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Rehabilitation for post-op IVDD dogs
 
Rehabilitation speeds healing and improves strength and mobility for patients recovering from spinal surgery
written for Dodgerslist by
Dr. Michael Wolf, DVM, Dr. Med. Vet.
Diplomate ACVIM (Neurology), CCRT
Animal Neurology & MRI Center

June 2011

Dr. Wolf with his wirehair Dachshund, Pino

Physical rehabilitation has become a proven staple in human medicine and doctors now recommend physical rehabilitation following a variety of procedures. These same techniques and modalities are now being applied to veterinary medicine. Canine physical rehabilitation is used to improve the performance and quality of movement for our pets as well as speed healing and provide positive psychological effects. At Animal Neurology & MRI Center we are applying a wide variety of physical rehabilitation to our post-surgical patients with great success. For us as a neurological center this is just another extension of the recovery process. The work that we are doing can be enhanced with physical rehabilitation.
Following certain surgeries pets may lose up to one third of their muscle mass in a matter of weeks and it may take that same pet more than a year to regain the lost muscle mass. Rehabilitation makes it easier and less stressful for patients to return to functional activities in their day to day life. The prognosis for return to function depends on a great number of variables including whether the pet is a working dog or house pet, as well as the degree of injury and overall body condition. Patients with intervertebral disk disease will have varying degrees of disability.  Rehabilitation protocols must be individually tailored to meet patient's needs during the recovery process. These protocols should be designed by a veterinarian certified in veterinary rehabilitation.  If your dog is showing signs of IVDD, it is not recommended to start a rehabilitation program without first having a full neurological evaluation.

There are many different modalities used to aid in the physical rehabilitation of patients. Such modalities include manual manipulation, hot and cold therapy, E-stim, laser and ultrasound treatments and aquatic therapy. The overall goal of each of these is to provide a non-invasive approach to improving the biomechanics and flexibility of the patient.

Below is a list of the most commonly used modalities for patients following the diagnosis and treatment of IVDD and other diseases including Degenerative Myelopathy, Wobblers, FCE and spinal fractures.

Cryo Therapy
Cold therapy is used to decrease pain perception and inflammation. It is applied to a spinal surgical patient’s incision for the first 48-72 hours post-surgery, until the incision is no longer warm to touch. 

Manual Exercises
The most common and easily learned modality is manual manipulation. This may include passive range of motion, standing exercises, slow leash walks or sit to stand exercises just to name a few. Manual exercises in immediate post-operative patients include massage and passive range-of-motion (ROM).  Joints of limbs are extended and flexed through normal ROM 5 to 10 minutes several times a day.

The goal of any manual manipulation is to allow the patient a structured exercise that will help maintain muscle mass, encourage proprioceptive feedback, muscle contraction and facilitate balance and strengthening. In our hospital we teach our clients to perform these exercises on their pets following spinal surgery. They are performed at home using a prescribed schedule.

Ultrasound Therapy
Ultrasound provides an increased blood flow to the area of injury, an increased extensibility of collagen tissue and decreased pain and spasm. Ultrasound is often used in conjunction with stretching and massage in patients and has been proven to accelerate the inflammatory phase of repair and thus accelerate wound healing.

E-stim or neuromuscular electric stimulation (NMES)

A popular practice used on neurological patients is E-stim or neuromuscular electric stimulation (NMES). This is the application of an electrical current to elicit a muscle contraction. E-stim is used to increase strength and endurance. It is beneficial because it can be started immediately in the post operative period to help with pain relief, it also helps combat muscle atrophy and allows for selective strengthening of muscle groups.

Laser Therapy
Laser therapy is used to treat pain and swelling and to speed up healing in muscles, tendons, skin, and other soft tissue, by stimulating tissue repair. It is frequently used at post-surgery sites. The laser beam is non-invasive and side-effect-free.

Underwater Treadmill
One of the most useful modalities for neurological patients recovering from IVDD is aquatic therapy. The aquatic therapy allows active muscle contraction with minimal weight bearing on joints and bones. It also allows patients that are weak on their limbs to be buoyant and have the ability to move. It is not unusual for a post back surgery patient that is not using its legs to walk on land yet to use them when walking in the water. Other conditions that may benefit from aquatic therapy include soft tissue injuries, osteoarthritis, fractures post operatively, muscle spasms and weakness and obesity.

Theraballs and balancing boards
Balance boards, wobble discs, theraballs and cavalletti rails are all items used to help rebuild core strength and flexibility, and facilitate limb use by retraining positioning sensors (proprioception). These items have proven to be useful for our post surgical patients to improve coordination, mobility and overall neuromuscular communication.

Acupuncture
Acupuncture is an ancient form of treatment that is believed to have originated thousands of years ago. Today it is used in veterinary medicine for a variety of disorders. Acupuncture stimulates healing in some conditions and provides pain relief in others. Following surgery, it can help reduce pain in patients and help to speed up the recovery period.

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