Front Matter

460 Canine Sports Medicine and Rehabilitation

include oxidative stress, deposition of beta‐
amyloid plaques (as seen in human patients
with Alzheimer’s disease), DNA fragmentation
or damage, and changes in intracellular signal­
ing leading to a loss of neurotrophic factors
(Dimakopoulos & Mayer, 2002). Because dogs
can naturally develop cognitive dysfunction,
and they develop brain beta‐amyloid deposi­
tion with cognitive deficits, they are being stud­
ied as a possible model for Alzheimer’s disease
research (Bosch et al., 2012; Davis & Head,
2014). Grossly, cortical atrophy and increased
ventricular volume have been noted in the aged
canine brain, along with reduced neurogenesis
in the hippocampus, which is responsible for
learning and memory (Head, 2011).

Metabolic changes

Metabolic changes in the geriatric patient
include decreased metabolic rate and immune
compromise (Goldston, 1995). Maintenance
energy requirements in older dogs decline by

approximately 20% as compared with young

adult dogs. Senior diets are commonly

restricted in calories due to reduced caloric

needs in an attempt to prevent weight gain.

However, they should provide an increased

percentage of highly digestible protein, with a

total composition of at least 25% protein

(Laflamme, 2005). According to Larsen and

Farcas, in 2014 there had been no studies that

indicate that geriatric dogs have any decrease

in digestive efficiency or nutrient absorption as

compared with young adult dogs. While some

functional effects of canine aging, such as

diminished hydrochloric acid production and

bile acid secretion, have been noted, these have

little overall significance, much the same as in

humans. The changes that have been docu­

mented in aged dogs in the function of the sali­

vary glands, small intestine, liver, and pancreas

likely reflect the general organ degeneration

association with aging (senescence) and may

not be clinically relevant as dogs have signifi­

cant digestive functional reserves (Larsen &

Farcas, 2014).

Case Study 18.1 Geriatric patient with obesity and compromised mobility

Signalment: 11‐y.o. M/N Labrador Retriever; 117 lbs.

History: Progressive pelvic limb weakness over sev-

eral years. Difficulty rising and going up stairs (fear of

climbing stairs worsened after slipping on stairs sev-

eral months ago). Diminished endurance on long

walks; swims in local pond when possible. Atopy,

hypothyroid.

Receiving Carprofen™ p.o. o.d., levothyroxine

p.o.  b.i.d., glucosamine/chondroitin/ASU p.o. o.d.,

omega‐3 fatty acid p.o. o.d., diphenhydramine p.o.

b.i.d., and chlorpheniramine p.o. b.i.d. Recently began

polysulfated glycosaminoglycan (PSGAG) injections.

Referral radiographs: Left stifle lateral view: signifi-

cant DJD; right stifle lateral view: moderate DJD; VD

pelvis, frog‐leg positioning: irregularity of left femoral

head, narrowing of coxofemoral joint spaces, left

greater than right.

Client’s goals: Slow progression of arthritis, enable

patient to accompany client on walks, and provide

best possible quality of life.

Physical examination: BAR; WNL except: signifi-

cantly overweight—body condition score 7–8/9;

panting throughout exam; lacking appropriate

abdominal muscle tone.

Rehabilitation examination:

Posture: Front end loading, moderate lumbar lor-

dosis, pelvis rotated ventral‐cranial; pelvic limb

conformation very upright, tarsi and stifles lack

appropriate angulation.

Sit: Sits with both pelvic limbs extended cranially.

Gait: Slides rear feet rather than lifting them at walk;

circumducts with external rotation of both hip joints;

minimal flexion of stifles and tarsi.

Neurological exam: WNL except patellar reflexes

diminished (left worse than right); proprioception

greatly delayed for both rear feet, with left worse than

the right, correcting each after approximately 3–5

seconds (repeatable).

Transitions: From sternal to stand: pulls forequarters up

then pushes up with both pelvic limbs while pulling

himself forward; immediately transitions from a sit to

sternal—not staying in sit for more than a few seconds.

Palpation: Triceps muscles very tight bilaterally,

mild resistance (muscular) to full thoracic

limb  extension bilaterally, slight resistance to full