Veterinary Rehabilitation, Dr. Laura Perez, 11/8/14
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Veterinary Rehabilitation, Dr. Laura Perez, 11/8/14
- 1. Veterinary Rehabilitation Can your patients benefit? Laura M. Perez, DVM, CVA, CCRT
- 2. Objectives Basic understanding of veterinary rehabilitation and its associated techniques and modalities Review the types of cases that would benefit from rehab Review basic techniques that can be implemented in your practice
- 3. Favorite quote “I believe that in the near future, failing to refer a patient for physical therapy will amount to malpractice” H.A. Apfelbach, MD 1959 Director of Orthopedics Rush Presbyterian Medical Center Chicago, IL
- 5. What is Veterinary Rehab? Human Physical Therapy Treating the soldiers of World War I (1914-1918) Equine Rehab 1960’s Equine and Canine Rehab Mainstream in Europe and UK by 1980’s Canine Rehabilitation Institute University of Tennessee
- 6. What is Veterinary Rehab? It is NOT just the underwater treadmill or LASER therapy!
- 18. What is Veterinary Rehab? Manual therapies Therapeutic exercises Modalities Hydrotherapy Problem solving Managing expectations Meeting owner’s goals
- 19. Manual Therapies Massage Joint mobilizations Joint compressions Stretching
- 24. Video
- 25. Therapeutic Exercises Peanut ball, donut, balance disc, etc. Rocker boards Cavaletti poles Hills, variety of surfaces, etc
- 28. Video
- 30. Modalities LASER Therapeutic Ultrasound NMES (E-Stim), TENS Magnetic Field Therapy (PEMF) Thermal Therapies (Heat, Cold) Shockwave Acupuncture
- 31. LASER - Effects Cartilage stimulation Fibroblast production Endorphin release Increased angiogenesis Lymphocyte production Accelerated inflammatory phase Acceleration of collagen synthesis Reduce oxidative stress Help take the body through the stages of healing more quickly
- 32. LASER - Indications Arthritic conditions Tendonitis, bursitis, fasciitis, capsulitis Neuralgia Ligament/tendon injuries Wound healing Scar tissue Improve circulation Pain relief Muscle spasm Superficial skin lesions Stimulate acupuncture points
- 33. LASER - CONTRAindications Over the eye Over cancer Over photosensitive scrubs Over areas recently treated with cortisone injections Over the thyroid gland Over areas of hemorrhage Over a pregnancy Over unclosed fontanels Over the vagus nerve Over the sympathetic ganglia Over the heart in cardiac patients
- 34. Ultrasound Continuous Thermal effects Increased blood flow Increased soft tissue extensibility Pain relief Pulsed Tissue repair Bone repair Reduce swelling
- 35. Ultrasound - Indications Muscle spasm Trigger points Tendonitis, capsulitis, bursitis Soft tissue healing Chronic synovitis Contusions Fracture healing Joint swelling Wound healing Adhesions Calcifications
- 36. Ultrasound - CONTRAindications Over eyes Over cancer Over areas of infection Over areas of reduced circulation Over a pregnancy Over the heart On the testes Immediately after exercise Immediately post-op
- 37. Ultrasound - Precautions Boney prominences Flared arthritic joints Implants Over major nerve or blood vessels Over intracapsular swelling Bursitis Over the growth plate in young animals
- 38. Neuromuscular Electrical Stimulation (NMES, Estim) - Indications Disuse atrophy Neurological atrophy Improper muscle firing sequences Joint effusion Pain Muscle spasm Post injury muscle inhibition Tendon/fracture healing
- 39. Neuromuscular Electrical Stimulation (NMES, Estim) - CONTRAindications Infection Anytime active movement is contraindicated 24 hours after active inflammation Over analgesic areas Animals with seizure disorders Irritated or broken skin
- 40. Magnetic Field Therapy Theoretic Mechanism of Action Damaged cells have altered rest potentials (permeability to Na+ and K+). The rest potential of the cell is proportional to the ion exchange occurring at the cell membrane. Ion exchange is affected by the rhythm of the pulsation introduced by a PEMF Ion exchange is responsible for oxygen utilization of the cell Lack of oxygen utilization is a problem with delayed healing and arthritic joints.
- 41. Magnetic Field Therapy Effects of PEMF Enhanced cartilage repair Stimulation of chondrocytes Increase in collagen synthesis Increase in osteogenesis +/- nerve repair??
- 42. Magnetic Field Therapy - Indications Bone healing Inflammation Muscle spasm Pain Disorders of the neuro system Tendon healing Degenerative diseases of the musculoskeletal system Infection Poor circulation MS, Parkinsons Burns and wounds
- 43. Magnetic Field Therapy - CONTRAindications Hemorrhage Electrical implants Cancer
- 45. Thermal Therapies - Heat Indications Pain relief Increase circulation Muscle spasm Facilitate tissue healing Prepare a stiff joint or muscle for exercise Chronic swelling Tissue scarring
- 46. Thermal Therapies - Heat CONTRAindications Circulatory problems Cancer Areas prone to hemorrhage Areas with poor/no sensation
- 47. Thermal Therapies - Heat Application Best AFTER the acute inflammatory stage (24- 48-72 hours) Superficial heat penetrates 1cm Deeper tissues need 15-30 minutes to warm up Use water as hot as the hand can tolerate 101-105 F
- 48. Thermal Therapies - Cold Indications Pain relief Reduce inflammation Hemorrhage Fever Muscle spasm
- 49. Thermal Therapies - Cold Precautions Poor/no sensation Impaired circulation Hypertension Cold sensitivity Over wounds
- 50. Thermal Therapies - Cold Application First 48-72 hours following acute musculoskeletal injuries OR any time there is heat and swelling Apply for 10-20 minutes every 2-4 hours New units use circulating cold for longer time (combined with compression) Effects occur when tissue temp gets between 59-66 F Do NOT allow for an airspace between the skin and cold medium Air gets colder and can damage the skin
- 51. Shockwave How it Works High energy waves (pulses or shockwaves) Energy is released at tissue interfaces Energy released causes a cellular reaction that results in the release of cytokines that accelerate healing
- 52. Shockwave Effects Neovascularization = increased blood supply to the treated tissue = regeneration in tendons, joints and bone. Reduce inflammation and swelling Improve tendon/ligament/muscle fiber alignment Fracture healing Wound healing
- 53. Shockwave Applications Osteoarthritis Joint injuries Chronic back pain/LS Disease Non-union or delayed healing fractures Tendon/ligament injuries Chronic wounds (lick granuloma)
- 54. Acupuncture Stimulatory for neuro patients Local points around a specific joint or limb
- 62. Who can benefit? Orthopedic cases “Pre” hab Post op Surgery is not an option Anesthetic risk, financial reasons, etc. Neurologic cases Chronic, degenerative diseases Medically managed IVDD, Post-op surgery FCEM
- 63. Who can benefit? Geriatrics Arthritic, overweight, subtle neuro deficits Overweight Athletic, working dogs Conditioning Sports related injuries
- 64. Evaluation Symmetry Stance, movement, muscle girth, etc. Current Abilities What are they still able to do? Current Problems – owner’s opinion Painful? Weak? Poor balance? Lack of endurance? Stiff? ROM? Flexibility?
- 65. Orthopedic Rory bilateral biceps and supraspinatus tendinosis Misty Older dog with extracapsular repair for rCCL
- 73. Misty’s Daily PT 6/30 7/01 7/02 7/03 7/04 7/05 7/06 Square sitting Feet up+ S.Stepping Balance Challenge Stepping Over-2-3” 2 Leg Standing Walk, O’s & 8’s
- 74. Neurologic Banner – T3-L3 myelopathy Jude - DM Pepper – FCE
- 83. Conditioning Beans – Schutzhund Sable – agility
- 84. Basic Techniques PROM, stretching Cookie stretches Sit to Stand Push ups Encourage leash walking!!!
- 85. Videos/pics
- 86. Fun stuff Ball work Wobble board Front feet up Beg Diagonals – Dog yoga
Editor's Notes
- OK, so I have 3 goals for this lecture. One, to give you a basic understanding of rehab and some of the techniques that are used and the modalities (toys) that are used. Two, go over the types of cases that seem to respond best to rehab Finally, review some basic techniques that you can be using in your own practice
- This was a quote used in the first lecture I went to at CRI and it stuck with me. First, a little context…it was said by a human orthopedic doctor in 1959. But I think its interesting in that it speaks to how PT wasn’t considered the standard of care in 1959 and can you imagine now a doctor, especially an orthopedic doctor NOT recommending PT? So, I think in time, rehab will also be part of the standard of care in veterinary medicine. It spoke to me also on a more personal level…
- So, this, unfortunately, has been my view on more than one occasion. This picture is from 2010 when I was recovering from ACL surgery on my right knee. And even though you can’t see it, if we could zoom on the left knee, you would see a matching ACL surgery scar. My left knee was done in 1997, 13 years earlier. I had a VERY different experience with both the surgery and the PT that followed. Recovery was faster and less painful with my second surgery, which is impressive since I was 13 years older. So, my point is that I think just like in human medicine, the more rehab becomes part of veterinary medicine, the more improvements and advancements will be made…we will become better at it, more effective and there will be more controlled studies done. Right ACL – summer of 2010; very different surgery experience, very different rehab experience Left ACL – summer of 1997 (13 years apart)
- A quick history lesson Cut? CRI – 2003 Univ of Tenn - ?
- Its more than just the toys
- PROM and stretching
- Joint mobilizations and joint compressions
- Assessing outcomes
- Active ROM; tricking your patients to do the movements you want them to do…usually with the help of treats.
- Balance, strength (especially core and back)
- Working within the animal’s comfort level. You won’t be successful if you’re fighting with the dog the whole time.
- Estim and acupuncture…don’t worry, this dog is sleeping
- Therapeutic exercises – tricking them into doing the movements you want
- Use of assistive devices when necessary. This is a dog with DM who was at least initially, having more difficulty with its left pelvic limb.
- Objective 1 I’m going to break down rehab into its major components. Just like most things in veterinary medicine, it is about problem solving, managing expectations and meeting owner’s goals which may not always be the same as your goals.
- Here are some of the manual therapies used in rehab. Massage can be stimulatory, meaning a quick rubbing, taping, brushing of the muscles will help “wake them up” and get them ready to work. I like using this with older dogs that have a hard time getting going in the morning or after sleeping. Slow, long stroking massage can be calming and pain relieving. Lighter touch Joint mobs Manipulating the joint to different grades to restore normal mobility to the joint; slides, glides, distraction. A simple example of distraction is when you pull your finger straight out, you can almost feel the joint capsule stretching. Joint mobs can be pain relieving but can also be used to restore normal ROM to the joint Joint compressions Mimic weight bearing through the joint early on and are especially helpful post-op on orthopedic cases Improve comfort, decrease swelling to the joint Stretching – easier to “guide” than to pull use the palms of my hands on joints to manipulate them
- Video of stretching
- Picture of all my equipment in car This is where the fun stuff comes into play…peanut balls, wobble boards, cavaletti. DON’T have to use “rehab” equipment. Sit to stands or 3 leg stands are done with nothing more than you and the dog (and maybe some treats) and are great simple therapeutic exercises. Rolled up towels in the house or brooms, rakes, shovels, pool noodles all make excellent cavaletti poles outside. Take advantage of what is in your environment: Hills are excellent way to get dogs to shift their weight….going uphill, they use more hind end, going downhill, more front end. Long grass, snow, sand, piles of leaves - all of these different surfaces will make dogs move differently, usually flex up their legs higher than normal, so you’re getting more ROM out of them without laying them down and forcing them to do it.
- Video of wobble board, peanut, etc.
- 20 minutes of walking 3x a week I don’t think owners walk their dogs enough anymore. And it should be a walk at a good pace…not meandering around sniffing while the owner is on their phone. Low impact, no fancy equipment, and you can utilize the environment around you.
- LASER – Light Amplication by Stimulated Emission of Radiation; the use of light energy to affect/excite underlying tissue; when you excite these underlying tissues, these are the effects that have been noted. Therapeutic wavelength window 600-1000 nanometers Speed of the process of and encourage healing Increased angiogenesis
- I most commonly use LASER for arthritic conditions, tendonitis/tendonosis, wound healing and pain relief. Superficial skin lesions – hot spots Neuralgia – pain along the distribution of a nerve or nerves
- Many of these contraindications have to do with LASER’s vasodilation effect Vasodilation – could result in the release of the steroid from the intended injection area LASER accelerates the inflammatory process, especially in chronic conditions, so this is counterproductive to what you’re trying to accomplish with the injection. Chlorohexadine – reacts to light resulting in inc photosensitivity and burns.
- Vibration created within the sound head creates energy that travels through the gel and into the patient – another means of “exciting” the underlying tissue. Deeper than LASER Therapeutic ultrasound can be used in two duty cycles – continuous and pulsed With continuous, there are more thermal effects, heating the tissue With pulsed, you are stimulating tissue repair, bone repair and decrease in tissue swelling
- With the effects on the previous slide, we can see what situations US can be used. I personally reach for US more for soft tissue and muscle – sore muscles/muscle contusions, muscle spasms, adhesions
- Most of these contraindications are due to the thermal effects and associated vasodilation. Situations in which the tissue is already “hot” or heat would exacerbate whatever is going on.
- These are scenarios in which you need to be very careful with your settings or else you could get yourself in trouble with associated thermal effects…create periosteal burn, heat up an implant, worsen swelling, or at very high doses in young animals, you can cause premature closure of epiphyseal plate
- NMES – the use of electrical current to stimulate a muscle contraction in the underlying muscle tissue I like to use estim mostly for atrophy, either disuse or neurologic Using estim allows for a more complete muscle contraction – place the electrodes on the muscle belly you are trying to fire, then get the dog to fire the muscle on their own while there is also stim from the unit can Low pulsing – very small movements/fasciculations = decreases effusion and provide pain relief Timing problem after injury or disease
- Similar to TENS, but TENS uses higher and lower frequencies than NMES More for pain relief/sensory use – units people use for lower back pain, neuropathic pain, etc.
- This is something that I saw used a lot in equine work…so it was interesting to see it is getting used more in small animal. Can we somehow affect how these damaged cells are able to utilize O2 and help to heal themselves
- I think we forget that we have access to these very simple tools. Via dilation of blood vessels and stimulation of local circulation, heat helps to mobilize tissue and metabolites, increase tissue oxygenation and increase metabolic rate of cells. I like heat for older dogs with stiffness and soreness. Can help relax tight or sore muscles and provide pain relief which can then often be the gateway to them allowing you to do other things with them.
- What to use and not use I don’t like electric blankets for animals Use the bean bag things that you put in the microwave. You can make your own by putting uncooked rice in tube sock and microwaving it…that way you can mold it around an area
- MECH of Action Constriction of blood vessels Dec tissue metabolism = inhibition inflammatory mediators Reduce nerve conduction = numbing affect Post-op or Post exercise
- I’ve safely used it 20 minutes, once an hour Game Ready – I don’t have experience with it with animals, but it sure felt awesome when I used it post-op Bag of peas
- I’ve never used shockwave, I saw it used a few times in equine work, but have never seen it used on a small animal. But, it is intriguing. High energy sound waves are generated by the probe. Area to be treated is clipped and gel applied Patient is sedated or anesthatized Tissue interfaces are where the density of tissue changes...
- I’ve never used shockwave, I saw it used a few times in equine work, but have never seen it used on a small animal. But, it is intriguing. High energy sound waves are generated by the probe. Tendons will heal and lose their nice linear arrangement…shockwave theoretically makes them heal with a more normal alignment
- I’ve never used shockwave, I saw it used a few times in equine work, but have never seen it used on a small animal. But, it is intriguing. High energy sound waves are generated by the probe.
- This is how I use acupuncture…more for the physical effects (in combo with some of the more TCVM points)
- Pepper – 5 month old intact female Great Dane with FCEM affecting predominantly her Left pelvic limb. Used manual therapies, therapeutic exercises and acupuncture for its stimulatory effects to her spine and down the length of her left leg. When there is a lack of sensation, I try to hyperstimulate. Something super easy to do for dogs like Pepper or any dog with poor hind end awareness is use either booties or scrunchies around their hind feet. I compare it to wrapping a ribbon around my finger. Suddenly I’m hyper aware of my finger…you’re trying to make these dogs hyper aware of their hind feet.
- Off the track TB mare, around 12 or 13 yrs old with chronic superficial keratitis that would occasionally result in the development of a corneal ulcer. So, we were trying to help encourage the body to heal the cornea.
- Warm water – increase circulation, warm the muscles to improve flexibility, soothing to sore joints Buoyancy – as the water level goes up higher on the limb, its has been calculated the percentage of body weight that the dog is actually “feeling” or bearing. At the hock, they are bearing 91% of their body weight. At the stifle, they are bearing 85%. And at the hip, they are 38%. This combined with the resistance of the water allows dogs to do work to walk through the water while not having to carry their full weight. Compression – can be helpful with swollen joints, muscles, etc. Can also be helpful in neurologic dogs in that with the water, you are giving them full body proprioceptive stimulus. Dogs also tend to over flex in the water, so you get the benefit of exaggerated ROM. As you experiment with the water level, you can alter their gait. Study in people, done in 1978, that found that ½ to 1/3 of the speed was needed to walk or jog across a pool in waist deep water to achieve the same energy expenditure as walking or jogging on land treadmill. So, yes, this is people, but we can maybe extrapolate from this a little bit. I often have owners wanting us to turn up the speed of the treadmill and sometime they need to be reminded that it is harder than it looks.
- Here is a very sweet, young black lab that is a little over a month post-op from a TPLO. It helps that she loves water to begin with, but this is from her 3rd session. We focus on getting them to keep a nice steady, consistent gait that doesn’t make them uncomfortable. This dog is actually FULL of energy and the UWTM is actually a nice way to get them to blow off some steam in a relatively safe, controlled environment. The owner of this dog has told us that she takes a nice long nap after her UWTM session.
- Now the treadmill is worktime, but I would be lying if I said we also didn’t get to capture some of these fun moments in between reps. Baxter, and he loves diving for sunken tennis balls.
- Objective 2 Pre-hab: Conditioning and weight loss prior to surgery; make them as strong as possible before surgery so that the recovery period is easier, better prepared for it DM, wobblers
- Geriatrics often have a couple of problems going on…coupled with the weakness associated with aging. Same with overweight dogs…they usually have some other issue that their weight is complicating Sports related injuries which are often soft tissue in nature and don’t have a “surgical” fix. They are usually the result of repetitive stress. These are dogs that are used to working or training and simply prescribing crate rest can be very difficult for them. For every one day of crate rest, it takes 3 days to regain condition.
- Just a really quick word on what I’m looking at during the evaluation. Mother nature likes symmetry!! For every day a dog is crate rested, it takes 3 days to regain condition Unlike the fancy pants specialists at UVS, I am the resident simpleton…weak? Make it stronger. Poor balance? = work on proprioception. Stiff? Improve the ROM or flexibility.
- Rory – 2yr MN Black Lab with intermittent to more consistent LF lameness. Diagnosis of bilateral biceps and suprapinatus tendinosis LF>RF confirmed with ultrasound. Treated with shoulder/tendon sheath injections. Would respond initially, but as soon as they started allowing more activity and play and rough housing, etc., he would become lame again. So, initiated controlled exercise and a serious strengthening program. Also incorporated therapeutic LASER and acupuncture. Started with active ROM (push-ups, give paw, backwards, side step, etc.), stretching, inc wt bearing on forelimbs, stand on unstable surface.
- Rory – 2yr MN Black Lab with intermittent to more consistent LF lameness. Diagnosis of bilateral biceps and suprapinatus tendinosis LF>RF confirmed with ultrasound. Treated with rest and shoulder/bursa injections. Would respond initially, but as soon as they started allowing more activity and play and rough housing, etc., he would become lame again. So, initiated very controlled exercise program and a serious strengthening program. Also incorporated therapeutic LASER and acupuncture. Started with active ROM (push-ups, give paw, backwards, side step, etc.), stretching, inc wt bearing on forelimbs, stand on unstable surface.
- Rory – 2yr MN Black Lab with intermittent to more consistent LF lameness. Diagnosis of bilateral biceps and suprapinatus tendinosis LF>RF confirmed with ultrasound. Treated with shoulder/tendon sheath injections. Would respond initially, but as soon as they started allowing more activity and play and rough housing, etc., he would become lame again. So, initiated controlled exercise and a serious strengthening program. Also incorporated therapeutic LASER and acupuncture. Started with active ROM (push-ups, give paw, backwards, side step, etc.), stretching, inc wt bearing on forelimbs, stand on unstable surface.
- Rory – 2yr MN Black Lab with intermittent to more consistent LF lameness. Diagnosis of bilateral biceps and suprapinatus tendinosis LF>RF confirmed with ultrasound. Treated with shoulder/tendon sheath injections. Would respond initially, but as soon as they started allowing more activity and play and rough housing, etc., he would become lame again. So, initiated controlled exercise and a serious strengthening program. Also incorporated therapeutic LASER and acupuncture. Started with active ROM (push-ups, give paw, backwards, side step, etc.), stretching, inc wt bearing on forelimbs, stand on unstable surface. Incorporated UWTM and acupuncture. Eventually moved to cavaletti, plyometrics, jumping circles, peanut work, etc.
- One…Rory blows bubbles underwater Two…he would find and hold the ball underwater and then scoot backwards. But that means he was doing an isometric contraction of his forelimb muscles which is great for strengthening the muscle without stressing the joint and its support structures.
- Misty – 13 year old FS Beagle with extracap repair for a rCCL. She was interesting to work with in that as a geriatric dog, we had to be more careful with what exercises we initially did. She was actually quite sore the night after her first session. Also, it took her a lot longer to build her muscle back and I think that’s just a function of her age.
- One of my favorite exercises because you get a lot of bang for you buck if you will. Beg position – hind legs are fully flexed, lots of back and core strength to maintain the position Stand – LOTS of hind end power and strength! Beg – controlled back into the position
- Misty – 13 yr FS beagle with ruptured cranial cruciate. Extracapsular repair was done. Doing well post-op but slow to regain ROM and strength. Initial focus on pain management and ROM. Simple strength then proprioception then core strength, etc. Good learning experience – very exuberant and happy to work for treats, but VERY sore after our first session. Dial back what we were doing – intensity, frequency, difficulty, etc. Square sitting, sit to stand, PROM, FFU Excellent example of owner dedication
- Banner – since he was a puppy, his owner was convinced something was wrong with his back. Always had a kyphotic stance. Eventually, started having consistent back pain and neurologic deficits. A very tricky and complicated surgery was performed and Banner was severely paraparetic afterwards. So, we had to start with the basics of re-teaching him how to do everything. Positional practice, proprioception/coordination, strength, refined more controlled movements. We probably used every rehab technique with Banner. LASER, estim, massage, stretching, positional practice, transitions (stand to sit, to down and reverse), strengthening, balance and coordination. Banner is back to hunting…it may not be “perfect,” but he can do it and he seems to really enjoy himself. Jude – 8 yr MN German Shep; progressive hind end weakness, scuffing, dragging, etc. Diagnosis of DM. Main goal is to keep these dogs as active as possible, for as long as possible. Strength and proprioception. As the disease progressed, we changed our focus to core, back and forelimb strength. Now in a cart. Also help the owners with “down dog” problems – bladder expression, hygiene, etc. Mel – spinal walking Hope – sitting with both pelvic limbs fully extended; positional practice, booties, scrunchies Pepper – FCE; ROM, stimulatory massage, acupuncture, estim; use what abilities the patient does have to your advantage; this dog had a withdrawal reflex/response, so I used that to initiate flexion and ROM through the limb.
- Banner – since he was a puppy, his owner was convinced something was wrong with his back. Always had a bit of kyphotic stance. Eventually, started having consistent back pain and neurologic deficits. A very tricky and complicated surgery was performed for his chronic stenosis and Banner was severely paraparetic afterwards. So, we had to start with the basics of re-teaching him how to do everything. Positional practice, proprioception/coordination, strength, refined more controlled movements. We probably used every rehab technique with Banner. LASER, estim, massage, stretching, positional practice, transitions (stand to sit, to down and reverse), strengthening, balance and coordination. Banner is back to hunting…it may not be “perfect,” but he can do it and he seems to really enjoy himself.
- At around 8 yrs old, just about all dogs start to decline in body condition. So, these older dogs that are having a hard time getting up and getting around, is not necessarily only due to arthritis…more likely related to weakness. Emphasis on hind end strength and back/core strength. That really applies to ALL dogs. Spinner – 13 yr MN Spintz mix; hind end weakness and cognitive dysfunction. Spinner is a tough dog to work with because it can be difficult to keep his attention and keep him focused. We take frequent breaks and I try to use very smelly treats. I usually put scrunchies on his hind feet and goose him in his hind end multiple times during our session. I also have the owner not feed him as much on days we have appointments. With Spinner, I focus on his attention, strength, stretching, and balance. Sit to stands, 3 leg stands, side stepping, backwards walking…all low impact exercises. His owners feel he is brighter and more interactive after his sessions, and they do their best to keep their end of the deal by taking him for regular walks and to places where there will be lots of good smells, etc.
- I read a study in humans where the goal was to have the subjects lose just 10% of their body weight and regardless of what their starting weight was, people felt significantly better. There were internal medicine benefits as well…drop in cholesterol, improvement in hypertension, etc. So, maybe thinking about weight loss in this way could be helpful. Hopefully, once the dog loses that 10% the owners will notice the physical improvements and will continue with the weight loss program. It is rare that the only problem these dogs have is their obesity. Sweet Lacey is a 13 yr FS Black Lab who has severe, severe arthritis in both elbows and both hocks and is about 20 pounds overweight. This is a classic case of killing them with kindness. I suspect from what I’ve seen and what they’ve admitted to, that these owners use food as a reward or solution for basically everything. Ohh, you’re sore this morning? Have a biscuit. We’re going out for a few hours and you’ll be home alone, here’s a stuffed peanut butter kong. This is a tough case because I don’t think the owners completely tell the truth as to what Lacey gets food wise from them. But, we have her on a restricted calorie diet, going for walks daily, LASER, acupuncture. I tried to establish more of a home exercise program for her, but basically, the owners don’t do it. These can be frustrating because you know if the dog just lost weight, so many of its other issues would improve. You really need a dedicated owner for these to go the way you want them to.
- Beans is a 6yr Gshep who has his IPO level 2 title (Protection dog work or Schutzhund); the offspring of a dog I work with for DM. He has been tested and is Normal (not a carrier and not at risk). Very athletic. We work on conditioning and plyometrics because he was having trouble getting over the 1 meter jump. Recently had a neck injury after hitting the sleeve. Worked on stretching, ROM with cookie stretches, massage, acupuncture. That was 2 weeks before his trial and he went on to get his level 2 title. Sable is a 8yr old Cockapoo who is an excellent agility dog. Owner was looking for massage, stretching, and of course I started to incorporate conditioning, specifically back and core strength and hind end strength and proprioception exercise. Developed what I call a “balanced exercise program” to ensure they had a well balanced plan for her going forward. Not just strictly agility training, but adding in warm up/cool down, endurance, strength, proprioception and skill training.
- Objective 3