Physical rehabilitation is becoming common in veterinary medicine. Several benefits have already been proved, and more continue
to be elucidated. In patients with patella and cruciate injuries, rehabilitation is the main part of conservative therapy.
But you may be hesitant because of the cost of some of the equipment required. Below are various methodologies you can readily
apply in your clinic at minimal extra cost.
Jennifer L. Wardlaw, DVM, MS, DACVS
Goals: Superficial heat can provide analgesia, decrease muscle spasms, increase impulse conduction, increase fibrous tissue elasticity,
increase vasodilation, and decrease blood pressure (if heat is applied for long periods).
How to do it: Apply warm packs for 10 to 15 minutes before a therapy session. Use hot packs, heat wraps, warm water, or towels immersed
in hot water. Don't use electric blankets because of their unpredictable hot zones and potential for burns. Don't place the
packs directly on the skin; instead, place them in a cloth or towel. Check intermittently that the skin is not too hot.
DIY tip: Create your own hot packs by immersing towels in hot water or dampening the towels and warming them in the microwave. Then
put the towels in a plastic bag, and place it on the affected area. Be sure the towels are not so hot that they cause burns.
Goals: Cold therapy can reduce a patient's inflammation, edema formation, muscle spasms, and pain.
How to do it: Just as physical rehabilitation sessions start with heat therapy, cryotherapy can be used for 10 to 15 minutes after each
session is finished. You can use commercial ice packs or frozen bags of vegetables. Always place insulation between the cold
source and the skin, and inspect the skin every few minutes. Sanitize cold packs between patients to prevent nosocomial infections.
It is also recommended to cover incisions with vitamin A and D ointment or a triple antibiotic ointment to prevent the damp
layer from potentially infecting the fresh surgical site.
DIY tip: Create your own ice packs by adding 1 part rubbing alcohol to 3 parts water in a plastic bag.
Goals: Walking exercises can increase range of motion, promote normal gait and placement, improve muscle mass and strength, improve
circulation of the blood and lymphatic vessels, increase endurance, and prevent joint degeneration.
How to do it: Place a leash on the patient, and position the patient on a firm surface that provides good footing. Walk the patient slowly
so the patient has adequate time to place each limb on the ground and shift its weight to that limb, ensuring even therapy
throughout all limbs. As the patient improves, you can increase the speed of walking and eventually allow the patient to run
on the leash. Other exercises that can be performed on a leash include:
Inclined walking—Walk the patient up a gradual incline or short flight of stairs. This increases hindlimb muscle mass and strength as well
as flexion, extension, and range of motion.
Figure-of-eight pattern—Walking a patient in a figure-of-eight shifts its weight on all four legs and increases the amount of body weight forced
on each leg as the patient turns.
Squats—Sit-to-stand exercises help build quadriceps and hamstrings. You can have patients perform these periodically during walks
or have them do repeated sets of stationary sit-to-stands. Make sure the dog sits with both legs under the rump. You can encourage
this by placing the weaker leg against your leg or having the patient squat in a corner or against a wall.
DIY tip: If your practice doesn't have a flight of stairs, make your own out of wood. The stairs should be 10 to 12 in deep for most
patients and have good footing material on them that can also be cleaned, such as rubber mats or outdoor carpeting. The ideal
height will vary depending on the size of the patient.