
What is the cause of your old dog's legs giving out from under them? Well, there can be a variety of causes. As our dog's get older, they are more prone to develop disease in general. Diseases like muscle and joint pain, neurologic conditions and even metabolic conditions that can cause weakness can lead to problems with their back legs.
Why do dogs legs give out as they get older?
As our dog's get older, they are more prone to develop disease in general. Diseases like orthopedic conditions, neurologic conditions and even metabolic conditions can cause problems with their back legs. A common concern that many pet parents have as their older dog ages is that the legs specifically the hind legs seem to give out on them.
What causes a dog to lose control of his back legs?
The most common causes for an older dog’s back legs collapsing, slipping out or hind leg weakness are osteoarthritis, intervertebral disc disease, lumbosacral disease and degenerative myelopathy. And some dogs have more than one issue contributing to their back leg weakness.
Why does my dog have a limp on his back leg?
Here are six possibilities. Arthritis:Osteoarthritis, which causes inflamed and painful joints due to cartilage breakdown, can cause dogs young and old significant pain in their hips and legs. Due to ongoing pain, dogs might experience weakness in the front or back legs.
Why does my dog have pain in his hind legs?
Arthritis is stiffness in the joints that can affect hind legs and cause weakness. Older dogs are especially at risk. As a dog ages, the cartilage between the joints may deteriorate, which can cause inflammation and pain. The condition may become what is known as Degenerative Joint Disease, which is the canine version of osteoarthritis.
Why does my dogs back legs keep collapsing?
Many mobility issues can cause a dog's hind legs to give out and collapse underneath them suddenly. For example, a dog's back legs can collapse due to an injury, leg weakness in an older dog, arthritis, or a more serious health condition such as Degenerative Myelopathy.
What would causes dog's legs to suddenly give out?
There are many reasons why a dog's mobility may suddenly change. Neurological conditions, degenerative mobility conditions, and injury are just a few of the possibilities. Only your veterinarian can help determine the cause of your dog's hind leg weakness and work with you to create a treatment plan for your dog.
How can I help my old dog with weak back legs?
Take short walks with your pup, keeping the pace slow and relaxed, to help slowly rebuild muscle. Swimming is another low-impact activity that's especially helpful for weak hind legs. Water supports your dog's weight, allowing him to move more freely than he can on dry land.
What happens when your dog's back legs give out?
If he is having a hard time walking, or he is staggering and wobbling on his feet, this back leg weakness may be a result of muscle atrophy, pain, or nerve damage. Other signs that can alert you to this condition are a reluctance or inability to stand, lameness, or paralysis in the legs.
What are the final stages of degenerative myelopathy in dogs?
Late Stages of Degenerative MyelopathyDog is unable to bear any weight on its rear legs for any length of time.Even once lifted, the dog is unable to stay standing without support and will collapse.Urinary and bowel incontinence.Weakness begins in the shoulders, causing front end weakness.More items...•
How long can a dog live with degenerative myelopathy?
Dogs generally live with DM for anywhere between six months and three years. Rehab therapy and regular exercise can help improve the quality of life for dogs with DM. Unfortunately, Degenerative Myelopathy has no cure at the moment. What is certain is that the symptoms worsen as time progresses.
How do you know when it's time to put your old dog down?
Signs To Look For Some common signs that it may be time to put your pup down include the inability or refusal to eat or drink, labored breathing, an inability to get up for potty times without help, urinary or fecal incontinence, and immobility. Essentially, this can come down to your dog's quality of life.
What are the first signs of degenerative myelopathy in dogs?
The first signs of degenerative myelopathy generally develop at around eight years of age, although the onset may be later in life in some dogs. Weakness and loss of co-ordination in one or both of the hind limbs (back legs) is often the initial sign, followed by dragging and scuffing of the digits (toes).
How can you tell a dog's quality of life?
When there are too many bad days in a row, or if the dog seems to be turned off to life, quality of life is compromised. Bad days may mean nausea, vomiting, diarrhea, seizures, frustration, unrelenting pain/discomfort, or inability to breathe.
What do you do when your old dog can't walk?
If your dog is truly unable to walk, you must take him in for a veterinary examination immediately. A dog's inability to walk is indicative of a very serious underlying condition. Joint disorders are easier to treat than spinal cord issues, though all are challenging.
Should you walk a dog with Degenerative Myelopathy?
Yes, dogs with Degenerative Myelopathy should stay as active as possible. Keeping a DM dog active can actually help slow down the progression of the disease. Physical therapy and regular structured exercises, including walking, can help dogs with DM maintain muscle strength and minimize their risk of muscle atrophy.
Why can't my dog stand up all of a sudden?
However, a disturbance of balance can happen to any dog, and causes vary from more common issues like ear infections, inner ear tumors, and hypothyroidism to much more serious conditions like brainstem tumors, strokes, and brain inflammation. Therefore, a professional diagnosis is critical if your dog can't stand up.
What does a stroke look like in a dog?
Some signs of a stroke in dogs include a head tilt, circling, loss of balance, and unusual eye movements. If you think that your dog is having a stroke, don't delay getting them to the vet for diagnosis and treatment. Treatment is mostly supportive, and it's important to treat any underlying causes.
How can you tell if a dog had a stroke?
Signs of a StrokeLoss of balance.Head tilt.Pacing, circling, or turning the wrong way when called.Abnormal eye movements or facial expressions.Impaired vision.Loss of control over bladder and bowels.Vomiting.Collapse, loss of consciousness.More items...•
What are the first signs of degenerative myelopathy in dogs?
The first signs of degenerative myelopathy generally develop at around eight years of age, although the onset may be later in life in some dogs. Weakness and loss of co-ordination in one or both of the hind limbs (back legs) is often the initial sign, followed by dragging and scuffing of the digits (toes).
Why do a dog’s hind legs collapse?
- Arthritis- Intervertebral Disc Disease (IVDD)- Degenerative myelopathy- Endocrine diseases- Acute injury- Shock
What other signs or symptoms should I be watching for?
Difficulty rising from lying down or sitting.Exercise intolerance, or not wanting to walk or play as much as your dog used to.Stiff or abnormal gai...
What should I do if my old dog’s back legs just collapsed?
Step one is always going to be getting your dog to the vet. Hind leg collapse should be considered an emergency.
If my dog’s legs are collapsing, what are the treatment options?
As you may imagine, treatment can vary depending on the underlying cause of the hind limb weakness or collapse. Dogs with IVDD may need surgery or...
What supplements can I give my dog for arthritis?
Many people believe that the best supplements for dogs suffering from arthritis are UCII (undenatured collagen), fish oil, and turmeric.
Why is my dog having trouble walking?
If your dog suffers from advanced arthritis where one or both hips/knees are affected, they ’re likely to experience trouble walking.
How to tell if a dog has arthritis?
Dogs with arthritis may not exhibit obvious signs of pain, but often you can recognize their discomfort by the way they stand, the way they walk, and the way they have difficulty getting up and down from a resting position.
How long does it take for a dog to heal from a sprain?
If your dog is only mildly affected with pain and little or no weakness in their legs, plenty of rest and anti-inflammatories should be enough to bring improvement for most dogs within a couple of weeks.
Why do dogs have weakness in their legs?
For example, any kind of cancer or condition that causes anemia (low red blood cell count) can lead to significant weakness.
What breed of dog is most at risk of getting a syphilis?
It can also occur in mixed breed dogs.
What is OA in the legs?
OA typically occurs when the cartilage in joints breaks down, which in turn leads to inflammation and pain. This condition can affect any joint, but mainly the large joints in the front and rear legs.
What are Back Leg Weakness?from wagwalking.com
This is why it is essential to monitor your dog to best determine what course of action you should take as a caring dog parent! One possible reason your dog might be showing signs of back leg weakness is due to an inherited condition. In this case, back leg weakness is a term that is often used to refer to Degenerative Myelopathy (DM), a disease of the spinal cord. In DM, the myelin sheaths that surround and protect the nerves in the spine degenerate to eventually expose the nerve fibers. This degradation of the myelin sheath disrupts the body’s communication between the spinal cord and brain, leading to a progressive weakness that can result in total paralysis.
What does it mean when a dog has degenerative myelopathy?from vethelpful.com
Dogs with degenerative myelopathy have neurologic deficits in proprioception (delayed righting of a paw that is placed upside down) or occasional knuckling/scruffing of their back feet. This progresses to knuckling and dragging their back legs which wears down their nails to short stubs and can cause sores if not managed properly.
What causes a dog's back legs to be weak?from orthodog.com
Arthritis is stiffness in the joints that can affect hind legs and cause weakness. Older dogs are especially at risk. As a dog ages, the cartilage between the joints may deteriorate, which can cause inflammation and pain. The condition may become what is known as Degenerative Joint Disease, which is the canine version of osteoarthritis. If your dog’s back legs are collapsing, look for these additional signs that may indicate osteoarthritis: 1 Difficulty getting up 2 Irritability 3 Pain when petted or touched 4 Difficulty squatting to use the bathroom or having accidents in the house
What is the condition of a dog's hind legs?from orthodog.com
Arthritis. Arthritis is stiffness in the joints that can affect hind legs and cause weakness. Older dogs are especially at risk. As a dog ages, the cartilage between the joints may deteriorate, which can cause inflammation and pain. The condition may become what is known as Degenerative Joint Disease, which is the canine version of osteoarthritis . ...
Why does my dog's hip rubbing together cause back pain?from orthodog.com
Hip dysplasia is a chronic condition caused by the hip joint ball and socket rubbing together due to a malformation. Over time, the rubbing together causes significant cartilage loss and can develop into osteoarthritis. Older dogs with hip dysplasia may experience back leg collapse, but also look for the following:
What is DM in dogs?from naturalpetshq.com
Degenerative Myelopathy (DM) Degenerative Myelopathy is a genetic and incurable neurodegenerative disease marked by deterioration and loss of function of the nervous system, especially the neurons in the brain. Onset typically occurs when dogs reach about eight years of age.
How to diagnose hip dysplasia in puppies?from vethelpful.com
Hip dysplasia is only diagnosed via x-rays of the hip that show abnormal formation of the joint . There are x-ray studies developed for young puppies over 4 months of age designed to detect developing hip dysplasia. These studies evaluate the hips in certain stress positions to determine if the joint exhibits excess movement or laxity under certain positions.
What other signs or symptoms should I be watching for?
Sometimes in the early stages of arthritis, IVDD, or other musculoskeletal conditions, you may not notice the hind legs collapsing yet. That is just one of the many indicators that a dog’s rear legs are becoming weak. Also, be on the lookout for:
What should I do if my old dog’s back legs just collapsed?
Step one is always going to be getting your dog to the vet. Hind leg collapse should be considered an emergency.
What kind of doctor do I see for a torn ACL in my dog?
Depending on what these tests show, your veterinarian may also recommend a consultation with a specialist. This may be a veterinary neurologist, orthopedic surgeon, internal medicine specialist, etc. These specially trained veterinarians are well equipped to handle the cases that are less straightforward or need advanced testing such as MRI or CT. Also, they can perform more complex surgical procedures such as a TPLO surgery for dogs (in the case of a torn ACL) or spinal cord decompression for IVDD dogs.
What is the cause of hind limb weakness?
IVDD causes abnormal pressure on the spinal cord and can result in hind limb weakness or paralysis.
Why does my dog's hind leg collapse?
Since arthritis is one of the most common reasons for hind leg collapse, we will spend a bit more time talking about how to relieve arthritis pain in dogs. For these guys and gals, multimodal treatment (i.e. combining a variety of treatments) can make a huge difference.
Why do dogs have a collapsed hind leg?
Of course, hind leg collapse can also be associated with an injury such as cruciate ligament tears (especially if both hind legs have ACL tears), spinal stroke in dogs, or trauma to the hips, spine, or pelvis. Often, these are a bit less of a mystery because you may have seen your dog get hit by a car, fall from a height, take a bad step, cry out in pain, etc.
Why do vets run blood tests?
Your vet may want to run blood tests to rule out causes of weakness such as hypothyroidism and diabetes.
What are Back Leg Weakness?from wagwalking.com
This is why it is essential to monitor your dog to best determine what course of action you should take as a caring dog parent! One possible reason your dog might be showing signs of back leg weakness is due to an inherited condition. In this case, back leg weakness is a term that is often used to refer to Degenerative Myelopathy (DM), a disease of the spinal cord. In DM, the myelin sheaths that surround and protect the nerves in the spine degenerate to eventually expose the nerve fibers. This degradation of the myelin sheath disrupts the body’s communication between the spinal cord and brain, leading to a progressive weakness that can result in total paralysis.
What causes a dog's back legs to be weak?from orthodog.com
Arthritis is stiffness in the joints that can affect hind legs and cause weakness. Older dogs are especially at risk. As a dog ages, the cartilage between the joints may deteriorate, which can cause inflammation and pain. The condition may become what is known as Degenerative Joint Disease, which is the canine version of osteoarthritis. If your dog’s back legs are collapsing, look for these additional signs that may indicate osteoarthritis: 1 Difficulty getting up 2 Irritability 3 Pain when petted or touched 4 Difficulty squatting to use the bathroom or having accidents in the house
What is the condition of a dog's hind legs?from orthodog.com
Arthritis. Arthritis is stiffness in the joints that can affect hind legs and cause weakness. Older dogs are especially at risk. As a dog ages, the cartilage between the joints may deteriorate, which can cause inflammation and pain. The condition may become what is known as Degenerative Joint Disease, which is the canine version of osteoarthritis . ...
Why does my dog's hip rubbing together cause back pain?from orthodog.com
Hip dysplasia is a chronic condition caused by the hip joint ball and socket rubbing together due to a malformation. Over time, the rubbing together causes significant cartilage loss and can develop into osteoarthritis. Older dogs with hip dysplasia may experience back leg collapse, but also look for the following:
What to do if your dog has a hind leg?from k9carts.com
For example, mild osteoarthritis often responds well to a combination of medication, light exercise, and dietary modifications to promote weight loss or reduce inflammation. Severe degeneration due to arthritis and/or dysplasia may require joint surgery or even joint replacement.
Why do dogs' back legs collapse?from naturalpetshq.com
Uncommon Diseases Causing Rear Leg Collapse in Dogs. Among the less common diseases that lead to young or older dogs’ back legs giving out are tick paralysis, myasthenia gravis and discospondylitis. Tick paralysis is caused by the toxic effects of an attached tick. It is more common in certain parts of the country.
How do you know if your dog has lumbosacral disease?from naturalpetshq.com
Lumbosacral disease symptoms depend on which nerves are affected. Some dogs have weak back legs and shaking (from pain) while others show limping and back legs collapsing, and some have urinary and fecal incontinence, while some have decreased tone and sensation to their tail.
Why does my dog's back leg swell?from naturalpetshq.com
The most common causes for an older dog’s back legs collapsing, slipping out or hind leg weakness are osteoarthritis, intervertebral disc disease, lumbosacral disease and degenerative myelopathy. And some dogs have more than one issue contributing to their back leg weakness. There’s a lot you can do to help your dog maintain quality of life.
What causes a dog's back legs to be weak?from orthodog.com
Arthritis is stiffness in the joints that can affect hind legs and cause weakness. Older dogs are especially at risk. As a dog ages, the cartilage between the joints may deteriorate, which can cause inflammation and pain. The condition may become what is known as Degenerative Joint Disease, which is the canine version of osteoarthritis. If your dog’s back legs are collapsing, look for these additional signs that may indicate osteoarthritis: 1 Difficulty getting up 2 Irritability 3 Pain when petted or touched 4 Difficulty squatting to use the bathroom or having accidents in the house
What is myasthenia gravis in dogs?from naturalpetshq.com
Myasthenia gravis in older dogs is an autoimmune disease that disrupts the message from the nerve to the muscle. Dogs with myasthenia gravis experience weakness that is worse after exercise. It’s not uncommon for senior dogs with myasthenia gravis to have a tumor somewhere in their body, the most common being thymoma.
What is the condition of a dog's hind legs?from orthodog.com
Arthritis. Arthritis is stiffness in the joints that can affect hind legs and cause weakness. Older dogs are especially at risk. As a dog ages, the cartilage between the joints may deteriorate, which can cause inflammation and pain. The condition may become what is known as Degenerative Joint Disease, which is the canine version of osteoarthritis . ...
What is the condition that causes a dog's leg to tremble?from blog.petwellbeing.com
One disease called canine degenerative myelopathy attack s the sheath that protects the spinal cord’s nerve cells slowly. Over time, dogs with this condition often experience hind leg tremors and weakness and trouble walking or standing. This disease is unlikely to cause pain.
Why does my dog have a tremor in his hind leg?from blog.petwellbeing.com
Nervous system problems: More severe damage to the nervous system might also interrupt the control your dog has over their front or hind legs. Trauma or certain diseases can result in nerve damage. One disease called canine degenerative myelopathy attacks the sheath that protects the spinal cord’s nerve cells slowly. Over time, dogs with this condition often experience hind leg tremors and weakness and trouble walking or standing. This disease is unlikely to cause pain.
Why do dogs' back legs collapse?from naturalpetshq.com
Uncommon Diseases Causing Rear Leg Collapse in Dogs. Among the less common diseases that lead to young or older dogs’ back legs giving out are tick paralysis, myasthenia gravis and discospondylitis. Tick paralysis is caused by the toxic effects of an attached tick. It is more common in certain parts of the country.
Why does my dog's back leg swell?
The most common causes for an older dog’s back legs collapsing, slipping out or hind leg weakness are osteoarthritis, intervertebral disc disease, lumbosacral disease and degenerative myelopathy. And some dogs have more than one issue contributing to their back leg weakness. There’s a lot you can do to help your dog maintain quality of life.
What is the cause of a dog's back legs to pant?
Intervertebral disc disease (IVDD) happens when the disc cushion between the bones of the spine breaks down and presses on nerves branching off the spinal cord. In dogs, the most common locations for IVDD are the neck and the mid-to-lower back or thoracolumbar area. Dogs with IVDD in the thoracolumbar area sometimes have weak back legs and panting due to pain early in the disease. In severe cases, you’ll see an old dog’s back legs collapsing or becoming so weak they can’t stand at all.
How do you know if your dog has lumbosacral disease?
Lumbosacral disease symptoms depend on which nerves are affected. Some dogs have weak back legs and shaking (from pain) while others show limping and back legs collapsing, and some have urinary and fecal incontinence, while some have decreased tone and sensation to their tail.
Where is IVDD most common in dogs?
In dogs, the most common locations for IVDD are the neck and the mid-to-lower back or thoracolumbar area. Dogs with IVDD in the thoracolumbar area sometimes have weak back legs and panting due to pain early in the disease. In severe cases, you’ll see a dog’s back legs collapse or become so weak they can’t stand at all.
How do you know if your dog has DM?
Dogs aged 8 years and older are more likely to show symptoms of DM. Early signs include difficulty jumping, weakness in the dog’s back legs including collapsing, stumbling, splaying out, slipping, “crossing-over” of rear feet, worn down toenails and abrasions on the feet from scuffing.
How to strengthen a dog's back legs?
Things you can do on your own to strengthen your dog’s back legs: 1 Slow walks daily. Don’t go so long it makes your dog sore the next day. 2 Swimming is good exercise as long as the season is right and your dog is willing. Don’t overdo it. Some dogs get so excited about swimming they end up in a lot of pain later. 3 Stretching. Move your dog’s limbs through their normal range of motion while she’s laying down to keep her limber. Check out this awesome book on how to stretch your dog: The Healthy Way to Stretch Your Dog. My dogs love it!
How to tell if a dog has arthritis?
Dogs with arthritis may not show obvious signs of pain, but you can see they are painful by the way they stand, the way they walk and the way they have trouble getting up and down from a lying position. They tend to be very stiff-gaited when they first stand up after lying down for a while, but they become less stiff as they move around. You may hear “crackling” sounds when you manually manipulate an affected dog’s knee or hip.
What examination is done to determine bone-related lesions?
Then, the veterinarian will proceed with an orthopedic and neurological examination to localize lesion and differentiate bone-related lesions versus nerve deficits.
Why do my knees feel weak?
Other possible causes of sudden weakness are hip and knee orthopedic issues such as hip dysplasia and cruciate ligament injury. An orthopedic examination and x-rays of the hips and knees will localize one or both of these conditions.
Why does my dog's back leg give out?
When your dog’s back legs suddenly give out or show paralysis, there are numerous potential causes. One of them is intervertebral disc disease or IVDD. This is when the cartilaginous disc in the backbones herniates and pushes the spinal cord. This places pressure on nerves preventing hind limb motor function.
Why do dogs droop their nails?
Another less common cause is degenerative myelopathy. This is an inherited degenerative disorder that causes progressive weakness. Initially, affected dogs may start dragging their nails. Later on, will show difficulty jumping and lose balance while walking. Occasionally, this symptom may progress to the front legs.
Why do dogs keep their mouths open when playing?
Many dogs keep their mouths open when playing and dog owners may wonder all about this doggy facial expression and what it denotes. In order to better understand this particular behavior, it helps taking a closer look into how dogs communicate with each other and the underlying function of the behavior.
Can IVDD be treated with surgery?
Fortunately, medications and rest can provide temporary relieve until planned surgical intervention. This will not require emergency surgery like severe conditions of IVDD unless it involves complicated fractures with a history of trauma.
Where did Joanne Fernandez-Lopez go to college?
Originally from Puerto Rico, Dr. Joanne Fernandez-Lopez graduated from North Carolina State University – College of Veterinary Medicine in Raleigh, NC. Prior to joining FVRC, Dr. Fernandez-Lopez worked in small animal general practice and as a relief doctor in South East Florida. Her professional interests include dermatology, surgery, internal medicine, preventive medicine, reptile medicine and practice management.
What is it called when a dog's paw is upside down?
This is called the “placing reflex” and tests the nerves going from his paw up into the spinal cord and brain stem. When the dog isn’t aware the paw is upside down, the vet concludes: The dog doesn’t know the paw is upside down (the placement nerves aren’t working); OR.
What happened to Murphy in the waiting room?
Thirty minutes later, in the waiting room, Murphy was unable to stand and had to be carried into the exam room. As always, a history is vital. Murphy’s story was remarkable in how simple it was:
What is the FCE in spine?
Fibrocartilaginous Embolism (FCE) This is where a small piece of cartilage enters the bloodstream and blocks the blood supply to the spine, causing swelling . Again, slightly puzzling was that both Murphy’s back legs were affected — usually, this is a one-sided problem, with one good leg and one bad leg.
Why are my dog's legs weak?
Possible causes of a dog’s back legs being weak include fibrocartilaginous embolism (FCE) and neuritis. Photo: MabelAmber
How many slipped discs did Murphy have?
Guess what? Murphy had not 1 but 2 slipped discs.
What did Murphy's problems look like?
Given that Murphy had good muscle tone, it looked like his problems were neurological.
Why is my dog's back legs not working?
Disc Disease. Disc disease is a frequent cause of a dog’s back legs suddenly not working. The puzzling thing was Murphy didn’t seem in pain, since normally this is a bloodcurdling, painful condition.
What to do if my dog's hind leg collapses?
If you notice hind leg weakness or collapse in your pup, take note of what was happening just before the collapse, whether or not your dog experienced any mobility changes before or after and how quickly your dog returned to normal, if they were able to get back up. These bits of information may help your vet narrow down the problem at hand and treat your dog as soon as possible.
Why do dogs' legs give out?
Slips and trips: It’s possible that your dog’s legs have given out temporarily because they simply slipped or had momentary weakness after turning in a strange way. If your pup lost their footing but was able to get back up and walk around normally, there’s probably nothing major to worry about.
Why do dogs have numb legs?
For example, herniated discs caused by degenerative disc disease are common causes of numbness, prickliness and weakness in a dog’s hind legs.
Why do dogs' hind legs hurt?
Here are six possibilities. Arthritis: Osteoarthritis, which causes inflamed and painful joints due to cartilage breakdown, can cause dogs young and old significant pain in their hips and legs. Due to ongoing pain, dogs might experience weakness in ...
Why does my dog have a stiff hip?
Dogs with this condition may experience stiffness in the hips and hind legs , an altered gait, reduced activity and pain. Vertebral problems: Along your dog’s back, the spinal vertebrae protect the spinal cord and the nerves ...
What is hip dysplasia in dogs?
Hip dysplasia: Hip dysplasia is a skeletal condition that commonly affects large dog breeds. The condition leads to the deterioration of the hip joint, which can cause total hip dysfunction and hind leg weakness or collapse. Genetics are often to blame for hip dysplasia, as are malnutrition and excessive growth in large dogs. Dogs with this condition may experience stiffness in the hips and hind legs, an altered gait, reduced activity and pain.
What causes a dog to have trouble controlling his front legs?
Nervous system problems: More severe damage to the nervous system might also interrupt the control your dog has over their front or hind legs. Trauma or certain diseases can result in nerve damage. One disease called canine degenerative myelopathy attacks the sheath that protects the spinal cord’s nerve cells slowly.