I am hoping this article will contribute to Navigating Mobility Challenges: Strategies for an Active Life.

This article was inspired by a recent conversation I had with another PwMS who commented on a video I had posted on social media about the importance of teaching a large breed dog (a Doberman Pinscher) to walk on loose leash as a Person with Multiple Sclerosis (PwMS). The individual mentioned that she owned a Labrador Retriever who had pulled her down a few years ago so her able-bodied son had taken over walking the dog. She noted that her dog continues to pull on leash, but this PwMS was under the impression that her son can handle that though she voiced regret about being unable to walk the dog anymore. 

How fortunate she was to have a family member step in, though I realize that might not be an option for other PwMS. In my mind, PwMS don’t need to absolutely cease walking their pet dogs, even if the dogs pull on leash–rather, PwMS simply need coaching on an accessible, force-free method to teach a pet dog to walk politely while keeping the leash slack.

In June of this year, I had been experiencing compromised balance from foot drop but I had also promised the Doberman’s owner to care for him in her absence–and he needed to be walked on a leash. His owner had mentioned that he pulls hard on leash. Knowing that, I knew I had to educate him quickly to walk on a loose leash beside me by using reward-based methods. I hope my experience will help you.

The game I am detailing below is the first stage of the  Reinforcement Zone (Garret, 2020).

Reinforcement Zone Game Stage 1

Your first task: move yourself to be beside your dog who is not moving. Your dog can be in a sit or a stand. 

All you need to do is give your dog a treat. You’re already giving your dog treats anyway, right? 

I challenge you to think about where your dog is when you usually give them a treat or put their food bowl down for them to eat–chances are, your dog is in front of you, right?

This means your dog already has a reinforcement zone–in front of you. We want to change that for your dog, to build value for your dog beside you. 

Game rules:

"Only give your dog a treat or their food bowl if they are not moving and just next to you. If you feel like your dog is getting a treat for doing absolutely nothing, you’re doing it correctly!"

If your dog eats kibble, you can even use this game to give them part of their meal one kibble at a time. All your dog needs to do is be still and next to you.

Troubleshooting 

If your dog jumps up at you or paws at your hand or otherwise tries to “help” you give them a treat or piece of kibble, simply close your hand around the treat or kibble. Their moving means the game is over. You can try again later in the same day.

The Reinforcement Zone game 

Stage 1 looks like this:

***I tend to reward my own dog on my left, but note that this game should be played on either side of your body, if you want to eventually train your pet to become your assistance/service animal. Moving on your left or right is one skill a service dog needs to have. 

If you’re a wheelchair user:

If you use a walker or rollator:

If you use a cane:

If you walk independently:

 Geeky Stuff - Literature Review

Web searches for stopping dogs pulling on leash

From 2004 to the present, the top search phrase entered into Google by Internet users in Canada and the United States was “How to stop leash pulling.” These results confirmed my personal suspicion about pet dogs pulling on leash, based on the frequency of Google searches seeking solutions online for addressing  this behaviour. My suspicions also result from observations over two decades working as a veterinary professional: most pet dogs pull on leash. This phenomena is actually quite complex, but to keep this short I am simply going to highlight the problem and provide an accessible solution in subsequent pages for my intended audience: PwMS with pet dogs.

Negative Health Outcomes Among the General Population from Pet Dogs Pulling On Leash

Dogs pulling on leash can result in the person walking the dog falling, resulting in traumatic brain injury (TBI) or limb fractures (Maxson et al., 2023; Forrester, 2020. No studies currently exist focusing on PwMS falling as a result of walking a pet dog on leash. From professional experience working with pet dogs, along with firsthand knowledge and experiences as a PwMS. Personal life experience and research have confirmed that having MS means we’re more likely to fall than those who do not have MS (Cattaneo et al., 2002; Mazumder et al., 2014). And as I mentioned earlier, recent discourse seemed to provide anecdotal evidence about PwMS falling from pet dogs pulling on leash.

Dog Walking Among the General Population

Up to 60% of pet dog owners do not walk their pets (Cutt et al., 2008). Dog walking and ownership have been promoted low-cost methods to increase exercise (Westgarth et al., 2014). However, Westgarth and others have also noted that dog behaviours may deter walking the dog such as dog fears or reactivity towards other dogs. Naviging dog fears and reactivity as a PwMS will be covered in a future article.

Commentary on Dog Ownership and MS

Indeed, if your dog was pulling on leash before your MS diagnosis, unless you have intentionally worked with your dog, chances are your dog is continuing to pull on leash. Because fatigue and all the other MS stuff.

Ultimately, I wish to educate fellow PwMS pet dog owners using an accessible game to teach their pet dogs to walk next to them with a slack leash. This also promotes animal welfare by preventing physical injury to the dogs and promoting the dog-owner bond (Westgarth et al., 2014)

Objectives:

1) coaching PwMS to play a deceptively simple game with their own pet dogs for walking on loose leash (Mazumder et al., 2014). 

2) Besides injury prevention, I am hoping that the dog walking on loose leash beside a PwMS acts as a non-pharmaceutical treatment for improving gait and walking speed for the owner (Fjeldstad & Pardo 2017)

3) promoting PwMS mental health from interactions with their own pet dogs through game-based training (Oliver-Hall et al., 2021; Napier et al., 2021). In turn, benefits to PwMS may result from increased social interactions with other pet dog owners (Westgarth et al., 2014)

4) promoting animal welfare through an enhanced dog-owner bond (Westgarth et al., 2014)

In doing so, I hope PwMS might receive the byproduct of improved mental health. Compared to the general population, PwMS have much higher rates of mood disorders such as depression or anxiety (Butler et al., 2016; Feinstein et al., 2014; Podda et al., 2020). So I am basing this on Napier et al. (2021) reporting significant increases in general self-efficacy levels with significant decreases in anxiety among pet dog owners from the general population after 10 minute sessions of online-guided training and play sessions. Given self-efficacy among PwMS positively impacts illness experience (Schmitt et al., 2014), why not take the opportunity to provide as many non-pharmaceuticals for improving life with MS?

Dog ownership puts people at risk of getting injured from their pets pulling on leash (Forrester, 2020; Maxson et al., 2023). The thing that concerned me most? The gender bias suggested to me that compared to people without MS, given 4 times as many women have MS compared to men (National MS Society, 2017) might be at greater risk of falls from their pet dogs pulling on leash.

Something else I also considered: in the 2000s, the most popular dog breeds were the Labrador Retriever, German Shepherds, and Golden Retrievers. In adulthood, these dogs usually weigh at least 60 pounds (American Kennel Club). While many of these breeds are often also service dogs that don’t pull on leash, given what I know as a professional trainer and veterinary professional, those dogs often are family pets. And the behaviours I have witnessed in family pets has shown me how often those dogs often pull on leash. Plus, before they are adults, the dogs need to be taught to walk on leash as puppies. Puppies aged around 5 months are large and rambunctious–while they are not as large as adults, they are still massive and that age they will pull on leash unless otherwise taught. I have even witnessed or heard about dog owners without MS who had one or more of these dogs getting pulled over.

Based on my understanding of Fjeldstad & Pardo (2017) reporting “an improvement in walking speed when individuals walked with the aid of a service dog compared with ambulating on their own.”  From human healthcare research, Middleton and colleagues (2015) describe walking speed as “a valid, reliable, and sensitive measure appropriate for assessing and monitoring functional status and overall health in a wide range of populations.”

Delving deeper into Fjeldstad & Pardo, I recognized the methods described told me what I needed to share: “the (service) dog was trained to walk beside the participant, so as not to pull or lag behind.” (p.40). From my rudimentary understanding, perhaps pet dogs taught to walk beside owners potentially benefits mobility of owners with MS.

Subscribe to Accessible Pet Training Series for Warriors: Episode 1 - Teach Your Dog Loose Leash Walking!

About The Author:

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Nanette Lai was diagnosed with Relapsing-Remitting MS in 2008. Her education includes PhD candidacy in Epidemiology from the University of Guelph, and a Master of Arts from the University of Toronto where she majored in Medical Anthropology. As a pet care professional, Nanette has worked as a veterinary professional since 1999 and received accreditation as a professional pet trainer from PetSmart in 2005. Nanette is a member of the Pet Professionals Guild (PPG) and the Canadian Association of Professional Dog Trainers (CAPDT).

As part of TraXel, Nanette aims to contribute content aligning with the company’s mission to help other patients with chronic conditions (including MS) live their best lives every day. The content will be presented in the form of instructional videos via TraXel’s podcast, for other pet owners with MS to virtually train their own pet dogs at home. Upcoming podcasts will demonstrate accessible positive reinforcement pet dog training because Nanette believes anyone can learn the mechanics and teach their own pet dogs to have incredible manners. She refers to this form of virtual dog training as positive reinforcement on steroids, because the methods she uses are effective and gives fast results (without the side effects)!

Sources cited:

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Butler, E., Matcham, F., & Chalder, T. (2016). A Systematic Review of Anxiety Amongst People with Multiple Sclerosis. Multiple Sclerosis and Related Disorders, 10, 145–168. https://doi.org/10.1016/j.msard.2016.10.003

Cattaneo, D., De Nuzzo, C., Fascia, T., Macalli, M., Pisoni, I., & Cardini, R. (2002). Risks of      falls in subjects with multiple sclerosis. Archives of physical medicine and rehabilitation, 83(6), 864-867.

Cutt, H., Giles-Corti, B., & Knuiman, M. (2008). Encouraging physical activity through dog walking: why don’t some owners walk with their dog?. Preventive Medicine, 46(2), 120–126.

Devasahayam, A. J., Downer, M. B., & Ploughman, M. (2017). The effects of aerobic exercise on the recovery of walking ability and neuroplasticity in people with multiple sclerosis: a systematic review of animal and clinical studies. Multiple sclerosis international, 2017.

Feinstein, A., Magalhaes, S., Richard, JF. et al. The link between multiple sclerosis and depression. Nat Rev Neurol 10, 507–517 (2014). https://doi.org/10.1038/nrneurol.2014.139

Fjeldstad, C., & Pardo, G. (2017). Immediate effect of a service dog on walking speed in individuals with multiple sclerosis and gait dysfunction: a pilot study. International journal of MS care, 19(1), 40-41.

Forrester, M. B. (2020). Dog leash-related injuries treated at emergency departments. The American Journal of Emergency Medicine, 38(9), 1782-1786.

Garrett, Susan. (2020, January 30). How do I Stop My Dog from Pulling on the Leash? Susan Garrett’s Dog Training Blog. https://susangarrettdogagility.com/2020/01/stop-my-dog-pulling-on-leash/

Gunn, H. J., Newell, P., Haas, B., Marsden, J. F., & Freeman, J. A. (2013). Identification of risk factors for falls in multiple sclerosis: a systematic review and meta-analysis. Phys Ther, 93(4), 504-13.

Maxson, R., Leland, C. R., McFarland, E. G., Lu, J., Meshram, P., & Jones, V. C. (2023). Epidemiology of Dog Walking-Related Injuries among Adults Presenting to US Emergency Departments, 2001-2020. Medicine and science in sports and exercise, 55(9), 1577–1583. https://doi.org/10.1249/MSS.0000000000003184

Mazumder, R., Murchison, C., Bourdette, D., & Cameron, M. (2014). Falls in people with multiple sclerosis compared with falls in healthy controls. PloS one, 9(9), e107620. https://doi.org/10.1371/journal.pone.0107620

Middleton, A., Fritz, S. L., & Lusardi, M. (2015). Walking speed: the functional vital sign. Journal of aging and physical activity, 23(2), 314–322.

Napier, A. D., Bennett, P. C., & Howell, T. J. (2021). The Effects of an Online-Guided, At-Home Dog Training Session on Owner Anxiety, Mood, and General Self-Efficacy During COVID-19. Human-Animal Interaction Bulletin, (2021).

National MS Society. (2023). Who Gets Multiple Sclerosis? Epidemiology of MS. 

https://www.nationalmssociety.org/What-is-MS/Who-Gets-MS

Oliver-Hall, H., Ratschen, E., Tench, C. R., Brooks, H., Constantinescu, C. S., & Edwards, L. (2021). Pet Ownership and Multiple Sclerosis during COVID-19. International journal of environmental research and public health, 18(23), 12683. https://doi.org/10.3390/ijerph182312683

Podda, J., Ponzio, M., Uccelli, M. M., Pedullà, L., Bozzoli, F., Molinari, F., ... & Tacchino, A. (2020). Predictors of clinically significant anxiety in people with multiple sclerosis: a one-year follow-up study. Multiple Sclerosis and Related Disorders, 45, 102417.

Schmitt, M. M., Goverover, Y., DeLuca, J., & Chiaravalloti, N. (2014). Self-efficacy as a predictor of self-reported physical, cognitive, and social functioning in multiple sclerosis. Rehabilitation Psychology, 59(1), 27–34. https://doi.org/10.1037/a0035288

Veldhuijzen van Zanten, J. J., Pilutti, L. A., Duda, J. L., & Motl, R. W. (2016). Sedentary behaviour in people with multiple sclerosis: Is it time to stand up against MS?. Multiple Sclerosis Journal, 22(10), 1250-1256.

Westgarth, C., Christley, R. M., & Christian, H. E. (2014). How might we increase physical activity through dog walking?: A comprehensive review of dog walking correlates. International Journal of Behavioral Nutrition and Physical Activity, 11(1), 1–14.