Tuesday, June 7, 2016

Cookie's Musculoskeletal Challenges: Restricted Activity and Weight Management

When your dog had surgery, or is recovering from an injury, a big part of successful rehabilitation is usually dramatic exercise restriction or even strict rest. While strict rest is often introduced only through the initial period (and there is actually an emerging movement against the use of too much crate rest), exercise and activity restrictions can last weeks or even months.

Even Cookie's therapy requires food for motivation.

With Cookie's iliopsoas injury, strict rest was ordered for a long time with extremely slow re-introduction to moderate activity.

To make things even more interesting, just as Cookie started being able to get out a bit more, she went nuts and injured herself once again. This set her way back.

Not only is this much restriction hard on the dog psychologically, maintaining functional muscles and optimal weight are additional challenges.

That is one of the reasons why some of the rehab specialists don't recommend too much crate rest and immobilization. While it may or may not be good for the actual injured part itself, such as with a torn cruciate, it results in major muscle atrophy through the entire body. Muscles are what protects the joints. Muscles are what moves the body. With too much atrophy you have a body that becomes dysfunctional. Joints themselves also benefit from movement. So at least some movement is important.

The amount of movement needed to keep the body functional is not likely to be enough to keep it slim.

Particularly when most available entertainment involves food one way or another be it training tricks, chews or stuffed Kong ...

As you can imagine, previously very active Cookie started to pack on some extra pounds. I did notice that and implemented some reductions but for the most part I figured she can lose it once she's back to full activity.

Puzzle games, training games ... none of that works without some form of treats.

But after the last setback she wasn't really improving the way she should and investigation revealed problems with her cruciate ligament(s).

Suddenly, the time I thought we had to get Cookie back to optimal weight was gone.

She needed to drop the extra pounds as soon as possible. Now what? She still needed something to entertain her. But we needed to find a way to stretch the calories she was getting way further.

I had no choice but to sit down, figure out what Cookie's resting energy requirement (RER) was, then start a spread sheet and calculate the caloric value of everything that went into her mouth and play around with it to remain within the limit of the RER.

When I need to offer less calories while not skimping on the overall volume of treats, I go for more water content first.

Slow-cooked or boiled lean meats contain much less calories than their dehydrated counterparts. Making such a switch allows giving just as many treats while not giving as many calories.

Switching to stuff that carries less calories. Did you know that the same amount of cooked chicken or turkey breast actually carries about half of the calories that cooked beef does? So we moved more toward those meats to make her treats even though I'm generally not a fan of feeding much chicken.

Switching to low-fat cream cheese to wrap her medications and supplements. Fortunately she didn't seem to care about the difference. Unfortunately, she's pretty sick and tired of any cream cheese by now so in order to get her to accept it I need to embellish it. Fortunately I found that smothering the "cheese rolls" in a bit of sour cream works.

After a discussion with Cookie's local vet we also decided to include L-Carnitine, particularly since we're trying both to get her to slim out and rebuild muscle.

These bones provide the most entertainment measured in time.
However, the marrow is very high in calories.
Finding the perfect bones such as this, with very little marrow and lot of other good stuff isn't easy.

With all the steps we took, together with Cookie being able to become more active again, the weight is coming down.

What I didn't do was adding extra fiber to bulk the food up. That doesn't seem to work and it does not keep a dog feeling satiated. Protein, on the other hand does, as well as is needed for building the muscles back up as well as for many other important functions in her body.The best thing to cut down on, naturally, is fat. Particularly with Cookie's diet that contains next to no carbohydrates.

The goal is to restore her to the body condition she had when she reached two years of age and keep her there. 

Meaning, knowing she has all the challenges, we want to keep her very slim, just like we've been doing with JD. I'm not having her lose the weight too fast but it's going down steadily while muscles are getting bigger and stronger which is good.

I would have never thought that the bullet that is Cookie could ever have weight issues. But such stuff can happen to any dog, particularly after injury or surgery.

Note: we did also go ahead and check her thyroid function. Firstly to find out whether sluggish thyroid could be involved with the injuries in the first place and secondly to make sure that our weight loss efforts are not an uphill battle. Her thyroid seems to be working fine, though.

Here is the problem with pain, injuries, rehab and weight.

Any reason for decrease in activity is a welcome mat for weight gain. On the other hand, any extra pound increases pain and inhibits healing and recovery. It's important to find a way to break out of that cycle.

Related articles:
From The End Of A Lead Line To Casa Jasmine: Meet Cookie, Our New Adoptee
And So It Begins Again(?) Our First Health-Related Heart Attack With Cookie 
I Didn't Know I Could Fly: Why Cookie Wears A Harness Instead Of A Collar
C.E.T. Oral Hygiene Chews For Dogs CAN Be A Choking Hazzard 
Our First Health-Related Heart Attack With Cookie: The Knee Or The Foot? 
Creative Solutions And An Incidental Product Review
Too Young For Pot: Cookie's Snack With A Side Of Hydrogen Peroxide  
Taming Of The Wild Beast: Cookie's Transition To Civilization  
Staying On Top Of The Ears: Cookie Is Not Impressed  
Putting The Easy Back Into Walking
Cookie's Ears Are Still Not Happy 
The Threat Of The Bulge Is Always Lurking 
Today Is Cookie's Three-Months Adoptoversary  
Cookie Meets The Electric Horse Fence And Her First Chiropractic Adjustment  
Why Examine Your Dog's Vomit? 
Why Is That Leg Still Not Happy? Cookie's Leg Keeps Getting Sore 
Cookie Too Is Insured With Trupanion
Does Being Insured Mean Being Covered? Our First Claim With Trupanion
Is Cookie's Leg Finally Getting Better?
Is Cookie Going To Be Another Medical Challenge Or Are We Looking To Closely? 
The Project That Is Cookie: Pancreatitis Up Close And Personal  
Pancreatitis: Cookie’s Blood Work   
Another Belly Upset: Pancreatitis Again Or Not?  
Happy Birthday, Cookie 
Incontinence? Cookie's Mysterious Leaks 
Who's Training Whom? Stick And Treat 
Don't Just Stand There, Do Something? Cookie's Mysterious Bumps 
Cookie's Mysterious Bumps Update
One Vomit, No Vomit 
Happy One-Year Adoptoversary, Cookie!
Cookie's Leaks Are Back: Garden Variety Incontinence Or Not?
Cookie's Leaks Update 
Don't Panic, Don't Panic: Know What Your Job Is 
The Continuing Saga Of Cookie's Leeks: Trying Chiropractic Approach 
Cookie's Minor Eye Irritation
Regular Wellness Exam: Cookie's ALT Was Elevated 
Cookie's Plantar Paw Pad Injury 
How Far To Take It When The Dog Isn't Sick?
Cookie Has Tapeworm Infection 
Cookie's Elevated ALT: The Ultrasound and Cytology  
Cookie's ALT Update
The Importance of Observation: Cookie's Chiropractic Adjustment
Sometimes You Don't Even Know What You're Looking at: Cookie's Scary "We Have No Idea What that Was" 
Living with an Incontinent Dog 
Summer Dangers: Cookie Gets Stung by a Bald-faced Hornet 
To Breathe or Not To Breathe: Cookie's Hind Legs Transiently Fail to Work (Again)
Figuring out What Might Be Going on with Cookie's Legs: The Process 
Figuring out What Might Be Going on with Cookie's Legs: The Diagnosis 
Cookie's Iliopsoas Injury Treatment: Trazodone  
Cookie's Iliopsoas Injury Treatment: Other Medications 
Cookie's Iliopsoas Injury Treatment: Laser, Hydrotherapy and Chiropractic 
Cookie's Recovery from Iliopsoas Injury: ToeGrips 
It Never Rains ... Cookie's New Injury 
Mixed Emotions: When What You Should Do Might Not Be What You Should Do for Your Dog 
Cookie's New Injury Update 
Cookie's Iliopsoas Injury: The Symptoms 
Cookie's Iliopsoas Injury: Battling the Zoomies 
Cookie's Muscle Injuries: What Else Is Going On?
Theory and Actual Decisions for an Actual Dog Aren't the Same Thing: Cookie's Knee Injury
Does Your Vet Listen to You? Cookie's Post-Sedation Complications
Would I Ever Treat a Symptom Directly? 
Platelet-Rich Plasma (PRP) Treatment for Cookie's Bad Knee(s)
Platelet-Rich Plasma (PRP) for Cookie's Bad Cruciate Update 
Injury or Surgery Recovery: Mishaps versus Setbacks 
See Something, Do Something: Cookie's Lumpectomy 
Cookie's Lumpectomy Update 
Using Pressure Pads to Evaluate Lameness in Dogs: My Observations
Cookie's Musculoskeletal Challenges: What Supplements Am I Using? 


  1. Very good info here, thank you. We also had to severely restrict our dog's activity after surgery (crate first), then barely any distance on walks. He didn't gain any weight, but this is very good info to know anyway!

    1. I'm glad your dog didn't gain any weight. Cookie's restriction went from three hours of running and playing daily to nothing ... it would be a surprise if it didn't show :-)

  2. Our foster dog had a luxating patella so I was always concerned about keeping his weight down.

    1. Yes, every time there is any joint issue, the weight needs to be way down. Keeping the weight down is both treatment and prevention.

  3. Finding the right balance is so important. While we have never had to restrict Ruby's movement because of surgery, she does have some joint pain and sometimes isn't always so active. We know if she gains weight her pain might increase so we are constantly working on finding the right balance.

    1. Yes, it's about balance. JD has bad hips so we keep him very slim. With Cookie it just kind of crept up. Not that she was fat but definitely heavier than should be. She's getting back into shape now.

  4. I wish I'd known more about this when my schnoodle had his knee surgery. I could not keep him quiet. It likely didn't help that one on the medications I had him on -found out later- caused hyperactivity in some dogs.

    1. Oh boy, no, having post-op meds that cause hyperactivity definitely does not help. It's important to always work with the surgeon to find the ideal combination of things. With Cookie, we had her on Trazodone. Otherwise nobody would survive her restrictions.

  5. Great info!!! We went through this with Seager and are still working through the consequences! He gained so much weight and, once gained, it is hard as heck to take it off!

    1. Sorry about Seager. Yes, it can be quite challenging to get the weight off once gained. Fortunately, Cookie didn't gain THAT much. But was definitely heavier than should be. So we're working on getting her as skinny as she was when she was two.

  6. Layla thank goodness is not over weight as I watch her like a hawk, but she is getting older and I worry about her joints so I love these posts with explanations, thank you.

    PS. I use Labane (Lebanese white cheese - Probiotic) when I give her pills and she loves it and does not know

    1. We watch those things too. But having her so restricted and desperate, we allowed more food than we normally would just so she'd have something to do.

      Lebanese white cheese? That sounds fantastic, I gotta see if we can get it somewhere.

  7. We have a constant challenge to keep Kilo the Pug happy and trained but slim. So far so good on the activity and injuries but that would certainly make things worse. He gets lots of raw vegetables as snacks and water with his food, much of which he works for. Will have to do more boiled chicken and turkey. I myself hurt my knees and put on weight- such a vicious cycle!

    1. Sorry about your knees. Yes, it's a vicious cycle. Trading dry treats for treats with more water content certainly helps. And lower cal meats for higher cal meats.

  8. We work very hard to keep Bentley at his ideal weight. Extra pounds are hard a his Basset Hound body. A change in his diet and adding more exercise was the key for us. I appreciate the information and the links.

    1. Great job keeping Bentley at ideal weight. It can be hard sometimes and yet it's so important. What did you change his diet to?

  9. Thanks so much for writing this article. I'm a dog trainer, and on occasion, have a client who gets injured and of course, deals with these very same issues! It's super helpful to pass this information along to other owners!

  10. Rehabilitation with active dogs is so tough. Yesterday we had to crate rest Shermie as he wasn't weight bearing on right front leg. Perhaps an elbow injury? But I knew puzzle toys were the solution as walking was out. A nightmare for any pet parent with active dogs but enrichment can save us all and your diet tips are great.

    1. Most definitely. Problem,with Cookie is that any given puzzle entertained her only for a while until the mental challenge is gone. The best puzzle so fat was Trixie (or something like that) first session entertained her for an hour. There were puzzles where it took,her 30 seconds,to,figure it out.

  11. I didn't know that dehydrated meat was higher in calories than boiled counterparts. I think it is great that you have found a way to keep giving her treats while cutting back on calories so she won't feel deprived.

    1. Fresh or boiled meat is about 70% water. Take that away and,you have much more calorie dense chunk. Pound per pound way less calories in fresh than dried simply because of the water content difference.

  12. Wow, that is a lot to figure out. Well done for doing so. I'm sorry you both had such a challenge. Thank you for sharing this valuable information.

    1. Thank you, Sadie. The biggest challenge really was to keep her quiet and happy (those two don't really go together well with such an vibrant soul). The Trazodone helped but it actually contributes to potential weight issues.

      It's easier now when she can be much more active again.

  13. Weight gain is a struggle for all of us! I can't imagine how difficult it must be to have to fight the extra pounds with limited exercise capability. You are an amazing dog mom to be able to get through all of these issues!

    1. It has been challenging. Particularly since pretty much all her entertainment during the restrictions involved food one way or another.

      It's going better now.

  14. Does Cookie like vegetables? Matilda will only eat cooked carrots, they end up soft and warm with a strong scent. I'll keep that in mind about dehydrated meats!

    1. Not really. Every now and then. If she did, it would indeed have been much easier. I guess I never tried boiling some carrots with bacon! LOL Perhaps I should try that see if it fools her :-)

  15. Great information here! I'm constantly reminding my pets that food does not equal love. :)

  16. My greatest fear of any injury that might happen to my corgis is crate rest. They are so active. I guess people (and dogs) live through it, as you are, but it just seems so daunting. I hope you find a happy balance between the rest and diet with Cookie. And that she doesn't injure herself again!

    1. Yes. Cookie is a very active girl too, used to 3 hours of running and play outside daily. Going to strict rest was unrealistic. I pointed that out to the vet immediately and we used Trazodone to help keep her from losing her mind.

  17. I never thought about animals putting on weight when they are on restricted activity, but it makes a lot of sense.

    1. Yes, it's quite logical, particularly when the only entertainment become tricks (require treat), food puzzles, food stuffies and chews.

  18. Excellent tips. Love the puzzles here. With three Huskies who had blown CCLs and one Epileptic Husky, rest and meds and weight gain are/were always an issue, as was working in exercise, which is not always possible. It's very true that it is not always easy to keep weight management in mind while rehabbing. Great post!

    1. The best puzzle - most entertainment out of it is the Trixie series. Even though even that got too easy in a hurry for Cookie, the first time she played with it for an hour with just two refills. Even though it's too easy now, she still enjoys playing with every now and then. But buys only about a minute per refill :-)

  19. Poor Cookie! It must feel like a catch-22 at times. I hope Cookie can return to her former glory soon!
    Love & biscuits,
    Dogs Luv Us and We Luv Them

    1. Thank you, Cathy. Couldn't have done it without the help of the Trazodone. She can now get her full time outside (3 hours daily) and even though still on leash, she can now go through the terrain, climb things, dig for mice ... I allow her trot as much as she wants not and let her do short runs. We are building her up to her normal activity level.

  20. Wow. This is complex. I had a hard time keeping my schnoodle quiet after knee surgery. I couldn't and didn't yield good results.

    1. It is tricky, particularly with an active dog. The Trazodone is a life-saver and many surgeons now use it for post-op chemical restraint.