For pet owners, animal rehabilitation has become a standard, not a luxury
For years, the baby-boomer generation has relied on physical therapy to address their aches, pains and injuries. Now, more than ever before, they have come to expect the same standard of care for their pets. Particularly as public interest in canine sports (agility training, flyball, etc.) has grown, an increasing number of pets – the old and achy as well as the young and athletic – are in need of such services. “Pet rehab gained momentum in the 1980s through the 1990s,” says Kim Spelts, BSA, CVT, VTS, CCRP, Peak Performance Veterinary Group (Colorado Springs, Colo.). “But, in the last 10 years, the field has exploded.”
In addition to “walk-in” patients, the Peak Performance Veterinary Group receives referrals from the United States Air Force Academy and local police departments, Spelts continues. In addition, “we have some [local] vets who are very progressive and interested in new therapies, and are great referrals.
“Any product you would find in a human physical therapy clinic, you would find here as well,” she points out. “We utilize many of the same techniques as human physical therapists, so we have much of the same equipment.” Indeed, some human massage therapists and chiropractors have extended their services to pets, notes Spelts. “But, state laws vary and [caregivers] must be careful so as not to hurt the animal. Today, there are two companion-animal physical therapy training programs in the United States – the Canine Rehabilitation Institute (Wellington, Fla.) and the Small Animal Rehabilitation Clinic at the University of Tennessee College of Veterinary Medicine.
A growing number of veterinarians today regard pet rehab as an opportunity. For one, many have opened rehab centers within their clinics, according to Janet Van Dyke, DVM, CCRT, CEO Canine Rehabilitation Institute. In addition, freestanding rehabilitation centers have opened across the country, and some trained veterinarians practice mobile rehabilitation, taking their services to various animal hospitals and clinics, she notes. Although it’s difficult to say exactly how many veterinarians and physical therapists currently provide pet rehabilitation services, the Canine Rehabilitation Institute boasts approximately 750 graduates from 37 states and 11 countries, she says.

Therapeutic benefits
Many pet owners are familiar with the benefits of physical therapy, which combines the science of biomechanics, physics, anatomy, physiology and psychology in treating human injury, pain and physical abnormalities, according to Peak Performance Veterinary Group. Pet rehabilitation employs the same techniques to achieve one or more goals:

• Facilitate speed and recovery from injury or surgery.
• Increase mobility and flexibility.
• Improve endurance and agility.
• Decrease pain.
• Maintain function and prevent further problems.
• Enhance quality of life.

(Source: Peak Performance Veterinary Group)

Depending on their ailments, injured pets may experience several benefits:

• Increased blood flow and lymphatic drainage to the injured area.
• Reduced pain, swelling and complications.
• Increased production of collagen.
• Reduced risk for contractions and adhesions.
• Improved normal joint biomechanics.
• Reduced risk for muscle atrophy.
• Reduced risk for other injuries.

(Source: Peak Performance Veterinary Group)

Who needs it?
Which pets need physical therapy? A better question may be, which ones don’t need it? There are numerous conditions that can be improved with physical therapy. For instance, degenerative myelopathy, a progressive disease of the spinal cord, which leads to hind leg weakness, ataxia (lack of coordination) and potential paralysis, is not curable. But physical therapy helps ensure pets’ strength and comfort.
Another common condition, fibrocartilaginous embolism, in which the blood supply to the spinal cord is blocked, can trigger several neurological issues, including paralysis. When provided within the first two weeks of injury, physical rehabilitation often leads to improvement and recovery.
Hip dysplasia, or the malformation of the hip joint, is a top cause of hip osteoarthritis in dogs. It generally is treatable through such surgeries as total hip replacement, femoral head osteotomy and triple pelvic osteotomy. But, when dogs are not good surgical candidates, physical therapy can help with the management of the condition. And, for post-surgical patients, rehabilitation helps facilitate a positive outcome.
Other common conditions that can be managed through physical therapy include invertebral disc disease and osteoarthritis/degenerative joint disease, reportedly one of the most common causes of chronic pain in dogs and cats.

Products and therapies
“The most important thing to recognize about pet physical therapy is that most of the work [involves] getting a proper soft tissue diagnosis and then [applying] manual therapies,” says Van Dyke. So, much of small-animal physical therapy involves “no products, just well-trained hands,” she points out. That said, laser and e-stimuli devices are popular technologies used today, as well as underwater and land treadmills, she adds. In fact, as veterinarians do a better job of diagnosing pets’ injuries, they are better informed to apply the best treatments and use the right products. “For instance, there is a growing interest in medical shoulder instability in the canine athlete, much like rotator cuff injuries in human athletes,” says Van Dyke. “For years, we have retired these canine athletes. Now we understand the pathology better and are able to treat these tissues specifically and get the athletes back to their sport.”

Today, veterinarians trained to provide physical therapy and rehabilitation have a variety of products at their disposal, including the following:

• Land treadmill. Although some land treadmills are designed for dogs, they can be used for cats as well. Used for patients with minimal or managed pain, treadmills help increase strength, balance and proprioception (awareness of where the feet are placed).
• Hydrotherapy. Exercising in water tanks or swim tanks helps build strength, muscle endurance, cardiorespiratory endurance, range of motion, agility and psychological well-being in patients. Whereas certain injured animals may have difficulty using a limb on land, they are more likely to do so in the water, particularly since limbs bear less weight in the water. In addition, water provides a source of stabilization and buoyancy, and its resistance helps with muscle strengthening and cardiovascular training.
• Low-level laser. Whereas high-level laser destroys cells and tissues, low-powered lasers help modulate cellular activity in tissue, thereby facilitating tissue repair and cell growth in skin, tendons, ligaments and muscles. Low-level laser technology also helps maintain cartilage use during periods of disuse and manage chronic pain.
• Neuromuscular electrical stimulation (NMES). During NMES, low-level electrical currents are sent through electrodes, which are placed on the skin, to depolarize the motor nerve and produce a skeletal muscle contraction. A common treatment for orthopedic and neurological conditions, NMES helps control pain, reduce edema, strengthen muscles, reduce muscle spasms and prevent atrophy.
• Therapeutic exercise balls and balance boards. Therapeutic exercises help maintain or improve joint mobility, and improve flexibility of muscles, tendons and ligaments.
• Therapeutic ultrasound. When sound waves are applied to tissues, their energy is scattered and then reabsorbed, resulting in localized heating of deep tissues. Ultrasound heating helps with treatment of such musculoskeletal conditions as restricted range of motion due to joint contracture, pain and muscle spasm, and wound healing.
• Thermotherapy. Cryotherapy (cold) is generally used during the first 24 to 72 hours following surgery. After that, it often is used together with heat therapy. Benefits of thermotherapy include decreased pain, decreased inflammation and decreased localized blood flow, resulting in an increase in overall bloodflow.

In addition, veterinarian physical therapists are trained to perform massage therapy to increase blood flow, improve oxygen delivery to tissues, facilitate muscle recovery, reduce pain and more.
(Source: Peak Performance Veterinary Group)

The reps’ role
Veterinarians trained in physical therapy likely will welcome the expertise of their sales reps. That means, distributor reps must be well informed on the latest technologies in order to steer their customers right. Clinics such as Peak Performance Veterinary Group and the Canine Rehabilitation Institute are great sources of information on how products work and how technologies have improved. “If they are [selling] the equipment specific to rehab medicine, they need to be trained about the specifics of each piece,” says Van Dyke, adding that the Canine Rehabilitation Institute can put together information they may need.
“[Reps should] come in and get a feel for our office,” recommends Spelts. “They should see what we have and understand what we need. They need to attend annual physical therapy conferences [in order to] be up on the latest treatment options and know how equipment is being improved.” Particularly with regard to laser treatment, the technology changes very rapidly, she adds.
Pet rehabilitation is a market that has escalated exponentially in the last five years. For reps, that’s an opportunity waiting to be tapped.