Nutrition during rehabilitation – how you can support your dog from the inside

After surgery, injury, or musculoskeletal diseases, we usually think of physiotherapy first when it comes to rehabilitation: targeted exercises, muscle building, coordination, and a gradual return to normal activity levels.

But nutrition can also play an important role during this time.

Because while we work from the outside in physiotherapy to restore mobility, strength, and function, the body simultaneously needs sufficient energy and nutrients to maintain muscle mass, nourish tissues, and support regeneration.

Why does the nutrient requirement change during rehab?

Many dogs move significantly less initially after surgery or injury. This can lower their energy expenditure. At the same time, repair and healing processes are taking place in the body.

This is exactly where a challenge arises: If the dog consistently receives more energy than they need, they can gain body fat. On the other hand, if the amount of food is simply greatly reduced, the supply of important nutrients decreases.The goal should therefore not simply be to “feed less,” but to adapt the nutrition to the dog’s current situation.

This is particularly important:

• Maintenance of muscle mass

• Energy intake tailored to requirements

• Avoidance of overweight

• Adequate supply of high-quality protein

• Supply of essential fatty acids and micronutrients

Maintaining muscle mass – protein plays an important role

One of the biggest challenges during prolonged periods of rest is the loss of muscle mass. If a leg is less loaded due to pain, surgery, or injury, the muscle mass can decrease accordingly.
This is disadvantageous for rehabilitation: after all, we later try to rebuild exactly this muscle mass through targeted training.
Protein provides the amino acids that the body needs, among other things, to build and maintain body tissue. Studies in dogs show that both the amount of protein and the quality or amino acid composition of the protein source can influence the maintenance of lean body mass. In a study of adult dogs, a lower-protein diet was associated with more unfavorable changes in body composition.
This does not mean that large amounts of protein should be supplemented during every rehabilitation. What is crucial is a tailored supply of high-quality protein and essential amino acids.

Especially during longer rehabilitation phases, it is therefore worth keeping an eye not only on the dog’s body weight but also on their muscle mass.

Body weight: Every extra kilo has to be moved

Body weight is particularly relevant during rehabilitation. A dog that suddenly moves less may need less energy than before.

Weight gain can be particularly problematic in orthopedic diseases, as additional body mass also has to be moved and supported by the joints.
Studies in overweight dogs with osteoarthritis show how important weight management can be. Even moderate weight loss was associated with a measurable improvement in lameness in one study.
Another study combined a calorie-reduced diet with physiotherapy in overweight dogs with osteoarthritis. After six months, mobility and gait analysis parameters improved; particularly good results were observed with the combination of weight management and intensive physiotherapy.

This is why weight management and rehabilitation are closely linked, especially in orthopedic patients.

Omega-3 fatty acids: interesting for dogs with joint problems

The long-chain omega-3 fatty acids EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid) have been particularly well studied in dogs, for example from fish oil.

Several controlled studies have examined their use in dogs with osteoarthritis. Among other things, improvements in various clinical parameters such as weight-bearing on the affected limbs, lameness, or discomfort were observed.

One study is particularly interesting for rehabilitation:
48 dogs were examined after a TPLO surgery due to a disease of the anterior cruciate ligament. The animals received either a normal maintenance diet or a diet enriched with protein and omega-3 fatty acids – each with or without additional physiotherapeutic rehabilitation.

Both the adjusted diet and rehabilitation were associated with improvements in various functional or clinical parameters. The authors concluded that both nutrition and physical rehabilitation during the first six months after surgery were associated with improvements in certain clinical outcomes.
In a further analysis of the same dogs, inflammatory markers in the joint fluid were also examined. The dogs fed with omega-3 and protein enrichment showed lower concentrations of prostaglandin E2 than the control group.

Nutrition and physiotherapy should be considered together

Rehabilitation means more than individual exercises.
No matter how well a dog can be trained – if it gains a significant amount of weight or loses muscle mass during a prolonged period of rest, it makes the return to normal activity levels more difficult.
Conversely, an adjusted diet alone cannot replace targeted movement therapy.

Therefore, a combined approach is optimal:

Exercise + targeted muscle building + appropriate body weight + tailored nutrition.

How exactly the nutrition should look always depends on the individual dog. Age, disease, activity level, body weight, muscle condition, medications, and the respective phase of rehabilitation play a role.
This is why the right nutrition during rehabilitation can look very different – from simply adjusting the daily amount of food to a targeted selection of specific nutrients.

Conclusion

Nutrition is often underestimated in rehabilitation. However, body weight, muscle mass, and nutrient supply can have a major influence on the conditions under which a dog undergoes its rehabilitation.
A tailored energy intake, an adequate supply of high-quality protein, and the maintenance of a healthy body weight are particularly important. For certain orthopedic diseases, omega-3 fatty acids such as EPA and DHA can also be a useful addition to the overall concept. 

Physiotherapy works on mobility, strength, and function – nutrition creates part of the prerequisites for this.

Because successful rehabilitation does not start with the next exercise session, but also in the food bowl.

Frequently Asked Questions - FAQ

1. Does my dog need less food during rehabilitation?
It depends on the activity level. If your dog moves significantly less after surgery or injury, its energy requirements may also decrease. However, the amount of food should not be drastically reduced across the board, as a continued adequate supply of protein, vitamins, and minerals remains important.

2. Why is protein important during rehabilitation?
Protein provides essential amino acids that the body needs, among other things, to maintain and build muscle tissue. Especially during prolonged periods of rest, maintaining muscle mass can be an important nutritional goal.

3. Can omega-3 fatty acids support rehabilitation?
The omega-3 fatty acids EPA and DHA have been studied in dogs, particularly in connection with osteoarthritis and orthopedic rehabilitation. Studies show positive effects on various clinical and inflammation-related parameters. However, they replace neither veterinary treatment nor physiotherapy.

4. How important is body weight during rehabilitation?
Very important. Overweight can place additional strain on the musculoskeletal system. Studies in dogs with osteoarthritis show that even moderate weight loss can be associated with an improvement in lameness or mobility.

Author

This article was created by Isabella Gollner, BSc, based on veterinary medical literature, nutritional science findings, and the references listed below. The goal is to provide dog owners with well-founded, understandable, and practical information about gastrointestinal health in dogs and to clearly explain the connections between gut flora, digestion, metabolism, and general well-being.

For the content, veterinary medical sources, standard scientific works on animal nutrition, and current findings on dog health were considered. Despite careful research, this article does not replace a veterinary diagnosis or individual consultation.

Scientific Sources

Baltzer, W. I., Smith-Ostrin, S., Warnock, J. J. & Ruaux, C. G. (2018). Evaluation of the clinical effects of diet and physical rehabilitation in dogs following tibial plateau leveling osteotomy. Journal of the American Veterinary Medical Association, 252(6), 686–700. doi: 10.2460/javma.252.6.686.

Verpaalen, V. D. et al. (2018). Assessment of the effects of diet and physical rehabilitation on radiographic findings and markers of synovial inflammation in dogs following tibial plateau leveling osteotomy. Journal of the American Veterinary Medical Association, 252(6), 701–709. doi: 10.2460/javma.252.6.701.

Wakshlag, J. J. et al. (2003). Effect of dietary protein on lean body wasting in dogs: correlation between loss of lean mass and markers of proteasome-dependent proteolysis. Journal of Animal Physiology and Animal Nutrition, 87(11–12), 408–420.

Mlacnik, E. et al. (2006). Effects of caloric restriction and a moderate or intense physiotherapy program for treatment of lameness in overweight dogs with osteoarthritis. Journal of the American Veterinary Medical Association, 229(11), 1756–1760. doi: 10.2460/javma.229.11.1756.

Marshall, W. G. et al. (2010). The effect of weight loss on lameness in obese dogs with osteoarthritis. Veterinary Research Communications, 34, 241–253.

Fritsch, D. A. et al. (2010). Dose-titration effects of fish oil in osteoarthritic dogs. Journal of Veterinary Internal Medicine, 24(5), 1020–1026.

Roush, J. K. et al. (2010). Evaluation of the effects of dietary supplementation with fish oil omega-3 fatty acids on weight bearing in dogs with osteoarthritis. Journal of the American Veterinary Medical Association, 236(1), 67–73.

Mehler, S. J. et al. (2016). A prospective, randomized, double blind, placebo-controlled evaluation of the effects of eicosapentaenoic acid and docosahexaenoic acid on the clinical signs and erythrocyte membrane polyunsaturated fatty acid concentrations in dogs with osteoarthritis. Prostaglandins, Leukotrienes and Essential Fatty Acids.