Canine Rehabilitation and Physical Therapy SECOND EDITION Canine Rehabilitation and Physical Therapy DARRYL MILLIS, MS, DVM, DACVS, CCRP, DACVSMR Professor of Orthopedic Surgery Director, CARES Center for Veterinary Sports Medicine Department of Small Animal Clinical Sciences College of Veterinary Medicine University of Tennessee Knoxville, Tennessee DAVID LEVINE, PT, PhD, DPT, DABPTS (Orthopaedics), CCRP, Cert. DN Professor and Cline Chair of Excellence in Physical Therapy Department of Physical Therapy The University of Tennessee at Chattanooga Chattanooga, Tennessee CANINE REHABILITATION AND PHYSICAL THERAPY ISBN: 978-1-4377-0309-2 Copyright © 2014, 2004 by Saunders, an imprint of Elsevier Inc. All rights reserved. No part of this publication may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying, recording, or any information storage and retrieval system, without permission in writing from the publisher. Permissions may be sought directly from Elsevier’s Health Sciences Rights Department in Philadelphia, PA, USA: phone: (+1) 215 239 3804, fax: (+1) 215 239 3805, e-mail: [email protected]. You may also complete your request on-line via the Elsevier homepage (http://www.elsevier.com), by selecting ‘Customer Support’ and then ‘Obtaining Permissions.’ Notice Knowledge and best practice in this field are constantly changing. As new research and experience broaden our knowledge, changes in practice, treatment and drug therapy may become necessary or appropriate. Readers are advised to check the most current information provided (i) on procedures featured or (ii) by the manufacturer of each product to be administered, to verify the recommended dose or formula, the method and duration of administration, and contraindications. It is the responsibility of the practitioner, relying on their own experience and knowledge of the patient, to make diagnoses, to determine dosages and the best treatment for each individual patient, and to take all appropriate safety precautions. To the fullest extent of the law, neither the Publisher nor the Editor assumes any liability for any injury and/or damage to persons or property arising out of or related to any use of the material contained in this book. The Publisher Library of Congress Cataloging-in-Publication Data Canine rehabilitation & physical therapy. Canine rehabilitation and physical therapy / [edited by] Darryl Millis, David Levine.—Second edition. p. ; cm. Preceded by: Canine rehabilitation & physical therapy / [edited by] Darryl L. Millis, David Levine, Robert A. Taylor. c2004. Includes bibliographical references and index. ISBN 978-1-4377-0309-2 (hardback : alk. paper) 1. Dogs—Diseases—Treatment. 2. Veterinary physical therapy. 3. Medical rehabilitation. I. Millis, Darryl L., editor. II. Levine, David (Veterinary physical therapist), editor. III. Title. [DNLM: 1. Dog Diseases—therapy. 2. Physical Therapy Modalities—veterinary. SF 991] SF991.C244 2014 636.7′089582—dc23 2013024902 Vice President and Publisher: Linda Duncan Content Strategy Director: Penny Rudolph Content Manager: Shelly Stringer Publishing Services Manager: Gayle May and Hemamalini Rajendrababu Senior Project Manager: Antony Prince Design Direction: Karen Pauls Cover Art: @ Grant Hindsley/AP/Corbis (cover center top row) Working together to grow libraries in developing countries Printed in China www.elsevier.com | www.bookaid.org | www.sabre.org Last digit is the print number: 9 8 7 6 5 4 3 2 1 Contributors Caroline P. Adamson Adrian, PT, PhD, CCRP Linda Blythe, DVM, DACVSMR VCA Antech, Inc. and VCA Veterinary Specialists of Professor Northern Colorado College of Veterinary Medicine Loveland, Colorado Oregon State University Conceptual Overview of Physical Therapy, Veterinary Medicine, Corvallis, Oregon and Canine Physical Rehabilitation History of Canine Physical Rehabilitation Julie Albright, MA, DVM, DACVB Barbara Bockstahler, DVM, CCRP Assistant Professor of Veterinary Behavior Section for Physical Therapy and Acupuncture and Movement Small Animal Clinical Sciences Science Group Vienna University of Tennessee College of Veterinary Medicine Clinical Department for Small Animals and Horses Knoxville, Tennessee Clinic of Surgery and Ophthalmology Canine Behavior Vienna, Austria Electrical Stimulation T. Craig Angle, PhD, ME.d, ATC, CSCS Associate Director of the Veterinary Sports Medicine Program Sherman O. Canapp Jr, MS, DVM, CCRT, DACVS, Auburn University College of Veterinary Medicine DAVCSMR Auburn University Owner and Chief of Staff Auburn, Alabama Veterinary Orthopedic and Sports Medicine Group Canine Locomotion Analysis Ellicott City, Maryland Common Conditions and Physical Rehabilitation of the Joe Bartges, DVM, DACVIM, DACVN Athletic Patient Professor, Medicine & Nutrition The Acree Chair of Small Animal Research R. Barry Dale, PT, PhD, ATC, SCS, OCS, CSCS Department of Small Animal Clinical Sciences Associate Professor College of Veterinary Medicine Department of Physical Therapy The University of Tennessee University of Tennessee at Chattanooga Knoxville, Tennessee Chattanooga, Tennessee The Role of Chondroprotectants, Nutraceuticals, and Nutrition Basics of Exercise Physiology in Rehabilitation Jacqueline R. Davidson, MS, DVM, DACVS, CVA, Anna Bergh, PT, DVM, PhD CVSMT, CCRP, CERP, CCRT, CVPP Postdoctoral Research Fellow Clinical Professor Department of Anatomy, Physiology and Biochemistry Department of Veterinary Small Animal Clinical Sciences Senior Lecturer College of Veterinary Medicine Anatomy and Physiology Section Texas A&M University Swedish University of Agricultural Sciences College Station, Texas Uppsala, Sweden Common Orthopedic Conditions and Their Physical Conceptual Overview of Physical Therapy, Veterinary Medicine, Rehabilitation and Canine Physical Rehabilitation v vi Contributors Contributors vii Robin Downing, DVM, CVA, CCRP, DAAPM Robert Gillette, DVM, MSE, DACVSMR Affiliate Faculty Veterinary Specialty Center Clinical Sciences Buffalo Grove, Illinois Colorado State University College of Veterinary Medicine Basics of Exercise Physiology Fort Collins, Colorado Canine Locomotion Analysis Hospital Director The Downing Center for Animal Pain Management, LLC Sallye Gregg, DVM Windsor, Coloardo Hospital Director Rehabilitating the Painful Patient: Pain Management in Regional Institute for Veterinary Emergencies & Referrals Physical Rehabilitation Chattanooga, Tennessee Physical Therapy for Wound Care Ludovica Dragone, DVM, CCRP Ambulatorio Veterinario Dog Fitness June Elaine Hanks, PT, PhD, DPT, CWS, CLT Dog Fitness Associate Professor Reggio Emilia, Italy Department of Physical Therapy Superficial Thermal Modalities Bellarmine University Louisville, Kentucky Marti Drum, DVM, PhD, CCRP, CERP, DACVSMR Physical Therapy for Wound Care Clinical Assistant Professor Department of Small Animal Clinical Sciences Kristinn I. Heinrichs, PhD, PT, ATC College of Veterinary Medicine Department of Orthopedics and Rehabilitation The University of Tennessee US Army Garrison Knoxville, Tennessee Vicenza Health Center The Physical Rehabilitation Evaluation Vicenza, Italy; Nursing Care of the Rehabilitation Patient Owner Therapeutic Exercises: Early Limb Use Exercises Peak Sports Performance International Therapeutic Exercises: Joint Motion, Strengthening, Endurance, Tempe, Arizona and Speed Exercises Superficial Thermal Modalities April Durant, DVM, DACVS Andrea L. Henderson, DVM, CCRT, CCRP Assistant Professor, Soft Tissue Surgery Resident, Canine Sports Medicine and Rehabilitation Kansas State University Department of Small Animal Clinical Sciences Manhattan, Kansas University of Tennessee College of Veterinary Medicine Applications of Extracorporeal Shock Wave in Small Knoxville, Tennessee Animal Practice Tissue Healing: Tendons, Ligaments, Bone, Muscles, and Cartilage Cassy Englert, PT, MS, OCS, CCRP Orthopedic Therapist Sharon Kerwin, MS, DVM, DACVS, CCRP Chattanooga Canine Rehabilitation and Wellness Professor Chattanooga, Tennessee Department of Small Animal Clinical Sciences The Physical Rehabilitation Evaluation Texas A&M University College Station, Texas Jeffrey Flocker, MPT, CCRP Common Orthopedic Conditions and Their Physical Canine Physical Rehabilitation of the SouthWest, LLC Rehabilitation Gilbert, Arizona Aquatic Therapy Steven M. Fox, MS, DVM, MBA, PhD President Securos Inc. Clive, Iowa Rehabilitating the Painful Patient: Pain Management in Physical Rehabilitation vi Contributors Contributors vii David Levine, PT, PhD, DPT, DABPTS (Orthopedics), Joseph M. Mankin, DVM, DACVIM (Neurology) CCRP, Cert. DN Clinical Assistant Professor Professor and Cline Chair for Excellence in Physical Therapy Department of Small Animal Clinical Sciences Department of Physical Therapy Texas A&M University The University of Tennessee at Chattanooga College Station, Texas Chattanooga, Tennessee Orthopedic and Neurologic Evaluation Regulatory and Practice Issues for the Veterinary and Physical Therapy Professions Lin McGonagle, MSPT, LVT Conceptual Overview of Physical Therapy, Veterinary Medicine, Director of Rehabilitation Services and Canine Physical Rehabilitation Colonial Veterinary Hospital The Physical Rehabilitation Evaluation Ithaca, New York; Assessing and Measuring Outcomes Owner Nursing Care of the Rehabilitation Patient Animal Performance and Therapy Center Superficial Thermal Modalities Genoa, New York Therapeutic Ultrasound History of Canine Physical Rehabilitation Electrical Stimulation Other Modalities in Veterinary Rehabilitation Lauren Elizabeth MacGuire, PT, DPT, GCS Range-of-Motion and Stretching Exercises Spine and Sport Joint Mobilization Knoxville, Tennessee Exercises for Proprioception, Balance, and Joint Position Aquatic Therapy Awareness Therapeutic Exercises: Early Limb Use Exercises Karen McLucas, LVT, LVMT Therapeutic Exercises: Joint Motion, Strengthening, Endurance, Neurology and Neurosurgery Technician and Speed Exercises Veterinary Medical Center Aquatic Therapy University of Tennessee Physical Rehabilitation for Geriatric and Arthritic Patients Knoxville, Tennessee Nursing Care of the Rehabilitation Patient Denis J. Marcellin-Little, DVM, DACVS, DEDV, CCRP, DACVSMR Ralph Millard, MS, DACVS, DVM Professor of Orthopedics Clinical Assistant Professor, Small Animal Surgery College of Veterinary Medicine Purdue University North Carolina State University College of Veterinary Medicine Raleigh, North Carolina West Lafayette, Indiana The Physical Rehabilitation Evaluation Exercise Physiology of the Canine Athlete Nursing Care of the Rehabilitation Patient Physical Rehabilitation for Geriatric and Arthritic Patients Anne Marie Manning, DVM, DACVECC Chief of Staff Angell Memorial Animal Hospital Boston, Massachusetts Physical Rehabilitation for the Critically Injured Veterinary Patient viii Contributors Contributors ix Darryl Millis, MS, DVM, DACVS, CCRP, DACVSMR Deborah Gross Saunders, DPT, MSPT, OCS, CCRP Professor of Orthopedic Surgery Owner Director, CARES Center for Veterinary Sports Medicine Wizard of Paws Physical Rehabilitation for Animals, LLC Department of Small Animal Clinical Sciences Colchester, Conneticut College of Veterinary Medicine Laser Therapy in Canine Rehabilitation University of Tennessee Joint Mobilization Knoxville, Tennessee Common Conditions and Physical Rehabilitation of the Regulatory and Practice Issues for the Veterinary and Physical Athletic Patient Therapy Professions Development of a Rehabilitation Facility for Small Animals and Canine Anatomy Business Considerations Responses of Musculoskeletal Tissues to Disuse and Remobilization Lisi Sharon, DVM, CCRP Orthopedic and Neurologic Evaluation The Israeli Rehabilitation Center for Animals Assessing and Measuring Outcomes doar Na Izreel, Israel Nursing Care of the Rehabilitation Patient Neurologic Conditions and Physical Rehabilitation of the Superficial Thermal Modalities Neurologic Patient Laser Therapy in Canine Rehabilitation Other Modalities in Veterinary Rehabilitation Amanda Sutton, MSc Vet Phy, MCSP Applications of Extracorporeal Shock Wave in Small Animal MSc Veterinary Physiotherapy Practice Royal Veterinary College Biomechanics of Physical Rehabilitation and Kinematics of London, United Kingdom Exercise Amanda Sutton’s Animal Physiotherapy Range-of-Motion and Stretching Exercises Littleton, Winchester Hants, United Kingdom Exercises for Proprioception, Balance, and Joint Position Massage Awareness Therapeutic Exercises: Early Limb Use Exercises William Thomas, DACVIM (Neurology), DVM Therapeutic Exercises: Joint Motion, Strengthening, Endurance, Professor and Speed Exercises Department of Small Animal Clinical Sciences Aquatic Therapy The University of Tennessee Physical Rehabilitation for Geriatric and Arthritic Patients College of Veterinary Medicine Knoxville, Tennessee Jim Minick Neurologic Conditions and Physical Rehabilitation of the Executive Director Neurologic Patient All Pets Wellness Center Lockport, Illinois Tyler Tucker, DPT Development of a Rehabilitation Facility for Small Animals and OnMark Physical Therapy Business Considerations Hunstville, AL Superficial Thermal Modalities Donna M. Raditic, DVM, CVA, DACVN Adjunct Associate Clinician Zoran Vrbanac, DVM, PhD Integrative Medicine Service Department of Radiology, Ultrasound Diagnostics and University of Tennessee Physical Therapy Knoxville, Tennessee Faculty of Veterinary Medicine The Role of Chondroprotectants, Nutraceuticals, and Nutrition University of Zagreb in Rehabilitation Zagreb, Croatia Physical Rehabilitation for the Critically Injured Cheryl Riegger-Krugh, PT, MS, ScD Veterinary Patient Clinical Professor Physical Therapy Program J. Randy Walker, PT, PhD, DPT Walsh University Acting Dean, Graduate School North Canton, Ohio The University of Tennessee at Chattanooga Canine Anatomy Chattanooga, Tennessee Joint Mobilization viii Contributors Contributors ix Tim Watson, PhD, BSc(Hons), MCSP, DipTP Bobbie Werbe, LVMT, BS, CCRP, CERP Professor of Physiotherapy Indianapolis, Indiana University of Hertfordshire Nursing Care of the Rehabilitation Patient Hatfield, Hertfordshire, United Kingdom Therapeutic Ultrasound Dana Whitlock, PT, DVM, MS, PT, CCRP Veteriarian, Sports Medicine and Rehabilitation Joseph P. Weigel, DVM, DACVS Holistic Veterinary Care Associate Professor of Surgery Oakland, California Department of Small Animal Clinical Sciences Massage College of Veterinary Medicine The University of Tennessee Knoxville, Tennessee Canine Anatomy Biomechanics of Physical Rehabilitation and Kinematics of Exercise Preface Individuals involved in veterinary medicine and surgery resulted in the need for close collaboration between veteri- have witnessed remarkable progress in their ability to diag- narians, physical therapists, and veterinary technicians to nose and treat problems that, in the recent past, would have provide optimal evaluation and treatment of animal been untreatable. Total hip replacement in the dog, laparo- patients. Currently, these collaborative efforts and relation- scopic procedures, arthroscopic surgery and the wide- ships are being used to create treatment protocols for many spread use of sophisticated imaging modalities such as types of cutaneous, neurologic and musculoskeletal inju- MRI, CT, and real-time ultrasonic imaging are daily occur- ries in animals. In this book, we hope to amalgamate the rences in veterinary medicine. With the availability of these knowledge that physical therapists, veterinarians, and vet- sophisticated diagnostic techniques, the expectations for erinary technicians possess to facilitate a faster and more enhanced functional results have grown. complete recovery from debilitating conditions. Human physical therapy is an internationally recog- It is with these goals in mind that this edition was con- nized discipline, and the positive efforts of post-surgical ceived and written. We have seen a tremendous interest, and post-injury rehabilitation have been documented and and growth, in veterinary rehabilitation since the first recognized in human health care. Relatively little attention edition of this book was published in 2004. Canine reha- has been given to veterinary patients afflicted with similar bilitation has grown from a small area of interest to a conditions. There is profound interest on the part of veteri- recognized discipline during this time, and all animal nary caregivers to learn about and provide rehabilitation patients, their owners, and veterinary caregivers are real- and therapy following surgery, illness, or injury. Tech- izing the benefits of this progression. This book has niques used in human physical therapy are being adapted expanded greatly from the first edition as knowledge within for use in small animal patients. this field has rapidly grown. Many chapters have been The purpose of this textbook is to provide a solid under- added to disseminate this new knowledge, and all of the standing of physical therapy techniques and interventions chapters have been updated to reflect advances in the for dogs. Most professional programs in veterinary medi- respective topics. We hope this book is useful as both an cine do not provide training in physical therapy. Educa- in-depth study of the field, and as a quick reference on tional programs in physical therapy do not include topics such as protocols for specific conditions that are evaluation and treatment of animals. These factors have seen clinically. xi