Movement as Medicine: Canine Exercise Therapy with Dr. Leilani Alvarez

Proper exercise and conditioning can support our dogs as they age. In this episode of Ask the Vet, Dr. Ann Hohenhaus welcomes her colleague, Dr. Leilani Alvarez, Service Head of Integrative & Rehabilitative Medicine at AMC, to discuss exercise, mobility, and how we can keep dogs strong and active throughout their lives.

Topics include:

• What a specialist in canine sports medicine and rehabilitation does
• The changes in strength, mobility, and function you may see in your dog as they age
• Differentiating between normal aging and early signs of mobility problems
• All the ways in which regular movement can support overall health and quality of life
• Why conditioning your dog for exercise matters
• What a well-balanced exercise routine looks like
• Common mistakes and habits that can lead to strain and injury
• Regaining strength and mobility after an injury

Also on this month's show:

• Trending animal story about Buck, a dog who was rescued after being found with a plastic bucket stuck over his head
• Animal news, including how dogs may try to help their families find lost objects in ways that look strikingly similar to human toddlers
• Pet Health Listener Q&A: When to worry about hydration in kittens; how sun exposure can lead to cancer; and what to do if your cat has one pupil larger than the other

Do you have a pet question for Dr. Hohenhaus? Email askthevet@amcny.org to have your question answered on Ask the Vet's Listener Q&A.

Transcript

0:00

We want to remind our listeners that this program is for informational and educational purposes only, and not intended to substitute for professional veterinary medical advice, diagnosis and treatment. The Animal Medical Center does not recommend or endorse any products or services advertised by Sirius XM. Welcome to Ask the Vet with Doctor Ann Hohenhaus. This is the place to talk about your pets and get advice for the top veterinarian from the Animal Medical Center in NYC. Hear from the leading authorities on animals and ask your questions. Now here's your host, Dr. Ann Hohenhaus. Hello everyone and welcome to Ask the Vet. It's the podcast for people who love their pets and want the latest in pet health and animal news. Like every month, I'm your host, doctor, and ho and house. I'm a senior veterinarian and director of pet health information here at the Schwarzman Animal Medical Center on the east side of New York City. As our pets live longer, we're seeing more age related changes in their strength, their mobility and overall function. Today, we'll be talking about what it means for pet owners and how exercise and conditioning can support our dogs over time. I'm absolutely thrilled to be joined today by my colleague here at AMC, Doctor Leilani Alvarez. She's the director of the Tina Santi Flaherty Rehabilitation and Fitness service and is a leader in the field of canine sports medicine and rehabilitation. I'm really looking forward to our conversation today and you should be too. The Schwarzman Animal Medical Center is the only level one veterinary trauma center in New York City, and the hospital has 115 years of being the very best place for pets. If you want advice on maintaining your pet's health, I'm here to help. Just send me your questions to our email, which is Ask the Vet at AMC ny.org and I'll answer your question on next month's show. If you didn't have a pencil to write down that email address, don't worry, because I'm going to give it again later on in the show. And now it's time for our trending animal stuff. It's time for the internet's most talked about animal. A stray dog who is now called Buck has gone viral after being found with a plastic bucket stuck over his head in Winston County, Alabama. Buck is a lab mix and he couldn't see or find food. And another dog who's now called Milo, a Belgian Malinois, stayed close by throughout boxer deal. The post, shared on social media, sparked a community led search for the dog, with volunteers coordinating their efforts over several days. The rescuers were eventually able to locate the dogs, remove the bucket from Buck's head, and take Buck to the veterinarian. Buck is now being treated for sinus and ear infections, and Milo is recovering from a hip injury and several cuts. Both dogs are now safe, and rescuers hope to find them a home where they can continue their friendship and be together. This story has drawn attention for the community response and for the bond between these two dogs. So this story about Buck and the bucket has a happy ending. But I just want to warn pet owners, not just dog owners about this one, but pet owners about chip bags like potato chip bags, Dorito bags, Frito bags. Those are the bags a dog wants to stick its head into to get every last crumb off of it, and then their head gets stuck in the bag because it's about the same size as a dog head. And then the dog runs the risk of suffocating because those bags are airtight to keep your chips nice and fresh. So be extra sure that chip bags, or any bag that's made of that same crinkly but airtight type of material is not out there for your dog or cat to get their heads stuck in it, because it might not have as happy an ending as the story of Buck and model. And now I'm going to turn to a topic that is increasingly important as our pets live longer, exercise, mobility, and how we can keep our dogs strong and active throughout their entire life. Joining me today is my colleague here at the shores of an animal medical center, doctor Leilani Alvarez. Doctor Alvarez is the director of the Tina Santi Flaherty Rehabilitation and Fitness service here at AMC. She's a board certified in canine sports medicine and rehabilitation, and specializes in the treatment of soft tissue and sports related injuries. She leads one of the small number of accredited residency programs in the area of sports medicine. She's also the author of the Handbook of Canine Exercise Therapy, which will be released in just a few days on April 13th. And this book really isn't a book for our our listeners to listen to. It's really a book written for veterinary professionals, but if you really like your veterinarian, it would be a great gift to give them. This book focuses on developing effective and evidence based exercise programs for dogs. So, Doctor Alvarez, thank you so much for coming and spending some time with us on asked the vet today. Thank you. And I really I'm happy to be here. So I always like to start my interview with our guest by asking about the pets that they have. So talk about what pets you have right now. I have two dogs and two cats. One of the dogs is a rescue and has epilepsy, so she's seizures, pretty regularly. And my cat, Lucas, who's an orange tabby, is the biggest problem maker in my house. He breaks into cabinets and steals food. So I often laugh because I say my pets, occupy more of my time than my children. So when Lucas breaks into cabinets, does he just like, you know, push up against them and dislodge the lock? I mean, how do how do cats do that? Oh, and he he has learned how to pop open the microwave. He has to push. I mean, I've tried it myself. I'm like, how does he have the strength to do this? So I microwave. It's really hard to open two minus two. I think it's a combination of, cleverness, persistence. And also, you know, he's he's a trouble maker, so he's just constantly trying to any way that he can to to I, you know, I, I really try to ascribe the things that I teach owners to my own pets, which is we want to prevent obesity. But Lucas, is determined that he wants to be overweight. And he's tried really hard. Yeah, but usually I don't think of orange boys as being troublemakers. Orange boys are usually, in my opinion, the best cat out there. I, they agree. Delightful. He's. He's like, typical Garfield orange tabby. Okay, so. Well, I could talk a lot about cats, but we're actually here to talk about dogs today, so dogs are living longer than ever before. So what strangers? What changes would you expect to see in a dog as it ages? This is a great question, and we often hear that age is not a disease and that is absolutely true. However, with aging come many expected changes. One of the ones that affects mobility, it's quite impactful, is the loss of muscle. So as we age, no matter what we do, even if we're working out, we're expected to lose a lot of muscle mass over time. In fact, in people, by the time you reach age 30, you're going to lose about 5% of muscle mass per decade. And when you're 60, that goes up to about 10% muscle mass per decade. So, you know, it's no surprise for any listeners that that are over 30 or 60 that you just don't aren't able to bulk up as you used to when you were younger, but multiple practically every body system is affected by aging. And things that affect our senior dogs include that metabolism slows down, so muscle is actually replaced by fat. So we do see it increased a dogs that are overweight as they become older. We also see atrophy of a lot of major organs. The brain is one that atrophies. Also our kidneys atrophy. Our nerves conduct more slowly and all of this can have an impact on mobility. Overall, what I would say is with aging, we tend to see a loss of strength, a loss of stamina. And importantly, these changes are slow and subtle. So oftentimes we don't notice them right away. We just see it over time. So what do we do about that? Well, I would say the most important intervention that you can do is implement exercise. Exercise is one of those interventions that I see as improving everything in the body. I think a lot of people think about exercise is going to be helpful for mobility, but it turns out that movement and regular exercise is probably one of the most impactful things you can do as preventative medicine. So we know, for example, in people that regular exercise is associated with 20 to 30% lower risk of all cause mortality. Now, what that means is all the different reasons why people die cardiovascular disease, cancer, you know, any disease. By just exercising regularly, you're reducing your risk of dying. And how that and your survivability. So you're expected to live longer. Also, another statistic that I love is actually speed of walking. So this has a direct association with survivability. So if as as a listener, you walk very quickly, you're likely to live much longer. And if you're interested to know the actual number, so you want to walk at least one meter per second. And if you walk that quickly, you are likely to have a substantially longer survivability. So 20% lower mortality risk if you walk at least one meter per second compared to people who are only walking 0.8m/s. And so this translates to our canine companions, because you can take them for a walk and you can time yourself. And the quicker you walk, the likelihood that both you and your dog will live longer. Exercise is also beneficial not just for survivability, but also we see decreased cancer risk in humans. We know multiple cancers have a decreased risk by just regular exercise. The ones that have been most heavily studied are colon cancer, as well as breast cancer and also prostate cancer. So those have like definitive evidence that regular exercises reduces the risk, as well as for cognitive function. So if you exercise regularly, your brain will actually function better because you're getting more blood flow to the brain. So you can decrease dementia in people. It would be Alzheimer's disease in your dog. It would be canine cognitive dysfunction. So lots and lots of benefits for movement. I really like to think about movement as medicine. Is what I like to tell my pet owners because I think as veterinarians we like to write prescriptions and we like to prescribe things to help our patients. And I speak when I give lectures. I tell my veterinary audience to start prescribing movement as medicine. So instead of writing a prescription for a drug, write a prescription for exercise. And if you don't know how to prescribe the exercise, you can get this handy book, which is the Handbook of Canine Exercise Therapy. And it guides you through exactly how to develop a healthy and safe exercise program for dogs. So, I think my watch tells me like, how many steps I take per second. So how does that translate? How can I translate my watch to a meter per second? Do you know? Ooh, I do now, actually, because when I first heard this statistic, I was like, well, how quickly am I walking? So if you go to your setting, depending on if you have an Apple Watch or whatever device you're using to track you, you can change the metrics on that so you can change it to meters instead of steps. Okay. Because like I, my watch is always, you know, giving me a clapping hands because I walked somewhere in some amount of time, but it's always in steps. It's not in meters. And I know a step is not a meter because for I, veterinarians talk about meters and centimeters. But for our listeners, a meter is a little smidge bigger than a yard. And nobody can take a step. Oh, maybe like a basketball player or a really tall basketball player could take a step. That was a meter. But Doctor Alvarez and I could not take a step. That was a meter unless we were like, you know, being really silly and taking jumping steps or something. Yeah. And that's why that's why distance is better. Because, as you said, if you're a basketball player and you have a really long stride length, you're going to be able to cover more distance and fewer steps. And you and I and, you know, we're going to have to take a lot more steps to cover that distance. Yeah, yeah, I bet I take like two steps per meter would be my guess. Yeah. But so so for every ball, the listeners you can change the way, that your watch tracks that in past as opposed to say, I'm going to log on and see what it tells me. So when a doc's, you know, people always say, oh, he's slowing down. And I from my perspective, I treat a lot of patients who the owner says, oh, I didn't realize he slowed down so much until you fixed fill in the blank, whatever the doc's problem was. And so how can owners really tell the difference between normal and appropriate slowing down, or is there appropriate slowing down? That's a great question because we just mentioned the changes associated with aging, which are expected to be loss of strength, loss of muscle mass, loss of stamina. And that absolutely can lead to slowing down. For me, the biggest indicator that differentiates between normal aging and something that really requires an intervention, and I'm worried about is the demeanor of the dog, in particular their socialization. Are they still engaging with you? Are they initiating play? Are they, slower in getting up because these can be signs of pain. So that would be a big indicator for me is aging is not associated with pain. It should not be associated with pain. So if you notice your dog is not engaging in social activities, this goes for your cat as well. Those are big indicators that they could be experiencing discomfort. In addition, not not finding joy or seeking out the activities that they really enjoyed, when they were younger. That can be another sign of pain. And in general, I would say also functional ability. So while you might do things slower, you still should be able to do those activities of daily living. We call them in a dog. That's things like getting up. That's an activity of daily living, being able to stand up while you're eating, being able to posture, to eliminate, to urinate and defecate. These are things that you should be able to continue to do no matter how old you are. So Doctor Alvarez and I share a patient, and he I saw him today laying down to drink because he's kind of sick right now. And so he's not doing daily activity normally because he had to lay down to drink from his bowl of water. He has a lot of good reasons to be doing this. So we're working very hard to make him better. But but that that is a dog who clearly is having some aging issues. So how can someone recognize not a veterinarian, but how can the average pet owner recognize that their dog is starting to lose strength and mobility? And then the follow up to that is what interventions should they do? Yeah. That's great. I there's a lot of things to look for. The one you just mentioned and is a really good one. Is your dog no longer able to remain standing while they're eating or drinking water? Are they starting to slip like when they walk across a hardwood floor or a marble floor? Do you see the legs kind of slipping out a little bit? Is it taking them longer to get up? Are they hesitating before they attempt stairs, or hesitating before doing an activity that they would just do quickly before? So, those are early signs. I would not wait until they're unable to get up. Right. You look for that slowing down and modifying how they're moving as the early signs. And what I will say to you is, again, I would not think of these are just normal aging. I think of those changes as we need to intervene. Normal aging for me, I don't need to intervene. But if we are showing changes of discomfort, inability to do activities of daily function, that is where I want to intervene. And so I'll just go ahead and answer because you asked that question. I might be biased, but I think one of the best interventions is movement. And it's not that easy to say we'll just move more because if you're in pain, you need to address the pain first. So I definitely recommend for all of our listeners if you're thinking, oh my goodness, my dog is hesitating before the stairs, my dog is having trouble walking across slippery floors. Please reach out to your veterinarian or your rehab specialist and they can guide you on how to safely implement movement. But a lot of times it's making sure that we don't have a painful condition that needs to be addressed with pharmacologic intervention, so they may need a pain medication. In addition, we want to make sure that all the other things that are associated with aging, like your kidneys, atrophy. That might mean that your kidneys aren't working as well, and that might be why you're weaker. So we need to see the internal medicine specialist or your primary care veterinarian to address whether they might need fluid therapy, etc.. So there are a lot of different things that can happen with aging that can explain the slowing down. But that doesn't mean we just accept it as aging. It means we need to intervene and help them. I think one of the things that said, I think sometimes tips pet owners off is in New York City. Most of us don't have stairs. We go up to our apartment on an elevator. We live in an apartment that's on one floor, and the dog doesn't have to do stairs or cat, for that matter. And then you go to visit grandma, or you go to a family member's house and take the pet, and they have stairs, or you go to the country house and you realize that the pet is standing at the bottom of the stairs and can't go up stairs anymore because you don't see that on a daily basis at home in New York, because you don't ask them to do stairs. And so I always tell pet owners that they should seek out stairs while they're in Central Park, walking their dog or the neighborhood park, or there are places in New York where they're public stairs and encourage the pet to go up and down the stairs, because you don't want to get to the some other house on the weekend and realize that you're going to have to carry the dog up and down stairs at night to go to bed. But it's a great piece up on people because they're not, you know, six days a week. They're not any place with stairs. So that's my unqualified advice about the. Yeah. And what I would say is, you know, I think about a lot of people do have like a few steps that they have to take before they can get to the elevator. But you're right. In some buildings that is from the ground level where they can enter an elevator, what I would say is, yes, I love that suggestion because you can use that as your baseline. Also, you always do want to challenge them to be able to be able to do those activities so you can detect when they're beginning to have trouble. But truly, what I would be looking for, for your average New York City, pet owner who may not have regular stairs, is, you know, how do they look when they get up? Is it taking them longer to get up? Or are they stable when they're standing to eat and drink? The other really big one is when they eliminate. So one thing to look out for, I call it the walking poop, is instead of being able to hold a squatting position to defecate, dogs will begin to take steps forward. Because holding a squatting posture is actually a hard exercise. It's, you know, you and I tried to hold a squat like, we get tired and we, you know, we're like, okay, I can't do this any longer. And it's an exercise we can use to strengthen and think about. Dogs don't have a toilet seat to sit on, so they have to use their muscles to hold that squatting posture. And that's another really good early sign is when they're having difficulty holding that squatting posture. If they're starting to walk or not, squat as low when they're pooping is another indicator that they're becoming weak. And maybe we should intervene. So then what would be a balanced exercise routine for just your nice average family dog? I, I have a great balance program that I can have all listeners hopefully implement right away. One thing that's important is you don't want to concentrate on just one exercise. I think all of us know that walking is great, and absolutely your dog should be encouraged to walk as much as they can tolerate, but that's more of an endurance exercise. So along with endurance, you want to include strength. You also want to include flexibility and range of motion. In addition, perhaps the most important exercise that I think is missed is exercises that increase awareness of where your legs are in space, and we call that proprioception. This is something that decreases as we age because again, that nerve conduction is slower. Your muscles are atrophying, so your reaction times are slower. So include proprioception. And then finally I recommend including something that is task specific because different dogs have different roles and not everybody has to perform the same functional mobility. So again, strength, endurance, proprioception, flexibility and range of motion and task specific. Those are the five areas for a balanced exercise program. So how can we implement this for your average senior dog? Walking is a good one that will take off your endurance strength. You can have them go to stairs like you suggested and in Central Park. Have them put their front feet up on the first step and hold that position until you see them slightly start to fatigue. Because the way that muscles gain strength is through a principle called overload. That means we have to push that muscle until it's slightly fatigued. And that's the trigger for it to actually gain strength. So just I call it an elevated stance. So we're just going to put front paws up like on a step. Have them hold to tolerance. Take a tiny little rest and then repeat that three times in a row. For proprioception, this is recognizing when an obstacle is in front of them and they have to get over it. So I recommend walking dogs over different textured surfaces. Maybe they go to Central Park, maybe walk over some mulch or where there's gravel. Something like that. At home you can actually create an obstacle course. So we talked to owners about putting down a broomstick like a couple of broom sticks, and then they have to walk over them without hitting it with their feet. So it just increases awareness. Also, for our New York City clients, they're walking on the sidewalk all the time. If you have them walk on and off of the curb, that really heightens proprioception, because you got to pay attention to where your feet are for flexibility and range of motion. If you capture a dog doing a play, Bo, it's a natural position that dogs do before they want to initiate play. You can either capture it and try to reinforce that with training, or I can teach a dog to do that by putting one hand under their belly. And then you take a treat from their nose to the floor in between their front legs and that will encourage them to make that play poster. And that's a great way to encourage flexibility. You can also, we have a video that maybe we can send out to listeners, where I showed owners how to do range of motion exercises as part of a massage routine. So you can do that daily. And task specific, of course, is going to be individual to your dog. For example, does your dog like to jump up on the bed? Well, this is something that's going to get hard as they get older. So how can you train for them to be able to have that? So the elevated stand is actually a great way to maintain strength to those back legs, so they can continue to be able to get up on that bed. Although I will say I do recommend as dogs get older to modify their ability to perform that task by adding something like a ramp or stair. So it's, it's a little bit easier for them to be able to perform that task. And I would just caution our listeners that dogs are really smart. And I had a client who came in one day and he said, I'm really worried about the dog because it can't jump up on the bed. And then his assistant was with him and said, what do you mean? When I'm there? During the day, the dogs jump up on the bed all the time, and when you come home, they look at you and you lift them up on the bed. So just be sure that in fact, your dog is really not able to get up on the bed because, you know, they're they are opportunists, those dogs. You may have had an opportunist, but the opportunist, the one that I make you work for them. Yeah. What I was going to say, that's a good one for that. Because we're teaching owners all the time home exercises. And I tell them, you know, you don't need to give a treat. Like, when you're first training them, you should give a treat. But once they know it, you just give the command and they don't need the treat. But of course, the dogs trained the owner. Yeah, exactly. Exactly. So, you know, you said a dog should have a task. What about fetch? Throw, fetch throw fetch. Is that a good set of activities. Well it could be if you prepare them for that activity. A common issue we have I think it's not just a New York City issue. I think probably any working, pet owner is probably experiencing this where they have more time on the weekend and we see this phenomenon I called the weekend warrior. So dog is sleeping most of the day and maybe just going out for regular leash walks during the week. But then on the weekend we play fetch for like an hour at a time. And the reason why I worry about those activities is the dog is actually not conditioned for that. So it would be like asking you and I and to go and sprint on the weekend when you know, we're not doing any strengthening exercises during the week and it's going to exhaust us, and if we have any little bit of arthritis, it's probably going to hurt our joints too. So while fetch is definitely a great exercise, it definitely carries a higher risk for injury. So the best things I can recommend if you have more time on the weekend is make sure you warm up your pet before you do any high level activity, and a good warm up is just a 5 to 10 minute leash walk. So before you just start throwing the ball or the frisbee, go for a 5 to 10 minute walk. Also, as your dog gets older, I don't think that's a great activity for them. You can do. Tug of war is actually a great resistance exercise is actually better for strengthening than playing fetch as an endurance activity. Whereas tug of war is actually a bit of more strengthening. And so you want to also include, during the week more strengthening exercises than not just the walk to prepare them and conditioned them for the higher level of activity. The other potential risk with playing fetch is rapidly turning. Just like soccer players in football, players tear their ACL. When we do that kind of activity in dogs, they also experience higher risk for tearing, their cruciate ligament and other soft tissue injuries. So I think that, you've already alluded to the fact that if you have a dog that hasn't been very active, or maybe a dog who's been on exercise restriction because of an injury or illness, the they're going to be a little out of shape. So what's the best way to help them ease back into shape? The key I would say, is start slow and low. Leash walks are a great way to begin mobilizing a dog that has been on exercise restriction. Another exercise I love is called weight shifting. So when a dog is just standing, you can slightly nudge them from the good side towards the injured side just so they begin to put a little bit more weight on that leg that was injured. And then the other exercise I love is what we call isometric exercises. This is similar to yoga exercises in people, and one that I already mentioned is that elevated stand. So just having them hold a position for a little bit longer without movement of their joint is a great way to strengthen in a safe way. It could even just be able to hold a standing posture without fidgeting. Is a great exercise to begin with. You'd be surprised. You know, just standing up for a dog that's becoming weak is actually challenging. So standing walking. And begin with some isometric exercises. Weight shifting, maybe a low level elevated stand are really safe ways to begin to reintroduce activity. You know what you haven't mentioned in your very complete list of exercises is what about swimming? Swimming is something I have found owners think is always safe because it's a buoyant exercise, and it certainly is gentle on the joints. So a dog that has arthritis, certainly not having that impact is really nice for, swimming. However, as anybody, any human that does swimming will know, it's a very cardiovascular demanding exercise. So this is again, not something I recommend if the dog has not been swimming all year long and now it's warm enough and the pool is opening, or it's warm enough and they can go in a lake or a river, just keep in mind that they're not conditioned for that. And so again, start slow and low. So typically in our rehab facility when we swim a dog, we do it no longer than one minute to start. And then we slowly progress that activity. The other thing I want to mention is that swimming is absolutely contraindicated. If you have a soft tissue injury. So it's very different if you have arthritis in a joint, swimming can be great. But if you've torn your ACL or you oh you've torn your shoulder tendon, we would not recommend swimming because it's actually very demanding on the muscles and the tendons. And so, swimming is not the right exercise for every dog. I guess the other thing to remember is dogs do not intrinsically know how to swim. Some dogs know how to swim, but not every dog knows how to swim. And I think you don't know which dog doesn't know how to swim until falls in the pool by accident, and then it's either good or a disaster. So be sure that if you are taking a dog to someone's house that has a pool and you don't, that you hang tight and close to that dog, or that the dog has a little life jacket. And I, I have a pet that's going on a sailing trip, a pet patient that's going on a sailing trip this summer. And I said, can I just ask, like, what kind of lifejacket does the dog have? And they whipped out a picture of the dog in a very cute little red lifejacket. And I was very happy about that, because if a dog falls overboard, it's not. You're going to have to get it back to the I don't think you can swim back to you necessarily, and it for sure can't grab on to, you know, the lifesaving ring that you throw out on the rope. So I was happy that that dog had a very nice, jacket to wear when it was out on the boat. So I think that's an important thing to keep in mind right now, especially as the weather warms up. Yeah. And I would say same as humans. Every dog on on a boat should have a life vest for the same reason why it's required for humans. Because even if you're a good swimmer, you don't know how long they would need to swim to be able to get to safety. So that life vest is lifesaving. Even for the ones that you know how to swim. The other thing that you can get and certainly if you have children and a pool, you probably have it already, but there are alarms that you can get for the pool that if someone is in there and splashing around, then you might have an alert that the dog is in there. I my concern about those is there probably are going to be false alarms. If you got a duck that lounge in your pool or something like that. So but pool safety or lake safety is really important, for your dog, you know, I, I have another question here, and that is what kind of mistakes can people make if they decide to. Now, after listening to you talk, start out on an exercise plan for their dog. What kind of mistakes do you see people make? How can people avoid those? That's a great question. And I love it because I do hope everybody starts to implement exercise therapy for their dogs. Probably the biggest mistake is doing too much. So you really need to start slow and really pay attention to their response after they begin doing that new exercise. So things to look out for. Fatigue. And so the dog is slowing down, not completing the task. Just as in humans, if you ever been to pet form is really important. So being able to maintain good form during an exercise of, for example, the elevated stand that we spoke about, where the front feet are up on a higher step, you know, the dog should be able to hold that position squarely. So if one of the legs is starting to slide out to the side, their legs are not aligned, their back is hunched. It's not a straight posture. Those are all signs that the dog is fatiguing. And we need to stop that exercise if the day following a new exercise introduction, they're slow, they're not willing to get up, then that's another signal that we need to back things off a little bit. The other thing is repetitive, overload. And so we do need a little bit of overload to gain strength. But you there's a fine balance between that and then overdoing it. And so definitely slow progression is, is is the way to get to our goal. It's a marathon not a sprint. So I want to take this opportunity to thank Doctor Alvarez so much for joining me today. I, I hope everyone listened very carefully because she had such great tips for pets and, on such an important topic that owners don't think about always until they recognize that there's a problem. Thank you so much. And I know that keeping your pet healthy is important to you. And with that said, I hope you'll reach out to me. If you have a question about your pet's health, I can respond to your question on next month's Ask the Vet podcast. If you just email me at Ask the Vet at amcny.org, we have a short break coming up, but please stay tuned because there are lots of interesting animal news stories. When we return, we're back with Dr. Ann Hohenhaus on Ask the Vet. Hello everyone and thank you for tuning back in to Ask the Vet podcast. It's time for the animal news. It's time for animal headlines, the biggest animal news from across the world. Patients at a children's hospital in Edinburgh, Scotland, have created the perfect gift for the gentoo penguins at their local zoo. They're painting colorful rocks. Gentoo penguins are the type of penguin that you would see in cartoons and children's storybooks. And they stand about three feet high or one meter. And since we've been talking about meters today, they're about a meter high. So with dozens of these penguins who carefully select individual stones to build their nest, these little works of art have brought joy to the animals and the children who paint them as well. For gentoo penguins, small stones paint an important role in nest building and courtship. Males often choose and present pebbles to a female. If she accepts, it becomes part of their shared nest. A small but meaningful step in forming a pair bond. This rock painting program began in 2023 with just 54 decorated rocks, and has since grown into an animal tradition. This year, children across the hospital created more than a thousand pebbles using safe, water based paint. Guided by the zoo team. Afterwards, they tuned in via live stream to watch the delivery, seeing the pens explore their creations and pick their favorite rocks in real time. Some of the penguins have already begun laying eggs, with parents and viewers eagerly awaiting the checks expected later this spring. This project is part of an ongoing partnership between the Edinburgh Zoo and the Royal Hospital for Children and Young People, helping young patients stay connected to the natural world during their hospital stays. If you'd like to watch this penguin nest building, it's on a live cam and you can get to that cam at www dot Edinburgh Zoo dot org dot uk Backslash webcams. You know, at sea we really like penguins and sometimes we help out our zoo colleagues by doing Cat scans on penguins. And you always know when there's a penguin around simply by the fishy smell in the hallway. Because penguins eat fish and they smell like it too. But they're really cute. Our second story today is about a recent study that has discovered that when humans lose an object, dogs may try to help find that object in ways that are strikingly similar to human toddlers. Researchers compared young children, dogs and cats in the same situation. A caregiver watched an object be hidden and then began searching for it without asking for help. Dogs and toddlers responded very similarly, paying close attention and interacting with the object in ways that suggested they were trying to help. Cats. By contrast, were much less likely to get involved. Mostly, they watched, occasionally looking between the person and the object, but rarely taking any action. However, when there was something in it for the cat, like a hidden treat, cats were equally engaged. This finding suggests that dogs willingness to help may stem from their evolutionary history as social cooperative animals, while cats, which evolved more independently are less inclined to assist unless it directly benefits them. And our last story comes from a village in England, and the villagers in England have organized a toad patrol. This is aimed at helping the local toad population cross their now busy roads. When the mating season approaches, many toads in the village of Cow in Staffordshire are making their way to the same large pond where they were born 4 or 5 years ago. As the area has developed, the environment has changed and the terrain that was once toad safe is now a perilous challenge of luck and courage. All the rural roads put them at risk for being hit by a car. Thankfully, now that the community has stepped in to help with buckets and other makeshift containers in hand, hundreds of toads have been able to make the journey without incident. Common toads are by nature excellent pest controllers in gardens and fields, as well as being highly efficient indicators of environmental health. In fact, one adult toad can consume thousands of insects, slugs, snails and beetles each summer. Unfortunately, research from the Frog Life charity tells us that populations of the common toad in the UK have decreased by about two thirds over the last 40 to 50 years, raising concerns for the toads future. So it's more communities organize their own toad patrols. It's a simple reminder that every animal plays an important role in the environment, and that small acts of kindness can make a real difference in our world. And now it's time for questions from our listeners. Our first question comes here from New York, from Andrea, and she asks, I have a water fountain and a bowl set up for my six month old kitten. But I have never seen her drink some either. She eats web food and dry food and seems healthy. Should I be worried about her hydration? So this kitten, according to the owners, eating both dry and wet food and wet cat food contains a lot of water. So this six month old kitten may be getting enough water in its diet from the wet food that it eats. What I'll bet is that if the owners stop feeding wet food and only fed dry food, she noticed that kitten at the water fountain more often because it would need a better source of water. So I'm probably not worried about this kitten's hydration because it's got water in its wet food. Things that you can do, though, to increase your cat's water consumption would be to mix some water in the wet food and make it a little bit more watery, but not so much water that the cat is too full from drinking all that water and doesn't eat enough calories. And the water fountain is a great thing. And I think I would just leave that fountain running because you don't know that that kitten stopped drinking in the middle of the night. Number one. And number two, when the cats are older and probably it's going to have a greater need for water if their kidneys are not perfect as as they age. Like Doctor Alvarez was talking about, having that water fountain there will encourage that cat to drink more water. If you bring out the water fountain when the cat's ten years old, it's probably going to say, what is this? And just ignore it. Just like the cats were ignoring the missing items in that news story. So I think just keep that fountain running. Change the water frequently and keep it fresh. And I think that's a great thing to have out for the kitten, but I'm not worried about its hydration at all. And our next question is from Diana. See, she wants to know, is it possible for dogs to get brain cancer from Sun exposure if they have squamous cell carcinoma or skin tags? So, Diana, you're correct that sun exposure can cause cancer in dogs and cats as well. But it wouldn't be brain cancer. It would be skin cancer. And if you have a black coated Labrador retriever, that dog is probably not at risk for sun exposure. Cancer. It's also dogs and cats that have pink noses, white ear tips, and light colored fur on their tummy. And those are the patients that we worry a lot about sun exposure and getting cancer from either being out in the sun all the time, or for some dogs, they lay on their back and kind of sunbathe. And those dogs will get skin cancer in the kind of bald area on their lower tummy. So you should worry about cancer from sun exposure, but not brain cancer specifically. So, Diana, keep your dog out of the sun, especially if it's a white coated dog. And our last question comes from Laura be. Laura asks. My cat sometimes has one pupil larger than the other. Is that normal or a sign of something serious? So, Laura, there are lots of things that can cause one pupil to be larger than the other. Probably one of the most common things is as cat's age. The colored part of their eye kind of gets lazy and thinner, and if it does more in one eye than the other, then the pupils are not equal. But it could also be a problem with the nerve controlling the eye that's bigger. Could also be a nerve problem in the eye that's smaller. It can also be something more sinister. So this is a problem that needs to be looked at by your veterinarian. And a workup of unequal pupils sometimes will require an X-ray of the chest and some special eye drops to see which part of the nerve controlling the eye is working. So it might take your vet a day in the hospital to sort through this, but I think it's important for your veterinarian to take a look at these asymmetric pupils. And now we're going to take a quick break. And when I come back, we're going to have important information from AMCs Usdan Institute for Animal Health Education. We're back with Dr. Ann Hohenhaus on Ask the Vet. Thanks everyone for tuning back in to ask the vet. As warmer weather approaches, it's a good time to talk about high rise syndrome. Those are the injuries that pets can sustain after falling from windows or balconies. Both dogs and cats are at risk, but cats are more commonly affected because they're naturally drawn to high places. And the opportunity to look outside at what's going on in their world, an open window or a loose screen can quickly become a serious safety hazard for your pets. High rise syndrome is first described in pets Here at the Animal Medical Center in the 1980s. And shockingly, in a five month period, we treated 132 cats that had fallen out of windows. While most of these cats survived, many had serious injuries, including chest trauma, head and face injuries, and fractured front legs. And this constellation of injuries occur because cats tend to land with their feet first, so they will break their wrist. And then as the wrists break, they bump their chin on the ground and fracture their jaw, or maybe some teeth. And then when their chest slams into the ground, they also will get a what we call a pneumothorax, or air leaking out of the lungs and round the lungs. So you can always see these injuries in your cat. And so it's really important that if your cat does fall out of a window, that they evaluated by a veterinarian immediately, because we know what the common injuries are and we can look for them. Now, it's really good news that these falls are largely preventable. You have to make sure that you have tight window screens. Be sure that any windows without screens are kept closed, and limit your cat's access to a balcony or terrace. Now, if you're interested in learning more ways to keep your pets safe and healthy, we've got a great event coming up on Saturday, May 2nd from 11 to 5. AMC will host Paw Day, the annual pet health and wellness fair taking place on Second Avenue between 76th and 77th Street as part of the Second Avenue's Street Festival. This event is free. You can just walk up and participate, and it's a family friendly event with the chance to meet AMC veterinary staff, learn about pet health and enjoy a full day of activities including a kids zone with hands on crafts, a stuffed animal vet clinic, face painting and more. Now you don't even have to register for this event. You can just stop by. Even if all you have time to do is say hi. And then this is something to keep checking our website for, because I think there's going to be an upcoming webinar, which is always popular by doctor La’Toya Latney from our exotic and avian service. And she's going to talk about reptiles. She's one of New York City's few reptile specialists. We're not ready yet to release the date and time, so be sure to check our events page frequently so you can sign up for this upcoming webinar. I want to thank Doctor Leilani Alvarez so much for joining me today to share her expertise in pet exercise. If you want to learn more or get in touch with the Animal Medical Center, you can visit www.amcny.org. Don't forget, if you want to know more about your pets well-being or looking for pet health advice, just email me at Ask the Vet at amcny.org and I'll answer your question on next month's Ask the Vet program. The Ask the Vet podcast is available on the Sirius XM app across all major platforms, and also you can download it from AMC's website. All of this is thanks to AMC's long standing partnership with Sirius XM. Don't forget to follow AMC on social media at Facebook. It's the Animal Medical Center and Onex, which is formerly Twitter and Instagram. It's @amcny. I'd really appreciate it if you take a moment to give the podcast a review and be sure to like and subscribe so you never miss an episode. Now, we already know who next month's guest on the show is going to be, and it's going to be Katie Campbell. She's the president and CEO of Red Rover, a national non-for-profit supporting animals and people in crisis. We're going to talk about the work they do to keep pets and their families together, including support for survivors of domestic violence and programs that help people keep their pets with them during the most difficult of times. Thanks everyone so much for listening, and I'll see you all next month on ask the vet.