Multimodal Arthritis Management: Body Conditioning

This is the 4th post in a multi-part series covering my elbow dysplasia journey. Part 1 covered how it was diagnosed and the specifics of my case. Part 2 covered my surgery and rehab protocol. Part 3 serves as an intro to my philosophy regarding long term arthritis management, and will link to each of the posts detailing the different modalities that contribute to my success. If you haven't read it yet please check that one out first!

Staying lean & strong is the cornerstone to my arthritis management strategy. Look at that nicely tucked tummy!

I know some of you reading my arthritis series really want me to get to the "good stuff" about supplements and stem cells and such. And I will, but IMO it's really important to start with the basics! All the treatments and interventions that we're going to discuss in upcoming posts will be of limited benefit if we aren't layering them on top of a solid foundation of healthy weight and good conditioning.

The Importance of Maintaining a Healthy Weight

A 2022 study found that a whopping 59% of dogs in the United States are overweight - and that only 17% of owners realized it. The general public has gotten so used to seeing overweight and obese pets that it's considered normal.

This is a double whammy for arthritic dogs. Not only does excess weight put additional load on joints thereby increasing their mechanical wear and tear; but adipose tissue (fat) actually produces pro-inflammatory cytokines, which adds inflammatory strain to those already stressed joints. In other words: carrying excess weight accelerates arthritic progression both mechanically and biochemically. And although in this post we're only focusing on arthritis, please note that in dogs obesity can also contribute to several other serious health concerns. Large retrospective studies have shown that for any given breed tested, lean dogs live 6 to 30 months longer on average than their overweight counterparts of the same breed.

Staying (or getting) lean is probably the single most impactful thing a dog can do to slow arthritis and mitigate its impacts. For obese dogs with arthritis, a modest loss of 6-8% of bodyweight even with no other interventions has been shown to significantly decrease lameness.

For long-furred dogs like me it can be impossible to tell at a glance if a dog is overweight because you can't see where the fur ends and body begins! And different dogs have different body types and builds - a lean bulldog is going to look vastly different than a lean greyhound. So a visual inspection isn't enough; it's important to get hands-on when you're evaluating your pup's body condition. While your dog is standing squarely, get your fingers under that fur on their sides and slide them back across the ribs, over the waist, and across the hips. Run your hand along the spine shoulder to tail, and again from the deepest point of the chest up to the leanest part of the waist to determine:

• Can you feel the dog's individual ribs, hip/shoulder bones, and the bony projections of their vertebrae (spinal processes) easily, while still feeling a breed-appropriate level of muscling?

• Do you feel a defined waistline between the ribs and hips, and a breed-appropriate "tuck" from the chest to the abdomen?

  
  

Compare how your dog feels with the descriptions in Body Condition Score chart below:

Canine BCS Scoring from the Association for Pet Obesity Prevention

My pawrents monitor both my Body Condition Score (BCS) and my weight. I'm kept no higher than 5 BCS which for me corresponds with a weight of 91-93 lbs. as measured on my home scale. To maintain my weight, they increase or decrease my daily calories according to my activity level. In the fall/winter when it's colder and I'm extremely active, I get extra food and snacks. In the summer when I am not as active, they cut my portions down accordingly.

It's really helpful to have a home scale to track your pup's weight consistently so that you can make adjustments quickly before too many extra pounds are gained or lost. Even for larger breeds there are some reasonably priced scales online; and they are well worth the investment! The one I use is an older Redmon model but it's similar to their current XL Platform Scale. Home scales may register a little higher or lower than your vet scale, so whichever you're using to track weight make sure it's always the same one.

If your pup needs to lose (or gain) weight, I recommend checking out the resources available at The Association for Pet Obesity Prevention, and to first consult your vet to ensure there no other health conditions (e.g. hypothyroidism, cancer) affecting your pet's metabolism. Your vet can also assess your pet's BCS and will identify a healthy target weight range and target daily caloric intake to get there.

In some cases weight loss may be as simple as a slight reduction in a dog's usual food, or (gasp) fewer treats (as unpopular as that might be). But in other cases you may need to switch to less calorically dense foods, change the balance of protein/fat/carbs in the overall diet, or decrease food but add supplements in order to maintain balance of essential nutrients. Feeding philosophies are a controversial topic that I won't get into just yet - the topic deserves its own whole post. For now I just want to convey the importance of finding a feeding strategy that allows your dog to maintain a healthy weight.

If your pup is on the extreme high or low ends of the BCS range, their caloric needs may be out of balance with the nutrient ratios in many commercial foods. You might want to consult with a veterinary nutritionist to formulate an effective diet plan that is also safe and nutrient-balanced.

Muscle Conditioning and Physical Therapy

Although it's best to err on the side of being leaner rather than larger, I also don't want to get below my ideal range as that would mean losing muscle. As one of my vets is fond of saying, "Bad joints need good muscles." That's because strong, balanced muscles help both to stabilize and to unload compromised joints, reducing their overall wear and tear. So in addition to my regular walking and hiking, I also do therapeutic and conditioning exercises specifically to improve muscular strength, flexibility, and body awareness.

Exercise and conditioning are critical to build and maintain muscle tone - but for a dog in later stages of arthritis, you may first need to get adequate pain control and inflammation control onboard to allow that dog to exercise more comfortably. This is the perfect example of why a successful arthritis management plan must be multimodal.

I'm in the early stages of arthritis and I do implement interventions that fight pain and inflammation - I'll describe those later when we reach the topics of Complementary Therapies and Medications - so I can exercise quite comfortably. But it's important to note that for dogs in pain or dogs who are obese, pain control and weight control might be prerequisites to enable safe exercise and conditioning. Though I'm breaking down the topics individually for purposes of this blog, in reality they are all interdependent.

Hydrotherapy

You may have read in Part 2 of this blog series how I used water treadmill (hydrotherapy) to help build back up after my elbow surgery. Hydrotherapy is useful beyond just rehab - sessions where the water level is up to the dog's abdomen can also be an excellent form of exercise for an arthritic (or overweight) dog. The water's resistance serves to strengthen muscles, while its buoyancy relieves the load on joints. I have continued doing a hydrotherapy session every 1 to 2 weeks since my surgery, and it noticeably benefits my strength and endurance for all of my adventures.

Learning a new conditioning exercise

In addition to hydrotherapy I have recently started incorporating some foundational conditioning exercises into my daily routine both morning and evening. I started monthly sessions with a CCRT / ACVSMR Resident to help with my exercise progression plan, and I can do the exercises daily at home. As I continue to progress in my form and understanding of the foundations, she will prescribe more advanced exercises into my routine. Over time this work should help with my whole-body strength, balance, flexibility and proprioception.

Before adding therapeutic exercises of any kind to your dog's routine for either weight loss or muscle conditioning, you should first consult with a licensed professional, as not all exercises are appropriate for all dogs. Check these links to locate a CCRT, CCRP, or ACVSMR Diplomate to help tailor a plan to suit your individual dog's needs, conformation, and condition. Many of these specialists offer virtual consultations if there is not one in your local area.

While conditioning exercises use active functional motions, my rehab vet has also guided us to learn a few Passive Range of Motion (PROM) stretches similar to what you'll see in linked videos for both forelimbs and hindlimbs. These don't do much for me with regards to actual conditioning, but they're really useful for mom to assess whether and where I might be experiencing any pain or stiffness that merits additional treatment. With her hands providing the support and guiding my movement, she can feel when I'm moving freely vs. when I'm I resisting a particular motion. As with everything else, if you are considering doing PROM with your dog, please consult your vet first, as some motions may be contraindicated for some conditions.

In Conclusion...

This post has focused on the fundamentals of how I help my body meet the demands of my lifestyle. In the next post we'll turn that around and discuss how my pawrents control my environment and lifestyle to meet the needs of my body. Stay tuned!