462 Canine Sports Medicine and Rehabilitation
release of inflammatory mediators such as
tumor necrosis factor alpha (TNF‐α), interleu
kin (IL)‐1β, IL‐6, and C‐reactive protein
(Laflamme, 2005; Wakshlag et al., 2011), which
signal inflammatory responses in peripheral
tissues. Increased inflammation in the body
plus concussive forces on the joints due to
carrying more body mass predispose obese
patients to more severe osteoarthritis.
A study published in 2002 showed that
food‐restricted dogs had longer median life
spans and delayed onset of chronic disease
(Kealy et al., 2002). Weight reduction (11–18%
of body weight) decreased pelvic limb lame
ness in dogs with radiographic evidence of
hip osteoarthritis in one study, while another
showed weight loss (6.10–8.85% of body‐
weight), decreased lameness, and improved
kinetic gait analysis scores in dogs with radio
graphic evidence of elbow or hip osteoarthri
tis (Impellizeri et al., 2000; Marshall et al.,
2010). Yet another study showed intensive
physiotherapy in addition to caloric restric
tion provided improved weight loss, mobility,
and ground reaction forces in dogs with osteo
arthritis over caloric restriction alone (Mlacnik
et al., 2006).
Designing and facilitating weight loss and
weight management and exercise plans
for overweight seniors can be one of the
most important and rewarding functions of a
rehabilitation therapist in providing and
maintaining their patient’s best possible
quality of life.Hypothyroidism
Hypothyroid patients suffering from either pri
mary or secondary hypothyroidism can
develop skin issues including seborrhea, hyper
pigmentation, secondary pyoderma, recurrent
bacterial dermatitis, and otitis externa/cerumi
nous otitis (Ettinger & Feldman, 2010). These
issues can impede treatment choices, including
the use of electrical stimulation over compro
mised skin or the ability to use hydrotherapy.
Hypothyroidism should be considered in
patients exhibiting muscle atrophy, lethargy,
weight gain, exercise intolerance, or neurologi
cal signs such as weakness, diffuse peripheral
neuropathy, knuckling, ataxia, seizures, vestib
ular signs, or facial nerve paralysis (Ettinger &
Feldman, 2010) (Figure 18.4).Figure 18.4 Hypothyroid patient receiving postoperative treatment for cranial cruciate ligament rupture. The client
complained that the dog panted frequently. Dog is overweight due to decreased metabolism without modification of
food intake.