476 Canine Sports Medicine and Rehabilitation
The decubital ulcer should be cultured to deter
mine appropriate antibiotic therapy, pressure
should be relieved if possible, and the wound
should be cleaned regularly. Topical therapy
may be used in addition to oral antibiotics and
laser therapy to promote local blood supply
and wound healing.
Hospice care
End of life issues are very difficult for clients.
The rehabilitation therapist can be an important
source of education on pain management, nutri
tion, and nursing care issues for terminal or
recumbent patients. Teaching clients to keep
these patients well padded, hydrated, ade
quately fed, and to express their urinary bladder
and bowels is often indicated. Laser therapy for
pain management and wound healing, massage,
and PROM to maintain flexibility and comfort in
the joints are all beneficial (Bjordal et al., 2003).
Discussing parameters that detract from an
acceptable quality of life is encouraged early
in the relationship with clients with hospice
patients so they can remain more objective.
Encouraging clients to write down how much
they are willing to assist their dog and what level
of dysfunction or loss of independence they are
willing to accept can be a valuable reference once
decisions about end of life are necessary.
Marketing to clients with geriatric dog
Clients with geriatric patients can be contacted
to educate them about the services that the
rehabilitation professional can provide. Clients
that purchase NSAIDs, thyroid supplementa
tion, urinary incontinence medication, chemo
therapy, or medications prescribed for cognitive
dysfunction, or even clients with geriatric
patients (based on age) are good candidates to
receive educational materials about geriatric
wellness or hospice programs offered by the
rehabilitation practice.Webliography
AAHA. 2005. Senior Care Guidelines for Dogs and Cats.
https://www.aaha.org/professional/resources/
senior_care.aspx.
AHA. 2016. Euthanasia: making the decision.
American Humane Association. http://www.
americanhumane.org/fact‐sheet/euthanasia
‐making‐the‐decision/.
AVMA. 2012. U.S. Pet Ownership and Demographics
Sourcebook. https://www.avma.org/kb/resources/
statistics/pages/market‐research‐statistics‐us‐pet‐
ownership‐demographics‐sourcebook.aspx.
Hellyer, P. W., Uhrig, S. R. & Robinson, N. G. 2006.
Colorado State University, Veterinary Medical
Center, Canine Acute Pain Scale v.2. http://www.
vasg.org/pdfs/CSU_Acute_Pain_Scale_Canine.pdf.
PetPlace. 2015. When is a dog considered senior?
http://www.petplace.com/article/dogs/keeping‐
your‐dog‐healthy/senior‐dog‐care/when‐is‐a‐
dog‐considered‐senior.
Seymour, K. 2014. Aging pets: senior, geriatric and
what it all means to experts and readers. http://
http://www.vetstreet.com/our‐pet‐experts/aging‐pets‐
senior‐geriatric‐and‐what‐it‐all‐means‐to‐experts‐
and‐readers.
WHO, 2017. World Health Organization cancer pain
ladder for adults. http://www.who.int/cancer/
palliative/painladder/en/. All websites accessed
October 2017.References
Alves, A. C., Vieira, R., Leal‐Junior, E., dos Santos, S.,
Ligeiro, A. P., Albertini, R., et al. 2013. Effect of low‐
level therapy on the expression of inflammatory
mediators and on neutrophils and macrophages in
acute joint inflammation. Arthritis Res Ther, 15(5),
R116.
Araujo, J. A., Landsberg, G. M., Milgram, N. W. &
Miolo, A. 2008. Improvement of short‐term mem
ory performance in aged beagles by a nutraceuti
cal supplement containing phosphatidylserine,
Ginkgo biloba, vitamin E, and pyridoxine. Can Vet
J, 49(4), 379–385.Figure 18.18 Providing soft bedding that is supportive
of prominent bony protuberances, while easy to rise
from, is helpful in maintaining mobility and preventing
decubital ulcers in geriatric patients.