Embedded Files
Page 8
One day postoperatively, the dog should be comfortable enough to place the limb down to assist with weight bearing. Cyrotherapy may be performed throughout the day for the first three to five days. If the dog is more active, cyrotherapy may be continued with. Moist heat is also appropriate at the three to five daytime period, but may not be tolerated well by the dog. Laser therapy should focus on the reduction of pain and swelling and also the healing wound. Laser therapy should be performed daily for an acute setting. Range of motion exercises should be performed to the stifle, hip, hock and toes. Flexion and extension of the stifle should be performed slowly and purposely throughout the day, with approximately two to three sets of ten each time. The hamstrings and quadriceps are the muscles of focus for neuromuscular electrical stimulation. The biceps femoris is one of the easier muscles to stimulate since it is fairly superficial and the motor point is readily accessible. As the dog progresses, controlled weight bearing is key. Quality over quantity should be adhered with walks. Leash walking is an important component of the home exercise program and owners should understand these needs to be controlled and not performed with a flexi lead or long lead. Walking in the underwater treadmill may be initiated at suture removal or in some cases earlier, depending upon the integrity of the incision and the surgeons’ and practitioners’ comfort level. Sessions typically start out with the water above the level of the stifle to reduce the stress, and again, quality over quantity is emphasized. The level of the water will reduce the stress on the stifle and the repair. Balance and proprioceptive work is maintained throughout the treatment sessions. As the individual repairs heal and stabilize, additional activity is added. The restoration of function is the goal with rehabilitation and progressive exercises will include balance board, cavaletti walking, theraball exercises, stair work, figure eight walking, controlled ball playing, controlled jogging and running, and then a progression of functional activities. Each cranial cruciate repair rehabilitates different but the same principle should be in place – reduction of pain, restoration of range of motion, and restoration of function. Weight loss if necessary and a home exercise program will be important components of the rehabilitation program. For a variety of reasons, some dogs with either partial or completely torn cranial cruciate ligaments are not surgical candidates. Physical rehabilitation will not repair the tear but it may improve the dog’s quality of life. If the objective measurements taken at the time of the initial evaluation are maintaining and the dogs’ quality of life is function, a conservative course of rehabilitation may be appropriate. Canine Hip Dysplasia Canine hip dysplasia is another common problem frequently seen in the rehabilitation clinic, both surgically and non surgically. Surgical cases are either seen after a femoral head and neck osteotomy (FHO), a total hip replacement, or other procedures. The key with post operative FHOs is to get the dog moving their hip and weight bearing as soon as possible. Pain control is paramount along with aggressive physical rehabilitation. Range of motion exercises, massage, laser therapy, cyrotherapy, weight bearing exercises, and possibly electrical stimulation for pain control is key treatments in the first few days postoperatively.
Google Sites
Report abuse