Canine Physical Rehabilitation

Originally published in TC Dog in 2004.

Physical rehabilitation for dogs is an exciting and rapidly emerging discipline in veterinary medicine. Physical therapy has been recommended for human patients for decades to facilitate recovery from musculoskeletal injuries, orthopedic surgeries, neurological disorders, and for managing chronic pain. Our canine companions suffer from the same and/or very similar conditions, and deserve the benefit of physical rehabilitation to ease their suffering and return them to more normal function.

Interest in rehabilitation care has been growing at an amazing rate over the last decade due to increasing owner awareness and expectations for higher levels of care for their pets. At the same time, medical specialties such as dentistry, oncology, emergency medicine, ophthalmology, and orthopedic surgery that were once available only to humans are now being applied to the pet population. The introduction of physical therapy and rehabilitation to veterinary medicine has encouraged veterinarians to not only learn about this field but to also partner with physical therapists in caring for their canine patients.

Better preventative medicine, more sophisticated diagnostic techniques, advances in surgical procedures with better results, and more effective outcomes for diseases such as diabetes and cancer means there are greater numbers of dogs of all ages with problems that can benefit from physical rehabilitation. National presentations by the American Physical Therapy Association (APTA) and American Veterinary Medical Association (AVMA), and the formation of the Animal Physical Therapist Special Interest Group within the APTA have added momentum to the practice of canine rehabilitation in the United States. Professional animal rehabilitation and physical therapy associations exist in at least 10 countries worldwide, allowing and encouraging veterinarians and physical therapists to exchange information and work together.

In August 1999, the First International Symposium on Rehabilitation and Physical Therapy in Veterinary Medicine was sponsored by and held at Oregon State University. Participants from 21 countries met over four days to present research and clinical findings and to share ideas. The second such symposium was held at the University of Tennessee in 2002 and the third at North Carolina State University in August 2004. Scientific research is being conducted at several university veterinary schools in the United States and throughout the world, showing rehabilitation to be an effective tool in treating our canine companions and improving their recovery process. There is also a wealth of information at our fingertips from research in human medicine, where dogs have been used for decades as a model for studying physical therapy in people.

Currently in the United States, there are several hundred facilities and individuals offering canine physical rehabilitation. We are just now seeing the introduction of some basic courses in canine rehabilitation offered at a number of the veterinary schools. However, the University of Tennessee Certificate Program in Canine Rehabilitation under the guidance of orthopedic surgeon Daryl Millis, DVM, and David Levine, Ph.D., PT (http://www.utc.edu/Faculty/David-Levine/) is the only university-based program to offer specific credentialing in this field. These pioneers in canine rehabilitation strongly recommend not only that veterinarians and physical therapists be well educated in this field, but also that they work in teams, utilizing both areas of expertise to treat the patient. To date, there are about 80 veterinarians and physical therapists in the United States that have completed the coursework and exams to become Certified Canine Rehabilitation Practitioners (CCRP) through this program.

Rehabilitation facilities have sprung up in great numbers on the East and West Coasts, with only a handful of facilities and trained practitioners in the Midwest. Locally, PineRidge Pet Care in Andover, Minnesota has two certified practitioners on staff. Amy Bear, DVM, CCRP, and Barb Guse, PT, CCRP, have worked together for three years, evaluating and developing specific rehabilitation treatment plans for a wide variety of canine patients. Amy has practiced as a small animal veterinarian for 14 years with PineRidge Pet Care (formerly Anoka West Pet Hospital). Barb's expertise and skills developed in her 18 years as a licensed physical therapist in human medicine carry over to the canine population in many ways. Her education and training in physics, anatomy, exercise physiology, psychology, biomechanics, and manual techniques for joint and soft tissue assessment is key to the practice of canine physical rehabilitation.

The goal of physical rehabilitation is applying physical therapy techniques to canine patients suffering from pain, injury, dysfunction, movement abnormalities, or recovering from surgical treatments, and returning them to normal function and their previous level of activity as possible. Benefits of treatment include improved comfort, maintaining joint range of motion, minimizing muscle loss and increasing strength, retraining leg use, and reducing the chance of other injuries. Overall, rehabilitation aims to improve the quality of life for the dog as well as the owner and provides a positive psychological boost for them both.

At PineRidge Pet Care, the process begins with a thorough evaluation of each patient, including medical history, current medications, comprehensive physical exam, home environment, and owner expectations and goals. This allows the veterinarian, physical therapist, and owner to understand what is going on with the pet and determines an appropriate, realistic rehabilitation program. Individual treatment plans may include pain medications and supplements, physical agents (heat, cold, therapeutic ultrasound, electrical nerve stimulation), manual therapy (massage, passive range of motion, stretching, joint mobilization), aquatic therapy (underwater treadmill, swimming), therapeutic exercise (physioball activities, balance boards, weight shifting, movement though tunnels and cones, negotiating obstacles and challenging terrain), functional activities (sit-stands, stairs, "job tasks" or competitive activities) or modifications to the home environment as required. Owners are encouraged to take an active role in the pet's recovery by following an ongoing prescribed therapy program at home.

Rehabilitation cases at PineRidge Pet Care include joint and soft tissue injuries, postoperative orthopedic surgeries (cruciate ligament repairs, patella luxations, fractures, hip replacement and salvage procedures, elbow replacement, etc.), neurological conditions (degenerative disk disease, spinal stenosis, FCE, postoperative neck and back surgeries), and congenital and degenerative disorders such as hip and elbow dysplasia and osteoarthritis. Individualized rehabilitation programs are designed to improve weight bearing, balance, coordination, strength, and endurance in order to regain and maintain the health of muscles, bones, and joints.

As veterinarians and pet owners become more aware of what can be accomplished, the interest and demand for physical rehabilitation continues to grow. Dogs in rehabilitation programs range from family pets recovering from injuries and surgeries; to seniors with chronic, debilitating conditions; to national agility competitors, field trial, hunting, and service dogs. Our canine companions deserve the best recovery possible. They are eager and willing to do what it takes to be comfortable, active, and have a good quality of life. It's up to us to give them that opportunity.

PineRidge Pet Care
www.pineridgepet.com
763-755-5321.
Bios to come!