Recognizing and treating pain in your older dog
Let's be honest: changes in the behavior and movement of an old dog usually come on gradually, and we hardly notice them or don't want to see them. The dog was still in great shape just recently! How can it be that he suddenly no longer jumps on the sofa, that his hind legs tremble, and he sleeps almost the entire day? The everyday life of an aging or old dog changes. Whereas he used to kick you out of bed long before the alarm clock rang, now you wake him up and force him to take painkillers and/or dietary supplements with his breakfast. As much as we would like it to be otherwise, age does not leave our dogs unscathed.
We pay far too little attention to changes in behavior or movement patterns. These include changes in your dog's activity, play behavior, and the protective postures your dog adopts. Often, it is the subtle signs that matter—and we must learn to read them.
Take the time to observe your dog in everyday life. Has your dog always enjoyed playing, running, and romping with other dogs? Changes often become noticeable when your dog hardly ever romps around anymore, you rarely see it galloping, and it avoids playing with other dogs.
Pain can be a reason for a change in behavior. Dogs, like humans, avoid movements that cause pain. This is completely normal. In everyday life, this can be seen in very ordinary situations: Your dog used to get up in the morning and start the day full of energy. When going on a trip, he was the first to get into the car, and in the evening he would jump up on the sofa to cuddle with you. Today, he weighs up which movements he can and wants to make. He has trouble getting up after sleeping, he avoids jumping, and he sometimes seems listless, tired, and sluggish.
We often think that this is just how it is with an old dog and that we have to accept it. But what if you took the time to find out whether these are just your old dog's typical quirks or whether there is more to it than that? Perhaps your dog is in pain, which you can alleviate with simple and effective exercises to give them a largely pain-free senior life?
Apart from the rather inconspicuous signs of pain, there are orthopedic conditions that cause older dogs in particular a great deal of distress. You have probably heard of the classic slipped disc. From an orthopedic point of view, this is one of the worst things that can happen to a dog, regardless of its age. In the following, I would like to introduce you to a selection of common orthopedic conditions. Not all of them are easy for laypeople to recognize. Nevertheless, there are signs that make it easier for you to identify pain and problems in your old dog's musculoskeletal system and take action.
Osteoarthritis in older dogs
Osteoarthritis is a chronic joint disease in which the cartilage in the joints gradually breaks down. Over time, this causes the bones to rub directly against each other, which can cause pain, inflammation, and limited mobility.
You can recognize osteoarthritis in your dog, for example, by the fact that they frequently lick their paws or other joints. Some older dogs even have thick lumps on their toe joints. The appearance is similar to the fingers of elderly people: they can hardly move some of their fingers, they have pain when grasping and holding objects, and they feel uncomfortable in wet and cold weather or when the weather changes.
It is similar with old dogs: they too sometimes experience pain with every step. After a walk, their joints ache because every step and the associated strain causes a stinging sensation in the affected joint.
Take a moment: slowly bend and stretch your dog's toe joints, placing the tip of your index finger on the joint you are moving. Is it flexible, does your dog smack its lips during the movement, does it pull its paw away, or do you feel a slight crunch or crack in the joint? These can be signs of changes in this particular joint that are hurting your dog and causing it pain.
You cannot undo osteoarthritis in your dog's toe joints or other joints. On the contrary, the symptoms are likely to increase with age because the range of motion of the affected joint becomes increasingly smaller. Nevertheless, you can work to counteract this and ensure that your dog does not increasingly resort to protective postures and that its muscles remain loose so that it can cope well with the growing limitations. It is important for your dog to be able to continue moving the affected joints well. Regularly bending and stretching the joints and loosening and strengthening the surrounding muscles will help your dog greatly.
Herniated disc (BSV)
A herniated disc occurs when the material of the disc slips or is squeezed out between two vertebrae. This can put pressure on the spinal cord or nerves. Recognizing a herniated disc is not that easy. If you have even the slightest suspicion, do not hesitate to consult a veterinarian immediately.
As with humans, herniated discs do not usually occur out of the blue. Affected people often suffer from back pain for years. They put strain on themselves, do too little exercise, do not allow themselves enough rest periods, and do not relax their muscles sufficiently. They do not take their complaints seriously and learn to live with constant pain. Often, it is the last straw that breaks the camel's back.
Dogs also learn to live with pain, but we don't notice it. Depending on their breed and character, they hide their discomfort from their humans. Only when they can no longer cope do they show that they are in pain. Dogs cannot hide the enormous pain associated with a herniated disc. The symptoms of a herniated disc are varied and depend on many factors. Not every dog will show every symptom. That's why you should know the most important signs and act quickly if necessary. An untreated herniated disc can have dramatic consequences for your dog.
Typical signs of acute pain include heavy panting. Affected dogs often refuse to walk more than a few steps and have difficulty standing up or lying down. They often have a very curved back and a very hard and tense abdomen. In the worst case, they can no longer stand because their legs fail them. This can affect all four legs, but more often the hind legs. Either one hind leg is affected, which sags and is dragged behind as if paralyzed, or sometimes both hind legs are affected. These so-called neurological abnormalities require urgent veterinary treatment.
You now understand why it is so important to interpret the warning signs early on and to take specific care to ensure that your dog's back muscles in particular remain relaxed and healthy even in old age. Take a moment to test your dog's back muscles. You will find them behind the shoulder blades towards the tail on the left and right sides of the spine; they are the long strands that run there, just like in humans. Using your thumb and index finger, press on the muscles on the left and right at intervals of about two centimeters: Start behind the shoulder blades and end in front of the pelvis, taking care not to press on your dog's spine or ribs. How do the muscles feel? Does the skin under the fur twitch, does your dog smack its lips, does it turn toward you jerkily, or does it even bend its knees slightly? These signs indicate that something is wrong with your dog's back muscles and that you should focus on relaxing their back. In addition to muscle relaxation, active exercises to strengthen the back are also useful in this context to ensure long-term pain relief.
Cauda equina compression syndrome (CECS)
Cauda equina compression syndrome refers to a narrowing of the nerve roots in the lumbar spine, usually at the transition to the pelvis (L7/S1). The causes are degenerative changes such as herniated discs or spondylosis, which narrow the spinal canal.
Typical symptoms include pain in the lumbar and pelvic regions, difficulty standing up or jumping, a drooping or pain-sensitive tail, lameness in the hind limbs, and urinary and fecal incontinence. Imaging techniques such as computed tomography (CT) or magnetic resonance imaging (MRI) are essential for a reliable diagnosis. Only these procedures can show how severely the spinal canal is actually narrowed and whether the affected dog may need surgery.
Even if—for whatever reason—surgery is not planned, it is very important to provide physiotherapy support to a dog with CECS in order to maintain the declining nerve functions for as long as possible. In addition, the muscles of affected dogs are also severely strained. As a dog with CECS gradually loses strength and coordination in its hind legs, it will increasingly use its front legs: this gradual process results in compensatory postures, tension, and pain. If your dog has been diagnosed with CECS, you can give them valuable extra time and ensure they are as pain-free as possible by learning to identify the weak points in their body and compensating for them with targeted exercises.
Hip dysplasia (HD)
Hip dysplasia is a joint disease in which one or both hip joints develop abnormally, which can lead to pain, instability, incorrect weight distribution, and osteoarthritis.
Typical symptoms include lameness, stiffness after periods of rest, reluctance to move, and pain or discomfort when climbing stairs. For dogs whose hip mobility is restricted by hip dysplasia, adapted exercise and active and passive physiotherapy exercises are essential.
Often, one hind leg is more severely affected than the other, but this has an impact on the entire body. The thigh muscles and lower back are particularly affected. A young dog can compensate for HD quite well on the surface. However, appearances can be deceiving, as small compensatory postures and muscle hardening gradually creep in unnoticed. At some point, the dog can no longer compensate for these growing limitations – resulting in lameness and pain.
In addition, HD causes the dog to age faster than it should, as it protects and restricts itself physically in order to avoid pain or reduce it. Older and elderly dogs in particular, which no longer have sufficient strength in their hind legs, work more with their front legs. This leads to tension in the shoulder and neck area and can even cause joint problems and arthritis in the front legs.
This vicious cycle can be broken with targeted physiotherapy to strengthen the muscles of the lower back and hind legs, as well as with appropriate active exercises.
Cruciate ligament rupture (CLR)
Cruciate ligament rupture is one of the most common orthopedic conditions in dogs. According to theory, it usually involves a tear in the anterior cruciate ligament in the knee joint, leading to instability, pain, and lameness.
In practice, it is often not so easy to diagnose a cruciate ligament rupture with certainty. The suffering of affected dogs is often prolonged. This is because a cruciate ligament does not always tear completely at once; often, it "only" tears initially. The result is pain and recurring lameness, which owners often do not attach much importance to because the dog is walking without problems again after a few days. Many dogs live with this constant cycle of pain and relief of the affected hind leg for years. The effects on the dog's entire body are massive. The dog puts less weight on the painful leg and distributes its weight to the opposite leg and also to the front legs. The muscles of the painful leg weaken, resulting in protective postures and back pain. The dog learns to live with constant pain.
If the frayed cruciate ligament eventually tears, affected dogs usually no longer put weight on the leg or only stand on their tiptoes. Putting weight on the affected leg is so painful because the cruciate ligament stabilizes the knee. If it frays or tears, the knee joint becomes so unstable that the lower leg slides in front of the thigh when the dog steps.
If you think your dog is limping from time to time, take a moment to ask yourself the following questions: Is it always the same hind leg? Do you feel that your dog sometimes limps after heavy exertion, protects one hind leg, and stands on tiptoes? If you answer yes to these questions, I recommend that you consult a veterinary orthopedist. During an examination, a veterinary specialist can perform various tests to check the anterior cruciate ligament. However, these manual tests are sometimes inaccurate because they can test whether a cruciate ligament is intact or torn, but not whether it is only partially torn. For this reason, false diagnoses are occasionally made. The safest way to test the condition of the cruciate ligament is with computed tomography (CT).
Whether your dog is advised to undergo surgery or conservative therapy after diagnosis depends on many factors and should be carefully considered. If you are unsure, seek a second opinion. In any case, before youstart treating your dog yourself at home, you should seek training from a physical therapist in dealing with cruciate ligament issues, because you need in-depth knowledge of both active and passive exercises so that you do not harm your dog.
Patellar luxation (PL)
In patellar luxation, the kneecap—also known as the patella—slips out of its normal groove in the knee joint. This causes pain and instability in the knee. Patellar luxation can occur in various forms and is classified into severity grades 1-4.
A typical symptom exhibited by a dog with knee problems is known as patella hopping: when walking or trotting, the dog takes a small lunge with one of its hind legs, which looks like a small hop. The reason for this is that the kneecap briefly slips out of the groove during movement. The dog tries to move the kneecap back into place by lifting its leg.
Knee problems do not usually occur overnight. As with humans, it is often a process that takes years, with occasional pain when moving incorrectly or after excessive strain turning into constant pain. Dogs also learn to live with this pain. The loose kneecap and the wearing cartilage in the knee joint are one problem, while the resulting protective posture and muscular tension are another. This is because long-lasting knee pain affects the dog's entire body, and the cycle of pain begins: repeated dislocation of the kneecap leads to a protective posture and muscle tension in the thigh, as the dog no longer puts full weight on the leg. It distributes its weight to the opposite leg and the front legs, resulting in tension and back pain.
Take the time to observe your dog in everyday life. Have you ever noticed your dog doing the patella hopping described above? How often a day does it hop like this, and with which leg? Have you also noticed that your dog occasionally nibbles at its knee, thigh, or lower back? Do you feel a slight crack or crunch when you slowly bend and stretch your dog's knee joint while holding it with your fingers on the inside and outside?
All of this may indicate that your dog has a problem with its knee. A veterinary orthopedist will be happy to help you with the diagnosis and can assess the severity of the problem.
When it comes to problems with the kneecap, physiotherapy focuses on relieving and strengthening your dog's thigh muscles: if the thigh muscles are too tense, this causes constant tension on the kneecap. Relaxing the muscles reduces the tension on the knee and, with subsequent muscle building, the previously wobbly kneecap becomes more stable.
spondylosis
Spondylosis is a degenerative change in the dog's spine in which bone spurs form below the individual vertebrae and stiffen the spine.
Many dog owners have never heard of this condition, but spondylosis is a major issue, especially in older dogs. The aforementioned bone spurs form in episodes. These are phases during which the affected dogs sometimes feel very unwell. They experience moderate to severe pain, are reluctant to move, and are very sensitive to touch on their backs. Changes in weather also often cause problems for dogs with spondylosis.
Dog owners often suspect that their dog may have a slipped disc. In this case, X-rays of the spine are essential for a reliable diagnosis, as they show the bone structures and reveal exactly how far the process of bone spur formation has progressed. Unfortunately, experience has shown that it is advisable to have the entire spine—i.e., the cervical, thoracic, and lumbar spine—X-rayed if spondylosis is suspected, as bone spurs often form in several parts of the spine.
In order to provide meaningful support to dogs affected by spondylosis, it is advisable to have painkillers at home for acute flare-ups. Physiotherapy is particularly important for the backs of affected dogs. On the one hand, relaxation of the muscles reduces or even prevents protective postures, and on the other hand, pain can be gently and effectively relieved, even during a spondylosis flare-up.
Even if it takes some getting used to, older and elderly dogs in particular benefit from windproof coats in the cold season because they keep their backs warm. When trying on the coat, however, it is important to make sure that it reaches the base of the tail and also protects the lower back well.