At Synergy Small Animal Rehabilitation, we understand that it can be a daunting prospect when you’re told that your pet requires rehabilitation, especially if they’ve just undergone major surgery. This can often feel like entering the unknown and the recovery process can be a long road, but be rest assured that your pet’s therapist will be along for the ride with you. They will be able to offer support and guidance through all the ups and downs, and will celebrate along with you when your dog or cat is able to live a more normal life again without pain.
So, to help make the process seem a little less overwhelming, we are going to post blogs about what to expect during a course of rehabilitation, starting with physiotherapy (a lot of dogs will end up doing both physio and hydro in order to get the best outcome and so keep your eyes peeled for the hydrotherapy instalment!).
What happens during an appointment?
A physiotherapy session at Synergy Small Animal Rehabilitation includes a thorough physical examination to locate the exact area(s) that require treatment, this will include the original complaint, as well as areas of previous injuries and/or where the body has compensated and could also be causing discomfort. This examination includes a thorough assessment of stance, conformation (how they’re put together) and posture, as well as how your animal moves, and finally palpating (feeling) the soft tissues and joints of the body to locate the areas that require intervention. Your animal may also be asked to perform functional tasks such as sitting, lying down, circling, or stepping over obstacles, depending on the reason for the session.
Static assessment - During this portion of the assessment your pet will be assessed on their posture, conformation, and how they’re weight bearing on each limb. To help give an objective view of this, we ask your pet to stand on our Companion Animal Stance Analyser. This piece of equipment is like a static force plate and gives us the percentage of your animal's body weight that is being placed on each leg.
Use of the stance analyser. Source: Author's own
Dynamic assessment - Here we will watch your dog move in a straight line at walk and trot to look for any signs of asymmetry, lameness, incoordination, scuffing, weakness, and more. You may also be asked to walk in small circles, ask your dog to sit and lie down, and your dog may also be challenged to stand on 3 or 2 legs to assess their strength and balance (not every patient will be asked to perform every task).
Dynamic assessment. Source: Author's own
Palpation - Your pet will be checked from head to tail to feel for areas of asymmetry, increased or decreased muscle mass, areas of pain or spasm, and knots within the muscles or other tissue.
Palpating the back muscles. Source: Author's own
Your pet’s joints will also be taken through their normal range of motion to look for signs of pain, clicking, smoothness of motion, swelling, and end feel.
Checking stifle (knee) range of motion. Source: Author's own
Treatment - After assessment your animal will be treated with a combination of manual therapies, thermal therapies (heat and ice packs), electrotherapies, and therapeutic exercise. This will be targeted to the problem areas that were found during assessment.
Manual therapies include things like massage, myofascial release, stretches, joint mobilisation, and passive range of motion. Electrotherapies include pulsed electromagnetic field therapy (PEMF), TENS and electrical muscle stimulation (NMES/E-stim).
Use of PEMF with red light therapy. Source: Author's own
Therapeutic exercise includes a variety of activities designed to improve the amount of weight bearing on a limb, active range of motion of a joint, posture of the animal, or to improve strength and conditioning of the animal. This may involve equipment such as cavaletti poles, steps, ramps, and balance equipment.
We are also available to discuss any changes to your current exercise equipment e.g. collars and harnesses, as well as the use of carts and orthotics/braces where appropriate.
Exercise on balance cushion. Source: Author's own
Fitting a tarsal (ankle) orthotic. Source: Author's own
With physiotherapy, there will also be a home plan for you to complete with your pet between each session which will include a combination of the therapies already mentioned as well as certain home environment and exercise modifications that will help prevent further injury or improve their quality of life around the home. These programmes are specific to your animal to aid in rehabilitation and/or improve performance through strength and conditioning. We will always help you to perform the exercises effectively before you leave the session.
Example of an exercise plan. Source: Author's own
This home plan is the key to long term success and therefore does require a level of commitment from you as the owner but we are always here to help you along the way and help you take control of your pet’s recovery. However, we completely understand that it can be overwhelming to have so much new information thrown at you at once, especially if this is the first time having physiotherapy for a pet of yours. Therefore, we use an online exercise database to formulate our physiotherapy exercise plans and you will get a digital copy of this each time it is updated which you can print out or log on to the website for videos of the exercises. We also have several blogs that go into detail about things like home management changes for arthritic dogs that can be accessed from our website. You and your vet will also receive reports intermittently throughout the rehabilitation process that will detail the session we had, what we found, what we did, what improvements we’ve seen, and what we're doing next.
This format will remain very similar with every session, however, it will change gradually as your pet recovers. As this happens, the sessions will be spaced further and further apart until your pet is discharged from our service or goes onto a maintenance plan.
After the session your pet may be tired and sleepy, as it will likely have been a lot of mental and physical stimulation for them. The next day, they may feel relaxed and more perky but if this is the first time they have had this type of treatment, it can cause a rare few patients to be a little more sore, but this is generally short lived and rarely lasts more than 48 hours. After the first couple of sessions, this will stop happening and you should start to see your animal improve. Careful consideration is given before commencing to avoid this where possible. If your pet does exhibit any stiffness or soreness the day after, this does not mean they are not ready for therapy, it can simply mean their body is adapting to the new form of exercise/moving or it could mean they have a low tolerance for change, so it’s important that you tell us when this happens so that we can adapt our approach and treatment, postponing the therapy is likely to make the issue worse. We also recommend that you give your dog a shorter walk than you would usually after having a session but you can return to normal exercise the next day, provided you don’t notice any increase in stiffness or lameness.
If you still feel that you have questions after a session, do not hesitate to get in touch with us directly, we’re always happy to help you out in between sessions when we can.
How many sessions will it take?
This is always a difficult question to answer but we understand it’s always in the back of everyone’s mind. It can vary depending on the patient and how they respond to the treatment. Unfortunately, not every treatment method works for every animal and as mentioned, the home exercise plan is an important component for us to see results. Some patients may show improvements straight away but in general, we hope to start to see some improvement in around 3-4 sessions but if we don’t, this isn’t necessarily a failing of the therapy, we may just need to adapt our approach (there could also be a need for additional medication if we feel your pet is particularly painful). Generally, it can take somewhere around 8-10 sessions (along with the home exercise plan) to create long lasting results, depending on the injury, and allow us to confidently move your pet onto a maintenance plan or discharge them from our service, but do be aware this can vary a lot from patient to patient. If you have ever had an injury or surgery yourself, you will know it does take more than one session or one exercise to get you back feeling and moving better. This applies to dogs and cats just as much as it does for us.
The frequency of these sessions can also vary and we will often suggest the best frequency for your patient, often starting with weekly sessions for the first few appointments but as mentioned, gradually spacing further apart. However, we appreciate this isn’t always possible with everyone’s schedule and so, if this frequency is not possible, do let us know as it is not set in stone and we can adapt to the individual client and patient. If we do space the sessions further apart than originally advised, we may give you more to do at home to cover the extra time apart.
What happens after discharge?
Once we discharge your animal, we don’t just disappear. We are still on the end of a phone or email to provide assistance should you need it, you are even welcome to come back in for a check-up provided your vet consent's to this. Although if this ends up being 6 months from your last visit, we will need an updated history from your vets.
In some cases, we don’t necessarily have to completely discharge your pet. Whilst we aim to make sure we have provided you with all the tools and knowledge to be able to manage your own pet at home without us, we are always available to provide long-term support if you would like it. For long lasting or chronic conditions, whether that be arthritis or a neurological problem, we are able to offer maintenance therapy every 1-2 months to give your pet a check over, make sure they’re still doing well and not deteriorating. If they do go backwards slightly, we are able to make the necessary adjustments to get them back to where they were or at the very least maintain them at their new normal. The choice to go onto a maintenance plan is entirely up to you as the owner as we appreciate it is a long-term commitment both financially and for your time, however, it does benefit many animals.
If you want to know more about how physiotherapy can help with your animal, do get in touch! And keep an eye out for our blog detailing what happens during a hydrotherapy programme!
All the best,