The tools that we choose to use to walk our dogs are really important, tools can absolutely have a positive or negative effect on our walk, based on how the tool is making our dog feel. As well as either negatively or positively impacting your dog’s emotional and physical health and wellness.
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When discussing tool usage with guardians, many guardians shudder at the thought of using a prong, an e collar, a choker or tightening harness. But what many guardians do not consider is that utilising a collar, a halti or a restrictive harness can impact how your dog feels and also control the type of walk experience that you are about to have or do have.

However as dog professionals we have a duty of care to help guardians and not vilify them, if we meet guardians with judgement straight away the guardian is going to defend themselves as human nature dictates, we could then seriously harm this relationship and furthermore contribute to the negative welfare for the dog.

Flat collars are just as restrictive as a prong collar, choke collar or slip lead in that they can impede the airway. A friend's dog, before I knew her, dogs' oesophagus collapsed and needed emergency life saving surgery due to using a flat collar.
We also need to be mindful that halti’s and figures of 8 devices do have a collar component to them as well as the strap across the muzzle.

A guardian surmised this perfectly: “Until I knew about Truelove Harnesses, I felt the only way I could walk my dog was with a halti for fear of being pulled over. I never enjoyed using it and did wonder about the damage it could potentially cause.” Please refer to this blog on haltis.

I would like to clarify as well. I am a full time wheelchair user and I also have arthritis in my shoulders and very limited feeling or sensation in my hands. I use Y Front Harnesses. You can check out my previous blog on Head halters or haltis - https://www.facebook.com/share/p/KLXwMvTgN7KLSaDS/?

Nottingham Trent University investigated the force and the pressure from a collar on the dog’s neck, they wanted to explore how collars can negatively impact dogs' health and wellness. They did not test the force on a dog due to the ethical implications and safety and well being of a dog, but instead used a cylinder with sensors and pressure points.

They tested a wide range of collars, including the slip lead, wide fitting collars and padded collars. They found that all of the collarsa could cause risk of injury to the dog, they exerted the force of 40 newtons onto the cylinder, which was classified as a firm pull, a strong pull at 70 newtons and a jerk which was 141 newtons. (Newtons is the range of measured force).

There was no collar used in the test which was considered that harm would not or could not be caused by. They also found that extension leads provided the force of the jerk measurement, when the lead abruptly stopped which was equivalent to not only a jerk but also a correction to the dog.

Thanks to the Nottingham Trent University study we now know of the damage that flat collars can do, researchers have also found is that if we look at the area in terms of diameter and circumference of the dogs neck and collar, this is a small contact area when we change this observation from a flat collar to a prong collar it is a much smaller contact area digging into the skin causing skin and nerve damage. (1)

Guardians also reported that their dogs coughed and hacked whilst using these devices, which reports to the researchers the hypothesis of the neck injuries which can be sustained from using these devices. (2)

It was also found that the pulling on these devices caused intraocular damage (eyes), they also found that this was higher during periods of pulling due to the valsalva manoeuvre, which means tightening of the glottis (the area between the lungs and the vocal tract), so airflow is completely cut off. It was found in humans when this is repeatedly done that there is an extreme loss of the field of sight, which they believe is the same result for dogs. (4)

Pulling on the collar and lead has been shown to increase the risk of permanent tracheal, laryngeal, oesophageal and ophthalmic damage in all dogs, and a much higher risk in brachycephalic breeds. (3)

I just want to reiterate that I am not sharing this information to upset anyone but to raise awareness of the damage that these tools can do, there are many injuries in which dogs attend the vets due to these devices and like any major injury the damage can be critical and life changing.

So if we explore harnesses, it is really important when selecting a harness that the harness is well fitting to your individual dog.

Chest strap harnesses have been found to impede shoulder and thoracic limb extension. This was done by measuring the dog’s gait. Gait analysis is used on both humans and animals to measure the kinetic and kinematic measurements. Kinetic is measured by measuring ground reaction forces, from the foot going to the ground using force platforms. Kinematic is measured by the position and body orientation segments or bony landmarks of the linear and angular velocities and accelerations and joint angles being determined. (4)

Linear motion is the motion of moving along a straight path and then measured in units of length, angular motion is the circular motion of objects at a fixed axis and the associated variables are measured in radians or degrees.

Researchers also hypothesised from their findings that prolonged use of repeated strain of a chest strap harness could cause tendinopathies which is damage to the tendons, tiny tears form, this can cause chronic, intermittent or unilateral lameness. (5)
It was also found through the research that the secure attachment and the type of attachment p[layed a role in guardians ease, enjoyment and ability to walk their dog on a loose lead, with little to no pulling. Guardians who walked their dogs regularly also reported that they felt that they had a strong attachment to their dog, whereas it was found that using aversive equipment weakened the attachment between guardian and dog as an indirect outcome. (6)

So when we look at an emotionally challenged dog not only do they have to contend with the environment and triggers, but they are also having to work with the equipment being used on them, now we have looked at various tools at length and the outcomes, it is time to consider how this can be damaging to a dog.

They may already be in a state of fight or flight which means that their muscles are tense, the brain is working at a very high speed sending information throughout their body and then we add the pain and the uncomfortability of the use of an aversive tool.
The dog could possibly redirect due to the pain and the triggers, this is when a dog could potentially bite their guardian, if their communications are not heard and acted upon, another dog or someone in their personal area that they can reach, this is not a bite aimed at anyone this is sheer frustration and fear of the situation that they are in, in an attempt to flee.

We also see dogs fighting the lead, this is also a sign of frustration, normally exhibited when the dog feels all of their other communications have been ignored, grabbing on the lead and the guardian pulling may feel like a game of tug to the dog. But due to the complexities of the dog's body and potential for injury it is much better to take a tug on a walk and redirect from the lead. Playing tug properly can help them with their feelings of anxiety and frustration. (7)

Many guardians do not see this behaviour as a game but disobedience and they become frustrated by the behaviour which depending on the guardian can lead to a correction. Consider instead taking out a favourite tug toy as a secondary rewarding reinforcer. This is not a cure to the frustration or the feelings of helplessness but this can be a communication tool between you both for your dog to help you to understand it is time to retreat and go home.

If your dog is doing this indoors, a vet check is needed, ask someone to record the behaviour or set up your phone in an area it can view but not get knocked over, also ask someone to video your walks, the vet can then analyse what is happening to the dog physically or refer you onto a canine chiropractor or hydrotherapist. You can also book a chiropractor or hydrotherapist yourself and just give the referral forms they give you to the vet receptionist. The chiropractor or hydrotherapist may even do this for you, but they will talk you through the process at your first appointment.

Every part of the anatomy has a purpose and a role to play, the muscles in the neck surround the vertebrae completely. This muscle's purpose is to provide flexibility and movement within the neck and head as well as protection for nerves and nerve impulses travelling to and from the brain.

When a collar is tightened on a dog the muscles become bruised, the damaged muscle fibres then shorten as they go through a self healing process. During this process however the muscles are drawing the vertebrae of the neck closer together, compromising the gaps between the vertebrae and impinging structures, this can result in devastating effects on the major nerves and vessels in the region. (Please refer to the anatomy diagrams for specific injuries and locations).

If a dog were on a collar and pulled sideways this would be a whiplash injury in a human. This type of force is too much for the dog's neck, this can leave the dog with chronic and repetitive whiplash pain.

Everything that a dog does with their body for movement is controlled by the neck, the neck has to be mobile and flexible working in tandem with the dogs shoulders, working together they allow the dog to turn and coursing ability. When they are damaged by a collar or a poorly fitted harness this can not only impact the dogs mobility but also their physiology.
If the dog's neck is injured or damaged then just like us humans, their posture will also be altered, this can further affect the internal organs as you can see in the diagram.

When the dog pulls on the lead, the lower back is affected in the lumbar region. Both in a rapid and chronic way, the changes may not be visible immediately and there could be other symptoms which bring about a diagnosis without the neck even being addressed, whilst more damage is being done by the dog pulling on the collar.

Due to the shapes and sizes of our dogs there is no harness yet manufactured where it is one size fits all, harnesses that are well fitted are much less likely to chase any damage, ill fitting harnesses can do damage as well as harnesses with the strap across the chest due to impacting the gullet and the windpipe, these injuries can also further damage the tongue.
The harness straps over the shoulders need to float over the body so as not to damage or restrict the shoulders, front strap harnesses also damage the shoulders and can alter gait.

The strap of the harness must be set on the ribs and not under the forelimb as this can cause rubbing and affect major neurological junctions. A neurological muscular junction is the synaptic connection between the terminal end of a motor nerve and a muscle. It is a site for transmission of action potential from nerve to muscle.

Action potentials are the changes in the electrical potential in a cell. For example, when you smell a scent such as food the olfactory neurons fire action potentials as a response.

The buckles and fastenings should also be fitted properly and not rubbing or bouncing on the back, this can make the back feel sore and irritated. (7)

Incorrect biomechanics of the dog's musculoskeletal structure can lead to the loss of joint confirmation and function leading to abnormal wear which can cause inflammation and arthritic conditions.

Biomechanics is the study of forces acted on and generated within the body, and the effects of these forces on tissues, fluids or materials, used for diagnosis, treatment or research purposes, this is exploration of the locomotion of the body, the biological occurrences within the body and especially focusing upon the musculoskeletal elements of the body.
(Physically the areas of damage which can occur to dogs with the use of collars, chokes, slips, haltis, e collars and poorly fitted harnesses are as follows.

The supraspinatus muscle can suffer tendinopathy, a condition in which the tendon becomes painful and has a limited range of motion. The supraspinatus muscle is a part of a muscle group which forms the rotator cuff, it is the smallest of the group of 4 muscles, which includes the rotator cuff of the shoulder joint. (From someone with arthritic shoulders, it is a daily struggle with the pain and the use, let alone walking on them, running on them and needing them for all of my movement needs, which is how dog;s differ from us and suffer more as a consequence.

There can also be damage to the infraspinatus muscle, this is another muscle within the group of four, this muscle is also a part of the rotator cuff, their role is to stabilise the glenohumeral joint, this is the ball and socket joint of the shoulder. (9)
It has also been found that there can be injury to the biceps, the biceps are a large muscle situated between the front and the upper arm. This muscle rotates the forearm and flexes the elbow. In Latin this muscle is known as the ‘two headed muscle of the arm.’

Infraspinatus myopathy is a uni or bilateral fibrotic myopathy of the Infraspinatus muscle which is normally a secondary trauma. With this injury we will see acute lameness, pain, and swelling within the shoulder area. Acute conditions are a severe and sudden onset, acute lameness means an inability to use a limb properly due to injury, illness, sprain, break or dislocation. (10) (11)

Myopathy refers to a generalised term of any disease that affects the muscles that control voluntary movement in the body.
Forelimb gait and lameness issues are a result of medial shoulder syndrome caused by repetitive microtrauma to multiple elements of the shoulder joint. Medial is the inner area of the shoulder and medial shoulder syndrome is when the area is overworked, which leads to degeneration of the tissue, which can further develop into fraying, disruption and eventually complete breakdown. (12)

When damage to the muscles occur, much like when we go to the gym or for a run, micro tears develop in the muscle which is seen as damage that the body will repair and also make the muscle stronger. However, the micro tears can lead to partial tears. Partial tears means that the tear has further torn the tendon, but does not specify dimensions. Partial tears can heal with the proper care and rehabilitation. If a full tear occurs, surgical intervention will be necessary. (13)

Dystrophic mineralisation which is the deposition of calcium salt in degenerated tissues can also occur, with this process the tissue is either necrotic (dead) and cannot be repaired due to the lack of blood flow to the tissue. Tissues can also go through this process when they degenerate, degeneration means that the condition such as osteoporosis is only going to get worse. This condition is mostly associated with trauma, inflammation and infection.

Chronic tenosynovitis of the shoulder usually occurs in middle aged dogs but can be diagnosed in young dogs of any breed, dogs seem to show an intermittent to constant Forelimb lameness which is further worsened by exercise.
Tenosynovitis is repeated injury to the biceps tendon, acute severe trauma and chronic osteochondritis dissecans of the shoulder joint. (14)

Changes in the biomechanics can potentially cause adverse pressures in the caudal anatomy which may exacerbate or hasten any conditions the dog is already predisposed to. Caudal means the lower end of the spine, tail and limbs. (15)
This can cause severe dysfunction, pain, referred pain, pins and needles, numbness in the paws which can result in chewing and licking behaviours of the paws. Referred pain means that there is pain occurring in one area of the body but the injury is actually somewhere else within the body, the common occurrences of referred pain are self mutilation of the paws even though the pain is elsewhere. (16) (17)

We discussed earlier, how tissues can become necrotic or degenerate due to the lack of blood flow, as can be seen in the diagrams, the blood flow can be cut off which essentially kills tissues within the dogs body. The blood flow to the brain can also be impacted by the tightening of a collar, which also impacts normal hormonal delivery which can catastrophically damage the eyes, ears and nose. (18)

The trachea and oesophagus are at risk also and are not well protected, we can see enlargement of the oesophagus and lack of muscle tone. Collapsed tracheas are also not an uncommon concern from the collar due to the pressure forcing a collapse.
The jugular vein and carotid artery can cause poor health around the head when they experience trauma or obstruction, the blood, nerve and energy flow to the dogs brain is vital, use of a flat collar, prong collar or electric shock collar can damage the vein and artery, again affecting dogs longevity of life.

The thyroid gland is located exactly where the collar puts pressure on the front of the neck, which can reduce thyroid hormone production due to the inflammation of the thyroid and by communicating that inflammation needs to be removed from the body.

The neck is the most critical region for balance, impulsion and flexibility. It is not just the neck that can become damaged but as a result of the damage to the neck, can further impact the rest of the body and create systemic issues. Systematic issues affect the endocrine system, which includes a complex network of glands and organs. (19)

The endocrine system is a group of tissues, richly supplied with blood, that release hormones into the circulation of the body, they can aid with nutrient uptake, to alter cell division and differentiation. (20)

The dog's tongue can also be hugely affected by collars, the dogs tongue is not just for taste and licking, the tongue is a vital muscle which is essential for the dog's balance, if the tongue becomes damaged the entire of the dog's balance can be affected.

The parasympathetic nervous system is also affected, this system is meant to lower arousal in dogs and calming them, this is done by slowing the heart rate, breathing rate, lowering blood pressure, promotes digestion and brings the body into a state of relaxation.

One of the responses of the parasympathetic nervous system consists of the working of the optic nerve to constrict the pupils, during rest, the glossopharyngeal nerve is activated, stimulating the flow of saliva to aid digestion and activates the bronchi to constrict for rest.

The parasympathetic nervous system is a subdivision of the autonomic nervous system integrated into the vagus nerve and regulates bodily functions outside of voluntary control. The parasympathetic nervous system begins at the brain and travels out throughout the body to the organs for quick communication. These organs include the lungs, liver, kidney, bladder and stomach.

The vagus nerve affects most of the body and retains trauma. We work with the vagus nerve and the parasympathetic nervous system to heal many areas of the body. The areas in which the vagus nerve controls such as the immune system, digestion and heart rate are involuntary body actions in which we cannot control, damage to any of these areas of the body are extremely worrying.(21)

The thymus is also affected and is another crucial organ for developing cells which fight off foreign cells that enter the body, the thymus is most active for puppies whilst the immune system is building, puppies don't know how to walk with any kind of restriction until they do learn and the thymus can be massively damaged during this time by a collar and can impact life longevity.

We often see puppies first scratching at their collar as they get used to the collar, we then typically see the puppy fighting with the lead and playing tug with it, we then see the puppy not understanding the radius of the lead and the collar can cause a snap back effect which is going to cause a lot of damage. This is why it is best to allow your puppy to wear a free range of movement harness from the start and also use a house line, a house line is very long and very thin, light lead this is NOT tethering, house leads allow the puppy to acclimate to the lead, doesn’t experience any jerks or corrections if properly supervised and the guardian gets to the lead before it could potentially get stuck under furniture.

Harness desensitisation is really important, this is to ensure your dogs comfortability and that the harness is the correct fittings so that they are not impeded in their movement and or injured. https://youtu.be/D3c5HeSrmK8?si=-jL3vWUJEtTb3A3b
Play with the harness and lead for trauma or pain related desensitisation after all clear: https://youtu.be/oOkonHEwbLU?si=NRxnvHjsUkZ7sj77

When your puppy is desensitised to the feel of the lead being attached to them in the home with the long line and you are ready to go outside, going up and down a few yards within a few repetitions using high value food and verbal reassurance and communication can really help your puppy to engage with you on a walk to avoid pulling, when Zombie pulled ahead I communicated with him, he turned back had a treat, then continued to check in due to the reinforcement. https://youtube.com/shorts/L1SrHikOYHM?feature=share

************************************Trigger warning, discussion of morbid outcome, please stop reading if you will be affected by the information. **********************************************



When people say that chokers don’t hurt, it's just a tug, a prong is just a pinch and an e collar is just a tickle, it is important to remember we do not have the statistics of the number of fatalities of dog’s killed by these devices either immediately due to the trauma or later due to the internal trauma and prolonged illness. I do not share the following information to scare anyone but be totally honest about my research findings, the next paragraph is a hard read.

It has been found that a year old German Shepherd was choked in the air for 60 seconds due to “misbehaving” during training. Four hours later finally the dog is taken to the vets, he is suffering with neurological damage and walking in circles, due to the lack of oxygen to the brain it was found that the brain and brainstem were compressed and herniated due to the lack of oxygen. So sadly the dog had to be euthanized as he could not survive this.

I hope you have enjoyed this blog and have a deeper or maybe even new understanding of why we as dog professionals constantly talk about tools and the impact that they can have on dogs. We are not commissioned to encourage you to buy Y Front harnesses or Tellington ttouch harnesses, we encourage you to do this to keep your dog happy and as healthy as possible and reduce the risks of injury either externally or internally.

So coming back to vet checks, when we encourage you to have a Vet check, all of the above is why, because we need the dog to have a thorough check to know absolutely that there is nothing going on internally which could affect their behaviour.
If we work with a dog without asking about a veterinary appointment and intervention, we are not doing our jobs correctly and doing yourself and your dog a disservice. If you have friends or family who need help with their dog and there has been a behaviour change especially, please encourage them to go to the vets first!

References

Carter, A., McNally, D. and Roshier, A. (2020) ‘Canine collars: An investigation of collar type and the forces applied to a simulated neck model’, Veterinary Record, 187(7). doi:10.1136/vr.105681.
Hunter A, Blake S, De Godoy RF. Pressure and force on the canine neck when exercised using a collar and leash. Vet Anim Sci. 2019; 8:100082.
Rooney NJ, Clark CCA, Casey RA. Minimising fear and anxiety in working dogs: a review. J Vet Behav Clin Appl Res. 2016; 16: 53–64.
Pauli AM, Bentley E, Diehl KA, Miller PE. Effects of the application of neck pressure by a collar or harness on intraocular pressure in dogs. J Am Anim Hosp Assoc. 2006; 42(3): 207–11.
Vieira de Castro AC, Barrett J, de Sousa L, Olsson IAS. Carrots versus sticks: the relationship between training methods and dog-owner attachment. Appl Anim Behav Sci. 2019; 219:104831.
Whittle MW. Clinical gait analysis: A review. Human movement science, 1996. 15(3): 369–387. doi: 10.1016/0167-9457(96)00006-1
Grainger J, Wills AP, Montrose VT. The behavioural effects of walking on a collar and harness in domestic dogs (Canis familiaris). J Vet Behav Clin Appl Res. 2016; 14: 60–4.
Lafuente MP, Provis L, Schmalz EA. Effects of restrictive and nonrestrictive harnesses on shoulder extension in dogs at walk and trot. Vet Rec. 2019; 184(2): 64.
Williams, E., Hunton, V., Boyd, J., & Carter, A. (2023). Effect of harness design on the biomechanics of domestic dogs (Canis lupus familiaris). Journal of Applied Animal Welfare Science, 1–17. https://doi.org/10.1080/10888705.2023.2259796
Jeno SH, Munjal A, Schindler GS. Anatomy, Shoulder and Upper Limb, Arm Supraspinatus Muscle. [Updated 2023 Aug 28]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK537202/
Chang LR, Anand P, Varacallo M. Anatomy, Shoulder and Upper Limb, Glenohumeral Joint. [Updated 2023 Aug 8]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK537018/
MSD Veterinary Manual. (n.d.). Muscular Trauma in Dogs and Cats - Musculoskeletal System. [online] Available at: https://www.msdvetmanual.com/.../muscular-trauma-in-dogs... contracture%20is%20a%20 uni [Accessed 9 Apr. 2024].
Harasen G. Diagnosing rupture of the cranial cruciate ligament. Can Vet J. 2002 Jun;43(6):475-6. PMID: 12058576; PMCID: PMC339306
Von Pfeil DJF, Megliola S, Horstmann C, Tan D, Glassman M. Comparison of classic and needle arthroscopy to diagnose canine medial shoulder instability: 31 cases. Can Vet J. 2021 May;62(5):461-468. PMID: 33967284; PMCID: PMC8048237
Spinella G, Arcamone G, Valentini S. Cranial Cruciate Ligament Rupture in Dogs: Review on Biomechanics, Etiopathogenetic Factors and Rehabilitation. Vet Sci. 2021 Sep 6;8(9):186. doi: 10.3390/vetsci8090186. PMID: 34564580; PMCID: PMC8472898.
Bruce WJ, Burbidge HM, Bray JP, Broome CJ. Bicipital tendinitis and tenosynovitis in the dog: a study of 15 cases. N Z Vet J. 2000 Apr;48(2):44-52. doi: 10.1080/00480169.2000.36157. PMID: 16032117.
Pangal, S. (2019) A myotherapist's perspective on harnesses, The BHARCS Blog. Available at: https://blog.bharcs.com/.../a-myotherapists-perspective.../.
Young, K. (2020). Trigger Points - Your dog almost certainly has them! [online] safehands. Available at: https://www.safehands.dog/.../trigger-points-your-dog...
Akiyama J, Ohta M. Hormonal and Neurological Aspects of Dog Walking for Dog Owners and Pet Dogs. Animals (Basel). 2021 Sep 18;11(9):2732. doi: 10.3390/ani11092732. PMID: 34573698; PMCID: PMC846520
Veterinary Manual. (n.d.). The Endocrine System of Animals - Endocrine System. [online] Available at: https://www.msdvetmanual.com/.../the-endocrine-system-of....
Dobias, Dr.P. Dr. (2024) Is your dog’s collar and leash making them sick? I dr. Peter Dobias, Dr. Dobias Natural Healing. Available at: https://peterdobias.com/.../connection-dog-neck-internal...
Grohmann K, Dickomeit MJ, Schmidt MJ, Kramer M. Severe brain damage after punitive training technique with a choke chain collar in a German shepherd dog. J Vet Behav Clin Appl Res. 2013; 8(3): 180–4.1

Youtube audio link - https://youtu.be/76A4ttsDJPQ?si=cBt4AyBWB39OAIgw
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As a continuation of last week's blog on adapting environments and being supported by professionals such as vets to do so, this week I am exploring part two.

The study that I referred to last week: Physiotherapeutic Strategies and Their Current Evidence for Canine Osteoarthritis referred to the possibility of further support from professionals such as vets to come and visit the patients home to identify areas which need amending or changing to aid the patient in their recovery or management of their condition. Is this something you would want from your vet? (Mille, McClement and Lauer, 2022)

Many of us are familiar with the vets telling us that our dog needs to be on crate rest for a period of time for recovery from an illness or injury. However it is not widely known that for an osteoarthritis diagnosis for a dog, the complete opposite has to be done. Movement can aid the healing process and the maintenance of the synovial fluid to be properly diffused through the cartilage to manage the arthritis and the symptoms that arthritis causes. (Kiviranta et al., 1988)

What we tend to see as professionals and have fed back to us, is that the dog is extremely frustrated in being confined to a crate, on top of the initial ailment we may then begin to see additional behaviours that haven't been seen before by the guardian and a decline in the dogs mental health, self harm can occur such as chewing their paws, focusing on one area to chew, OCD behaviours in constant digging, chasing their tail, spinning, pacing, barking.

We also see a decline in the mental health of the guardian who feels at a loss, they cannot bear to see their dog struggling, they want to follow the vet's advice so that their dog recovers as fast as possible but they can also not cope with the decline that they are seeing in their dog.

I have also had cases where the dog is resident in a multidog home, everyone got along until the crate confinement and upon reintegration back into the home with no confinement, sudden fights and lack of tolerance towards one another.

Guardians then feel under even more pressure and of course feedback to the vets as they are quite rightly extremely worried, to be told to go and find a behaviourist. Which of course is not all vets at all, but has occurred in some instances.

The guardian then does not feel comfortable with working with the vet and or asking questions for their consult history evaluation because they feel that they have been pushed away and told to deal with this problem themselves with no help or support from their dog's physician.

So then we as behaviourists then see a further breakdown in the relationship between guardian and vet, mental health decline for both guardian and dogs involved and a very fraught situation building in some cases.

So by addressing the pyramid level 2 and embracing low level impact activities, scored with the dogs body weight, injury, treatment, surgery and outcome of the medical model we can then see guardians who are not experiencing such a decline because of their dog being placed on crate rest. (Millis and Levine, 1997)

The third level of the pyramid model is home exercises.

Home exercises complement clinical treatments for osteoarthritis (OA) but have limitations due to guardians' lack of anatomical knowledge. (Millis and Levine, 1997)

This is where the treatment of an holistic approach can fall down as the guardian only has access to the hydrotherapy or Physio clinic during their allotted appointments. However, being taught properly how to do additional exercises at home can help the guardian to have the knowledge to aid their dogs' healing and recovery journey. Such as coaches like myself qualified in canine conditioning to help with targeting specific muscles utilising different categories.

Regular home exercises, such as strengthening, proprioceptive, and balance exercises, and massage, can improve compliance and outcomes when tailored to the dog's and guardians needs. Adequate pain management and proper exercise execution are crucial. This means that a multidisciplinary approach is needed, all of the professionals involved in your dog's healing must be in contact with one another so that if pain medication is required then all of the professionals can work around the agreed exercises, the intensity and also the changes that are planned ahead of time for the dog to be supported physiologically from all angles.

Muscle strengthening is vital for OA management, improving stability, proprioception, and reducing pain. For dogs, exercises like sit-to-stand, resistance training, and regular walking on varied terrains are recommended to enhance muscle strength, aerobic capacity, and weight control. Strengthening should be progressive and continuous for long-term benefits. (Millis and Levine, 2014)

Controlled joint motion is essential for joint health. Passive range of motion exercises, performed without muscle contraction, can improve flexibility and joint health. While not central to physiotherapy protocols, they are useful as complementary techniques alongside active exercises. (Salter et al., 1980)

Balance and proprioceptive training are important for maintaining functionality and stability in OA patients. These exercises help improve balance, reduce pain, and enhance muscle coordination, though their specific effects on osteoarthritic dogs need further study.(Saussac A, 2019)

Massage therapy can increase blood circulation, reduce muscle tension, and improve joint flexibility. In dogs, it is often used to relax and relieve pain. Guardians can learn basic massage techniques to apply at home, there are some great books and online courses available for guardians and professionals alike!

Aquatic therapy we know as hydrotherapy, including swimming and underwater treadmill exercises, offers high-intensity, low-impact exercise options for dogs with OA. This can help improve muscle strength and joint range of motion, especially in overweight dogs and dogs experiencing heightened pain who would not be good candidates for home exercises. (Millis and Levine, 2014)

Pyramid Level 4: Treatment by Physiotherapist refers to the
Physiotherapists evaluate the patient and their environment, develop a treatment plan, and integrate it into daily life. They act as consultants, working with both the patient and the guardian.

The effects of OA vary by patient and are influenced by comorbidities and daily activities. Environmental factors, breed, age, and guardian compliance are also considered. A holistic assessment tool like the International Classification of Functioning (ICF) adapted for veterinary use is proposed. (Millis and Levine, 2014)

Based on this assessment, an individualised exercise plan is created. Best practices in human medicine suggest at least 12 supervised sessions with progressive intensity, complemented by a home exercise program. Techniques like manual joint therapy, taping, and stretching are applied by the physiotherapist and are not suitable for home use. (Zinc and Van, 2018).
Exercises must be performed correctly to be effective, requiring specific and appropriate prescriptions. Physiotherapists should monitor and correct movement patterns creatively. Early contact with a physiotherapist is beneficial for optimising at-home and multimodal management strategies. Lifelong support through periodic reassessment ensures the adaptation of treatment as OA progresses. (Kloek et al., 2018)
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A collaborative, multidisciplinary approach involving a veterinarian, physiotherapist, hydrotherapist, canine behaviourist, and canine conditioning coach can provide comprehensive care for a dog patient and support their human caregiver effectively. Here’s how each professional can contribute and how they can work together:
The Veterinarian is the primary medical provider, diagnosing health issues, prescribing medications, and overseeing the overall health of the dog.
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Coordinates with a multidisciplinary team of the guardians choosing the treatment plan, referring to and communicating with other specialists as needed. Monitors the dog's progress and adjusts medical care accordingly.

Physiotherapist develops and implements physical therapy plans to manage pain, improve mobility, and enhance the quality of life for dogs with conditions like osteoarthritis.

Working closely with the veterinarian to ensure the physical therapy plan aligns with the dog's medical needs. Provides the guardian with exercises to perform at home (evaluates the home) and liaises with the hydrotherapist for aquatic therapy integration.

Hydrotherapist, specialises in water-based therapies, using pools or underwater treadmills to provide low-impact exercise that can help with rehabilitation and conditioning.

Coordinates with the physiotherapist to incorporate aquatic exercises into the dog’s overall therapy plan. Communicates progress and any concerns to both the physiotherapist and veterinarian.

Canine Behaviorist addresses any behavioural issues, providing training and behaviour modification strategies to ensure the dog's psychological well-being and mitigate any issues that might interfere with treatment.

Works with the physiotherapist and veterinarian to understand any medical conditions affecting behaviour. Educates the guardian on how to manage the dog’s behaviour, especially during exercises and treatments, ensuring a stress-free environment.

Canine Conditioning Coach, focuses on fitness and conditioning, enhancing the dog’s strength, endurance, and overall physical fitness.

Working alongside the physiotherapist to create a balanced conditioning program that supports rehabilitation goals. Monitors the dog's fitness progress and adjusts routines to ensure they are safe and effective.

A multidisciplinary team should have frequent updates and meetings among all team members to discuss the dog’s progress, challenges, and any adjustments needed in the care plan.

-Developing a unified care plan that integrates medical treatment, physical therapy, behaviour management, and conditioning exercises.

Ensuring the caregiver is well-informed about all aspects of the dog's care, including how to perform exercises, manage behaviour, and recognize signs of pain or discomfort.

Providing a support network for the caregiver, allowing them to reach out to any team member with questions or concerns, ensuring continuity of care.

By combining their expertise, we as professionals can address the dog's physical, medical, and psychological needs comprehensively, enhancing the dog's health and quality of life while providing valuable support to the caregiver.

So when I write a blog explaining the importance of rugs what I am actually explaining is that osteoarthritis in dogs is my area of brain strength and knowledge and that this is just one stitch in a huge tapestry which is your dog's health and wellbeing. This same model could be applied to any illness or ailment.

It is so important that you as the guardian have as much support and knowledge from professionals as possible to be able to understand what it is that your dog is going through, like any family member and that you have the resources and knowledge to access a rehabilitation or care model that aids both you and your dog.

Next week I will be discussing the impact of walking equipment and the physiological impact.

References

Mille, M.A., McClement, J. and Lauer, S. (2022). Physiotherapeutic Strategies and Their Current Evidence for Canine Osteoarthritis. Veterinary Sciences, [online] 10(1), p.2. doi:https://doi.org/10.3390/vetsci10010002.
Kiviranta, I., Tammi, M., Jurvelin, J., Säämänen, A.-M. and Helminen, H.J. (1988). Moderate running exercise augments glycosaminoglycans and thickness of articular cartilage in the knee joint of young beagle dogs. Journal of Orthopaedic Research, 6(2), pp.188–195. doi:https://doi.org/10.1002/jor.1100060205.
Millis, D.L. and Levine, D. (1997). The Role of Exercise and Physical Modalities in The Treatment of Osteoarthritis. Veterinary Clinics of North America: Small Animal Practice, 27(4), pp.913–930. doi:https://doi.org/10.1016/s0195-5616(97)50086-6.
Millis, D.L. and Levine, D. (2014). Canine rehabilitation and physical therapy. 2nd ed. St. Louis: Saunders, Cop.
Salter, R.B., Simmonds, D.F., Malcolm, B.W., Rumble, E.J., MacMichael, D. and Clements, N.D. (1980). The biological effect of continuous passive motion on the healing of full-thickness defects in articular cartilage. An experimental investigation in the rabbit. The Journal of Bone & Joint Surgery, 62(, pp.1232–1251. doi:https://doi.org/10.2106/00004623-198062080-00002.
Saussac A., Sawaya S.G. Impact of a training program with the motorised platform Imoove-Vet in agility dogs; Proceedings of the 6th VEPRA-1st ECVSMR Conference 2019; Ghent, Belgium. 19–21 September 2019; p. 140
Zink, C. and Van, J.B. (2018). Canine Sports Medicine and Rehabilitation. John Wiley & Sons, Inc.
‌Kloek, C.J.J., van Dongen, J.M., de Bakker, D.H., Bossen, D., Dekker, J. and Veenhof, C. (2018). Cost-effectiveness of a blended physiotherapy intervention compared to usual physiotherapy in patients with hip and/or knee osteoarthritis: a cluster randomised controlled trial. BMC Public Health, 18(1). doi:https://doi.org/10.1186/s12889-018-5975-7.

Helping our dogs at home!

Youtube audio link: https://youtu.be/xW6Vp2oG9KA?si=hOO7__p1iL_n4idN

Not all invisible conditions cause symptoms that we can see such as vomiting, changes in stools, limping, lethargy.

During the chronic pain symposium - the ‘Prevalence of radiographic appendicular oa and associated clinical signs in young dogs’ with - Dr. Duncan Lascelles, I witnessed a dog from his study of a year old dog with arthritis in comparison to an older dog with arthritis both going up a set of steps. The older dog showed physical signs of struggling, the young dog did not, but to trained eyes an altered gait.

Another research paper looked at the impact of unwellness in dogs of all ages and the impact on owners and found that the owners of elder dogs were resigned to their dog becoming arthritic whereas owners of younger dogs couldn't believe it as they didn't see any obvious symptoms. (Belshaw, Dean and Asher, 2020)

This is why it is so important to seek out an integrative vet who will spend a good amount of time with you and your dog, observe their movements and want to know every detail about your dog to make a diagnosis or clear them.

Something I am acutely aware of with being a millenials, is how animals have become subjected more than ever to poor care and the main character of a social media profile at their expense.

In Britain we had You've been framed with a segment dedicated to animals, the clips were supposed to be funny. For your friendly neighbourhood neurodivergent behaviourist, these clips were not funny. In the US I believe there was a show called America's funniest animals or something like that.

We now have TikTok where it's funny to watch an “influencer” torment their chihuahua, they get lots of influencer deals and paid partnerships because they are torturing their dog and people are liking, commenting, saving and sharing these posts.
So lots of people with animals show either causing distress to animals, poor husbandry practices, saviour videos, bad grooming videos, dog attacks in public, kids pushing dogs to bites etc.

It becomes mentally exhausting blocking these creators, reporting them and social media says it does not violate their community standards, commenting to be met with more stupid.

As a professional we have to protect our brains, when we don't we can't deliver, many of us don't protect our brains because we do want to raise awareness that these videos/ practices are not OK.
So how can we protect our peace?

Begin by making a difference at home. Many people don't realise that the minimalist media savvy home is not beneficial for the dog. Those oak cherry wooden floors, marble swirl delight floors, milky way floors are not helping our dogs and are adding additional pressure onto them physically.

I get it carpets are expensive and rugs are annoying, especially for renters. But what's more expensive is the knowledge that your dog is in pain. Especially as a Wheelchair user I get rugs are annoying but I'd rather have difficulty myself than my dogs.
Physiotherapeutic exercises and following the physiotherapy pyramid can help dogs with pain reduction for osteoarthritis, remember the citation above that this isn't just for senior dogs?
(Mille, McClement and Lauer, 2022)

Like everything concerning dogs the understanding of osteoarthritis is still within its infancy and much of what is known, just like our canine psychology is borrowed from.human anatomical studies or borrowed from animal models meant for human research for human treatment. (Douglas and Malcolm, 1955).

The physiotherapy pyramid was devised to demonstrate a systematic organised approach to prioritising a foundation for success.
The more practical and cost effective modalities lie at the foundation of the pyramid which should be sought first, then the layers above can be sought to add into patient care as long as patient comfort is kept at the centre of the pyramid.

The foundation of the pyramid being environmental modifications, this is where we at home can make changes right away, by adding rugs in, non-slip flooring, ramps, steps, reduction of access to stairs and jumping on and off furniture. (Fox, 2017)

The next step according to the pyramid would be an exercise plan as executed by a professional such as a physiotherapist, canine chiropractor or hydrotherapist, canine conditioning coaches like myself are utilised for maintenance of that exercise in four different areas, such as flexibility, strength, balance, coordination and stamina.

Follow this link to see the pyramid: https://www.ncbi.nlm.nih.gov/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Click%20on%20image%20to%20zoom&p=PMC3&id=9863568_vetsci-10-00002-g001.jpg
The next step of the pyramid is then osteoarthritis specific exercises for the home, slings and other assistive devices may also be introduced as a part of the individual's care plan and finally to the top of the pyramid is the physiotherapist treatment.

Due to the lack of studies, just like in all areas canine, the pyramid is used by clinicians based on experience, clinical judgement and feedback from the dog guardian instead of evidence based protocols and the biggest area that is to be analysed and changed is the immediate home environment. (Mille, McClement and Lauer, 2022)

Independent locomotion is important for dogs from not only a rehabilitation perspective but also from a behavioural perspective. (Millisle, 2004).

Many times I have worked with clients who have been extremely stressed as their dog has been advised to be on bed rest, however the dog was showing extreme signs of stress and uncomfortability due to crate rest. Now vets in the US have been discussing non rest and non surgical based treatment for injuries like torn cruciate ligaments, with more success in the dog being able to return to sports in a much shorter time span. https://orthodog.com/article/dog-acl-tear-no-surgery/

It has also been found that dogs quickly lose their confidence when trying to move if they slip on the flooring or can cause further injuries which is why it is so important to rethink the flooring situation and the best possible outcome for the dog.
Raised bowls, beds, orthopaedic beds, soft grass outdoors and removal of substrates such as shingle, gravel, hard gritty or rough or irregular ground is also needed to be considered not just for the recovery period but for the dog's mobility, safety and enhancement, especially in protecting healing of distal limb osteoarthritis. (Caring for a dog with osteoarthritis, 2018).
Due to this being such a long but important topic I will be discussing the other components of the pyramid next week. But remember flooring has to be non slip and fit for purpose for your dog's health and well being.

References

Belshaw, Z., Dean, R. and Asher, L. (2020). ‘You can be blind because of loving them so much’: the impact on owners in the United Kingdom of living with a dog with osteoarthritis. BMC Veterinary Research, 16(1). doi:https://doi.org/10.1186/s12917-020-02404-5.
Mille, M.A., McClement, J. and Lauer, S. (2022). Physiotherapeutic Strategies and Their Current Evidence for Canine Osteoarthritis. Veterinary Sciences, [online] 10(1), p.2. doi:https://doi.org/10.3390/vetsci10010002.
Douglas W.W., Malcolm J.L. The effect of localized cooling on conduction in cat nerves. J. Physiol. 1955;130:53–71. doi: 10.1113/jphysiol.1955.sp005392.
Fox S.M. In: Multimodal Management of Canine Osteoarthritis. 2nd ed. Group T and F, editor. CRC Press; Boca Raton, FL, USA: 2016.
Mille, M.A., McClement, J. and Lauer, S. (2022). Physiotherapeutic Strategies and Their Current Evidence for Canine Osteoarthritis. Veterinary Sciences, [online] 10(1), p.2. doi:https://doi.org/10.3390/vetsci10010002.
Millis D.L. Getting the Dog Moving After Surgery. J. Am. Anim. Hosp. Assoc. 2004;40:429–436. doi: 10.5326/0400429.
Caring for a dog with osteoarthritis. (2018). Veterinary Record, 182(15), pp.440–440. doi:https://doi.org/10.1136/vr.k1645.