cold or damp floors will support your dogs joints. Choosing the right size of bed, as well as a filling that supports their weight is also important. Non-skid flooring (to prevent falls) and even carpeted steps or a ramp to help your dog get around the house are also some options to consider.

Massage – just like us, some dogs benefit from massage for aching muscles, and massage also helps to stimulate blood flow to atrophying muscles. Canine massage therapy is an emerging specialty based on the human fields of remedial massage and human movement, though many qualifications in this field are through online courses, so a recommendation is a good idea. Treatments can cost upwards of $30 per session.

https://animalrehab.com.au/collections/courses

Heat – Warm compresses, or heat packs, can sooth sore joints, though it’s important to take care as dogs (and plenty of humans!) can be injured by burns caused by excess heat and your dog can’t tell you if the heat pack is too hot until it is too late.

Dogs that have short hair, hair loss or are very small are at a higher risk of suffering from thermal burns. Burns can range from 1st degree to the more serious 4th degree burns. It’s common for vets to see dogs being brought in from well intentioned dog owners trying to help their dogs with heat lamp or heat packs / heating pads, but you really must be very careful.

Please take care when using heat as every degree in heat provides a different result – some disastrous.

Exercise to Relieve Arthritis and Joint Pain in Dogs (But Does It Come with a Catch?) – this is no surprise to any of us with joint issues. Maintaining a healthy exercise routine is one of the best ways of maintaining mobility, even with arthritis and joint pain.

We know that exercise stimulates circulation to joints. But if it’s a weight bearing exercise like walking, there’s a risk of doing increased damaged to joints already suffering from osteoarthritis. So this is where non-weight bearing exercise comes in.

The upside for exercise is all the secondary benefits that come with it. It stimulates your dog which is good for their mental health. It can also help with weight reduction via burning calories / energy with has a flow on effect for reducing pain associated with arthritis and joint pain in dogs.

For us humans, non-weight-bearing exercise is often recommended for people with severe arthritis (think aqua-aerobics!). This can also be an option for dogs with joint pain, if there is a centre in your area.

https://www.aquapaws.com.au

Be sure to check with your vet, as aqua therapy is not recommended for dogs with open wounds, certain spinal or skin conditions.

https://rehabvet.com/rehabilitation-physiotherapy-hydrotherapy-contraindications-cautions/

Aqua therapy for dogs generally requires an initial consultation, with follow up sessions based on the dog’s needs and prices vary depending on the centre and services available.

Supplements and food – There is a lot of information out there about how diet and supplements can affect your dog and help with arthritis, with dozens of products that are said to promote healthy joints.

Some of these contain glucosamine, chondroitin and other substances to help improve joint health.

https://www.petbarn.com.au/petspot/dog/food-and-nutrition/feeding-dog-hip-joint-health/

Others dog food supplements aimed at helping joint pain contain Omega-3 fatty acids to help reduce inflammation. It is always important to check with your vet before making radical changes to your dog’s diet!

One really important consideration with any supplementation is a dog’s circulation. It’s a commonly accepted concept that “the better a dog’s circulation, the more they stand to benefit from joint pain supplements”.

As dogs age, circulation diminishes in a similar way as humans experience. Dog’s extremities (their legs and feet) and considerably more bony and less fleshy than humans so a focus on improving circulation can go a long way to getting more bang for your buck with the supplements and joint pain foods you invest in.

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“Dog’s extremities and considerably more bony and less fleshy than humans so improving circulation can go a long way to getting more bang for your buck with the supplements and joint pain foods you invest in.”

Alternative therapies – Many dogs (and their humans) have found pain relief and increased mobility through complementary and alternative therapies such as acupuncture and homeopathy.

Acupuncture in dogs is often used to treat arthritis and relieve pain, usually through needles, acupressure or heat applied at specific points, referred to as meridians. Homeopathy for dogs tends to be used to treat minor stomach upsets, scratches, insect stings and in some cases, remedies are used to treat anxiety in dogs.

https://animals.howstuffworks.com/pets/medical-treatment-for-dogs-ga5.htm

It is important to do your research though and find someone with experience working with dogs. As Veterinarian Dr Haussler, assistant professor at Colorado State University put it when interviewed for TheBark Magazine:

“Make sure that if the person working with your dog is not a veterinarian, he [or she] is at least a licensed professional, whether a [human] licensed massage therapist, [human] physical therapist… As long as they’re working together with a veterinarian, I think that’s great.”

https://thebark.com/content/complementary-and-alternative-medicine-right-your-dog

Medications – This is an area best discussed with your vet. There are several options when it comes to prescription medications for dogs, ranging from regular injections, analgesics that provide pain relief, steroids to reduce inflammation, and NSAIDS (non-steroidal anti-inflammatory drugs). Very few medications are completely without side effects, so it is important to discuss all options with your vet and, if medication is recommended, your dog will need regular monitoring and tests to keep on top of any symptoms or side effects. Vets have some great advice for relieving arthritis in dogs.

https://thebark.com/content/vet-advice-relieving-your-dogs-arthritis

So all of these things can help, and to ease our dogs’ pain, we would move heaven and earth and drain our savings. But there are only so many hours in the day! How do we fit in vet appointments as well as massage, acupuncture, aqua-therapy and everything else?

One of the (hundreds!) of interesting things about dogs and their humans, is that arthritis is a problem for both and, even more interesting, “arthritic dogs are an almost perfect model for arthritic humans, which means that while researchers are developing new treatments for arthritis in humans, dogs also benefit (and vice versa).”

https://thebark.com/content/new-pain-management-canine-arthritis

TRANSLATIONAL STUDIES – WHAT ARE THEY? AND WHY ARE THEY RELEVANT

Translational research is the process of applying knowledge from basic biology and clinical trials to techniques and tools that address critical medical needs. Unlike applied sciences, translational research is specifically designed to improve health outcomes. [1]

When researchers want to test a particular therapy, they may use a translational study to determine the benefit this could have on human patients. Many translational studies use animals to test new therapies, before moving on to human studies.

For arthritis, however, this has been more difficult, as animals such as mice, which are often used in animal studies due to low cost and ease of handling and care, are not a good model for human joints. “The canine model is probably the closest to a gold-standard animal model for OA currently available. The canine stifle (knee) joint is remarkably similar to the human knee” [2]

Dogs, it turns out, are a great model for human arthritis. But for lots of reasons (all of which we dog lovers would agree with!), animal studies involving dogs are far less common. Luckily (for your dog), Translational studies also work the other way – if a study is undertaken in humans, the results can be applied to dogs, because of the similarities in joint structures.

ARTHRITIS IN HUMANS
(AND HOW THIS CAN HELP YOUR DOG)

In a 2017 study, twenty (human) patients with knee osteoarthritis were treated with localised muscle vibration therapy (LMV), with some pretty amazing results. The group who had LMV could climb stairs faster and had increased “knee flexion” after the treatment. [3]

After vibration therapy to their quadricep muscle, the people in this study showed improvements in standing up from sitting, walking and climbing stairs and not just that, but also reported “a significant reduction in pain” [4]. But how did they measure this? They used the WOMAC Index.

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ARTHRITIC JOINT PAIN & THE WOMAC INDEX

The Western Ontario and McMaster Universities Arthritis Index (WOMAC), was developed in 1982 at the Western Ontario and McMaster Universities, and is widely used in the evaluation of Hip and Knee Osteoarthritis. It is a self-administered questionnaire consisting of 24 items divided into 3 subscales: pain, stiffness and physical function.

Pain is assessed in 5 ways: during walking, going up or down stairs, sitting or lying, and standing upright.

Stiffness asks patients to rate stiffness after first waking, and also later in the day.

Physical function rates 17 different items: using stairs, rising from sitting, standing, bending, walking, getting in/out of a car, shopping, putting on/taking off socks, rising from bed, lying in bed, getting in/out of bath, sitting, getting on/off toilet, heavy domestic duties, light domestic duties.

Patients are asked to rate their pain, stiffness and physical function on a scale of 0 to 4 and the results are tallied to give a total WOMAC score.

WOMAC is available in over 65 languages and has been linguistically validated. [5]

The researchers used the WOMAC index to measure the difference people felt before and after the vibration therapy. You can see the difference in the results from the patients who received vibration therapy (LMV) in figure 3. The group who received vibration therapy are shown with a white dot.

The 2017 study of patients with arthritis treated with vibration therapy showed an improvement in WOMAC index in the treated group. Standing up from a sitting position and walking (called a timed up and go, or TUG), and climbing stairs are two of the most used bed-side functional tests to assess participants with pain due to osteoarthritis of the lower limbs, and improvements were observed in both these measures. [6]

In fact, vibration therapy was considered to be effective for pain control because it had a much more specific mechanism of activation of the gate control compared with TENS because of its specificity in activating highly myelinated fibers [7], and therefore with a strong homotopic gating effect [8].

The study also showed that these effects were long-lasting, with patients’ improvements “statistically observable 2 days after the end of the vibration sessions” [9].

So what does all this mean for your dog?

Well, for dogs with arthritis, who have trouble exercising, vibration therapy could increase their joint mobility, make it easier for them to climb stairs, and reduce the pain they feel.

This study was important because it showed that pain from arthritis can limit active exercise, and muscle weakness can make arthritis even worse! Vibration therapy was introduced “as an alternative with the aim of providing muscle strengthening” [10].

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DECADES OF RESEARCH, BUT IN HUMANS!

It turns out, vibration therapy has been studied (in humans) for decades.

For several years, researchers in the fields of physical therapy and allied health have been researching “Whole Body Vibration” therapy, examining the impacts this has on muscles, strength and power, and the potential for whole body vibration therapy to be used “as an alternative to traditional exercise programs.” [11]

A study (on humans!) from 2008 looked at skin blood flow improvements from whole body vibration and found that just 5 minutes of vibration therapy led to a “significant increase” in skin blood flow in humans. [12]

Why is this important?

Well, increased blood flow, or just plain old improved circulation, plays an important role in tissue healing, increased muscle flexibility and strength [13] and can even prevent bone loss due to osteoporosis [14].

The 2008 study concluded that vibration therapy was a good method to increase circulation, especially when compared with some of the alternatives: heat packs, which can cause burns when used incorrectly, and medications, which can have side effects [15].

Of course, exercise also increases circulation, but as the study pointed out, that can be difficult for older people (and dogs!), so vibration therapy offers a safe and effective alternative.

Another study in 2007 looked at whole body vibration therapy and the impact on blood flow to the lower extremities. This study was comparing skin blood flow (in humans) after exercise alone, after vibration therapy alone, or a combination of the two. Now, you would think that the combination of the two would show the greatest increase, right? Well guess what? The group receiving only vibration therapy showed the greatest increase in blood flow. [16]

One of the reasons for this was that during high intensity exercise, “blood flow is directed away from areas where it is not immediately needed” [17] (p.75). So, in other words, blood flows to organs and large muscles during exercise, rather than to the hands and feet.

The authors of the study concluded that vibration therapy could significantly increase skin blood flow and that this would be effective “in populations where aerobic exercise…is not feasible.” [18]

An area of medical research where vibration therapy has been studied in some depth is wound healing. Circulation plays a vital role in wound healing and a study of people with leg ulcers from 2002 showed that vibration therapy three times a day for 30 minutes resulted in 62% of leg ulcers healed in 12 weeks, compared to only 40% healing rate for compression bandages alone. [19]

Even more interesting was that 81% of the participants in the study reported either a complete absence or a reduction in pain. So just having vibration therapy three times a day reduced the pain from a nasty wound like a leg ulcer.

Increased mobility, pain relief, improved circulation, wound healing, muscle strengthening and maintenance… these are all areas where vibration therapy has been shown to work in humans.

So, what about dogs?

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30,000 YEARS OF ANIMAL INSTINCT
IN OUR DOMESTIC DOGS

Dogs descend from pack animals. 30,000 years ago, the only dog on planet earth was the wolf. All dogs are descendants of the wolf and over time these breeds have grown to approximately 440+ different breeds today.

“We raised puppies well before we raised kittens or chickens; before we herded cows, goats, pigs, and sheep; before we planted rice, wheat, barley, and corn; before we remade the world”. – Ed Yong”

But here’s what most people don’t know about this 30,000 year old animal instinct…

Dogs go to great lengths to hide their pain. Signs of weakness made a dog the weak link of the pack. Not only did it become vulnerable to predators, but even to its own pack that had to remain strong in order to survive.

So what does this mean to our domestic friends?

It means if your dog is limping, it has already been hurting for some time. And if you’re like me, the thought of them suffering in silence for some time sits a little uneasy – almost like we’ve neglected to notice but it’s not your fault. Dogs are good at hiding their pain because of this 30,000 year old animal instinct.

“Asking an old lady to exercise on her arthritic joints is the equivalent of cruelty in dogs.”

There are other ways to get the same benefits of exercise without the pain infliction. It’s the essence of what we’re doing here at Dog Cloud to help educate Dog Lovers globally to better care for their best friends.

Podcast Transcript

Scott: Welcome to another Dog pod. You're here with Scott Groves and Dr. Kevin Cruickshank. We welcome you back again, Dr. Kev.

Dr. Kevin: Thanks Scott. What a beautiful setting. I do not know where people listen to us, but it can't be better than where we are recording it.

Scott: It is a pretty nice part of the world and it is a gorgeous day here again, so welcome everybody. This week we are following on our little three part where we are talking about sort of small, medium, and this week we are up to large dogs. So we thought we thought we'd dive into some of the common issues, and I guess things that dog owners should know about some of the larger breeds, and how they can care for them better, and some of the things that we could talk about as we get into the large breeds. But I think as we cover large breeds, first to probably mention a few of them because we have got giant breeds. We are going to group them all together a little bit today.

Dr. Kevin: Yes, I think it makes a lot of sense to talk about large breeds and giant breeds. We kind of refer to large breed dogs as adult size over twenty-five kilograms, and probably the giant breeds over forty or certainly over fifty kilograms. So a lot of our popular family dogs fall in this these categories. So breeds like Labradors, Golden Retrievers, Rottweilers, Dobermans--they all are large breeds. When we are thinking of giant breeds, you think of the obvious ones like Great Danes, St. Bernard's--

Scott: Bernese Mountain?

Dr. Kevin: Bernese Mountain dogs, they are lovely dogs, really are. And a lot of our Mastiffs as well, Bull Mastiff, and then there'S Neapolitan Mastiffs is a very big dog as well.

Scott: What is the biggest you have seen? Is it typically Great Danes would get as big as any dog?

Dr. Kevin: Great Danes are quite a lean dog actually, so physically in size and how tall they are, yes probably some of the biggest, but may not be the heaviest.

Scott: Right.Dr. Kevin: I think Neapolitan Mastiffs are probably some of the heaviest and and biggest in size. They can be the size of a Great Dane and as stocky as a Rottweiler sort of thing, and we have some very large and muscular Rottweilers. It is not uncommon to see them up sixty-five, seventy kilograms. So that requires a bit of a team effort when we have them in the clinic as well, and we have hydraulic lift tables and lifts to manage those sorts of sizes of dogs as well.

Scott: This is something I was going to ask you about today because in thinking through this because I knew what was coming this week, I thought, you know, as dog start to age, and I know what you guys do, you are essentially almost training them up onto a table at a vet. But what do dog owners do when they have got a really big dog in their home, and the dog starts to struggle later in life.

Dr. Kevin: That is actually quite a practical consideration, definitely. Even just taking them out for walks and getting them into their vehicles, and that sort of thing, you can get a lot of very good either cut purpose-built available in pet stores ramps, and that sort of thing to get into the back of a vehicle. That sort of thing, or a lot of people make their own. So that is a practical consideration because you can not be lifting even a forty, fifty kilogram dog is difficult lifting into the back of an SUV or something like that. And then sometimes ramps over the steps, or stairs at home, if they are starting to battle there as well, that is a consideration. But I see photos of big dogs, German Shepherds, lying up on the bed at home and that sort of things that people that sometimes take top place. And even partners getting relegated to the spare bedroom or something like that. People adjust and accommodate. They also take up a fair bit of space just for their beds and sleeping and that sort of thing as well.

Scott: We are aware of that one. Okay. So let us talk about some of the common issues with the larger dogs. Obviously being longer limbed animals, the hip dysplasia certainly becomes a lot more common as a condition with these larger dogs. Is that a good place to start?

Dr. Kevin: Yes, I think so. I think a lot of what we might be talking about today is orthopaedic conditions. So hips are definitely one that some of them, and interestingly some of the breeds do not have as much of a problem with hips. And then their knee joints moving down the back legs, so the knees or what we refer to as the stifles, and the biggest problem there is cruciate disease--ruptured cruciate ligaments, or the equivalent in humans is an ACL. So we do see that a lot more commonly in a lot of these larger breeds of dogs. And moving to the front legs, elbow dysplasia is now becoming much more recognized than hip dysplasia has been known about for many years, but you can actually get. So when we talk about either hip or elbow dysplasia: it is not actually a disease directly itself, but it is an increased risk of getting severe arthritis in those joints. And that normally means the dysplasia really refers to the bad shape of those joints. So hip joints that aren't a perfect ball and cup shape quite often either the cup part of the joint is too shallow, or the shape of the head which is like the ball part that fits into the joint that shape is incorrect or at an abnormal angle. And so those make those joints often not as stable and that predisposes them to getting severe arthritis. Just because a dog has bad hips visibly, like on an X-ray, does not necessarily mean that they are going to suffer with symptoms of hip dysplasia. You can do other environmental things as well to help minimize that.

Scott: Ok.

Dr. Kevin: Even before we get to actually diagnosing it, trying to reduce these problems in the breeds, they have been known about for a long time. Selective breeding is a very important thing because if we can try and breed from dogs that are known to have better hips than average in the breed, then we can have far less problems, or less likelihood that the offspring are going to have bad hips as well.

Scott: Okay. And if they are above average in that, I guess assessment. They probably should not be breeding. Is that--

Dr. Kevin: Correct. That is the way the selective breeding works. So you get the parents that you are intending to breed with, they need to be an adult dog before these changes can actually be seen on x-rays. So they have x-rays in very specific positions, and then those x-rays--actually your regular vet can look at them and have an opinion as to how good or bad those hips are. But actually there is a list of certified hip scorers that these get sent off to and different countries all have their official schemes. They get sent off to a special radiologist who will then look at very fine criteria and come up with an actual score for each hip, and then it is known from all the dogs over the years that have had been hip scored--this process we refer to as scoring--and you can know the average for the breed. And so if a dog is better than average that's going to be a good one to breed from. If its scores are worse than average, then you rather do not breed from that dog because it is likely to push the shapes of the offspring into a worse position.

Dr. Kevin: The difficulty comes if you have got one really good hip and one not so good hip. And of course dogs are not only born with hip problems, so you have got to look at the rest of it. In a lot of these breeds something like labradors, they can get various genetic eye problems. So cataracts is an example. So you might have everything else in the dog is perfect--It does not carry the genes for the cataract problems, it does not have heart conditions, and one of its hips is marginally bad, and the other is very good--well, you might still choose based on the net assessment of the dog. It is still a good dog to breed. Never forgetting the temperament as well. You really want to choose when you are breeding. So it is a very complicated thing when they are breeding. But if you have got an outlier that has got a really bad, sort of double the average score, well that might knock it out. It is sort of like a veto that everything else might be perfect about the dog breed, but then should not be bred from.

Scott: How much of this comes back to the ethics of breeders?

Dr. Kevin: Very much. It is down to the integrity and the ethics of that individual breeder because there is no compulsion to actually have hip scoring. Obviously if they can provide evidence that the parents have been very healthy and good, they should be able to have a better reputation as a breeder and command a better price for their puppies. So it is in their best interest to do as much of this testing ahead of breeding. But there is no obligation. You do not even have to be a registered breeder to breed. And so that is also my advice to people looking at getting a new puppy: do your research; ask for these bits of information; have the parents been eye-tested, heart-tested and hip-scored.

Dr. Kevin: And nowadays as well as hip scoring, there is also elbow scoring. So the elbows are complicated joint. It is actually three bones coming together. So two below the elbow--the radius and the ulna, and the humerus above. So if there is a little bit of abnormality in the shape, they can very quickly get arthritis later on in those elbows as well. So in the same way the elbows can be scored as well.

Scott: I have got about fifteen questions that has just come out based on what you have just said in the last five minutes. I want to backtrack a little bit a couple of things that we just sort of talked about. Hip dysplasia- I find in conversations with other dog owners, the true definition of dysplasia is quite confusing. Because I think a lot of people think of it like it in terms of displacement where something is moved. So what is the true definition? What is the best way to fully understand dysplasia? You mentioned the shape of the bones.

Dr. Kevin: Yes, so you could put really dysplasia as misshapen. It is just the wrong shape. So it is the how perfect the joint really is. And then what that leads to is, especially so a hip joint is a sort of classic joint, it is a ball in a socket. And if your socket is not really tight around the ball, and so I am using my hands and unfortunately the listeners can not see, but if I mean basically showing a very flat sort of almost an open palm versus a cupped up hand. If it is very flat then there is a lot more wiggle room for the ball part to move around. The body does not like that instability and what it tries to do to stabilize that is create new bone on the edges. That is actually what arthritis is. Arthritis is new bone being put down and it is trying to stabilize the joint, but instead it actually starts impairing the joint and causing pain. So arthritis is inflammation in any joint and very commonly new bits of bone growing around the edges of the joint.

Scott: And that agitates the ligaments?

Dr. Kevin: And it also limits the range of motion of the joints as well, so that is why they have a very stiff, awkward sort of gait. So that is a slow process. Now if you have got a badly shaping hip but you do not overuse that hip, you are probably not going to get a severe wear and tear on that joint, so to speak. And so if you don't over exercise that dog when it is very young, but you also keep up good exercise so that it does not get overweight.

Scott: Yeah. It is a big problem with big dogs.

Dr. Kevin: Absolutely, and yes they are carrying heavy weight. And that is also why that next problem that I spoke about the cruciate ligament problem--

Scott: Yeah, that is what I wanted to circle back to. Let us dive into that. Explain that. When you say cruciate sort of disease, what is actually happening? Like what are you seeing in the joint?

Dr. Kevin: So cruciate disease is just a group term for, the most common thing is the actual cruciate ligaments tears, but it does not necessarily snap instantaneously. It is a wear and tear disease. And so we don't often see it in dogs even younger than five. We have a bit of an acronym: fat five and female. Not fully understood why female dogs are a little bit more prone than males. It's like a 60/40 split, so it is not a big difference. But definitely overweight dogs, fat over five years old because it is a wear-and-tear thing. So if that ligament tears 10% you still got 90% of the ligament there. It is like a rope that is fraying. You are not necessarily going to see it. The dog might be a little bit sore for a day or two, and then walking around fine. So you didn't realize that necessary that actually a little bit of the ligament frayed and tore. And then over the years wear-and-tear it suddenly--they might just be doing one exercise, running down some stairs, jumping to catch a ball, or something, and then the last little percentage tears and suddenly they pull up lame.

Dr. Kevin: So that is also to do with, often, the shape of the knee joint itself and various quite technical angles of the bones in that joint. So dogs at stand with a very upright stance. So another large breed that we have not mentioned yet, the Boxers, they are typically a breed that stands with a very upright stance. If you look, they do not have much bend in the knee and the back leg really, they stand quite upright. And that predisposes, puts more strain on that cruciate ligament. So the job of the cruciate ligament is to stabilize the knee joint. It runs inside the joint and it stops the knee moving backwards and forwards in the joint. So when the dogs tear the cruciate ligament, initially it is sore, but it doesn't actually stay that sore longer term, but they still can not use the leg. Because every time they try and take weight, they just have a feeling of it collapsing or giving away on them. So then it is quite a technical thing about the different, but nearly always they need some form of surgery. There's very many different techniques of correcting that, but once they have had that surgery, they normally go very well. They can still unfortunately damage the meniscus in the joint which is part of like the shock absorbency. So definitely--

Scott: So like that gets worn away?

Dr. Kevin: Or tears actually because there is too much movement in the joint and then the meniscus can get a tear in it. So that is often checked during the time of surgery and addressed. If it has got a little tear then we correct that at the centre.

Scott: Yeah. Now that is a great understanding of that. With the breeding, you mentioned the averages. And now I want to circle back to one breed which is the Labradors, and we have spoken about it off podcast, but it is hard to find a good Labrador, you were saying, with good hips because they all tend to be fairly high in some--

Dr. Kevin: But because of breeding and selective breeding over the years, I think there has been a marked improvement in the last fifteen to twenty years.

Scott: That is great.

Dr. Kevin: We used to see it even worse. And that is why these schemes were put in place and through breeders doing the right thing. So yes, you got to be realistic that you can not expect hip scores of zero. But for example in the Labradors, the breed average is about 8.2. And it is a scale that goes right,--there is not necessarily a top point, but very bad hips can be twelve, fifteens sort of thing. So eight is actually in the scheme of things not that bad. And if you have got a dog who has got a four on one hip and a five on the other, that is really doing well better than average. So that is a good. But you might have a dog that has a two on one side and a ten on the other, that becomes a tricky decision and maybe the mother has fours or five so very good, and the father has two, an excellent hip on the one side and and one hip that is not so good. But as we were talking earlier, there might be lots of other considerations that you would still find that an acceptable combination of two dogs because there are so many other factors as well. And yes, you can not really expect to find in many breeds like that, a dog that has no problems with its hips at all.

Dr. Kevin: Another breed that has unfortunately quite a bit of hip dysplasia is German Shepherds. And amazingly even some of the smaller breeds--Pugs, if you look in the average...

Scott: Also Rottweilers as well...

Dr. Kevin: Unfortunately they get on quite a lot of hip dysplasia, they are very prone to cruciate problems as well.

Scott: What can a dog owner do, let's say I have a mate growing up and he always had Rottweilers. And he was always concerned about their hips, I remember even from a young age. What can a dog owner do? Is it matter of just keeping weight off, keeping good exercise, good mobility?

Dr. Kevin: Careful exercise. A tip that I would give people is avoiding, a lot of these breeds love fetching balls and that. But keeping them on the ground and not encouraging them to bounce and jump when they are excited. So throwing frisbees, and jumping up in the air, coming down and landing can be quite a jarring thing either for the knees or the hips. So also having good obedience with their dog that you might actually throw the ball, keep the dog at the side, and once the ball has stopped, let them go and fetch it. Because that sudden trying to stop and chasing a moving ball can be very jarring and damaging as well.

Scott: Yeah. That is a great tip. Excellent love that. With some of the other breeds when you start looking at probably some of the more, I guess winter Saint Bernards, some of the big Huskies, Bernese Mountain dogs--what sort of common conditions might you come across there? And then we will get to Great Danes in a minute.

Dr. Kevin: Quite a lot of them... slobber a lot! And that is the big lips that they have. Funny enough there is a type of cosmetic surgery, technically cosmetic, but it actually can be really helpful to keep that slobber more in their mouths. It is not commonly done. It is something that people know the breed does. It is not a medical problem, but unfortunately also, being considerate to the climate where you live. Like here on the beautiful Gold Coast, having a St. Bernard even a Bernese mountain dog, we have actually got quite a few Bernese Mountain dogs. They are very popular breed at the moment and they cope pretty well with the heat. But St. Bernard, they do suffer a lot and so not exercising them in the heat of the day. They can suffer from heat stroke very easily.

Scott: Would you keep them clippered more?

Dr. Kevin: You certainly can. People are more looking for the authentic breed, would rather not have them shaved. Sometimes that long hairy coat actually provides insulation from the heat just like you find woolly sheep in really hot climates in the outback, and that sort of thing. The wool insulates them from the heat as well. So the to the degree that happens, and also the dogs living in a hotter climate will not develop as thick an undercoat as if they are in a colder climate. They have grown up with it through their lives.

Scott: Yeah adapting over the years. Yeah.

Dr. Kevin: We just got a beautiful example of a German Shepherd walking past, a lovely lean one. They are actually a dog that a lot of people look at them and say they are far too skinny, but they are naturally actually a working dog, and they are very lean. They are very athletic dogs as well. But just seeing that beautiful one walking past reminded me of another condition that unfortunately they very prone to. They have got a very deep chest and breeds with deep chests. And so another one classically is the Great Dane, are prone unfortunately to gastric torsion. And it is a condition that people consider in having those breeds or who have those breeds really need to know about, because it is one of these things that can be an absolute emergency.

Scott: So what happens?

Dr. Kevin: Yeah, what happens with this is that their stomach which is actually hanging in the way that a dog is standing horizontally compared to us standing upright, their stomach is hanging from underneath the back. And for various different reasons, and they are not fully understood, that stomach can actually twist on itself. And then what happens is then the gas that is in the stomach can not get out, the fluid can not get out anywhere. It is of course extremely painful, and the the gas very quickly starts to build up and it actually pushes up against the diaphragm. They battle to breathe and they start to go into a medical type of shock, and within an hour or so, it can be fatal. It causes a lot of problems for the heart. The heart can't circulate the blood of course wind the whole intestine and the stomach is twisted, none of the blood can move through those twisted blood vessels, as well. So it is something that needs emergency treatment right away, whether it is the middle of the night, or daytime, and it very often does happen in the evening time.

Scott: Why is that?

Dr. Kevin: It is often associated with eating too close on exercise. So either eating first and then going and exercising, or even if they have come back from a big walk and then are fed very soon. Some of that is various hypotheses as to what is happening. And if they are swallowing a lot of gas when they are eating, their stomach can fill up. If it fills up with a lot of air and gas, we think it is more prone to twisting on itself. Very much so if they eat and then go and exercise, then the running around this coming back to their shape the deep-chested nature, there is a lot of space for that stomach to twist on itself. So if it is hanging and it has got all the for heavy food and it is swinging from side to side as they run, we think it just suddenly flops right over.

Scott: Pendulums right over?

Dr. Kevin: We have actually got to be also careful in the hospital. If we have got them under anaesthetic, if we are turning them over to operate on the other part of their body, or move them from one area of the hospital into the theatre or something like that, we also got to be very slow and gentle that we do not just flip them too quickly because you can flip their stomach as well.

Scott: Right. Wow so crazy.

Dr. Kevin: It sometimes starts where they don't necessarily have the full torsion where they are not twisted, and they have just got bloat. And then that is easier to address. We normally give them an aneesthetic and put a tube down their throat. Let that gas all out. And if you have caught them then before they have actually twisted, then they do not always need surgery.

Scott: What symptoms is a dog owner going to see?

Dr. Kevin: I think that is really important that we chat through this one because it can start off just looking like the dog's unsettled. It is restless, can not lie down, and you sort of say, "What is wrong? We have just gone for a walk. Why are you so restless?" And then very quickly they will often be trying to vomit, but most times nothing coming out. But just a bit of a retch and a retch, and they look quite quickly over twenty minutes or so, they just seem to get a lot worse. They are uncomfortable. They are lethargic, and then you might notice that their stomach is swelling. And it actually swells right up and it can be taunt like a drum. So you actually just tapping on the stomach, the stomach looks a bit bloated. They might look sort of pregnant, but it can be difficult to miss that. You would think it is so obvious, but a lot of that is underneath the rib cage.

Scott: And that is more stomach than chest? Is that where it is coming out?

Dr. Kevin: Correct. So just behind the chest, there is a whole abdomen area. And by the time you see that, it is definitely a run do not walk situation. Get to an emergency clinic straight away. But yes, the unproductive attempts to vomit, and sudden lethargy, and unsettled nature, those are the most common early symptoms of it.

Scott: Is this just something that can happen quite randomly across these breeds like German Shepherds? Is there no way of pre-checking it as part of a breeding process or part of identifying it--

Dr. Kevin: Different to what we were talking about with the orthopaedic problems, we can't screen for it, and it has not really got a genetic link. So much so that because it is quite a high-risk factor, we do all the work for the Gold Coast police dogs, and progressively they have put each one on a bit of leave and we have done a preventative surgery for them called a gastropexy. What we go in then is before they have ever had any symptoms of it, and we actually go and permanently stitch the stomach to the side of their abdomen, so that it can still bloat up, but that's not life threatening.They could still get a lot of gas building up, but it will not ever twist on itself because it is attached in one point. So it takes a bit of recovery and it is a moderately costly operation, but I think in any of the breeds that are prone to it--so your Great Danes, your German Shepherds, Dobermans, and deep-chested dogs--it's well worth considering. We often offer that if we desexing one of those breads, whether it is a male or a female, to do that operation at the same time. Because they are still a young dog, they are under anaesthetic anyway. Moderately costly operation. It is technically very challenging for us, but they recover so well. There is very little complications or problems and it is a lifelong prevention for them.

Scott: Yeah. That's great.

Dr. Kevin: That is a very good thing to get done early.

Scott: It is a very good thing to be aware of, is it not?

Dr. Kevin: Absolutely. So it is called, just for people listening, gastric torsion or it also goes under the acronym of a GDV-gastric dilatation volvulus is a bit just remember GDV.

Scott: Internationally does it have any other names?

Dr. Kevin: Also referred to just as bloat.

Scott: Okay.

Dr. Kevin: So gastric torsion, bloat, GDV, they are the most common names for it. And so the other tips for people preventing it is not feeding your dog and then exercising. And I am not just talking about going for a walk, even just bouncing a ball, throwing, playing around in the backyard or in the kitchen or whatever soon after eating. Also not waiting quite a long period once it has gone for a walk, recovering from that so that it is not--

Scott: How long are we talking about?

Dr. Kevin: I would wait up to an hour before feeding, and that is thought to be because they are still breathing up quite heavily, and they are probably sucking in a lot more air when they eating their food. They are enthusiastic to eat their food and suck up air.

Scott: Some big dogs eat at a million miles an hour too--

Dr. Kevin: Absolutely. Some people are very critical of feeding dry foods then to these breeds because the dry food itself can swell up and bloat. I don't think there is a direct big problem, that has been looked at and researched a lot. But sometimes adding some water to that food can be a helpful thing. Feeding twice a day instead of once a day so that they are getting a bit of a smaller meal each time.

Scott: Right. So it's not a big large meal? Yeah, right.

Dr. Kevin: Yeah. So those are things sometimes it is thought also feeding a bit from a height, so putting the food bowl up on a little bit of a platform, on a step, then they not bending down as much. The thought is maybe they are not going to suck in as much air. That's not such a big issue there.

Scott: Yeah, great. Have we missed anything with the larger dogs?

Dr. Kevin: Quite a few of them unfortunately are prone to ear infections. Again, sometimes to do with their behaviours. So dogs that love swimming are going to get more ear infections--so your Labradors, Golden Retrievers, unfortunately. The dogs with either floppy ears coming down or big ears that are like big funnels and let everything go in, like a German Shepherd, unfortunately can be quite prone to ear infections. And skin infections, some of them, unfortunately I keep seeming to be picking today on German Shepherds, but some of them--

Scott: They are really popular, aren't they? I mean they are used as police dogs almost all over the world. They are beautiful dogs. Very intelligent.

Dr. Kevin: But unfortunately they do just seem to be quite prone to certain skin allergies, very sensitive skins as well. Seem to get yeast infections quite easily. So ear infections, my tip there is pick up on it early because they can become chronic recurring problems. Head-shaking is one of the first signs just seeing a dirty waxy area at the outside.

Scott: Okay, and in terms of prevention and maintenance, same with the sort of stuff we spoke about with some of the medium dogs or the fairy dogs, keeping clippered.

Dr. Kevin: Yes. Sometimes a routine cleaning with an ear cleaning liquid. Certainly after swimming it is a very good idea. Once a week or once a fortnight just doing an air cleaner is good.

Scott: In the medium dogs and in multiple other episodes, we have talked a fair bit about teeth and dental hygiene. Big dogs naturally have pretty strong bites and I imagine they are, I don't imagine I know, they are biting into all sorts of different things, particularly through either boredom and other stuff as well. Bones as we spoke about in the last episode with medium dogs, and the danger of bones. Talk us through teeth and dental with large dogs. What do we need to be aware of?

Dr. Kevin: Fortunately, I think it is one of the things that they seem to suffer a lot less with. We do not see as rapid a build up of calculus and tartar on them, with one exception being Greyhounds. Unfortunately, they, for whatever reason their local immunity in their mouth, they suffer from a lot of very bad dental disease. Greyhounds do, almost irrespective of diet, and that sort of thing. So Greyhounds having them have a scale and polish early to try and look after those teeth. Keep them healthy is a very good thing.

Scott: Is it the same for Whippets or some of those long snitch breed?

Dr. Kevin: No, no, sure because those long-snouted dogs definitely. Whippets, Italian Greyhounds also seemed to have, and again a smaller breed but a Dachshund, those long snout seem to just also get dental disease a lot worse. But for the rest of them, the large breeds have far slower buildup of tartar. Some of that is diet-related and chewing on things, but I think it is just more a lucky thing that theirs are not as bad.

Scott: Is it because they got bigger mouths?

Dr. Kevin: I think so. The teeth are not as crowded in, definitely. And and also the type of diet, and how much they spoilt, and soft foods, and that sort of thing. But some big breeds, like Rottweilers, tend to get a lot of chipped and actually broken teeth because they have got such a strong jaw and they might be chewing on something that they should not be. So we do see them having quite a few broken teeth sometimes. But teeth problems not too bad. And as a general rule, skin problems not too bad other than like I am saying some of the German Shepherds can be prone to skin allergies.

Scott: Is the skin allergies noticed in the same areas as we spoke about in the last episode with Bulldogs? Is it a lot of groin?

Dr. Kevin: Yes. Lower ventral abdomen and in their groin area. Their paws, quite a few of them get a lot of skin infections in between the toes and their paws. And then some are more breed-specific, Boxers are quite prone to some hormonal skin problems, having an under active thyroid gland sometimes as well. So that is something they suffer with a bit.

Scott: Interesting. Well as always you are a wealth of knowledge, Dr. Kevin. Thank you for being with us. I do not think there is anything else before--

Dr. Kevin: I think they are a lovely group of dogs, that are working dogs. They can be family dogs. Wonderful, you know that you can get out and do a lot being--

Scott: Just because they're big, I think some people fear them, don't they? And like Great Danes are some of the biggest sooks on earth.

Dr. Kevin: But it is also very important to do good obedience work in the early stages so that you have got control of a big dog, because some of them can be very aggressive. And we have not had really much time to talk about behavioural issues, but you can have behavioural problems with some of them, and you want to have good control. So good socialization when they are young and dog training would be my closing remarks.

Scott: Might make a good topic for our next next podcast.

Dr. Kevin: Indeed.

Scott: Thanks so much for joining us. And as always if anyone has got any questions, just follow us on all the socials and feel free to fire through questions and ask Dr. Kevin, and we will do our best to answer them on the next one. But thank you for joining us.

Dr. Kevin: It would be a pleasure to shoutout and answer anyone's questions indeed.

Scott: See you next time. Thank you.

Dr. Kevin: All the best.

[END]

SOURCES:

1. https://health.ucdavis.edu/ctsc/area/education/DETR/index.html

2. https://www.hindawi.com/journals/arthritis/2012/764621/

3. Benedetti, M. G. et al. Localized muscle vibration reverses quadriceps muscle hypotrophy and improves physical function: a clinical and electrophysiological study. International Journal of Rehabilitation Research 40, 339-346 (2017) – https://pubmed.ncbi.nlm.nih.gov/28723717/

4. Benedetti et al, p.7

5. (https://www.physio-pedia.com/WOMAC_Osteoarthritis_Index)

6. Benedetti

7. Lundeberg et al., 1984;Salter and Henry, 1990a, 1990b)

8. (Staud et al., 2011)

9. Benedetti, M. G. et al. Localized muscle vibration reverses quadriceps muscle hypotrophy and improves physical function: a clinical and electrophysiological study. International Journal of Rehabilitation Research 40, 339-346 (2017) – https://pubmed.ncbi.nlm.nih.gov/28723717/

10. Maloney-Hinds, C., Petrofsky, J. S. & Zimmerman, G. The effect of 30 Hz vs. 50 Hz passive vibration and duration of vibration on skin blood flow in the arm. Medical Science Monitor 14, CR112-CR116 (2008) https://pubmed.ncbi.nlm.nih.gov/18301353/

11. Maloney-Hinds, p.113

12. Maloney-Hinds, p.113

13. Maloney-Hinds, p.113

14. Lohman III, E. B., Petrofsky, J. S., Maloney-Hinds, C., Betts-Schwab, H. & Thorpe, D. The effect of whole body vibration on lower extremity skin blood flow in normal subjects. Medical Science Monitor 13, CR71-CR76 (2007) https://pubmed.ncbi.nlm.nih.gov/17261985/

15. Stewart, J. M., Karman, C., Montgomery, L. D. & McLeod, K.J. Plantar vibration improves leg fluid flow in perimenopausal women American Journal of Physiology-Regulatory, Integrative and Comparative Physiology 288, R623-R629 (2005) https://pubmed.ncbi.nlm.nih.gov/15472009/

16. Lohman III, E. B., Petrofsky, J. S., Maloney-Hinds, C., Betts-Schwab, H. & Thorpe, D. The effect of whole body vibration on lower extremity skin blood flow in normal subjects. Medical Science Monitor 13, CR71-CR76 (2007) https://pubmed.ncbi.nlm.nih.gov/17261985/

17. Lohmann et al, p.75

18. Lohmann et al, p.75

19. Wilson, J., Arseculeratne, Y., Yang, Y. & Cherry, G. Healing venous ulcers with cycloidal multidirectional vibration therapy. Journal of wound care 11, 395-398 (2002) https://pubmed.ncbi.nlm.nih.gov/12494831/)

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