Canine Physical Rehabilitation: A Revolution?
World Small Animal Veterinary Association World Congress Proceedings, 2013
Kirsten Gollan, MSc, MNZSP, Veterinary Physiotherapist
Animal Physiotherapy & Rehabilitation Ltd, Hamilton, New Zealand

Canine rehabilitation utilises the principles of "human" physiotherapy and rehabilitation and combines this with an in-depth knowledge of canine anatomy and physiology to provide rehabilitation of both the pet and canine athlete.

Advances in medical and surgical veterinary care can be complemented by effective physical rehabilitation techniques. Clients want more options for treatment and management of medical and surgical cases. Clients are looking elsewhere for options for the management of lameness, assessment of performance changes in the athlete and postoperative management in conjunction with "medical veterinary care."

A greater understanding of musculoskeletal injury and owners relating their dogs' injury to their own has led to a number of "additional" therapies becoming established. Physiotherapy treatment is undertaken with knowledge of soft tissue injuries, effective options for managing and treating these injuries and a sound anatomical knowledge.

A physiotherapy assessment begins with a subjective history much like a generic consult. Further questioning into the types of symptoms, occurrence - did they begin gradually or after a particular traumatic event? When do the symptoms occur - after exercise/rest, how long do they last for? Screening questions such as changes in behaviour, appetite, and general health are also included.

During the subjective assessment the dog is allowed to move freely around the consult room, its general posture/demeanour/movement are noted. The postures observed include sitting/standing and lying. This period gives the dog time to relax and also to be observed in "natural" movement.

The dog is then assessed walking, trotting, turning a circle, walking over objects and other appropriate tasks - in working dogs this may include jumping and speed work.

The dog is then assessed for range of movement of the neck, spine and tail as well as all four limbs. The dog is also palpated looking for signs of pain, heat, swelling or muscle spasm. It is important to examine the whole dog even if there is an obvious lameness of a particular limb. The dog may have secondary soft tissue problems. A gross neurological assessment will also be completed. Ideally the dog has been seen by a veterinarian (but not always!) therefore a further veterinary examination may be required to assess more specific joint problems. Integrating physiotherapy into the general veterinary practice begins by opening the gates to understanding the muscular system of the canine and the importance that it plays.

Providing owners with additional options for managing soft tissue injuries often provides the opportunity for them to feel that they are able to participate in the treatment of their dog.

Early physiotherapy treatment of soft tissue injuries includes:

 Ice or cold therapy to reduce inflammation and limit secondary damage due to the inflammatory process.

 Rest - this may be crate rest or splinting/bandaging for peripheral injuries.

 Advice to owners - limiting jumping especially into cars or onto beds and advising care with wooden floors/stairs.

 Gentle massage - depending on the location of the soft tissue injury it may be appropriate for the owners to commence gentle massage. This should be carried out in the direction of the muscle fibres and with a light pressure only.

 Stretches - demonstrating stretches to owners can be effective in assisting in managing soft tissue injuries. For neck and spinal stretches using food to encourage the dog to move in the desired direction. It is important to show the owners how to isolate the stretch to the appropriate area.

As the injury heals it may be appropriate to use heat prior to the massage and stretches which assists in increasing the circulation to the area.

Deeper tissue massage can also be used as the pain and inflammation reduces.

Rehabilitation

Following the healing of soft tissue injuries, following surgery or in conservative management of arthritis or joint disease, a rehabilitation programme is often appropriate. This improves the outcome of surgery, helps reduce further injury and assists in the long term management of joint disease.

Options of rehabilitation that may be appropriate may include:

 Water treadmill/swimming. The water treadmill is an effective way of providing rehabilitation in a controlled environment. The dog is placed onto a treadmill and the water level filled depending on the ability and level of the dog's weight bearing. The therapist can then assist the dog to perform a normal gait pattern within the support of the water. The speed of the treadmill and the depth of the water can be managed along with accurate time management. Swimming is also an effective option of rehabilitation especially in dogs with osteoarthritis and hip dysplasia as it enables muscle strengthening to support the joints without weight bearing. Owners need to participate in their dog's swimming where possible as dogs can effectively swim without using all 4 limbs!

 Land based exercises. These exercises will vary depending on the desired outcome. Examples for getting dogs to increase weight bearing and aid in restoring stride length is walking over a ladder, walking figure of 8s and walking around a fan.

Dogs can also benefit from static and proprioceptive strengthening which can be done through a range of functional exercises. Use of wobble cushions can provide an uneven surface for dogs to stand on which uses their muscles in a static position and challenges their balance reactions. This also challenges joint receptors and improves limb placement/stability.

Summary

Canine physical rehabilitation is a dynamic and evolving practice. It can be integrated into everyday veterinary practice by providing owners with increased understanding and empowering them to be more involved in the management and treatment of a number of musculoskeletal injuries. Including simple exercises as appropriate can assist with compliance as well as healing of the injury.

Owners are often looking for further information and options for supporting musculoskeletal injuries or the post-operative period for their dog. Providing them with further information and advice can help them to feel involved in their dog's treatment. This can be provided during face to face consults but written information/handouts are also useful as a reference for owners to keep.

  

Speaker Information
(click the speaker's name to view other papers and abstracts submitted by this speaker)

Kirsten Gollan, MSc, MNZSP, Veterinary Physiotherapist
Animal Physiotherapy & Rehabilitation Ltd.
Hamilton, New Zealand


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