Conservative Treatment Books: Instead of or Before Surgery (Pre-hab):

This book is the program to follow to begin recovery for most orthopedic or muscular injuries! This includes hip problems, ankle problems, and others.

Has your pet been injured, and it’s not “life or death”? A torn knee ligament, hip dysplasia, and luxating kneecaps are examples of “not life or death”.

Then take a moment to look over this site, follow the instructions on the “injured” page, and take a deep breath!

This book is the program to follow to begin recovery for most orthopedic or muscular injuries!

Conservative treatment after torn knee ligament, instead of or prior to surgery:

booklet with instructions for you to follow with your dog after injury, instead of surgery or prior to surgery

(click on the THIS LINK, and you should be directed to Amazon in your country, unless you live in these countries –  Australia, Brasil, India, Mexico, Nederland = you should click on the name of your country to be taken to the book).

(available on Kindle and in paperback, and you may order the paperback through any bookseller)

Some Reviews…

A Few Amazon reviews I took time to copy/paste here for you (additional testimonials are above, in the Feedback section):

“I’ve known Deborah Carroll for several years and she has worked with us rehabbing our 90lb Hound/Lab mix. I have always found her to be chock full of great scientific information in rehabbing your pet and the booklet simplifies all that into simple to understand protocol and reasons to follow the protocol to help your dog. Short read but well worth it. I love it!”
D.B., Amazon Review

“The book easily outlines a plan to rehabilitate your dog from a knee injury. I now feel like there is hope for his long term recovery. Thanks Deb!”
Amazon Review

“Using the methods described in this book, we were able to completely rehabilitate our Labrador retriever from a torn ACL without having surgery. Very thankful that this book was so easily accessible!”
H.P., Amazon Review

“I chose not to have my 9 year old Lab put through the stress of surgery on his torn CCL – knowing that he is already showing signs of the other leg being injured. After much research, I found Deborah’s website and read a lot of the blog posts where I learned of her book. I have been using the therapy in the book now for about a month and it is working well in conjunction with some holistic remedies and massage, Since the process of healing is really the same for both non-surgery and surgery dogs, this book will help either way! Easy to follow, but you do have to stick with it to see results.”
Amazon Review

“I have worked in a variety of animal care fields – as a veterinary technician, pet sitter, and behavior consultant – since 1997, and have several mutual clients with the author. As such, I have seen first-hand what she can do for both her clients and patients. Her knowledge, skill, and bedside manner are impeccable, to the point that she has become the only person that I refer people to for small animal rehabilitation in the Austin area. I am so glad that she has written this book, so that people who live outside the Austin area can benefit from her expertise. I highly recommend it!”
Emily S., Amazon Review, From Beaks to Barks

“This was an easy to read and understand guidebook. There were lots of practical tips offered. Her program is something I can follow on a day to day basis. The author has obviously had lots of experience with dog rehabilitation and wants the best for our dogs.”
Lori L., Amazon Review

“I love Deborah Carroll and her approaches to rehab/conditioning- we see her next week.”
Courtney K, Austin, TX Courtney’s Agility Page

What Would You Do For MPL’s? (Medial Patella Luxation)

Hi, Deborah-

Dr. D at our clinic is referring a 1.5 yo M 31# mixed breed with bilateral medial patella luxation to you. How should we proceed?

Thank you-

 

Hi!

Glad you contacted me, and I will tell you that I start out MPL’s here on my website, if they will (and, as my website says 53.7 times, I’m editing and revising and changing a lot of content appearance):

Luxating Patellas

and this is one of the many pages I have yet to fix all the links on, add photos to, revise content, etc…
but it’s still relevant, so check it out if you’re interested.

The books on the page noted above are titled about CCR, but I cover how the books are relevant to MPL on this page:

Pet Injury

I have a lot on my website to help pet parents and clinicians and others work with their pets on their own in the home (or at the clinic).
I have a lot of words explaining that ^^ on my site, so I won’t fill up this email with more 🙂

Let me know if you have additional questions!
Thanks!
Deborah

Successful Rehab of Colorado Hiking Dog with Torn Knee Ligament & No Surgery

Hi!
Hope all is well with you. Thanks for keeping me in your circle for emails!
You should feel free to tell or post on social media anything about the rehab of Sputnik.
He’s doing amazing.
When we moved out here (Manitou Springs, CO), he got a little re-injured. Our yard is built into a hill and he tried to jump a retaining wall to catch a squirrel. I’ve learned that he needs more restriction and leash time here – given it’s so hilly and he’s so prey driven. It was very minor and I  used all your techniques, books and notes to help with it. I”m grateful we kept notes!
And…the thing that makes me happiest in the whole world…he LOVES to hike and be outside on trails. It melts my heart to know how happy he is and how much he just loves to have walks and exercise. I can’t believe he’s 11 years young. You’d never know it by looking at him and if you didn’t have his protective mom telling him he’s been injured, no one would ever know. I promise because it’s happened time and time again that people say “really?” when I mention it!
I also thought it might be a good idea to see if there was a specialist here given I don’t know the terrain as well yet. I was curious to know about whether hiking was good for him.
Turns out that YOU got lots of kudos from our orthopedic (specialist) doctor,  she said I did everything right.
And she said given how well he’s doing, she thought we made the right decision for Sputnik
by not having surgery.
I can’t tell you how this eased my mind given surgeons just want to tell you to always have surgery.
I am forever indebted to you and all your help.
I know I get some credit for sticking to a plan. (Yes, YOU do, Renee!-Rehabdeb)
That’s huge. But you were my teacher and that is the important thing! Thank you!
Sputnik is doing great.
He’s hiking up to 4-5 miles a time – many days a week (with rest periods too. I know he’s not a young pup anymore and he gets days off!). Walking some pretty hefty hills and is happy, happy, happy.
Thank you!
Happy Holidays!
~ Renee
12/15/16
Sputnik now sees vets at Mountain Shadows Pet Hospital and recently received praise on his non-surgical CCR recovery from an orthopedic surgeon at Colorado Canine Orthopedics

Successful Rehab Without Water Treadmill

Water Treadmill is Not Necessary for Your Pet’s Rehabilitation

Compared to the number of dogs in the world, then compared to the number of ruptured cruciate ligaments on aforementioned dogs, then compared to the number of these dogs with ruptured ligaments that are treated by a veterinarian, then compared to the number of those dogs who are taken to surgery after initial veterinarian assessment for surgical repair after the torn ligament, there are relatively very few rehab clinics in the world and fewer still with water treadmills…as compared to the number of these dogs with ligament tears, etc…

Dogs of the world do relatively “ok” in all areas of the rehabilitation treatment spectrum after torn knee ligament and/or meniscus and definitely do not need to be “put down” due to ruptured cruciate ligament (torn ACL, CCL). I have encountered clients in my practice who were told unless they had surgery performed on their dog, regardless of the size of dog (even), the dog would have to be euthanized. Just wanted to clear up that bit of misinformation (much to your delight, I hope).

That being said, and along with explaining the title of this blog, of foremost importance I will note that I came into veterinary functional rehabilitation in 2004 with approximately 25 years experience in human sport science, functional program design, and nutrition. I decided to call my practice “functional rehab”, not having seen that designation applied much but having presumably heard the term somewhere. I decided to use it when I began an independent, mobile rehab practice in 2007, two years after starting and running a rehab clinic for a veterinary specialty hospital.

I became more aware of the water treadmill via my work at the hospital, and I found that the use of it was/is widely promoted within small animal veterinary medicine and the canine rehab model, which draws heavily from structured, academic-oriented, human physical therapy concepts. I think the overall concept is decent, yet the wtm is one very, very small tool in the vast array of protocol and modalities that exist in order to better the health of your pet.

I also believe the introduction and overuse of the water treadmill in small animal medicine is due to a misunderstanding of the science that exists regarding functional physical recovery and a misapplication of “human” based machines and protocol from physical therapy models. Also, the use of the wtm was brought over into small animal veterinary rehab I presume because it has been such a great tool in equine medicine and has been for decades.

Quite simply put, horses and other very heavy animals often struggle with pain after injury/surgery, and the pain control medicines and protocol that exist for (especially) horses do not often alleviate pain as much as we’d like to see. That, coupled with the sheer weight of these large animals, can really do additional damage to a healing body. The water treadmill for an animal that weighs a ton or so is a godsend, I’d think. In those cases the water displaces just enough weight so as to encourage appropriate exercise protocol while building recovery and assisting with pain control (because all the weight isn’t on the damaged limbs).

Water treadmill for horses or other very heavy animals is extremely helpful for recovery. Water treadmill for smaller animals is not necessary, often a trauma to the pet, often an unnecessary additional cost to the pet caretaker, and definitely overused. After a week of easy recovery post-surgery the pet should have enough analgesic available (and dosed) and should definitely have ability to walk on dry land and should be pursuing a controlled plan daily in the home environment.

Unfortunately, I found that what is not taught within this same model of small animal veterinary rehab is a good basis and understanding of program design, writing training programs, and the development of dynamic activities/protocol designed to encourage healing and increase muscle and bone mass. These are principles I began learning over 30 years ago as an athlete, as a self-coached athlete, and then as a coach and trainer to others, even world-class athletes.

What does this mean to you and your pet (primarily dogs…)?

The chief complaint I hear from people who contact me is that they were referred to a veterinary rehab clinic or three (no, not all clinics are the same) for post-surgical rehab, and after many weeks of walking in the treadmill, moving around on balls, and doing a variety of other cookie-cutter things, the pet is not much better or is not to a place where the owner feels comfortable with letting them be loose and rambunctious.

Their pet isn’t where the owner thought they would be after surgery.

When I was in a clinic setting and working on utilizing the wtm we had and I helped design, I did structure the workouts to be progressively difficult, using a 3x workout adjustment protocol, meaning that if three workouts went well, then I changed the protocol, making the workout more dynamic. This could be done by increasing time or lowering water in the tank. Since I do not believe that much benefit is realized by walking in a wtm more than 20 min., and some data is published to recommend that animals not be worked beyond that time anyway, I find more benefit realised by lowering the water height, thus increasing the force on the joint/leg/muscle/bone.

Overall, over time, and according to decades of research, however, the most benefit is realized by work on dry land, where possible, using gravity to strengthen bones, connective tissue, and muscle. I began developing protocol for just that for small animal rehab since I did not find any published when I arrived on the scene in 2004.

Your pet will use their leg to some extent and will use it increasingly after surgery if he/she is not in pain. That has been my finding after working with hundreds and hundreds of cases, some having had surgery and some going the conservative route. With that in mind, a structured workout program is entirely necessary and may vary from any standardized protocol depending on the nature of the pet and the owner.

If your pet is not using the leg within 2-3 days after surgery, then my findings are always that they are in pain, and that they are in pain due to

1) not enough post-op analgesic, which I believe should be a combo of at least two analgesics for potentially several weeks while we pursue the best activity and homework for healing (in this area we commonly use an nsaid and Tramadol, however I find more benefit and big-picture-science backing the combo use of Gabapentin and Tramadol);

2) infection, the pain of which will only be finally remedied by antibiotics (and subsequently the infection remedied as well); or

3) structural abnormality, i.e. some sort of failure related to the surgery, yet not necessarily the surgeons/your/your dogs *fault*.

The homework protocol I generically recommend is found here. If you are within range of my services, I recommend you contact me for an evaluation appointment and we establish a base for your dog and then you perform the exercises which will bring solid healing while helping to also protect the opposing limb.

Thank you!

Jicky E-Collar

Should My Dog (or Cat) Still be Limping After ( Knee ) Surgery?

Pain, pain, and also pain –

This info about pet limping and pain could apply to almost any orthopedic surgery…
and some of it applies to almost all injuries as well!

Chocolate Lab lying on floor with bandage on leg after surgery

 

 

 

Pet limping after injury or surgery is overwhelmingly due to pain. The pain is caused by one or more of the situations I introduce in this post. Continued pain is so common that this post on my website has been the most visited post for over a decade. The most common answers I give to questions about limping are as follows, based on what I have found true in my practice:

Limping –

If your pet is limping, your pet is very likely in pain.

Many clients say they don’t think their limping pet is in pain and/or their vet said their pet isn’t in pain. Trust me, limping is usually because of pain.

Bandage –

If your pet has on a bulky bandage, as Jake does in the photo, and your pet is limping, it is likely because of the bandage or cast, that they are bulky…and there may also be pain.

Eating, Drinking, Happy –

Eating, drinking, running, tail-wagging… if your pet is doing some of these things, it doesn’t mean they are not in pain. (Hint: Most pets shouldn’t be running anyway after surgery)

In contrast, if your pet is NOT doing these things (wagging, eating, drinking, seeming  happy), that could indicate pain.

Pain – 

There will be general pain on average for about 2 weeks after surgery, because…surgery. Plus, sometimes the surgery doesn’t go well or complications occur with surgery methods. In those cases, the pain will last a lot longer.

There may be other pain, on top of general pain, due to overuse of the body part that had surgery and…

There may be pain due to an obvious or a hidden infection. This one happens A LOT.

Lesson is: your pet can be in a lot of pain and could still be wagging their tail, eating well, and chasing prey!

That’s the short answer section.

Your pet is not limping “just because he/she had surgery”

I put part of that sentence in quotes because many times I’ve heard people (clients, veterinarians, clinic staff, etc…) say the pet is limping because of surgery or injury as if surgery and injury are somewhat abstract and causing the pain. Surgery is painful, and torn ligaments and other soft tissue damage are painful, too. Your pet is usually limping because they are in pain.

I try to bring people around to understanding factors other than a good surgery or injury can cause the limping. Pain is the #1 reason for limping.  Additionally, injury is painful, surgery is painful, infection is painful, bandages are awkward and may cause a feeling of instability, torn connective tissue may lead to a feeling of instability, and all these factors can contribute to limping.

When we work out a cause for the pain/limping/lameness, then we may work  on more correct solutions to the problem.

Your pet is limping because he/she is painful after surgery (or injury) in almost every case.

Your pet should not be limping more than a couple of days after surgery if

1) they have enough of the right pain medications,

2) don’t have an infection,

3) the right procedures were followed in surgery,

4) your pet didn’t destroy the surgery by chewing or with too much incorrect activity.

I have worked with many pets that have limped or been lame more than a full year after surgery. In some cases the lameness has been going on for a few years. Some of these limping cases are because there are problems with the surgery.

All of my cases have improved when we have done the right work as best possible for the true problem causing the lameness. This may mean getting x-rays to check the surgery if there was surgery. This may mean getting another opinion if necessary about post-surgical limping. You may need to try out antibiotics if the other factors I’ve mentioned are all eliminated. You may also need to get better pain management drugs plus use them to the best benefit to go with rehabilitation work.

An exception to the “limping due to pain” rule would be as in Jake’s case (above photo), because if your pet’s surgeon is using a bandage on your pet after surgery, the bandage or cast will be a little awkward. The awkwardness will make your pet walk funny. Your pet will probably act a little weird with the bandage in place. They may not want to walk in the bandage, they may be a drama queen, they may take exaggerated movement strides, etc…

Most surgeons have discontinued bandaging after knee surgery.

Don’t worry that your pet does or does not have a bandage after surgery. Without bandage is proved to be best in general.

Whether they have a bandage or not, most pets will do best with the e-collar around their neck until 2-3 days after stitches or staples are removed if they have had surgery.

The post-surgical or post-injury pet limping is not an abstract limp caused by mystery forces.

The limp and lameness have overwhelmingly turned out to be because of pain, in my experience with hundreds of cases.

With right amounts of pain medications for your pet’s particular situation, body chemistry, and processing ability, the severe lameness almost always stops. Sometimes “right amounts” of pain medications for your pets particular situation” includes antibiotics. The “particular situation” may be a sneaky little persistent infection. Medications for pain usually do not help very much in combating infection pain; usually only antibiotics will stop infection pain.

Next step is often to try a course of broad-spectrum antibiotics. Infections are not always hot, not always swelling tissue and joints, and they do hurt! At the same time, your veterinary team should be checking out the surgery area to see if it is in tact from what they can feel. They will likely want to do another x-ray to see what is going on inside your pet. This is a good idea in most cases; an x-ray shows random surgery failures as well as cloudiness from swelling in the area, among other things.

If the pet limping does not stop after thoughtful application of treatments I have mentioned in this post, then other factors may yet need to be discovered. Again, your pet should not continue limping more than a day or two after surgery if the above factors are met. The same goes for pets that have had re-do surgeries; if they are limping, there are other problems. The main problem in these cases is usually not enough of the right pain medications.

There is probably some “odd” discomfort and/or feeling of instability after surgery or after those injuries that involve tearing or rupturing of supportive connective tissue, and…

Maybe things feel a little “different” or unstable to your pet. Usually you will notice pets being reluctant to walk on slick floors or are using more caution over tricky surfaces when they feel unstable. I have torn connective tissue in my shoulders, hips, and knees, and I find that I guard my body while doing certain movements. Sometimes I subconsciously tend to be suspicious of my joint’s dependability in some situations. I have been active in body science for many decades, and I know my body well.

This body guarding happens in pets, too, and overcoming this disuse is a big part of my work on them and with their humans to achieve better overall function.

I do in-person and phone consults to help people help their pets to solve pain issues. I will write more on topics that are introduced in this post. In the meantime, please search the words “infection” or “pain” in the search box. Please look over the Q&A and some case stories on this site. I have hundreds more stories than I’ve had time to post, and I’d like to post them to help you. I will as time allows 🙂

It is often a LOT of work to get to the bottom of continued limping problems. In my opinion getting to the bottom of limping diagnosis takes so much time because

1) people do not know that their pet should not be limping after a few days in most cases.

2) people have not followed a solid recovery base program like this for injuries or this for surgeries,

3) veterinarians are hesitant to override the medications the surgeon has given.

Sometimes they are not well-versed in multi-modal pain moderation. Most doctors are not taught a lot about pain evaluation and pain control in school. What your vet learns about pain control is mostly from drug reps, journals, through word of mouth from colleagues, from conferences, and personal experience working with hundreds of cases. I have also learned this way over the decades. Personal experience with hundreds of cases is the best long-term teacher if the learner is open to making changes and solving puzzles.

4) In some cases the surgery has failed.

Surgery failure happens most often because the pet is too active, the pet’s body rejects some of the surgery technique, or the surgery technique wasn’t complete. The last event happens frequently in FHO surgeries, in my experience. I have created successful non-surgical programs for recovery from all hip and knee issues without surgery. I have recovered lots of pets that had too much bone remaining on the femur after FHO and the client didn’t want another surgery. In those cases, we followed deep pain control protocol and my foundation-building programs as well as my advanced drill programs.

If you can get your veterinarian to work with you on the steps I mentioned while you are following strict restrictions and a program like mine, then you will be able to solve the limping issues much sooner. I have a local “team” of veterinarians who have come to understand working on pain in a more focused manner. Some are members of IVAPM and have worked on discovering more about animal pain. Some of them also perform acupuncture as therapy for pain, and often the client and I bring one of them onto the evaluation and treatment team. More on this later or elsewhere on this site…check Q&A for now.

me giving laser therapy treatment for pain control and nerve regeneration on Magnolia the Weimaraner after spinal surgery

These are some basic bits of information for your thought. I mostly deal with continued pain cases, surgery complications, non-surgical interventions, and neurological cases. Daily I work with people and pets to help them pursue avenues to in order to get to the bottom of things and reduce or eliminate pain.

If you would like advanced or personalized exercises, then please contact me for a consult. There is a contact form at the bottom of this page <<Click on link . Use this form if you would like to schedule a paid phone or in-person consult with me for rehabilitation for your pet.

Blessings – Deborah

(Revised January 27, 2018. Originally posted 2007)