A few months ago, I extended an invitation to our local practices to take advantage of our rehabilitation therapy program as a professional courtesy if anyone in the field had a need. Out of the many invitations that I sent out, only there was only one response-Daphne. Yay! Here was an opportunity to “give back” a little to the awesome veterinary community that we are a part of.
Daphne- The Orthopedic Challenge
Daphne was a tiny 7 pound dog with an amazing collection of orthopedic issues for her 7 years. Congenital elbow luxations, surgically repaired but with significant arthritic changes that limited joint movement, healed broken toes on the right front foot, arthritis in multiple joints (front and hind legs), and hip dysplasia just to name the big issues. Daphne currently had a chronic lameness issue with her right front leg and her mom was interested in seeing if rehab therapy would be helpful in managing her symptoms.
But Will Rehabilitation Help?
Could rehabilitation therapy really help when faced with so many issues? Well, the honest answer is-maybe. We really don’t know when starting new cases if our program will achieve the results that both ourselves and the owners are looking for. The best place to start was by setting realistic goals that can be adjusted as therapy progresses. After discussing Daphne’s history with her owner, we decided to set some early conservative goals of improved pain management and less lameness on her right front leg.
My personal goal for any patient is to increase their quality of life and independent function at home. They may not walk with a perfect gait, but they can do it by themselves and without significant pain (or no pain at all). Pets don’t care how they look or move. They just want to be able to participate in family stuff and be one of the gang.
We started Daphne on a weekly therapy schedule that included swimming, manual therapy (joint movement and massage), laser therapy and PEMF therapy. Swimming is really a front end driven modality. Some dogs use all four legs to swim, but all will engage their front legs. Daphne had very little range of motion in her elbows so her front legs had a pretty straight, stiff gait. The underwater treadmill would strengthen her limbs but not really get the range of motion that I was looking for. In the pool, she would have greater shoulder and elbow engagement with a weightless environment. Less pain for the patient means happier movement overall. Even her toes were engaged with each stroke.
Over time, as Daphne became stronger and more comfortable in the pool, I added in some balance and strengthening exercises that would address her core muscles and all four limbs. With regular therapy, her endurance and conditioning increased and we hit a “coast” mode of keeping things limber and pain-free.
So where are we today, 11 weeks after starting our journey? Well, there have not been any dramatic results, but Daphne is showing improvement thanks to her rehabilitation therapy. Her owner reports that she has stopped licking her joints (a pain response) and has not been affected by the cold as she normally has been during past winters. When the weather is cold, Daphne usually becomes painfully stiff with limited activity at all. Her lameness has decreased and overall she is more active at home. Subtle improvements but definitely an improvement and worth the time and effort according to Daphne’s owner.
Rehabilitation Can Be a Valuable Tool for Many of Our Pets
Daphne and her owner represent the vast majority of the patients that we see coming through for rehabilitation therapy. They have chronic issues that are not going to go away. They are instead are managed long term. Owners are looking for pain to be better controlled, movement a little less stiff, more engagement with family and generally happier. Most people realize that their pet will not suddenly become the nimble athlete that they once were or have the playful energy of their youth. Accomplishing these basic goals are the results that, to me, make rehabilitation therapy a valuable tool for providing the best quality that we can to our pets lives.
For now, Daphne will continue her therapy with the adjusted goals of maintaining any progress that we have made so far. It is the “use it or lose it” principal when it comes to orthopedic issues. As time goes on, we may have to adjust her program to suit her needs. For now, rehabilitation is working well for our girl so we are thankful. Go team!