From improving memory and cognition to strengthening muscles and enhancing quality of life, regular exercise is beneficial to the health and well-being of your geriatric canine patients.

We’ve all seen it. The 80-year-old ladies lifting weights, doing Tai chi, going for power walks, staying healthy and mobile. These active octogenarians are striving for not only a long lifespan, but a long health-span as well. Likewise, our older canine patients need to exercise and keep moving to achieve a health-span that matches their lifespan. But first, let’s look at the terminology and science around aging, the changes we are combating, and what exercise can do for the geriatric dog.

Currently, geriatric animals account for about half the U.S. pet population, and this percentage continues to increase annually. These animals show age-related decline in organ function, musculoskeletal health, and cognition. Dogs can be defined as geriatric when they have completed 80% of their expected lifespan. Dogs are commonly categorized into life expectancy groups by size, which means their age of becoming geriatric is also based on their size. A small dog is considered geriatric at 11.5 years of age, a medium dog at 10.2 years, a large dog at 8.9 years, and a giant breed dog at 7.5 years of age.

SENESCENCE AND ITS EFFECTS

Senescence, a term used in aging, actually occurs throughout an animal’s lifespan. It’s a process by which cells age and permanently stop dividing, but do not die. Over time, large numbers of senescent cells can build up in tissues throughout the body, leading to damage or loss of function in those tissues. Senescence leads to increased susceptibility to infectious and chronic disease, loss of resistance to external and internal stressors, and an inability to maintain and repair somatic systems. In the brain, senescence frequently coincides with changes in the structural plasticity of dendritic spines and aberrant neuronal plasticity directly associated with impaired brain functions.¹ This manifests itself as memory loss and cognitive decline.

HOW EXERCISE CAN SLOW AGE-RELATED DECLINE

Can we change this decline? Of course, or we would not be writing this. Experiments in mice showed that voluntary running and enrichment produced a doubling in the number of new hippocampal granule cells as compared to mice housed in standard living conditions.² Why is this important? Because the hippocampus is the area of the brain in charge of memory and learning.

In elderly humans, sequential imaging studies have shown hippocampal atrophy.³ Think about your elderly relatives. Do they process as quickly or learn as easily as they used to? Some of this aging process may be prevented or reversed by exercise.⁴ Indeed, older adult humans who exercise throughout life have less brain tissue loss than sedentary individuals.⁵

Synaptic plasticity, neurotransmission, and growth factor gene expression are heightened in the hippocampus of physically active rats and mice.⁶ Also, physically fit aged humans performed better on cognitive tests than their sedentary counterparts.⁷ In short, we can use physical exercise to prevent or reverse hippocampus atrophy in our pets and patients.

PREVENTING SARCOPENIA

Now on to the muscles. Sarcopenia is a syndrome characterized by progressive and generalized loss of skeletal muscle mass and strength, and is correlated with physical disability, poor quality of life, and death. Risk factors for sarcopenia include age, gender and level of physical activity.⁸

The loss of muscle mass is associated with an increase in body fat. Despite normal weight, there is a marked increase in weakness. The loss of muscle quantity appears to be mainly due to a degradation of contractile protein, resulting from both the reduction of single muscle fibers and a decrease in the cross-sectional area of residual muscle fibers.⁹

There is an important correlation between inactivity and loss of muscle mass and strength. This suggests that physical activity should be a protective factor for the prevention and management of sarcopenia. Progressive exercises can produce substantial increases in strength and muscle size, even in the ancient population.¹⁰ Preventing or postponing the onset of this condition enhances survival in people, and should also be a natural part of recommended management for our geriatric canine population.

FIVE EXERCISES FOR THE GERIATRIC CANINE PATIENT

Now that we know the science, what are the best exercises for our geriatric pets and patients? We will review five favorites:

1. Cookie Stretches — When done correctly, this exercise can be used to flex and extend the cervical, thoracic, and in many dogs, the lumbar spine. They can also be used as a diagnostic tool to assess for pain or restrictions along the spine, and as an exercise to cause weight shifts onto one or a pair of limbs. Cookie Stretches enhance balance and can be considered similar to “doggy yoga”. They can be done every day and performed by most owners with little risk of harm.

A cookie is brought sequentially to the shoulder, behind the front foot, back to the shoulder, to the hip, behind the rear foot (repeated on the other side), and to the chest, the floor, between the front feet as far back as possible, and lastly, with the front feet elevated at withers height or higher, the dog’s nose lured straight up to the sky.

Bonus: A nose straight up is of utmost importance for full spinal extension; if the dog can’t do it, there’s a problem that needs addressing.

2. Cavalettis — These can be used to decrease pacing, enhance even weight-bearing, increase limb joint flexion and stride length, improve balance and proprioception, strengthen muscles, including in the trunk, and reduce foot sliding.

Cavaletti spacing depends on the goal and the dog’s speed. The widest is for the patient with severe weakness and/or cognitive or neurological deficits. This width is usually 1 to 1.5 the length of the dog from nose to tail base. This allows all four limbs to cross before the next obstacle is attempted. The distance from floor to withers is a starting point for the trotting dog. Spacing for the walking dog is approximately the distance from floor to point of shoulder. The narrowest spacing is for enhanced limb flexion, balance and proprioception. Small adjustments may need to be made for each option, wider or narrower depending on the speed of the patient. The faster the dog moves, the longer the stride length.

Bonus: To check the distances, video from the side and follow one foot to make sure it hits in the same place between each set of Cavalettis. It is also imperative to start 5’ to 6’ before the Cavalettis to allow the dog to set their stride before they step over the first one, and maintain the same speed 5’ to 6’ past the last pole.

3. Wobble Board — With the handler controlling the board, this exercise can be gentle and safe enough for one-week-old puppies and also challenging enough for competitive adult canine athletes. With no shear force on any joint, all the muscles that stabilize the limb joints and spine can be strengthened. By having different-sized domes and the ability to move them or add others, as seen with the OctoBoard (www.optimumpetvitality.com/store), the challenge can be increased, and the limbs protected during exercises.

Wobble Board exercises can be done with the dog controlling the board, but the degree of difficulty or challenge is significantly limited when compared to having the handler control the board. With the handler standing on the board, the dog can have two, three, or four feet on the board. When three feet are on, the fourth limb has to balance the whole body, which is a fast way to increase strength in that limb while performing safe isometric contractions.

Bonus: Hold on to a solid surface to prevent losing your balance while you control the movement of the board.

4. Backwards Walking — This is one of the best exercises for strengthening the muscles of standing, rising and propulsion. It can be done any number of ways. Our favorites include placing the dog in a heel position and walking backward; getting in the dog’s space in front of them and walking into them; or luring them with a tasty treat at chest to nose height.

The idea is to have the dog take large steps with the rear limbs to strengthen the muscles on the caudal aspect of the fore and rear legs — the muscles of propulsion in the rear, and deceleration and standing in the front. Keeping these muscles strong prevents the way-too-often-heard: “We said goodbye because he couldn’t get up any longer.”

A very important detail is to have the dog looking straight out or down, not up. If the dog looks up, they are not able to take a long stride with their fore or rear limbs, significantly decreasing the ability to strengthen the targeted muscles.

The duration of this exercise can involve backing up as few as three to five steps before each meal for a weak dog, all the way up to walking backwards 100’ to 200’ in the yard for a stronger dog, whether geriatric or young.

5. Sideways Walking — This is the best exercise for strengthening the muscles that stabilize the hips and shoulders. As dogs age, they frequently have a tendency to lie with their elbows lateral to the body instead of under the shoulders. This puts stress and stretch on the deep and superficial pectoral muscles. As these muscles remain in a stretched position, and atrophy, it creates a situation in which the dog is more likely to have a splay injury.

The muscles that support the hip joints also atrophy if the dog is not active as they age. Dogs with hip dysplasia commonly have atrophy of the pectineus, gluteal, and biceps femoris muscles, the muscles that help hold the joint together. When these weaken, greater laxity can occur in the joint, leading to more pain and less active exercise.

By adding Sideways Walking to a dog’s exercise program, we specifically target all these muscles. To perform the exercise, with praise for proper performance, the handler can gently walk into the dog from the side; stand in front of the dog with a treat and walk sideways holding an arm extender to guide the dog; or place a small dog on a raised surface such as a bed or countertop and guide them sideways, so the handler does not have to lean over.

These are our five favorite exercises, but you can also have access to everything you need to know in order to prescribe, perform, teach, and progress 24 exercises for your geriatric and other patients, from puppy to athlete. Since all these exercises are designed for strengthening with safety, they are a great tool to add to your toolbox. You can sign up for Optimum Geriatric Exercises at www.optimumpetvitality.com/courses-professionals.

Science shows that exercising decreases the pain associated with osteoarthritis, improves cognitive function, can reverse age-related memory loss, strengthen muscles and improve quality of life in your canine patients.

Dr. McCauley shows three methods to teach Sideways Walking.

¹Cellular Senescence in Brain Aging. Ewa Sikora, Anna Bielak-Zmijewska, Magdalena Dudkowska, Front Aging Neurosci. 2021; 13: 646924. Published online 2021 Feb 25. doi: 10.3389/fnagi.2021.646924.

²Enriched environment and physical activity stimulate hippocampal but not olfactory bulb
neurogenesis. Jason Brown , Christiana M Cooper-Kuhn, Gerd Kempermann, et al. Eur J Neurosci.
2003 May;17(10):2042-6. doi: 10.1046/j.1460-9568.2003.02647.x.

³Imaging hippocampal function across the human life span: is memory decline normal or not? Small SA, Tsai WY, DeLaPaz R, Mayeux R, Stern Y Ann Neurol 51: 290–295. (2002).

⁴Exercise Enhances Learning and Hippocampal Neurogenesis in Aged Mice. Henriette van Praag,
Tiffany Shubert, Chunmei Zhao, and Fred H. Gage. J Neurosci. 2005 Sep 21; 25(38): 8680–8685.
doi: 10.1523/JNEUROSCI.1731-05.2005Aerobic fitness reduces brain tissue loss in aging humans.
Colcombe SJ, Erickson KI, Raz N, Webb AG, Cohen NJ, McAuley E, Kramer AF (2003) J Gerontol A Biol Sci Med Sci 58: M176–M180.

⁵Aerobic fitness reduces brain tissue loss in aging humans. Colcombe SJ, Erickson KI, Raz N, Webb AG, Cohen NJ, McAuley E, Kramer AF (2003) J Gerontol A Biol Sci Med Sci 58: M176–M180.

⁶Exercise: a behavioral intervention to enhance brain health and plasticity. Cotman CW, Berchtold NC (2002) Trends Neurosci 25: 295–301.

⁷A prospective study of physical activity and cognitive decline in elderly women: women who walk. Yaffe K, Barnes D, Nevitt M, Lui LY, Covinsky K (2001) Arch Intern Med 161: 1703–1708.

⁸Clinical definition of sarcopenia. Valter Santilli, Andrea Bernetti, Massimiliano Mangone, and Marco Paoloni. Clin Cases Miner Bone Metab. 2014 Sep-Dec; 11(3): 177–180. Published online 2014 Dec 10. PMCID: PMC4269139 PMID: 25568649.

⁹Age-related functional changes and susceptibility to eccentric contraction-induced damage in
skeletal muscle cell. Seung-Jun Choi. Integr Med Res. 2016 Sep; 5(3): 171–175. Published online 2016 May 20. doi: 10.1016/j.imr.2016.05.004

¹⁰Reversing sarcopenia: how weight training can build strength and vitality. W J Evans. Geriatrics.
1996 May;51(5):46-7, 51-3; quiz 54.

¹¹Exercise and knee osteoarthritis: benefit or hazard? Neil J. Bosomworth, Can Fam Physician. 2009 Sep; 55(9): 871–878.