Canine Rehabilitation: A Growing Field
Canine Rehabilitation
A German shepherd dog begins to have difficulty completing jumps over 6ft. fences during his police work. A miniature dachshund cries when he jumps off the couch, hunches his back in pain, and stands unsteadily with his hind toes knuckled under. An elderly bassett hound becomes increasingly lame with arthritis. A cocker spaniel puppy is hit by a car and suffers a hindlimb fracture. An obese Labrador retriever can’t play with her owner as long as she used to. A dog gearing up for an athletic season is deconditioned from a winter’s rest.
What do these dogs have in common? Despite their differences in abilities, sizes, and conditions, all are candidates for canine rehabilitation. Just as physical therapy helps guide people through injury or illness to recovery, canine rehabilitation (rehab) maximizes functional return while protecting the dog from further injury. Whether it’s surgery or medical care, veterinary treatment can be optimized through rehabilitation.
Growth of canine rehabilitation
The field of canine rehabilitation has experienced huge growth in the last ten years. An established practice in the United Kingdom, this subset of veterinary care is now offered in some form in major metropolitan areas, and is beginning to spread into suburban and rural veterinary practices. A search for certified canine rehabilitation practitioners or therapists reveals more than 150 providers in 30 states and 10 countries. Media exposure of dogs working in underwater treadmills has brought the aquatic therapy aspect of canine rehab to the public eye and veterinary awareness. The melding of the professions of canine veterinary medicine and physical rehabilitation is enhancing the recovery of dogs across the nation.
Guide to recovery
Canine rehab practitioners act as “health coaches”, guiding an injured or unhealthy dog through recovery to wellness. The rehab provider works with the veterinarian to maximize recovery while protecting the dog from further injury. In the example of the miniature dachshund described at the beginning of this article, the veterinarian examines the dog, determines an increasing degree of neurological damage, and performs an emergent surgery on the spine to relieve pressure on the spinal cord. Because neurological tissue is slow to recover, the dachshund continues to show weakness and lameness following surgery. He returns home using a wheeled cart, and the veterinarian refers the dachshund to the canine rehabilitation practitioner. The canine rehab provider examines the dog and assesses the degree and areas of weakness. She then designs a rehabilitation plan of progressive exercise to improve the dog’s balance, ability to sit, stand, walk, and eventually ascend and descend stairs. She educates the owner on protecting the dachshund through recovery at home as well as a home exercise program. Twelve weeks later, the dachshund is happily chasing squirrels in the back yard, although he will never catch one!
What happens during canine rehab
The most well-known modality of canine rehab is aquatic therapy, such as deep water swimming or walking in the underwater treadmill. On-land exercise, application of heat and cold, electrical stimulation, and manual therapies are also commonly used. Land exercise may address strengthening, balance, increased use of a favored limb, and coordination with guidance from the canine rehab provider. For example, to encourage use of a right forelimb, the provider may help the dog through right turns, down ramps or stairs, over or through low obstacles on the ground, play encouraging tapping objects with the left forelimb, and other functional activities that encourage weight shift over the right forelimb. The use of warm packs or ultrasound may be used to warm tight muscles before other manual work, such as stretching, is done, or to increase blood flow to the area for enhanced healing. After exercise to an inflamed joint, such as after cruciate repair, ice may be applied to minimize further inflammation. A rehab practitioner may use electrical stimulation of muscle groups at risk for, or showing evidence of, weakness and loss of tissue mass (atrophy). Depending on the training and background of the provider, manual therapies may include massage to reduce adhesions or loosen overused muscles, nerve mobilization, stretching of soft tissues, joint mobilizations, lymph drainage, or myofascial release.
Canine rehabilitation: a developing profession
As the practice of canine rehab has grown, so has concern for its regulation and the maintenance of quality care. Canine rehabilitation is currently not regulated as a separate profession or trade in the United States. Individual state veterinary and physical therapy practice acts limit and define the way canine rehab is provided in that state. Most states require the veterinarian to have an established relationship with the dog in question and to request a consult before rehab may be performed, unless the rehab is provided by the veterinarian or his staff. Canine rehab may be performed by a veterinarian, veterinary technician, physical therapist, or physical therapist assistant, all of whom require additional training to fill in the gaps of their professional education. Veterinarians and techs must apply rehabilitation principles to their canine clients, and physical therapy professionals must integrate canine anatomy and veterinary surgical techniques into their treatment plans.
The ideal canine rehabilitation practitioner has considerable knowledge of canine anatomy, physiology, common conditions, neuromuscular assessment, tissue repair and recovery, education in the rehabilitation principles of exercise progression, and experience and training in the creation and instruction of treatment plans. Two certification programs exist for canine rehabilitation: The University of Tennessee’s Certification of Canine Rehabilitation Practitioners (CCRP), and the Canine Rehabilitation Institute’s Certification of Canine Rehabilitation Therapists (CCRT). Both have veterinarians and physical therapists among their faculty, require weeks of courses, thousands of dollars, and offer certification exams. Graduates of the University of Tennessee program have had a scientifically-based training heavy on research results and evidence. The Canine Rehab Institute’s courses are lab-based, including hands-on canine work with every class. A canine rehab practitioner who has completed either certification process has shown dedication to this developing profession, as certification is not required to practice.
Canine rehab drives innovations in rehab products and services
As canine rehabilitation progresses and becomes more common, demand for higher-quality services has increased. With more practioners and clients in rehab, this increased demand for services and better rehab options has driven improvements in wheeled carts, artificial limbs, and orthotics (splints and braces) for dogs. No matter the amount of time an injured or disabled dog requires these services, all benefit from these advances. Consumer use, requests and questions support research in the burgeoning canine rehab field, further enhancing the level of care provided. As pet owners seek the highest quality care they can afford for their pets, and bring their knowledge and expectations of human treatment options to their veterinarians, canine rehabilitation will continue to improve and grow.
Dog owners hope to never need canine rehabilitation, but a skilled practitioner can make a tremendous difference in the dog’s quality of life when needed. Ask your veterinarian what options are available for rehabilitation for your dog. Investigate the experience, skills, and facilities of providers before you need one, and have a safe and healthy year!
Bethany Wiltshire, PT, MS
Canine Rehabilitation Practitioner
Rock River Canine Sports & Rehab, LLC
