Archive for the ‘T – Therapy’ Category

Rehabilitation & the “C” Word (Canine Cancer)

Wednesday, April 2nd, 2014

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It has happened. Your dear companion has been diagnosed with cancer. Now what? For a lot of patients with cancer- human and furry alike- surgery, chemotherapy, and radiation treatments may be recommended. The question is- how can I keep them going during this difficult time?

In human literature, it has been found that mild to moderate rehabilitation is beneficial during recovery and treatments for neoplasia. By moving, a person can experience improved motion and strength, increased quality of life, decreased pain and fatigue, and improved lymphatic flow. Even if movement is just walking around the kitchen or the yard, it is stimulating the body and can have prolific dividends.

So the question is-Is this possible with my furry companion? At this time, there are studies underway to determine that very thing.  But if you think about it, why wouldn’t it help? Moving is a way to allow your companion to engage and actively be a family participant. Rehabilitation can help keep a member of the family going, whether it is a walk around the block, or around the yard.  Through a controlled and focused rehabilitation program, animals can stay as functional as possible during treatment and allow them to thrive on the road to recovery.

Take Sammy for example. A 10-year-old Lab, he had a past history of progressive arthritis as he got older, and has had issues with his rear limbs. He was presented to us for pain management and strengthening, which was successful. During one of his appointments, a swelling was noted on the rear limb that was painful. Further investigation revealed a tumor in his hind limb and lungs. At that time, recommendations for handling his neoplasia was discussed, and the owner’s chose not to treat. We continued his therapy, but decreased his exercise to stretches, walks, and gentle weight bearing and strengthening exercises. Modalities and manual therapy was used for pain management and to maintain muscle flexibility. So far, he has been doing well and though the mass on his limb has gotten bigger, Sammy is still a happy dog with a good quality of life.

Sammy is one of many dogs that benefited from massage, exercise, and pain management when faced with a progressive and invasive foe. Others can reap the benefits of remaining mobile as well, with an appropriate rehabilitation program.

Drug Therapy May Bridge DM and ALS

Friday, March 21st, 2014

*Article provided thanks to University of Missouri College of Veterinary Medicine *

dm, als, degenerative myelopathy

Dr. Joan Coates, a veterinary neurologist and professor at the University of Missouri College of Veterinary Medicine, was recently awarded a grant from the National Institute of Neurological Disorders and Stroke, part of the National Institutes of Health, to explore a potential therapy for canine degenerative myelopathy. The study involves treating dogs diagnosed with degenerative myelopathy (DM) with a drug therapy that is also being tested in people with amyotrophic lateral sclerosis (ALS), or Lou Gehrig’s disease.

“What we hope to do is slow the disease progression, and ultimately, halt the disease progression,” Coates said.

Coates was part of a team that also includes Dr. Gary Johnson, an associate professor in the MU CVM Department of Veterinary Pathobiology who is involved in genomics research, and investigators at the Broad Institute and Massachusetts Institute of Technology, who established that the same genetic mutation that causes DM in dog also causes some forms of ALS in people. The mutation is wide-spread in the dog population and DM exists in many breeds, such as Pembroke Welsh corgis, Rhodesian ridgebacks, German shepherd dogs, Chesapeake Bay retrievers and boxers.

Both DM and ALS are incurable neurological diseases that cause progressive neurodegeneration in both the central and peripheral nervous systems. The diseases lead to weakness and muscle atrophy, and culminate in paralysis and death. In DM, the onset of clinical signs starts at around 9 years of age with weakness beginning in the hind limbs and affected dogs are usually paralyzed within 11 months. Many pet owners choose euthanasia when their dogs can no longer use their hind limbs. However, if the dogs live longer with DM, the disease would continue to spread through the central nervous system eventually affecting the rest of the spinal cord, muscles, nerves and the brain. In end-stage DM, dogs can develop swallowing dysfunction and lose their bark.

Coates’ focus now is the search for a treatment that will benefit DM and ALS patients.

She is collaborating on a drug therapy project with Dr. Timothy Miller at Washington University in St. Louis. Miller is leading a clinical trial in ALS patients. Coates said beneficial effects of the drug have been observed in rodent studies giving hope that those benefits will carry over to treating DM and ALS.

“Possibly more can be learned in treating DM so that we can then go back and expedite therapeutic approaches in treating ALS,” Coates explained. “We hope to have pharmacologic studies completed in a year and from there we can take it to a clinical trial in DM-affected dogs.”

Similarities between the canine and human nervous systems, and the homogeneity in onset and clinical progression of canine DM, will facilitate translation of therapies into human applications. Furthermore, dogs with DM offer a ready clinical population in which therapies can be evaluated in an environment closely mimicking human clinical trials.

ALS is caused by many different genetic mutations or is sporadic. Moreover, the disease progression and the type of onset are variable. These heterogeneities pose challenges in management of clinical trials for the ALS community.

“The challenge in any therapy involving the nervous system is getting the therapy where the pathology resides — you have to get the treatment into the spinal fluid and the nervous tissue.”

To that end, Coates is collaborating on other translational and comparative medicine projects. With her fellow researchers within the College’s Comparative Neurology Program, she is working to establish biomarkers — the biochemical signatures of diseases — in spinal fluid and blood in an effort to further characterize DM. She is also partnering with Dr. Teresa Lever, an assistant professor in the MU School of Health Professions, to study swallowing dysfunction in dogs.

As the links between ALS and DM becomes clearer, Coates hopes that she, together with fellow veterinary neurologists, will foster collaborations with other ALS researchers to expand on different treatment approaches for DM and ALS and eventually a cure.

In Loving Memory Of Kona

Friday, March 14th, 2014
understand dm, degenerative myelopathy
understand dm, degenerative myelopathy
We were lucky enough to first meet Kona back in 2012. Her vet diagnosed her with Degenerative Myelopathy (DM) so she started visiting us to swim and receive laser and massage therapy.  Kona loved her swimming! And we sure loved seeing her. She was a happy face and a lively warm soul that brightened up everyone’s day when she walked through our door.  Although there was a time when Kona could no longer walk well on dry land, she was still able to move in the water and could swim well. Kona’s wonderful family would take her to a lake house every summer. She loved these trips and would spend the majority of her days there enjoying the water. It was such a pleasure to be a part of your life Kona, your beautiful soul will continue to live on and your strength to inspire others. You will be remembered, dear Kona.
“Dogs may not be our whole lives, 
but they make our lives whole”

Understanding Degenerative Myelopathy (DM)

Friday, March 7th, 2014

degenerative myelopathy

Canine Degenerative Myelopathy (DM) is a progressive neurologic disease of the spinal cord. It is characterized by weakness and coordination of the hind limbs. As the disease progresses the hind limbs will become weaker and weaker until they are paralyzed. The disease will continue to progress up the spinal cord eventually causing front limb paralysis and death. DM is most often caused by a genetic gene mutation, and is comparable to ALS or Lou Gehrig’s disease in people. At this time the disease is incurable, but there are things you can do to help slow the progression and provide your dog quality of life. 

Dogs are usually older than 5 years when signs first appear. Often the first symptoms owners notice are stumbling and tripping over the back paws, however there are many symptoms to be aware of including:

  • Progressive weakness of the hind limbs
  • Worn nails
  • Difficulty rising
  • Stumbling
  • Knuckling of the toes
  • Scuffing hind feet
  • Wearing of the inner digits of the rear paws
  • Loss of muscle in the rear legs progressing to general muscle loss
  • Tremors of the rear legs
  • Urinary and fecal incontinence
  • Front leg weakness
  • Mental anxiety
  • Pressure sores on boney prominences
  • Inability to rise
  • Poor hygiene
  • Pneumonia
  • Depression
  • Infection/sepsis

*Note that the above symptoms may represent other medical concerns that should be discussed with your veterinarian

DM has been identified in 43 breeds, including German Shepherds, Boxers, Golden Retrievers, Bernese Mountain Dogs, Shetland Sheepdogs, Corgis, Pugs, and Chesapeake Bay Retrievers.  If you have a dog who is showing these symptoms (whether they are a breed that is predisposed to DM or not) you should visit your veterinarian as soon as possible.

There is no known cure for DM at this time. The disease is non-painful, however, it is important to develop a physical therapy plan as soon as possible.  Physical therapy has been shown to increase life expectancy significantly as well as significantly increase your dog’s quality of life.

When developing a therapy plan for a dog with DM, the whole dog has to be taken into consideration. Often dogs diagnosed with DM also have arthritis or other old injuries (like a repaired torn cranial cruciate ligament) that should be taken into account. The general plan for DM includes 5 parts: active exercise, passive exercise, massage, hydrotherapy, and paw protection. Depending on the dog, we may also recommend laser therapy and acupuncture. As a rehab practitioner and vet, our goal is to slow the progression of the disease by keeping your dog as active as possible. It is also recommended that you request an at home exercise plan from your rehab vet. The more regular your routine for providing planned exercise and activity, the better it will be for your dog.

There are products that can be helpful for you and your dog as you work together. The Help ’em Up Harness will allow you to safely give your dog assistance moving around. As the disease progresses, eventually a dog wheel chair will be needed. Dogs use the wheel chair a couple hours a day to allow them some freedom of movement and to explore their world. You will want to regularly consider your dog’s quality of life. (What is your dog’s favorite thing to do? Is it to eat, play ball, swim, go on walks, or greet mom when she gets home? Having good quality of life means enjoying these things.) He/she should be checked every 3-4 months for urinary tract infections, and any wounds in order to closely monitored for signs of infection. In the latter stages of the disease, as the weakness moves forward in the body, it may become more difficult for your dog to breath and pneumonia may become a risk. At this point in the progression, it is important for you to watch for mental anxiety and depression. At some point, euthanasia becomes the kindest gift to then give your dog, but until then, enjoy your time together, and be thankful of each other and all the other two and four-legged creatures in your life.

Importance of Rehab

Sunday, January 5th, 2014

ImportanceofRehab-01WHY IS REHAB IMPORTANT?

If your dog is young, old, post-operative, or arthritic, it might be time to consider canine rehabilitation. Essentially physical therapy for dogs, canine rehab can help with many different doggy afflictions. People often are surprised to hear that rehab is an option for their own dog, and we are frequently asked how rehab works or why someone should consider it for their furry companion.

WHAT IS CANINE REHAB?

Canine rehab is a field of veterinary medicine that focuses on soft tissue injuries (muscle pains, ligament tears, and tendon strains, for example). Rehab is a way for dogs to reinforce normal neurological pathways, to gain strength and coordination, and to increase joint range of motion. It identifies painful or problematic areas; rehab vets can help with those undiagnosed lamenesses for which other vets may prescribe just R & R (or “rest and Rimadyl,” in the veterinary world). Canine rehab utilizes three main treatment options: 

epcorgis_small_squareExercises are at the core of canine rehab. Just like people, dogs respond well to small amounts of consistent exercise. If you want to tone your biceps, for example, you focus on high repetitions, low weights. The same is true for your dog: if Fido just had knee surgery and has lost tone in his hamstrings, we ask him to start with gentle weight-shifting exercises a few times a day instead of hiking him to the summit of Pike’s Peak.

Another tool of rehab is hydrotherapy, the use of water to aid in your dog’s treatment in the form of underwater treadmills and swimming pools. The buoyancy of water helps alleviate stress caused by weight-bearing on your dog’s joints, while still offering strengthening properties as your dog swings its legs through the water. Depending on your dog’s issues, a rehab vet may utilize the treadmill, the pool, or both.

Lastly, rehab incorporates different modalities to offer a well-rounded treatment plan. Cold laser, therapeutic ultrasound, and muscular electrostimulation are available to your dog. All reduce pain, encourage greater blood flow, and increase the rate of healing. Used alone or in conjunction with exercises and hydrotherapy, almost every patient feels the benefits of these modalities.

WHO NEEDS REHAB?

Any dog can benefit from rehab. Our typical patients include post-operative and geriatric dogs, but we also have young, healthy pups. If your dog is in agility and you’re looking to improve her weave-pole time, we can help with that. If your puppy is too uncoordinated to function all four limbs at once, we can help with that, as well.

Post-operative patients (especially all you TPLO’s out there) are the most obvious rehab candidates. Just like in people, dogs need more than just strict rest to fully recover from orthopedic procedures. Surgeons have learned that six weeks of strict cage rest after slicing-and-dicing does not result in healthy dogs or happy owners. Rehab helps ease a dog back into normal activities by safely strengthening the muscles around the weakened bones or joints.

Pre-operative patients are less obvious rehab candidates. If your dog just “blew out a knee” and had corrective surgery, the surgeon likely told you that more than 80% of such patients end up “blowing out” their other knee. Rehab will help your dog strengthen BOTH legs after the first surgery to help protect both knees, thereby decreasing the risk of a second surgery (and a second surgery bill). This is true for non-knee anatomy, as well: wrists, elbows, shoulders, hips, ankles, and spines can benefit from a little extra muscular support, as well.

Even if your dog is already scheduled for surgery, it’s a good idea to bring him or her by beforehand for an introduction to some of the exercises that will follow the surgery; that will give him/her a head start post-operatively. They can jump right into the treatments rather than spending some of that precious post-op time in the introductory phase (this is especially true for the underwater treadmill).

fitpawsYoung and old dogs are both known for their lack of limb-control (known as proprioception). In older patients, it’s likely due to a medical condition, such as arthritis or a neurological disease; in puppies, it’s due to…well, being a puppy! Exercises to help your dog place its paws accurately and work on balance can make a significant difference in your and your dog’s lives. Take dogs diagnosed with degenerative myelopathy, for example. This is a debilitating neurological condition with 6-month prognosis from the time of diagnosis without rehab. With it, they can stay comfortable for a year or more.

Dogs with a bum leg or two also find rehab useful. Some dogs are born with inherently bad joints: think bulldogs, dachshunds, and German shepherds. Some are born with angular limb deformities, which occur when bones do not develop and meet correctly within the joint.

Healthy dogs can benefit from rehab, as well, for all of the same reasons just listed. Rehab can help agility or working dogs strengthen muscles and avoid injuries. Hunting dogs can improve their retrieval times and decrease risk of injury by improving their proprioception. Even if your dog is just your walking buddy who likes to play fetch, rehab can help improve their overall fitness level to help prevent any number of metabolic and orthopedic complications that accompany an aging animal. Just like exercises keeps your own cardiovascular, gastrointestinal, musculoskeletal, and nervous systems in better shape, they help your dog in the same ways.

WHAT DOES A REHAB APPOINTMENT ENTAIL?

massageAt CRCG, your first appointment will be an evaluation. A rehab vet examines your dog as a whole, feeling each palpable muscle, tendon, ligament, and joint. This gives the vet a complete picture of what is painful for your dog and how to best approach treatment. The vet then demonstrates and helps you practice various simple exercises for you to do with your dog at home. The vet also lays out a general game plan for rehab, and you both discuss how that does or doesn’t work with your own goals or schedule.

Appointments can include any of the methods discussed above: exercises, hydrotherapy, and manual modalities. During each appointment, you are right there with your dog. A tech does not whisk your dog away “to the back” for treatments; you are an integral part of each step along the way in your dog’s rehab. Rehab is truly a team effort, and without your dedication at home, it would be a slower and less successful process.

Who else is part of your dog’s rehab team, you may wonder. A rehab vet is a veterinarian who underwent additional training and certification. A certified veterinary technician may also make an appearance to help with certain exercises.

WHAT IF I WANT TO LEARN MORE?

Visit our website (www.dog-swim.com), give us a call (303-762-7946), or come visit us at CRCG! We’re happy to answer any questions or help determine if your dog could use some form of rehab.