Practical Physiotherapy for Small Animal Practice

David Prydie, Isobel Hewitt

• Publisher: Wiley-Blackwell
• Year: 2015
• Print ISBN: 9781118661543
• eBook ISBN: 9781118661475
• Edition: 1
• Topic: Medicine
• Subtopic: Veterinary Medicine

Practical Physiotherapy for Small Animal Practice provides a concise and accessible introduction to physiotherapy that demonstrates its benefits to both veterinary patients and practitioners.  One of the fastest growing specialties in veterinary medicine, this book will help you to successfully introduce physiotherapy into your practice improving rehabilitation and recovery of dogs and cats. 

Key features:

• Covers an array of different treatments and techniques, such as manual therapies, therapeutic exercise, electrotherapy, and hydrotherapy
• Includes practical advice on selecting equipment, examinations, treatment protocols, and charging
• Offers strategies for introducing physiotherapy into the practice schedule, including space and staffing requirements
• Companion website provides over 50 printable client education handouts for download

Chapter 1
Introduction

All professions develop and evolve as new research is conducted; pioneering techniques become everyday techniques and in veterinary medicine, the use of physiotherapy to complement current treatments is becoming more widely recognised and utilised. Many owners are becoming more aware of physiotherapy through magazines, dog training clubs, social media and word of mouth that often they seek out physiotherapists and are asking whether it could be beneficial for their pets. Physiotherapy must always be carried out after a veterinary consultation and with veterinary consent. It is important to seek out appropriately qualified practitioners to carry out physiotherapy in order to ensure that no harm will come to animals during treatment. This textbook aims to introduce physiotherapy, discussing and outlining its basic principles.

Physiotherapy is defined as the therapeutic use of physical agents or means, such as massage or exercises, to treat disease or injury. It is an extremely useful adjunct to medicine, human and veterinary. The aim is to restore mobility/function and quality of life to patients. This is done by stimulating the healing process to restore injured tissues, improve the balance/strength of the injured tissues and stabilising the cardiorespiratory, neurological and musculoskeletal systems. Physiotherapy also has an important role in optimising performance and injury prevention in sporting and working animals. It can be performed on any animal, but the majority of cases seen in small animal practice are dogs.

Physiotherapy is often used to correct complications that may have occurred as a result of surgery; however, if introduced early and appropriately, these complications can be avoided. The rehabilitation must be of the highest standard to fulfill the expectations of owners and veterinarians alike. For example, following TTA surgery, physiotherapy will aid correct gait re-education-whereas without physiotherapy, the animal may adopt an adaptive gait pattern.

Physiotherapy can be beneficial for animals in a wide range of conditions. Traditionally, physiotherapy is divided into a wide variety of specialties. In veterinary medicine, we could see the following divisions:

• Musculoskeletal.
• Respiratory.
• Orthopaedics.
• Neurological.
• Sports medicine.
• Elderly care/geriatrics.
• Developmental problems.

Musculoskeletal: Most people consider this as ‘traditional physiotherapy’. The conditions seen can be split into soft-tissue injuries, such as sprains/strains or ruptures of ligament, tendon or muscle; bursitis and bone or joint injuries, such as fractures (Figure 1.1) or joint disease, such as OCD. The injuries may be a result of either a traumatic event or overuse, where the owner cannot recall the specific onset of symptoms.

Figure 1.1 Post fracture. This picture shows an Alaskan Malamute following a femoral fracture after being kicked by a horse. The main aims of physiotherapy for this dog are to improve its weight bearing on the leg and increase its muscle mass/strength.

Respiratory: This is the acute care of animals in hospital; it could be post-anaesthetic recovery or ventilated animals. Physiotherapy is aimed to manage secretions, prevent pressure sores, prevent atelectasis, reduce the work of breathing and optimise the ventilation/perfusion ratio to ensure high oxygen saturation levels. These aims are achieved using positioning (for pressure relief, postural drainage or to influence ventilation/perfusion ratio within the lungs), manual techniques such as percussion (Figure 1.2) or vibrations to remove secretions, neuromuscular techniques such as rib springing to increase lung capacity and manual hyperinflation or bagging to improve ventilation and aid secretion removal.

Figure 1.2 Respiratory physiotherapy. Following anaesthesia any animals requiring ventilation have the potential to develop retained secretions. Ventilated animals will also be sedated and therefore not move around, which can cause secretions to pool in the lungs and need removal.

Orthopaedics: Physiotherapy following surgery is used to maximise the success of surgery. By working with the surgeon, the recovery can be optimised. Orthopaedic surgeons may have their own protocols for rehabilitation following surgery and knowledge of these protocols is needed by the owner and therapist before embarking on a rehabilitation programme. These protocols guide the therapist on how much weight can be put through the leg and when different exercises can be introduced.

Neurological: Neurological physiotherapy is the rehabilitation of the animal following neurological injury, which can involve single limb or whole body. Neurological damage can be managed conservatively or surgically and may completely resolve or can leave lasting damage. The amount of initial damage usually has a significant impact on the amount of recovery that can be achieved. Long-term solutions to permanent damage sometimes have to be sought, such as wheels, harnesses or splints, to support the animal's everyday activities (Figure 1.3).

Figure 1.3 Neurological physiotherapy. After a neurological event, physiotherapy can aid recovery by providing sensory input and re-education of normal movement.

Sports medicine: The preparation of an animal for athletic activity is extremely important requiring physical training, skill training and cardiovascular training. Physiotherapy can help guide owners on appropriate conditioning programmes for certain sports and specific to the animal being trained. Different sports will place very different demands on a dog, for example, the endurance capability of a sled dog opposed to the speed of a racing greyhound.

The rehabilitation of sports injuries is also extremely important as often these animals are not lame but subtle changes in muscle tightness can affect their performance.

Elderly care/geriatrics: As pets (and owners) are living longer now, there is a high population of arthritic animals seen in clinics; they can often have other co-morbidities such as diabetes that can complicate the rehabilitation process. The provision of a holistic approach to managing these animals, using tools such as Aim OA (http://aimoasys.com/why-aim-oa/) will mean they can stay comfortable and functional for longer. The AIM OA website is available for veterinary practices to help provide holistic care for the elderly and arthritic animals. It uses a management strategy encompassing pain relief, exercises, diet and environmental factors.

Developmental problems: A large number of young animals are seen with genetic/developmental problems, and they benefit greatly from physiotherapy to support their joints. Conditions such as hip and elbow dysplasia are often seen. Physiotherapy can improve their quality of life and prevent further problems or surgeries such as total hip replacements.

The benefits of physiotherapy

Physiotherapy can be of benefit to all animals; however, the choice of treatment can be limited by any concurrent disease or illness. The behaviour of an animal, the level of understanding of the owner and their emotions can all influence the success of physiotherapy. For example, a nervous owner will unsettle the animal causing it to become tense which can adversely affect the examination and subsequent treatment session. The objective of physiotherapy is for the animal and the owner to be par...

Table of contents

• Cover
• Title Page
• Copyright
• Table of Contents
• About the authors
• Preface
• Acknowledgements
• About the companion website
• Chapter 1: Introduction
• Chapter 2: Anatomy: structure and function of the musculoskeletal system
• Chapter 3: Healing
• Chapter 4: Clinical examination
• Chapter 5: Modalities
• Chapter 6: Manual therapies
• Chapter 7: Common neurological conditions and their rehabilitation
• Chapter 8: Therapeutic exercise
• Chapter 9: Splints, supports and aids
• Chapter 10: Pain
• Chapter 11: Treatment protocols
• Chapter 12: Setting up a physiotherapy clinic
• Appendix 1: Nomenclature
• Appendix 2: Regenerative medicine
• Appendix 3: Further reading
• Appendix 4: Useful websites for aids and equipment
• Index
• End User License Agreement