Front Matter

458 Canine Sports Medicine and Rehabilitation

treatment and to protect them from exposure
to other patients in the physical rehabilitation
environment.

Recommended management
of the geriatric patient

Frequent examinations (at least every 6
months), including complete blood count,
serum biochemistry, thyroid panel, urinalysis,
and fecal flotation are recommended for geriat­
ric patients (Hoskins, 2003). A comprehensive
physical examination should include evalua­
tion of dental health and mammary glands, and
a digital rectal examination in addition to eval­
uating muscle mass and body condition score.
Any new masses should be documented and
aspirated (if indicated) by the primary care vet­
erinarian. When discussing patient history with
client, nutrition and behavioral issues should
be reviewed. Thoracic radiographs may be
considered as well as an electrocardiogram,
intraocular pressure, and blood pressure
evaluation. Practices may consider providing
discounted rehabilitation packages, making
frequent visits more affordable as well as pro­
viding hospice services for terminal patients.
Training support staff to provide client educa­
tion and nursing care for geriatric patients

creates an outlet for clients to express concerns.

Maintaining a spreadsheet to monitor body

weight, body condition score, muscle mass, and

pain scores is appropriate to provide objective

assessments of how the patient is progressing

over time.

Common conditions of geriatric dogs

that may affect rehabilitation therapy

Musculoskeletal changes

Many clients with senior dogs notice a loss of

muscle mass, or muscle atrophy (Figure 18.3).

As the body ages, lean body mass including

muscle, bone, and cartilage declines (Metzger,

2005). Muscle atrophy may be secondary to loss

of muscle fibers themselves, reduced oxygena­

tion of the muscles, or fibrosis developing

within the muscles (Goldston, 1995). Neurogenic

muscle atrophy occurs more rapidly than dis­

use atrophy due to poor innervation of the mus­

cles. Conditions causing neurogenic atrophy

include intervertebral disc disease, fibrocarti­

laginous embolism, or more peripheral condi­

tions such as diffuse lower motor neuron

disease. It is extremely important to differenti­

ate between muscle atrophy that is due to a dis­

ease process versus loss of muscle mass in

Figure 18.3 Geriatric dog with muscle atrophy demonstrating postural changes including of mild kyphosis and
reduced extension of the pelvic limbs.