Written by Shannon Fujimoto Nakaya, DVM
Mobility, preferably independent mobility, is often a concern in aging companion animals. Partly, this is about perception. We are conditioned to associate animals romping, running, playing with joy and health. But there are many other times when an animal is happy and content without zipping around, particularly older animals. How many 80 year old humans are running marathons or even jogging? Good for them who are and keep it up as long as possible; but many octogenarian humans and their animal equivalents are content with more moderate activity, like maybe a walk on the beach, or sniffing the neighborhood for newcomers (akin to reading the local paper for a dog), or migrating from the sunny spot in bay window to the pillow on the couch in the case of a cat.
Partly the importance of mobility really is about independence and quality of life. An older pet is less likely to care about retrieiving the tennis ball you launch across the field, but being able to get out of the sun and into shade, or being able to get up and go to the bathroom away from where it rests, or being able to accompany the family from room to room . . . those things can contribute to quality of life. As much moral commitment one might have to an animal companion, if that companion is non-ambulatory and weighs as much, or even half as much, as its caregiver, physically helping that companion can fall somewhere between difficult and impossible. So keeping that 150 pound dog able to get up and go out to poop and pee, in some cases, becomes essential to its quality of life and survival. There are non-ambulatory animals that enjoy superb lives; however, there is usually a very dedicated caregiver involved in helping the non-ambulatory individual compensate for his or her disability. Cheers to those caregivers. We will get to that type of commitment later in this book, but this chapter is more focused on preserving and maintaining the mobility that our animals companions do have.
The goals with mobility, at least as I see it, are:
- To maintain and preserve as much independent mobility as possible.
- To avoid or prevent injury.
- To maintain comfort; to avoid pain associated with movement.
So how might we accomplish this:
- Keep your animal companions lean; lean pets age more slowly and more gracefully. Avoid obesity, which is associated with premature aging and more health problems. More on this topic and charts to assess your dog's body condition at www.longliveyourdog.com. Cat body condition charts on this page at purina.com.
- Keep them moving as much as they are able. This keeps things circulating, which contributes to overall health and well being.
- Exercise in regular shorter sessons rather than intermittent long ones; avoid the weekend warrior syndrome.
- Create a safe environment to avoid accidents and injury.
- Provide surfaces with traction: area rugs, runners, foam tiles.
- Safety gates to prohibit access to danger zones.
- Stairs can be a huge and dangerous obstacle for older and handicapped pets. Just try getting down on your hands and knees at the top of the landing and think about going down in that position; it will give you new respect for what our pets have been challenged to do regularly throughout their lives. It is not just the fact that the height of the steps is a larger percentage of our pet's limb length (think about a stairway where each step is half the length of your leg) that makes stairs a challenge. It is also the depth of each step that requires our four legged friends to arch their spine, hop, and then land in a different arched position. It wears and tears on their joints and their spines. Nevertheless, many animals accomplish this feat many times a day, day after day, for years. But it does get harder as they get older. And it can become more dangerous if they slip.
- Carpeted stairs or stairs with traction are better than smooth stairs.
- In areas where are only a few steps, ramps put much less strain on pet's bodies. The slope of the ramp needs to be gradual enough for maximum benefit to the pet. For the three steps into and out of my house, a 1:6 ratio worked for me and my dog. That's still 12 feet of ramp to go up 2 feet in height, and that is half the ADA (Americans with Disabilities Act) requirement for ramps for humans. Ramps need to be sturdy enough and wide enough for an animal to trust them. Railings can be useful to keep unsteady animals from falling off a ramp. Ramps require traction, especially in areas where they can get wet. If your pet has had any type of leg or spinal injury, and you have steps going into and out of the house, and you don't anticipate moving, building the ramp(s) sooner lets your pet get the most benefit out of your investment. Ramps can supports healing, prevent further injury, and make like easier as pets get older. Building ramps was one of the best home-improvment investments I made.
- In areas where there is a full flight of stairs, ramps usually won't cut it. Safety gates keep animals from attempting this on their own. Small animals can then be carried up and down. It is more complicated with larger animals. One of my clients designed and built an elevator using an electric winch motor anchored in the ceiling, two ton rated chain connecting the motor to the elevator box, and guides and castors in the wall to prevent the elevator box from swinging as it went up and down. Clearly, this is an advanced DIY (do it yourself) project and one that could prove dangerous, so please(!) know your limits and contract help accordingly. And again, if you can't carry your pet up and down the stairs, and that pet must sleep next to you, and you're not planning on moving downstairs or to a ranch-style home, then making this investment sooner allows you and your pet to get maximum benefit from that investment.
- Regular nail trimming aids in traction. In both cats and dogs, older animals often do not wear their toenails down as readily as younger animals. When pet's toenails grow to long, they prohibit the the toepads from making contact with the floor. It's like humans with long fingernails can't use the tips of their fingers to type or play the piano. Severely overgrown toenails force an animal to shift weight backwards, which forces hyperextention of their carpi or wrists, and increases stress on their rear legs. In older cats, curved toenails on the forepaws will sometimes grow around the front of the toe and into the toepad causing painful wounds.
- If your pet still has it in him or her to want to and be able to swim, swimming is a remarkable activity for maintaining muscle tone, range of motion, and cardiovascular conditioning. Canine rehabilitation centers utilize heated underwater treadmills and jets to improve coordination and muscle mass in patients with a wide range of conditions that impact mobility ranging from back problems to arthritis. Search "canine rehabilitation" for more information or to find a facility in your area.
- Stretching can help preserve range of motion. A canine rehabilitation therapist or veterinarian can guide you towards the exercises which will be safest and most beneficial for your pet.
- Light massage or whole body rub downs can improve circulation.
- Supplements. There are many joint supplements out there. I am choosing to focus on the most common with the most evidence of efficacy.
- Glucosamines have been scientifically shown to have a protective function on joint cartilage. This in turn prevents and slows joint degeneration and associated joint inflammation or arthritis. Glucosamines are better for preventing degenerative joint disease (DJD) rather than reversing DJD. A patient who is already has DJD and arthritis can still benefit from glucosamines in that it can slow further deterioration; however, the clinical improvement may not be so obvious. Glucosamines are generally very safe and very well tolerated at recommended doses. Rare allergic reactions are possible. Some labrador retrievers were found to get very thirsty when given doses of glucosamines greater than 1000 mg/day. The excessive thirst resolved when the dose was decreased. For pets on glucosamine supplements in addition to glucosamine-supplemented diets and treats, some attention should be paid to total daily glucosamine intake.
- Omega-3 fatty acids can reduce inflammation in dogs. Researchers are studying the effects of omega-3 fatty acids in cats and I expect that we will all know more about this in the next few years. Omega-3-fatty acids are generally considered to be safe and are generally well tolerated at recommended doses.
- In my work as a complementary and alternative care veterinarian, I meet patients who, because of some other health condition or drug sensitivity, can't take many of the drugs commonly prescribed to patients with pain associated with arthritis, inflammation, and degenerative joint disease. Many of these patients will show improved comfort and mobility with acupuncture and Chinese herbals. Acupuncture can also be helpful in managing patients with neck pain and back pain. You can find out more about veterinary acupucnture and find a veterinary acupuncturist in your area through several websites:
- International Veterinary Acupuncture Society (www.ivas.org)
- American Association of Veterinary Acupuncturists (www.aava.org)
- Chi Institute (www.tcvm.com)
- Not all conditions that cause decreased mobility are associated with pain. Not all patients with decreased mobility need pain medications. Still, a number of them do and there are a number of drug options for these patients. All of these are prescription drugs that appropriately require a veterinarian to prescribe and to monitor the patient.
- Non steroidal anti inflammatory drugs (NSAIDS) such as meloxicam (Metacam), firocoxib (Previcox), and carprofen (Rimadyl) are commonly prescribed for dogs. Cats tend to be much more sensitive to these drugs and serious adverse reaction can and do occur; NSAIDS are used much more conservatively in cats.
- Opiate analgesics (pain killers) like Tramadol or Buprenorphine can benefit patients with more severe pain.
- Gabapentin works on the brain and diminishes the sensation of pain.
- The Help-em-up harness (www.helpemup.com) is really helpful for supporting and lifting larger dogs that can still walk but need help getting up. A sporty, light, and functional design that doesn't slip off the dogs, doesn't inhibit movement, and doesn't get in the way of pooping and peeing. The harness is padded and comfortable for the dog and can be worn all the time. The handles conveniently positioned and are easy to grab and hold for effective front and rear end support. Speaking as a petite human, this harness makes it possible for me to support dogs with mobility issues that I would otherwise not be able to lift or hold.
- Orthotics or braces can be helpful for certain types of mobility issues, particularly those affecting a knee, a hock, or a wrist. As with other assistive devices, the best results are achieved when the device is custom made according to the individual patient's needs. Martin Kaufman at Orthopets (www.orthopets.com) is a genius of creative solutions.
- Wheel carts for pets used to be a DIY project for the wholy committed and creative. Thanks to companies like Eddie's wheels (www.eddieswheels.com) and k9carts (www.k9carts.com), custom made wheels for handicapped dogs can be special ordered. I believe Eddie's still tops the specialty market offering custom designs like off-road wheels, front end carts, and quad carts. Even more recently, I've seen a "walkin wheels dog wheelchair" in seven different sizes (mini to XXL) being offered through a pet supply catalog.
Wheels for pets are great assistive devices for dogs and cats that have the coordination and stamina to go on walks. Depending on the pet's condition, however, carts may not be appropriate and can even be dangerous. Once a pet is strapped in to a hind end cart, for example, it cannot easily lie down because its hind end is held in position for mobility. If a pet does not have the strength to stay standing in its front end and pull the cart, it will not benefit from the cart, or worse, could get hurt. Cart wheels can get caught on table legs or corner, and carts can tip over; so leaving a pet in a wheel cart unattended is inappropriate. Wheels for pets are amazing devices when appropriately selected according to the needs of the patient.