Years ago the norm was to perform surgery on an animal and crate rest or confine them afterwards for extended periods so as to prevent damage or injury to the surgery site. Although rest is an important part of the recuperation process, we now know that prolonged immobilization leads to muscle atrophy, weakening of tendons, ligaments and bones and decreases in range of motion. In this article I will present some situations where pets were left with significant loss of function and discomfort after surgery or injury. The collaboration of the veterinary field with the physical therapy field has led to advances in pet rehabilitation that would never have been possible. There are now options to help animals further their healing process and give them a more normal life. Dogs with neurological conditions such as degenerative myelopathy, recuperating from back surgery, disc herniations, hip dysplasia, fractures and orthopedic procedures. I will also discuss several of the modalities that are incorporated in this amazing new field of animal care.
The field of physical therapy came out of necessity after World War I veterans injuries led to the development of techniques and treatments that could allow their return to a more normal life. In the 1960’s many of the techniques used in human physical therapy were applied to horses. When I graduated from veterinary school 18 years ago, there were few veterinarians trained in this area. The focus was on immobilizing, splinting and keeping animals still for the most part during their healing process. Nor, did many physical therapy colleges offer courses applying their techniques to animals. In 1993 the American Physical Therapy Association endorsed having a collaborative relationship with veterinary field to provide physical therapy services to animals. The field of canine physical rehabilitation in veterinary medicine has seen great advances and successes in helping animals to achieve optimal health thanks to this collaborative effort.
First and foremost, the most important goal of canine rehabilitation is to decrease pain. Further goals are speeding up the healing process, improving function and reducing the chance of further injury. Rehabilitation will help the arthritic pet by decreasing pain and allowing the pet to gain strength to help compensate for the condition.
Some of the traditional modalities used in canine rehabilitation include basic modalities such as cryotherapy (icing after injury) and heat for chronic injuries and arthritis to improve stiffness. Other hands on therapies include: massage, passive range of motion, joint mobilizations, stretching and therapeutic exercises. In many cases, pet owners are taught how to perform therapeutic exercises, massage and stretching if the pet will allow it. Incorporating the owner as an active part of the rehabilitation process accelerates healing. This empowers pet owners with the ability to help their pet in an otherwise hopeless situation. Other traditional therapies include therapeutic ultrasound, cold laser (low level laser therapy) and hydrotherapy in heated underwater treadmills. Some nontraditional/complementary modalities include acupuncture and spinal manipulation/veterinary chiropractic.
STORIES OF HEALING:
Rocco’s owner knew there was a problem when her Chihuahua puppy mix, Rocco, was not using his hind legs well. He bunny hopped when he ran, attempting not to fully extend his hips. He was also beginning to have significant atrophy of the thigh muscles in the right leg. After taking radiographs of his hips and spine, she found that her dog had a congenital malformation of the hips called Legg-Perthes disease. This malformation occurs when the blood supply to the femoral head is inadequate and lead to severe arthritis in his hip joint. A femoral head ostectomy (FHO) was performed to remove the diseased femoral head and create a smooth articulation between the ball and socket. Rocco was on his way to recovery. The only problem was that he would not use the leg after the surgery. Atrophy set in very quickly after the surgery and Rocco was pretty much on three legs. This is not an uncommon problem in small dogs after surgery. They are light weight and head strong! During the healing process they guard the leg naturally and find it easy to get around on three legs quite easily. After dealing with Rocco’s pain, it was time to focus on getting him back to running on four legs at the park!
Rocco began a regimen of therapeutic exercises at home that included stretching, core strengthening and exercises to encourage weight bearing. As Rocco was not always the most cooperative patient we tried to make his rehabilitation fun. Tug of war was one of his favorites, and is hard to do without putting both hind legs on the ground! Rocco came for rehabilitation twice weekly and exercised in a heated underwater treadmill. This was helpful as he could exercise in an environment where concussive forces are decreased due to the buoyancy of the water. Resistance of the water is good for strengthening. After 8 weeks of therapy, the owner is pleased that Rocco is using his surgical leg consistently.
Molly is a typical feisty 6 year old dachshund. When Molly’s owner left in the morning she was fine. She came home to find that Molly was not using her hind legs at all. It was determined by her veterinarian that she had no motor function or deep pain sensation in her hind legs. Emergency surgery was performed to remove a herniated disc in her spine. After the surgery, Molly had deep pain sensation, but no motor function. Without physical rehabilitation she could have been left with the option of life in a cart. At 4 years of age this was not the best option for a very dedicated dog and owner. Molly’s owner sought out options for her beloved dog and physical rehabilitation was the logical choice. After 3 months of home exercises and visits to have her exercise in the weightless environment of the underwater treadmill, Molly is beginning to walk on her own. I have to say that without the dedication of her owner, this would not have happened. Molly already had the dedication!
Bella is a three year old grandkitty to a very loving woman who took over her care after she was hit by a car. Although she escaped a potentially fatal injury and was able to walk after, the nerves in her lower spine were damaged and she was unable to urinate or defecate on her own after the accident. The hope was that with time, her bowel and bladder function would return. The owner had to express her bladder multiple times daily and gave her medication to help bladder function. After several months of this, she sought out alternatives as Bella was not improving. Bella received cold laser therapy to stimulate the function of the nerves in her spine. Dr Charisse Davidson at the Veterinary Specialists of the Valley injected stem cells harvested from Bella’s fat into the area of the affected spinal nerves. I am pleased and astounded to say that Bella and her healing really took off. She is now using the letterbox all by herself!
These are just a few of the amazing stories of dedication on the parts of humans and animals to improve quality of life. I now see the possibilities for these animals thanks to the advances in the field human and veterinary medicine. These therapies give options and hoe to those in difficult situations with their pets and have led to improved quality for animals and their companions.