by Barry B. Burtis D.V.M.
Cain is an eight year old male Rottweiller. He is healthy, strong, well-muscled and at 38 kilograms (83.6 lbs.), a proper weight. He is a very fit and active fellow. One day, recently, after a vigourous run in the park, he returned to his owner slightly lame in one of his rear legs. When there was no improvement in the following few days he was taken to a veterinarian. It was determined that Cain had a complete rupture or tear of the anterior cruciate ligament in his right knee joint. He needed to have surgical repair of the damage in order to correct the lameness and lessen future arthritic disease in the affected joint.
Gerda is a four year spayed female dachshund. She has a lovely laid back personality, always friendly and easy going. The only time her pace becomes a trot is when she hurries to her feeding bowl at mealtime. She weighs 14 kilograms (30.8 lbs.), she should weigh almost 3 kilos ( 6.6 lbs.) less. She was rushed to see her veterinarian one morning when her owners found her weak and unsteady on both her rear legs. She was diagnosed with intervertebral disc disease, causing compression of her spinal cord just behind her last rib. When her condition worsened over the following twenty four hours, she was referred to a surgeon specialist to have decompressive back surgery.
Now there we have two very different patients, with very different problems. One is a male, one a female. They are different breeds, different weights, and different ages with different body condition scoring and differing levels of fitness. Cain sustained an injury to his joint that will affect primarily his musculo-skeletal system. With Gerda, the primary damage was neurological. However, after very different kinds of surgery that each patient had to undergo in their treatment, both needed the same kind of therapy to achieve an optimum recovery. They both needed to have some physical rehabilitation or physiotherapy, as it is commonly called.
Physical therapy in human patients is common and well accepted. Until recently there has been little study of physical rehabilitation of animals. Advances in the management of people receiving physical therapy have allowed the adaptation of some of these techniques and procedures to small animal patients. Many changes occur in the musculo-skeletal system of patients recovering from orthopedic surgery or those afflicted with chronic conditions. There are many potential situations in which physical rehabilitation may be used in animals; however, the benefits for orthopedic or neurological patients are two of the most common. Animals with osteoarthritis, chronic pain and obesity, or those needing post-operative reconditioning or geriatric rejuvenation can also often get significant help from physical therapy.
When a limb is immobilized by disease, injury or when recovering from surgery the disuse results in many changes in surrounding body tissues. Degeneration occurs in the articular cartilage which covers the bone surfaces where they move when they meet in the joint. Muscle atrophy is another common consequence of inactivity. It has been shown that dogs with anterior cruciate injury followed by immediate correction still may have a loss of 1/3 of their muscle mass in the affected limb within 5 weeks of their surgery as their recovery begins. Ligaments and tendons will also have a decline in their structural and material properties when they are affected by the immobilization of the body part where they are located. Finally, there is decreased bone formation and normal or decreased bone resorption in any bones near the site. Properly administered physical rehabilitative therapy at the correct time is one of the best ways to reduce and overcome these changes.
It takes a team approach to best deliver this kind of therapy to animal patients who need it. Veterinarians, licensed veterinary technicians and licensed physical therapists educated in animal anatomy and physiology should be involved in the treatment plan for any animal receiving physical therapy. Next time I will discuss some of the specific therapeutic exercises that have been developed to help patients like Gerda and Cain.