Frailty Syndrome in Geriatric Dogs: Physical Therapy and Home Care to Reverse Frailty

What is frailty syndrome in geriatric dogs and what can I do about it?

Frailty Syndrome in Geriatric Dogs

What is the frailty syndrome?

You might assume this refers to dogs that are overweight and are at risk for arthritis, loss of mobility, metabolic disease, etc. While obesity is a common problem with older dogs, there is another condition I will highlight here: frailty in dogs.

With advances in veterinary medicine, our dogs are living longer. In their geriatric years, dogs can develop issues that include

  • changes in appetite
  • dental disease
  • fluctuation in hormones
  • reduced blood flow to the brain
  • slower nerve and balance reactions, etc.

A dog becomes frail and compromised when these changes cause

  • lowered body weight
  • decreased muscle mass (called “atrophy”),
  • thin skin
  • bone loss
  • weakness
  • limited endurance

Similar changes can occur after extensive surgery or prolonged illness in an older dog.

Frailty Syndrome in Geriatric Dogs

The term “Frailty Syndrome” is often used to describe the above combination of signs and symptoms.

A veterinarian can advise the dog owner about nutrition (percentages of fats, amounts of protein, supplements), dental care, pain management and assessment of cognition for the elderly frail dog.

An animal-trained physical therapist can evaluate and treat the dog’s function, mobility, coordination, balance, and strength.

How can physical therapy help?

Here is a list of items a therapist should look for during the evaluation, along with tips for helping manage and even reverse aspects of Frailty Syndrome.

Physical therapy evaluation

The physical therapy evaluation will include

  • examination of posture and weight distribution
  • watching the dog rise and sit or stand from a lying position,
  • balance testing
  • sensation to touch and pinch
  • proprioception (the dog’s sense of their body position in space)
  • feeling for areas of pain, swelling, tenderness
  • measuring limb circumference to assess muscle mass
  • checking the joints for a range of motion
  • gait analysis
  • testing reflexes and strength

Information to share with your therapist

To help your therapist to get the full picture, you need to share information about

  • your home environment (one level, stairs, other pets, type of flooring)
  • changes in behavior you may have noticed (dog paces around the house, seems lost, has a hard time standing still, is falling)
  • how much time they sleep and rest during a 24-hour period
  • any changes in bowel/bladder function
  • changes in water and food consumption
  • how they use their food/water bowls (if the dog is able to stand up or does it sit or lie down to eat and drink).

What types of interventions can help your dog

Types of physical therapy interventions may include

Modalities to decrease pain such as
  • laser therapy
  • TENS or PEMF
  • range of motion exercises (within pain-free range)
  • low force strengthening
  • light functional exercises (to conserve energy)
  • weight shifting in standing (forward and back, diagonally, side to side)
  • paw placement on different surfaces and heights to stimulate balance and awareness of body position

Therapists will adopt all exercises to allow for slower speed, zero or very low resistance, fewer reps and longer rest period between exercises.

This enables muscle tissue adequate recovery time to avoid painful lactic acid build-up, which is harder for a frail dog to metabolize and eliminate.

If the dog has a difficult time standing, the therapist will use physio- rolls, balls, carts or clinic standers (see Eddie’s Wheels for Pets) to assist with weight-bearing.

Water is also used to assist with standing and walking, via the underwater treadmill, a tub or a pool.

Pools can also be used for swimming, with the frail dog wearing a flotation vest, to improve circulation and cardiovascular health.

What can you do at home?

Follow all preventative measures given by your vet to maintain good dental care of mouth and teeth, maintain the proper length of nails and health of paws and pads.

Nutrition and hydration

Follow the vet’s advice on nutrition and ensure your dog gets plenty of water and has easy access to food (even if you have to bring it to them). Hydration and food intake are often decreased when there is limited mobility in the frail dog.

Restoring mobility and strength

If the dog has difficulty walking, don’t pass on giving them the opportunity to stand up, often, during the day and evening. Frequent standing: even if only for 20 to 30 seconds and increasing gradually to 1-2 minutes every few hours (ex: 5 times per day) can make a significant difference in cardiovascular health and endurance even if the dog is very frail.

If a dog needs assistance to stand, use a sling, harness, or place them over a stack of cushions. If you have a wheeled cart that your dog will no longer walk in, place them in it just to stand.

Use toys and treats to keep the dog moving and active, even while lying down. Engage them in moving their head or limbs by tickling the belly or rubbing lightly across their back or under the chin. Help the nervous system by providing sensory stimulation through petting, light massaging, brushing their coat, rubbing their ears and paws.

If your dogs can walk, short but frequent walks are best. Three 6-10 minute walks are more beneficial than one 30-minute walk for a frail dog.

Advanced techniques

As the dog gains strength, try low impact functional exercises such as “sit to stand” for 6-10 reps. If the dog has difficulty with this, place a cushion or step under the rump for a boost. For balance and coordination do leash-guided walking around cones of chairs in a wide circular pattern, on carpet, grass or other non-slippery surfaces. Challenge balance safely by having dog stand on an inflated mattress, a couch cushion, foam pad.

For safety, help them gain traction on the floor with the following: Dr. Buzby’s Toe Grips, carpet runners, non-skid booties or socks such as those made by Sticky Pawz or Woodruff Wear, placing non-skid pads on steps, use of ramps with sides, etc.

Precautions and contraindications

Avoid the following

  • deep tissue massage
  • stretching,
  • heavy resistance
  • over-challenging your dog to the point of fatigue
  • slippery surfaces such as tile or wood floors
  • walking the dog up and down hills or steep stairs
  • activities that include jumping or running

Frailty can be reversed, even if just partially, through home care and physical therapy.

In the most severe cases, PT can help maintain the status and prevent it from becoming worse. In either situation, it is important to ensure safety and maximize your dog’s quality of life.

Despite limited mobility and decline in former levels of function, happiness and high spirits can be achieved by meeting their needs at this new level. Accept your dog as they are, and show joy while providing their care.

If your dog feels special and loved, they will be content in fulfilling their main life purpose: to be your faithful companion.

Related articles:
New Solution To An Old Problem For Dogs With Mobility Issues

Further reading:
Tips for Caring for Senior Dogs

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