Posts Tagged ‘Canine Rehabilitation’

Sammy – Geriatric Case Summary

Monday, February 2nd, 2015

geriatricthumbSammy, a 9-year-old MC Great Pyrenees, was presented to the Canine Rehab and Conditioning Group in August 2014 approximately 6 weeks after slipping and falling on the stairs. Radiographs revealed severe osteoarthritis in bilateral hips, affecting the right side worse than the left. Rimadyl had initially helped him feel better, but it was clear to his owners that he was becoming more uncomfortable and less mobile. At his first appointment, Sammy was bright, alert, and responsive, with a body condition score of 8/9. He had a very wide-based, plantigrade stance in his hindlimbs. Observation of his gait revealed significant weakness in his hindlimbs with grade 2-3/5 lameness bilaterally. Sammy had severely decreased extension in both hips, worse on the right (left hip extension: 125°, right hip extension: 102°, normal: 160-165°). For the first 2 months, we treated Sammy weekly with cold laser, massage, and walks in the underwater treadmill. He was only able to go 3-4 minutes at first in the treadmill, but after 8 weeks, he was up to 8 minutes. We re-evaluated him at 8 weeks and, due to significant improvement, we decided to decrease the frequency of his appointments from weekly to twice-monthly. He continued to improve thanks to rehab appointments and home exercises to focus on strengthening his hindlimbs and core muscles. For the first time in months, Sammy climbed the stairs at home without assistance just before Christmas. His hip extension has improved, as well: both have increased to approximately 140°. He continues to visit twice monthly to maintain his improved state and continue strengthening his hindlimbs and core muscles.

Fletcher’s Busy Week

Monday, August 18th, 2014

Fletcher has had a big couple of weeks. Last Wednesday he had surgery for a dying tooth and removal of the large benign lipoma on his right side. Thank you to Apex Dog and Cat Dentistry and Veterinary Surgical Services (VSS) at Veterinary Referral Services of Colorado (VRCC). They went the extra mile to make sure he was comfortable throughout the entire procedure.

lipomaThis is a picture of the lipoma before removal. We felt that as he continued to lose weight it would become a problem so since he had to have the tooth worked on, it was best to get both done while he was under anesthesia.

 

 

 

 

perfectpatientJust waking up from the procedure. He was the perfect patient. It is so hard to watch a loved one go through something like this. It’s also frustrating because they can’t tell you how they feel. Since we don’t know him all that well yet, we don’t know how he handles pain. Not to mention that he has been through a lot of changes in the last few months and we didn’t want to confuse him by putting him through this experience. However, the tooth situation could not be ignored and it would be worse if we did nothing. There is no perfect time so better sooner than later.

 

 

watermelonWe were a little concerned that he wasn’t drinking enough water so we thought enjoying some watermelon might help. The t-shirt is not a fashion statement. Just a deterrent for a little interest in licking the incision.

 

 

 

 

PEMFTaking a break from the shirt for a PEMF treatment. PEMF therapy, although having the word “magnetic” in the name, does not use an actual magnet, but creates a magnetic field by running electricity through a circle made of a conductive metal. The pulse, or drop and surge in frequency, creates an electro-magnetic field, and causes a small amount of electricity to flow through all of the tissues penetrated by the field.  PEMF fields directly affect cellular chemistry, causing a cascade of healing effects.

 

fatThat was one large lipoma. I am sure removing it helped the total weight loss to date….He weighed in at 111 lbs (from 125) on Friday.

That is a lot of fat!

 

 

 

 

toothbefore toothafter

Look at that beautiful tooth! Dr. Beebe performed a root canal. It might be a little hard to see in these pictures – the tooth before is pink and the after result is white. http://www.dentistvet.com/root-canal-therapy.html

Looking good Fletchie! He is a very good patient and well on the road to recovery. Fletcher handled the procedures with aplomb! He has done so well with every new situation he has encountered. We are proud of him and thank our lucky stars every day that he came into our lives.

Swimming vs. Hydrotherapy

Thursday, August 7th, 2014

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Whether it’s the cold, dark depths of winter or the dog days of summer, a dip in the pool can buoy both bodies and spirits!  We all know that recreational swimming is great exercise for dogs.  It is also a fun and social activity for dogs and owners.  Not only that, it allows for a controlled environment that is beneficial both physically and physiologically.

For anyone who has been to a local lake or pond in the late summer months, it is not a surprise that an indoor swimming pool is a cleaner environment.  Lakes and ponds can spread bacteria, giardia and other undesirables to your dog.  Plus there’s no mud to track back to your car, house and your shoes!

The health benefits of recreational swimming are undeniable.  Swimming provides excellent cardiovascular conditioning and helps maintain muscle mass.   Swimming is a great weight control exercise and alleviates stress on the joints so that overweight dogs can get back into the swing of things while reducing risk of injury.

Swimming is an energy outlet, for sure.  A tired dog is a happy dog, and oftentimes a tired dog makes for a happy owner.  As in humans, swimming gets those endorphins going—which is great for overall well-being but it can also be therapeutic for behavioral disorders or for dogs that are just plain bored or tired of being cooped up in the house.

Swimming provides social benefits, as well.  Aerobic exercise can reduce depression in dogs that have exercise restrictions.  Of course, you’ll need approval from your veterinarian before starting a swimming exercise program.  Swimming can also boost confidence and it encourages dogs to learn from other dogs.

Perhaps most importantly, recreational swimming provides an opportunity to build the bond between dog and owner.  It’s a great way to spend time with your dog without distraction.  It’s a time to step away from the daily grind and spend one-on-one time with your pet and serves as a reminder of why pets are so important in our lives.  They give us so much and spending time with them is all they ask of us.

Now that we’ve covered the many benefits of swimming, let’s discuss the difference between swimming and hydrotherapy.  At our facilities, recreational swimming is for healthy dogs that enjoy water and have no physical issues that require supervision and assistance.  Hydrotherapy is utilized on the rehabilitation side to help dogs that have physical issues and, for their safety, require supervision by a rehabilitation therapist.  Our therapists are rehabilitation certified veterinarians, physical therapists and certified veterinary technicians.

The ultimate goal is to graduate the patient to the recreational pool and we release the dog from therapy when they are strong and healthy enough to swim recreationally.

Rehabilitating a dog with water has many benefits. One is decreased weight bearing and non-weight bearing exercise, which reduces pain. In the water, gentle range of motion of all four limbs is accomplished and strengthening is provided by the water resistance. The therapy water is heated to around 84 degrees Fahrenheit which helps to relax the muscles and increase circulation. Hydrotherapy is also used for neurological re-education. There seems to be psychological benefits for the dogs that occurs because they are able to exercise without pain.

Hydrotherapy is used for a variety of reasons including recovery from surgery, chronic conditions such as arthritis, degenerative myelopathy or hip dysplasia, obesity or weight management, or sports conditioning. The benefits of recreational swimming and hydrotherapy are both phenomenal. The important difference between the two is the state of your dog’s physical health. If your dog is generally healthy, by all means, get swimming! Just as with humans, staying active and keeping your muscles strong will help prevent injury in the future.

However, if your dog is injured or otherwise compromised, swimming may not be appropriate and hydrotherapy is necessary for them to get back into the game (or pool). If your dog has been diagnosed as having any of these health conditions, swimming may not be an appropriate form of exercise:

  • Heart disease
  • Respiratory disease
  • Seizure disorders
  • Endocrine diseases
  • Open wounds or infections
  • Fecal incontinence

If your dog has any of these conditions or if your dog is not otherwise in good health, we recommend a rehabilitation exam in order to determine if swimming and/or rehabilitation is best.

The Canine Rehabilitation and Conditioning Group (CRCG) offers year-round swimming 7 days a week at its Englewood and Broomfield locations.  Open and private swim times are available.  Rehabilitation is offered 7 days a week.  Give us a call or visit our website at www.dog-swim.com for more information on our services and find out how you and your canine companion can start making a splash!

Lucille’s Success Story

Friday, July 11th, 2014

LucillesSuccessStory_coverLUCILLE’S SUCCESS STORY

Lucille, an 8 year old pit bull mix, first came to see us in October of 2013. She had fallen out of a 2nd story window while her owners were out of town and was diagnosed with a Carpal Medial Collateral Ligament tear. She was not bearing weight on her right front leg and would vocalize when in pain. She received laser therapy treatment to help with the pain and to decrease inflammation around the affected joint. Lucille’s treatment plan also included walking in the underwater treadmill, range of motion exercises and working on carpal stabilizer muscles. Lucille’s family has since moved, but they contacted us and let us know that she is doing well, running around and playing with her siblings.  These videos show Lucille is a happy dog! We love happy success stories! Yay Lucille!

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Ellie’s Success Story

Wednesday, July 9th, 2014

 

ELLIE

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Ellie, a 13.5 year-old FS English Cocker Spaniel, was a champion hunting dog who lived in a hunt club kennel in Longmont.  She retired after an accident in 2009 and shortly after was adopted by her new dad.  Ellie has rear limb weakness and dragging that her RDVM diagnosed as mild hip dysplasia. When she was diagnosed, Ellie’s dad started swimming every other week.  They were eventually referred to us, where we found compensatory pain in her paraspinal muscles as well as restrictions in her neck range of motion.  The first couple of weeks with us was spent focused on manual treatment and laser therapy to address her pain. Shortly after we started hydrotherapy, clinic exercises, as well as an at home program.  We’ve been seeing Ellie since May, 2014 and we have seen a significant improvement in her muscle pain as well as an increase in her strength and stamina. Dad has also seen significant improvement in her strength and discovered that one of the best reasons to come weekly is for the mental stimulation it provides for her as well. Ellie is a super sweet, albeit opinionated, girl–but that’s one of the reasons why we love her.

Top 5 Conditions that Respond to Rehabilitation Therapy

Monday, May 12th, 2014

Top 5 Conditions That Respond to Rehabilitation Therapy

Suzanne Starr, DVM, CCRP, Paws in Motion Veterinary Rehabilitation Center, Natick, Massachusetts

top5conditions

The goal of physical rehabilitation, in combination with medical and surgical care, is to restore normal or near-normal mobility and musculoskeletal function. Manual therapy includes massage, stretching, passive range-of-motion (ROM) exercise, and joint mobilization. Modalities include heat and cold therapy, therapeutic neuromuscular electrical stimulation, laser therapy, and therapeutic ultrasonography. Targeted exercise can include use of exercise balls or wobble boards, cavaletti rails (ie, horizontal poles positioned at varying heights and distances for dogs to step over), underwater or land treadmills, and pools.

Although dogs with assorted conditions can benefit from physical rehabilitation, the following are the top 5 canine conditions that the author believes best respond to rehabilitation therapy.

Top 5 Conditions That Respond to Rehabilitation Therapy

1. Postoperative cranial cruciate ligament rupture surgery
2. Postoperative femoral head and neck ostectomy
3. Spinal cord diseases
4. Osteoarthritis
5. Obesity


1. Postoperative cranial cruciate ligament rupture surgery
Cranial cruciate ligament disease is one of the most common orthopedic conditions in dogs. Surgery is arguably the best approach to restore stability when the cruciate ligament has been damaged. Regardless of the surgical procedure, rehabilitation initially involves pain management, massage, passive ROM, and icing. As tissues heal, patients often progress to weight-shifting exercises and water treadmill walking (Figure 1). As lameness improves, therapy may include leash walking (ideally involving hills), followed by jogging and trotting.

Figure 1. Because underwater treadmill walking has little impact on the joints, it can benefit dogs affected by orthopedic and neurologic conditions.

2. Postoperative femoral head and neck ostectomy
Femoral head and neck ostectomy is most often performed to treat Legg-Calvé-Perthes disease (ie, avascular femoral head necrosis), coxofemoral luxation, and femoral head and neck fracture. In addition, this surgery can be a salvage procedure for painful hip dysplasia or osteoarthritis. Adequate pain management is important to encourage early use of an affected limb. Early therapy involves massage and gentle, passive ROM. After the skin incision has healed, underwater treadmill activity can promote partial weight bearing and return to normal gait. Once the affected limb is used in a four-legged walk, additional weight-bearing exercises can be introduced. Tools (eg, balance board, exercise ball) can help improve weight bearing while strengthening the core.

3. Spinal cord diseases
Common spinal cord diseases include intervertebral disk disease, fibrocartilaginous embolism, degenerative myelopathy, spinal trauma, and inflammatory CNS disease. Classic signs are proprioceptive deficits and severe paresis or paralysis of the pelvic or all limbs, depending on lesion location. A thorough neurologic examination is essential. When indicated, cerebrospinal fluid tap and MRI or CT should be pursued. Once the diagnosis has been confirmed, therapy, including physical rehabilitation, can be planned. Physical rehabilitation therapy has a role in both these circumstances.

Therapeutic goals for dogs with spinal cord disease include reducing pain, maintaining joint flexibility, preventing or reducing muscle atrophy, and restoring coordination and proprioception. Techniques depend on the severity of signs and spinal cord disease, but massage, passive ROM, targeted exercises using an exercise ball (Figure 2), and water therapy are commonly used. In dogs with severe paresis or paralysis, the benefits of water therapy are extensive. Buoyancy of the patient when surrounded by water strengthens mobility, as dogs often initiate movement in the water before initiating movement on land. When the dog can walk without support, adding exercises such as stepping over obstacles (eg, cavaletti rails) can help improve overall coordination.

Figure 2. Targeted exercises, such as using an exercise ball, can help core conditioning, weight bearing, balance, and ROM.

4. Osteoarthritis
Patients with osteoarthritis can benefit from a multimodal therapeutic approach. A patient’s condition often deteriorates rapidly becomes a vicious cycle: because the arthritis is painful, the animal typically becomes more sedentary, leading to muscle atrophy and weight gain, subsequently worsening the condition. Pain management through analgesic medication and physical therapy can help. Gentle exercise in an underwater treadmill or a pool helps build muscle strength and endurance while minimizing stress on painful joints. When the patient is able, targeted weight-bearing exercise is ideal to strengthen the joints.

5. Obesity
In the United States, an estimated 50% of dogs between 5 and 10 years of age are overweight or obese, making this one of the most common canine medical disorders. Health problems caused or complicated by obesity include joint and/or musculoskeletal problems, exercise and heat intolerance, and pulmonary and cardiovascular disease. Although attention may be given to designing the appropriate diet for weight loss, exercise is often overlooked. When combined with caloric restriction, exercise can induce a negative energy balance critical for weight loss. Scheduled sessions of physical activity can help burn calories,  build muscle mass, and improve client motivation and compliance. Exercise sessions should be customized for each patient.

Closing thoughts
Therapists not only provide a service during rehabilitation sessions, but also participate in designing daily home plans. Clients often benefit greatly from receiving specific guidance following their pet’s injury or surgery. In addition, therapists can recommend slings, harnesses, wheels, and other assistive devices that can help patients and caregivers. It is therefore important for general practitioners and specialists to consider and discuss rehabilitation as part of their patients’ complete care plans when appropriate.

SUZANNE STARR, DVM, CCRP, practices at and owns Paws in Motion Veterinary Rehabilitation Center in Natick, Massachusetts. Her areas of interest include senior and postoperative patient care. Dr. Starr completed an internship at Angell Animal Medical Center and earned her DVM from Tufts University.

 

Canine Neurological Diagnosis & Rehabilitation

Monday, April 21st, 2014

lab_treadProblems in the nervous system can be as variable as our patients. Signs and symptoms range from a mild weakness or dragging of the toes to seizures and behavioral changes. Proper suggestions for rehabilitation in these cases are based on signs and symptoms, neurological evaluation and diagnostics, and realistic goals set by guardians and therapists.

As previously mentioned, neurological signs and symptoms are widely varied. Proper diagnosis of the problem is based on a thorough examination, localization to the proper area of the spinal cord, and diagnostics to confirm. Examination involves a full physical examination and a neurological examination. Based on the patient’s history and the signs observed at home and in the clinic, a picture is created to help localize the most likely problem area(s).  A list of differential diagnoses is then created. Diagnostics to isolate the problem may include blood work, urinalysis, radiographs, advanced imaging (MRI, CT) and cerebral spinal fluid analysis. These help to create a good picture of the problem at hand.

When a diagnosis is found, an analysis of the most proper treatment for the patient is identified. Rehabilitation is an important part of this treatment. Using rehabilitation to help patients with neurologic symptoms can help resolve weakness, improve balance, and reteach proper gait patterning—helping patients to move as well as possible. Weakness is addressed by exercises focusing on muscle contractions. It may start as exercises to maintain a standing or sitting position and can progress to advanced exercises on a fit disc, peanut, or pods. These exercises for strengthening also address balance, which is important because every patient needs balance to perform normal functions such as posturing to go to the bathroom and navigating the house. Regular walks (to the patient’s tolerance) can encourage proper gait patterning. If a patient cannot walk without assistance, other modalities can help to encourage normal movement. These can include carts, treadmills with assistance, and swimming. Each of these modalities engage the central pattern generators, spinal cord and brain to retrain the body to walk again. Even if there is no muscular or spinal issue to address, rehabilitation can help patients that are having trouble with integration of information. Exercise and repetition can increase the input to the brain, and the proper amount of input to a specific part of the brain can help maintain nervous cell health. Nerve cells need stimulation in order to remain healthy and active.

In rehabilitation, realistic goals are necessary to anticipate a return to function. Some problems with the nervous system will not allow for full return to function or may even be slowly degenerative. The goals and expectations of rehabilitation should reflect this so that the goals are reasonable for the patient to achieve.

Success in cases of nervous system involvement is dependent on a collaborative effort from the patient, guardian, regular veterinarian, neurologists, and a rehabilitation therapist. With communication, information, and realistic prognoses, a pet can maintain or recover function to live with a good quality of life.