Dog wheelchairs, underwater treadmills, and canine physiotherapy have hit the mainstream. People are opting to spend money on their beloved companions at an unprecedented rate. At the same time, medical advances are opening up new possibilities to aid our furry loved ones. While this can be a wonderful way to add years to our 4-legged friend’s lives, if we aren’t careful, it can come at the price of their mental well being.
Consider things from the dog’s point of view. How would you feel if you were taken for medical intervention and no one communicated what was going on? In our dog’s case, we can’t even let them know that this is for their benefit and not some new method of torture we’ve cooked up. We need to consider the emotional toll these interventions can take on our dog’s quality of life. Animal welfare science insists we must take into account both the physical and mental wellbeing of our pets.
We all have our specialties. As trainers, we deal in changing behavior and feelings. We are not physiotherapists or veterinary professionals. This means we can train dogs to participate and love their physio but we do not create their specific programs. We work together with a dog’s veterinary team and defer to them for all things medical.
We were hired to work with Mr. Spot, a rescue dog, to help him learn to walk. Mr. Spot had no use of his back legs and his new adopters wanted to see how far he could go with orthopedic surgery and physiotherapy. Their main goal was giving him a good quality of life. While we didn’t know all that might be required, our daily work with fearful and aggressive dogs involves teaching them to love things they once feared. We were confident this could be applied in a therapeutic setting.
When we first met Spot, he tolerated most interventions but he didn’t enjoy them. We wanted to change this right away.
Why is it important to change how dogs feel about physio?
First and foremost, we are doing these things to give our best friends a better life. No one in their right mind spends thousands on orthopedic surgery because they hate their dog and want them to suffer. We have realized that the welfare of dogs cannot simply be measured by the length of their lives. Quality of life matters as well.
There is a solid movement working towards the amelioration of the mental wellbeing of our pets. Behavior professionals are pushing us to move towards more humane methods of training. Animal welfare science is increasingly studying companion animal welfare with more papers being published on the topic. The Fear Free movement is helping the veterinary profession make the leap towards stress-free vet visits. Groomers are also starting to take note. As trainers, we know that every interaction someone has with a dog is teaching the dog, whether we consider the impact or not.
If that isn’t enough:
It could speed up healing
Stress has been shown in several studies to slow the healing process and have other effects on health. This has been seen in a number of species including humans. It is very likely the same effect could be seen in dogs.
It is usually easier
Mr. Spot is a willing participant in his exercises. No struggling to hold him in place. No contention needed. He volunteers and even gives the extra push when called upon. Definitely, no muzzling required to keep everyone safe.
New possibilities for canine physiotherapy
There are some things that can only be done if we get the dog to actively participate. Otherwise, they may block a movement or just make it difficult to get them into position. We can also get them to be a full participant in their treatment which can open up the possibility of new exercises that may be beneficial. Here is a video of Mr. Spot learning to pick up his leg and put it down with the pads of his feet down. Imagine being able to tell a dog he has earned a cookie every time he puts the correct foot down on the underwater treadmill.
It avoids behavioral side effects such as fear and aggression
This is the big one for us trainers! Whenever a dog is afraid or in pain, they may make associations about what caused that fear or pain. How they feel in your presence can also color the way they feel about you. Most dogs bite out of fear or pain. In a young dog, this could mean that all strangers or touches become something to fear. Unfortunately, we don’t always have control over what association is being made. Many dogs may associate the clinic environment or physiotherapy room with something unpleasant. For others, it is the white coat of a vet, a specific intervention or even an object that may be cause for concern. However, some dogs may just make the association that strangers touching them is to be feared. There can be long-term fallout especially for young dogs undergoing extensive orthopedic surgery.
Mr. Spot was a young dog with a long life ahead of him. He was spending his formative months being poked and prodded (entirely for his benefit but he couldn’t know that). As trainers, we know many young dogs will choose to inhibit their behavior in stressful situations. As they grow older, they may start to speak a little louder with growls, snaps or bites. Our work with dogs with fear and aggression issues has taught us not to discount these smaller signs of discomfort. We’ve learned that a dog just tolerating an intervention is at risk.
What can you do to make sure your dog is enjoying physiotherapy?
Learn dog body language
One of the most important things any dog owner or professional can learn. This is the cornerstone of our training program. Understanding dog body language will allow you to know when your dog is uncomfortable and when they are happy to proceed. Once you learn the basic signs of fear and anxiety, you can start looking at the broader picture.
Are things getting better or worse? Is my dog showing more or fewer signs of stress?
Is my dog moving towards or away from an object or person? Small shifts in movement can be important.
Is my dog loose or tense?
Take a look at this poster highlighting the more subtle signs of fear and anxiety in dogs. It only takes a minute and is available in multiple languages.
Here is a wonderful video by Eileen Anderson on how to know if your dog wants to be petted. It shows how subtle the communication can be. Once you start to see the signs, you will be surprised how obvious it can become. You’ll wonder how you never saw it before.
Work with a dog trainer
Some clinics and canine physiotherapists already work with a trainer. If your clinic doesn’t have someone on hand, hire an experienced positive dog trainer who has some practice training husbandry behaviors and fearful dogs. We recommend this article for help choosing a dog trainer. We all have our specialties. As behavior professionals, our job is not to devise a physical therapy program but to train a dog to participate and enjoy his therapy. It is imperative we work together with the veterinary and physiotherapy team to achieve the goal of improving the quality of life of our canine client. If something isn’t working, we should always decide as a team how best to proceed. Remember, it is the veterinarian’s role to prescribe behavioral and pain medication to help with physio or modify any protocols.
Be your dog’s advocate
You are your dog’s voice! If you see something that makes you uncomfortable, you have the right to speak up. Call a timeout if you need to give your dog a break and discuss things with your trainer, veterinarian or physiotherapist.
Prepare your dog
Aside from emergency procedures, most orthopedic surgery is planned in advance. We can pre-train and prepare a dog for their physiotherapy exercises before surgery. This makes it easier as the dog may not be feeling as great after surgery. Ask your vet or physiotherapist what types of handling will be required of your dog and what physio exercises will be necessary.
It may not always be possible to take all the fear out of physio. If this is the case, we need to seriously stop and consider if it is worth pursuing therapy. In some cases, the pros will outweigh the cons and in other cases, they won’t. This decision will have to be made on an individual basis. Things to consider: the level of fear and stress involved, if this a short or long-term intervention, the ease with which your dog recovers from stressful situations, our ability to make the situation better with training or drugs, and the potential long-term benefits. If an individual intervention is causing particular problems, we should also ask ourselves if this is a want (something desirable) or a need (something absolutely necessary).
But I’ve tried food and my dog still doesn’t like…
Here are a few common mistakes when training dogs to enjoy their wheelchair, treadmill or canine physiotherapy exercises:
Asking for too much
Trainers are great at breaking apart behaviors. It is what we do every day. There is almost always a smaller step or a way we can present something at a smaller intensity. Think of what the dog can do today, what the finished product looks like and then break it apart into individual steps.
Poisoning your food
Food coming before the scary thing can actually make dogs not trust the presence of food. For the most part, we want the dog to perceive the scary thing and then start the food to create a new positive association. This rule may get relaxed if we just want a dog to be comfortable in a new environment, we are luring the dog, or you are hoping to just distract the dog from the procedure.
Waiting too long to start training
It is tempting to try to get away with waiting to see if the dog will adapt on their own. Unfortunately, by the time we realize the dog isn’t adapting, we have already created negative feelings about the exercise or object. If the dog is likely to adapt quickly, it won’t take much longer to go at their pace and for the dogs that don’t adapt, you will save time by not having to backtrack. It is much easier to teach a dog to love something neutral than something they already dislike. Luckily for us, most dogs don’t have experience with physiotherapy equipment.
Lying with luring
This is one of the most common mistakes I see people making. Holding the food out to get the dog to move but as he advances, you move the food. When you hold out the food, you have made a contract with the dog. If you change the terms of your contract after the dog has moved, he may not believe you next time. Once a dog is trained, you can get him to follow a moving lure or target, but start off by keeping your promise to the dog. Hold out the food and wait for him to take it. Then produce another piece at the next checkpoint. Continue until you reach your destination.
Not reading subtle body language
If your dog is looking worried or scared, you may have to take things slower. Every dog is an individual. Things can also change from day to day. Tolerance is not enough! Many dogs will inhibit their behavior in a scary situation but it doesn’t mean they are comfortable.
Rate or value of reinforcement is too low
This is a big one if food has not worked for you in the past. How quickly the food comes is the rate of reinforcement. You want to make sure the rate is very high when training anything new or scary. It is better to do a short session with a very high rate, then to dole out one treat every 5 minutes and hope for the best. Value of the food is also important. Don’t be cheap. If diarrhea is an issue, most dogs enjoy canned gastro food. If it isn’t an issue, then shop around for what your dog likes best.
While high level training is wonderful, for most canine physiotherapy, simple classical conditioning will be your best friend. This just means forming an association (in our case a positive one or +CER in technical terms) between the task we want to condition and something the dog loves. In simple terms, dog sees or feels something, then the food starts.
Even painful stimuli can be conditioned to be fun: Mr. Spot’s toe pinch
When we found out we would need to pinch Mr. Spot’s toes in order to get him to reflexively pull up his legs, we weren’t happy with the idea of causing him pain. So we set about training him for the task. We had already worked with Mr. Spot extensively at this point so we had a pretty hefty trust bank account from which to draw. The fact that Mr. Spot is a pretty drivey dog who enjoys his work was also in our favor.
Here is a video of Mr. Spot happily getting his toes pinched for some cheese (notice the wagging tail and the anticipation of eating something great). These are not light pinches. They involve a fair amount of pressure as pulling up his leg is not an easy movement for Mr. Spot. (For professional trainers, this is actually an operant procedure with a focus on getting a hefty classical side-effect.) Mr. Spot is free to stop the session at any point but he is happy to keep playing the game.
1) Make sure the dog knows what is coming
We knew we had to announce the toe pinch before we reached for Mr. Spot’s back feet as we didn’t want him to wonder when a pinch might be coming. We have a number of other exercises involving his back legs and we didn’t want him getting squirrely when we were behind him. You can see in the video, we always say “pinch” before we reach for his foot. At first, Mr. Spot did not know what this word meant but after a number of repetitions, he caught on. You can see he gets excited when we say the word now.
2) Start small if possible
We knew it would be easier to make Mr. Spot love the pinches if we started with one pinch and worked up instead of trying to get in as many repetitions as possible right away. We were able to work up fairly quickly once he developed a +CER to the first one.
3) Be generous
When trying to build an emotional response to a fearful or painful stimuli, it is important not to be cheap. This is the difference between the excitement you may feel when someone is handing out a 1000 dollars rather than 25 cents. The more generous you are, the faster things will progress.
For dogs, that usually means lots of really tasty food. Mr. Spot gets little pieces of steak for most of his regular tasks so we wanted something extra special for the toe pinches. This turned out to be string cheese and special dog cookies he goes gaga over. Once Mr. Spot loved the pinch, we could start to reduce the amount of food per pinch but we had to start out big. One big piece of cheese and a cookie for the one pinch.
4) Make sure you have a yippee response
Before adding multiple repetitions, we made sure that Mr. Spot was happy when we pinched his toes once. What we looked for in Mr. Spot was a tail wag and an excited look towards the food after a pinch. We didn’t want tolerance, we wanted love for this exercise.
5) Build up incrementally
Once Mr. Spot was loving the toe pinches, we could start to build up. Every few days, we added an extra pinch per leg. We still fed after each pinch but now we could do multiple pinches per session.
6) Listen to the dog
This is where understanding body language and developing a training dialogue with your animal comes in. If Mr. Spot wasn’t feeling well, pinches became harder. We would alter the number we did based on what he could give us that day. We still pushed him to improve but his limits were respected. He injured his hip at one point in an unrelated accident and he was able to let us know that things had changed. Alternatively, he would sometimes ask for more pinches on certain days and we took advantage of this within reason. Mr. Spot asks for more of an exercise by choosing to stay in this activity when we cue him into the next one. When it fit our larger goals, he got to choose.
The future of canine physiotherapy
The advances in medical therapies and technology are astounding. If we can make our dogs willing patients, then the sky is the limit to what we can achieve.
This blog was written as part of Companion Animal Psychology’s Train for Rewards blog party. To discover other training blogs, click the button.
Mr. Spot’s program of stretches and exercises was overseen by a veterinary team and rehab specialists. We are not veterinary specialists and work under the guidance of medical professionals to train Mr. Spot to enjoy his physio activities. We love working in collaboration with other professionals. A strong team is one which utilizes the strengths of all its members. If you are a physiotherapist or veterinary professional interested in learning how to make your life-saving procedures more friendly to your four-legged patients, please get in touch. Behavior is our specialty!
Jennifer Gailis MSc, CTC, CPDT-KA