What to Expect From Rehab-

Realistic Expectations From Rehab –

When I discuss what to expect from rehab, the importance of maintaining workouts and scheduled appointments is key to the equation. I urge pet caretakers to continue the work and not put too much time between our rechecks or phone updates.

If you do the work as prescribed, then you should expect improvements.

Formerly paralyzed Sully the Great Dane walking around the block.

People frequently contact me.

People that contact me all have the same intent of finding solutions for their pet’s (and often their own) discomfort after injury, surgery, or prolonged diagnostic challenges. How they respond to my information and to their pet regarding my information all differs. I have made it a point to observe and adapt my work to differences in their interpretations of medical information and my plans. Hopefully my adaptations address a greater number of worldwide people and some broader issues.

Other life happens during the intent to do planned life and plans for rehab work. Some common interruptions to rehab work are holidays, school breaks, and trauma in the human family.

As I was encouraging one client to not postpone our two-week recheck during a school break, I noted the information in the following paragraphs. She rescued her dog, it’s young, it’s her first adult dog, and he had one FHO to repair the pelvic area prior to her rescuing him and after an unknown accident . The other hip seems fine. This was her first rehab rodeo.

About your text and the schedule…

We can meet when you want, however I recommend sticking with two week rechecks for now. 

Part of the benefit of meeting in two weeks is to help encourage your staying on track.

Part of the benefit of meeting is that in two weeks, potentially he’s had three or four workouts of at least two of the three drills I gave you to work. If that’s the case, I will need to change the drills in two weeks to advance him to the next point.

It actually ends up being somewhat of a waste of time if you do the same base-building drills for four weeks. Sometimes people stick on week one when they should advance. Sometimes people advance all the way to week four but they should not have gone forward past week one as per my written parameters.

BUT, if you cannot meet when I propose, by all means, continue the same plan. Don’t stop 🙂

Also, often people get tired of doing the same drills if we don’t meet to discuss results and upgrade the work. In this case they often begin to cut jout certain work or allow too much time to pass in-between drills. 

Don’t find other drills online to do because they are not part of the foundation and recovery we are building.

Follow-through…

So, if you are doing a drill every other day, and you really only get to work on two out of the three drills I prescribed, then you will definitely need an upgrade for your pet in no more than two weeks.

Adaptation to exercise drills occurs in specific amounts of time. Doing the same workout over and over without changes is a waste of time and energy if you want improvement.

If you abandon ship altogether, when recovery is not complete, then the injury will likely resurface or other injuries will occur.

Sometimes people don’t follow through at first, yet they often pick the program back up and begin again and the pet improves again.

The reality is that regardless of what happens to any body, mine or yours or your pet’s, there isn’t a “going back” to a set point; there is a “new normal”.

You have already seen great progress with him, and that’s from your doing the work. When you do the work for surgery recovery, you also strengthen the opposite side without overusing the “good” leg.

In humans or any other animals, disuse leads to dysfunction. It doesn’t matter how many thousands of dollars a person may have spent on clinical rehab; if people don’t go back to doing their exercises when problems arise then dysfunction continues.

Often the problems returning are obvious because lameness and limping return. This is disuse. Sometimes people notice muscle atrophy or weakness before limping begins. This is because of disuse.

You should expect…

My programs work to build muscle to support the body, support the joints, and improve function. They also work to improve proprioception and increase neuro-muscular abilities.

Pets will use the better-functioning body parts and will ignore damaged ones to get to where and what they want.

So long as they are comfortable with drugs (or adjunctive therapies or both), they will use the injured limb more, and I count on that for them to build muscle and to better support the joints. When they are comfortable on their own, they will usually use *all* their parts as normally as possible. Without interventions, animals will not usually use a painful, damaged, or disabled body part very well, and their dysfunction will continue.

After we work more and he progresses, I will give you guidance to return to certain drills. You will also use other drills once or twice a week over the next year just to maintain better function. 

Check out this post on Goals of Therapeutic Exercise for more ideas.

Thanks!
Deborah

Updated February 12, 2018. Originally posted December 8, 2014

Degenerative Myelopathy and Neurological Conditions

Question from the International Veterinary Academy of Pain Management, 2012:

“Does anyone have any recommendations regarding treatments for a 14 year old Husky with Degenerative Myelopathy? So far, the only thought I have is a cart. Also, my understanding is these animals are not in significant pain – is this true? Thanks for any info.”

From: A Veterinarian in the U.S.A.

RehabDeb Response:

Hi!
I apologize for taking so long to reply. I have a 30-yr. background in human sport science and nutrition, worked two years in a veterinary specialty hospital designing and building the rehab dept., and since 2007 have had a mobile practice wherein I serve a huge number of “mystery-ortho-neuro” cases, many of which are presumed to be D.M. (Degenerative Myelopathy) (or, as of 11/2014, may have been tested using protocol at Missouri).

The functional rehabilitation protocol I have developed over time, and which has been successful at improving function to varying, yet notable, degrees is derived predominately from my experience in sport science program design coupled with principles of neuroscience. A body at rest stays at rest and only changes with dynamic interference…
(original RehabDeb quote :))

I DO agree that while D.M. may not produce pain in and of itself, it is highly likely that an animal with any neuro condition has self-induced pain by nature of the fact that they are compensating, stressing tissues, and possibly pinching nerves, akin to when our sciatica or sub-scapular, etc…get impinged and cause us pain.

Pain management discussion aside, for my own patients I introduce a system of simple, vibration-based, massage with a less-than-ten-dollars Homedics unit (https://rehabdeb.com/pet-massage/), Low-Level Laser Therapy (MUCH research exists regarding nerve conduction, regeneration, re-invigoration), and a plan of return to whatever level of function is possible via primarily-human-induced and animal-activated movement exercises, retraining brain-to-limb neural pathways and encouraging focus on movement and function. I prefer to use dry land and gravity, and I work with clients on methods to help them get this work done. Strength and endurance/conditioning drills I propose, depending on each animals status, are best

I begin with laser twice a week for a month and review exercise protocol that the owner is charged with doing if they are capable and which I do if the owner prefers. I use a front harness designed for riding in the car that has fleece and the best stitching I have found and only costs $30 shipped from Petsmart (no longer available-2014). This is the Travelin’ Dog harness. I turn it around, and it is “perfect” for hind end support (legs through arm holes, tail through neck hole) while relieving owner back stress, if used properly. It is much better designed for the body than the blue neoprene sling or a belly towel, less pressure on the abdomen than a belly sling, and less problematic than a Bottoms-Up sling. No one pays me to promote these items; I have just found that they are simply the best and inexpensive, and in my years of experience I deem that they work better than a lot of what is out there. I have pics around this blog of neuro dogs wearing these harnesses.

There are many more things that may be done, however getting the owner started on helping the animal around the home in a manner that hurts neither owner nor animal, and in a manner that is most productive time-wise, is one of the major components of my mobile practice. I tend to not involve owners in activities that, again, would potentially cause more harm than good or waste more time than be productive. This list includes ROM, balance balls, and balance boards, among other not-as-productive work that should be performed.

I also utilize a brand of boots with excellent traction, usually sometime along the way but not usually right away. Depending on function-ability I will introduce the boots when I believe they will not encumber the pet and will be more help than hindrance. The right boots always seem to encourage hind limb use when there already is function and they give stability in the home on tile and wood floors. I also often have pet owners stop using boots if they have begun using them before the pet is functionally ready.

On several elderly canine patients I have also used Epsom salts baths to great benefit.  Owners HAVE to ensure they rinse off all the salt residue after the bath, otherwise if the dog licks it, which they usually will, diarrhea will likely ensue.

These are some of the basics, and I will be glad to discuss the topic further if you’d contact me.

Blessings-

Deborah Carroll

 

Anecdotal Progress

Anecdotal Progress – Am I Seeing What I Think I’m Seeing?

Exercise is thought to have beneficial effects on Parkinson’s disease.

Jay L. Alberts, Ph.D., neuroscientist at the Cleveland Clinic Lerner Research Institute in Cleveland, saw this firsthand in 2003 when he rode a tandem bicycle across Iowa with a Parkinson’s disease patient to raise awareness of the disease. The patient experienced improvements in her symptoms after the ride.

“”The finding was serendipitous,” Dr. Alberts recalled. “I was pedaling faster than her, which forced her to pedal faster. She had improvements in her upper extremity function, so we started to look at the possible mechanism behind this improved function.” As part of this inquiry, Dr. Alberts, researcher Chintan Shah, B.S., and their Cleveland Clinic colleagues, recently used fcMRI to study the effect of exercise on 26 Parkinson’s disease patients.”

RehabDeb says: The above is a quote from an article regarding research looking at the benefits of exercise for Parkinson’s patients, found on Science Daily dot com, and as I read it this morning, I thought it to be a perfect example of the practice protocol I have developed that has proved beneficial for several orthopedic conditions in lieu or surgery…whatever reasons one might have for not having surgery performed on their pet.

I am one person working alone, however I have over 35 years background and experience in principles of human sport science, exercise physiology, program design, and the like. There are a few others with similar backgrounds working in veterinary rehabilitation. I began using simple principles based on years of experience, and I’ve seen much success, as evidenced by improved quality of life, improved function, and veterinary professional confirmation.

I don’t have money to drive clinical research, and while I have ideas about whom I could approach about getting involved with this research, I am busy in my practice and haven’t wanted to take the time aside to pursue individuals, grants or corporations. At some point I intend to write more about the beneficial outcomes and to further discuss cases, however in the meantime, take the first paragraph as affirmation that science is observation of a particular outcome or experience as well as the steps to prove what we imagine/postulate/thought we observed.

It has been proved anecdotally time and again that when the conservative and slowly progressive non-surgical interventions I have outlined in the homework discussions on this site and/or in my books are followed within the parameters I outline, improvement of the condition ensues, barring extenuating circumstances. I do not see the discussion as being whether surgery or no surgery is better; I present the protocol I use as beneficial guidelines instead of not giving a program of recovery to those who choose to wait or altogether forego surgery for some conditions.

AND, I have provided return-to-function programs that are for pets that have had surgery. Following a program of progressive and structured recovery will only serve to improve the outcome and the pet’s quality of life if done well and correctly.

In other words, for injuries and conditions that are not “life or death”, the fact is there are very many people who will not choose surgery for their pet (or for themselves, for that matter). The instead-of-surgery protocol I develop and use fills a need to help the pet recover.

Keep moving forward; there is no time constraint on the “one step at a time” methodology…you can always begin, again, now.

Blessings-Image

Very Productive Pet Massage That’s Easy to Do Correctly and Helps Recovery

Simple Vibration-Based Pet Massage Video for Rehabilitation

Simply Put –

This technique uses one particular type of inexpensive, hand-held massage unit technically sold for people but great for use in pet massage. This unit produces a low-to-moderate level of vibration and is usually pretty quiet.

The technique very practically covers main areas for relaxation, improving circulation, and encouraging healing. This massage technique conquers many areas in the amount of time required for benefit and therefore is a lot of benefit for time expense.

I have developed my methods over the years to try to give the best bang for the buck, time-wise. It’s disappointing to me finding out people have wasted resources doing sub-standard work. I know it’s frustrating for them and for the pet, plus the pet usually is not recovering well in those situations. Plus, money swirling down the drain on occasion…

My methods aren’t perfect, but I am a hard-wired problem-solver, and I have the knowledge and experience to support that. I am confident that this method will be a great use of your time and money and that your pet will benefit.

This is the only rehabilitation some of my clients are able to do themselves on their pets. That is usually the case when the client is not very mobile and cannot do walks or drills I prescribe. I have been surprised at the great positive feedback I have received in those situations; most often they find their pet is getting up and moving more after several sessions of this massage.

Instructions –

Please watch and listen to the massage video to see how to use this massager unit AND so you will hopefully have success introducing the massager. This video is not going to win awards, but the instruction is solid, and you will have the info you need if you do what it says.

Most people tell me they notice immediate benefits. Please do this massage daily for the first month after injury or surgery, using the full technique during that time.

Since it vibrates, you definitely don’t want to scare your pet before you get to show them how wonderful this massage is. Watch the video and listen to my words so that you introduce it without drama. Please don’t start by turning on the massager and shaking it at your pet. I have seen funny people do this. Not always funny to the pet, and you also might lose a useful tool!

In my experience, less than 1% of pets will act like they are not into the massager; the remaining pets either love it immediately or grow to appreciate it if you follow the plan. When they feel the benefits, lots of pets get used to the massage time and come “ask” for it. My Grace Dane used to love her massage, and when I turned on the massager, her cat, Calvin, would come running to get his, too! Yes, that’s them in my banner pic.

Please do not let your pet just get up and walk away during the massage –

Sometimes your pet may seem to get bored or, if it’s a dog, they may test the Alpha status by getting up and wandering off. This does not mean they do not like the massage.

When I am in-person to show the massage method to people, I have 100% success, but I’m also not the “pet parent”, and I’m not worried about whether I’m doing it right or if the pet likes it.

Keep the faith and use the technique ideas I give to you in the vid. Start with the massager turned off. Even if that is the only way you can ever use it, your pet will gain benefits. This unit with four feet on it keeps the body contact more even and balanced. If you use the system I recommend, massaging body parts in a certain order and for a certain time, you don’t have to worry about whether you are “doing enough” of the right thing.

Benefits –

We all (probably) know that we need touch and that touch is healing. Touch releases endorphins. Oxytocin is a good thing. Touching a little or a lot with emphasis will encourage circulation.

You want to relax your pet, reverse muscle tension, and increase circulation to the injured area. You don’t want to bruise your pet, injure a healing area, or waste time. When you use your hands, you will not gain the depth of circulation improvement that the consistent, low-level vibration gains.

The benefits far outweigh any other type of massage you could do, in my experience. That is because with this low-to-moderate level of vibration, using the tool I recommend and not a dozen others on the market, you will loosen up tight tissue and easily encourage circulation in a non-aggressive way. That is also because most people are not trained in massage and/or do not have hundreds of cases-worth of experience with a variety of injuries.

Using the unit with four feet on it keeps the contact more even and balanced. If you use the system I recommend, massaging body parts in a certain order and for a certain time, you don’t have to worry about whether you are “doing enough” of the right thing.

This massage method is a very beneficial help to encourage circulation, relaxation, nerve conduction, cell stimulation, and other healing, so be encouraged to carry out the work. They usually learn to relax and enjoy the massage time, especially if you do it as I have outlined. Most will like it immediately.

Oh, I’ve Been Doing My Own Massage –

That’s a good idea and very thoughtful on your part! Chances are that you don’t have any particular training in massage or pet massage, and you might be confused about techniques. There are a lot of videos online about doing pet massage. Many of those videos are not coming from people with decades of experience resolving extensive injuries.

Many of the online videos describe good stuff to do, though, and you probably found out you can even get a certificate in pet massage therapy. Maybe you should, if you are interested and have aptitude. For now, for healing after surgery and injury, please do the method I describe for the first month, at least.

Your pet has likely been enjoying your touch, unless you have provoked painful areas. Our own human LMT might do that to us, press the pain, but don’t do that to your pet. Don’t force range of motion, either. If you use this vibration technique, you will merge many aspects of healing. You will be “doing it correctly” and not have to worry about causing further damage or wasting time.

But I’m a Licensed Massage Therapist –

I have a lot of clients who are licensed massage therapists. Yay! And after I discuss it with them, they always understand the benefits to this vibration level and technique if they have been trained in advance massage techniques.  If you are licensed, you have beneficial knowledge to apply to your home rehabilitation program.

You will also understand that while your human clients will (maybe) give verbal feedback to you about your massage technique and what they think they need or want, your pet doesn’t speak in the same verbal language. Your pet will give signs to you, too, but you might not read them correctly.

I do not recommend that LMTs use the more aggressive massage units they would use for humans on a cat or dog or other smaller pet. I had one of these, but I finally broke it recently. It’s a big black thing with heavy-duty handles and lots of rpms. You know. It might have a second use as a jackhammer.

I honor your training and ask that you alternate the technique I recommend with your own technique every other day. I have received very positive feedback from LMTs over the 10+ years that I have seen clients through this massage technique.

Pretty Sure I Know What My Pet Likes –

We don’t usually know our pets extremely well in injury status. We project our distressed emotions on our pets, who, in turn, mirror them and wonder what they can do to help us, because we are so distraught. Our being distraught is normal, and their response as companion animals is normal, mirroring our distress and trying to help.

Not knowing how to read your pet’s cues is common, even among veterinarians, and even though we all usually tend to think we “know” our pets. We do to some extent. But when our pets injure themselves, we also tend to get very emotionally involved and upset.

I have had to work with my intuitive and empathic skills along with “book” knowledge to weed through the nuances of animal reaction over the years to gain more advances in rehabilitation. This is a deeper topic for a different post, but it comes up a lot in my first appointments with people, so, just a few thoughts here. I recommend you overcome your mixed emotions, follow the above massage video, and be confident that you are providing a new level of help for your pet!

Lie Down? Sit? Stand?

Yes, they may either lie down or sit or stand…but those that stand usually end up relaxing into lying down! If they are lying on one side, do the beginning session, move to the limbs (only doing it the way I describe), and then get them to turn over. I explain this in the video (I think).

Where Do I Get This Massager –

Here is what the massager looks like, along with a link to buy it on Amazon if you choose:

group of small, four-footed Homedics massage units

Otherwise, I have used this method for pet massage since I first found the massage units in 2008 in a Target store in Austin, TX, USA. I saw the unit, had an epiphany, and started formulating the method based on knowledge and my own extensive experience. You may usually find the unit near the pharmacy department, sold for humans. It’s not in the pet department. I don’t think Target has carried the unit for many years. It used to light up, have 3 AAA batteries, and cost $4.99.

Most commonly I find the massagers in a CVS store locally. They seem to average $7.99, no longer light up, and take two AAA batteries. I recommend you change the batteries about every five hours of massage. Do that so the massage vibration remains closer to peak for this machine.

People have told me they have found the units in Walgreens, Fry’s, Wal-Mart, and Sears. Most stores call it a seasonal item, and they offer the units at Winter holiday time.  One of the main reasons I decided to provide links to products I recommend was to show this massage unit.

Some units rattle, so check for that. The rattle won’t matter if your pet is mostly deaf.

Blessings-

Deborah

(First Published Around 2011, Updated February 26, 2018)

Quality of Life of Obese Dogs Improves –

Quality of Life of Obese Dogs Improves When They Lose Weight –

This is recent research conducted in the UK, where they estimate 1/3 of the dog population is obese. Study conducted by Waltham/Royal Canin.

Feb. 21, 2012 –

Researchers at the University of Liverpool have found that obese dogs that lose weight have an improved quality of life compared to those that don’t.

A study of 50 overweight dogs, comprising a mix of breeds and genders was undertaken by scientists at the University in collaboration with the University of Glasgow, Royal Canin and the WALTHAM Centre for Pet Nutrition.

How?

Owners completed a questionnaire to decide the health-related quality of life of their dog prior to weight loss. A follow-up questionnaire was completed by the owners of 30 dogs that successfully completed the weight loss programme, enabling changes in quality of life to be assessed.

A range of life quality factors were scored, including vitality, emotional disturbance, and pain. Quality of life of dogs which succeeded with their weight loss programme was also compared with those dogs that failed to lose weight successfully.

Results –

The results showed that quality of life improved in the dogs that had successfully lost weight. In particular, their vitality scores increased and the score for emotional disturbance and pain decreased. Moreover, the more body fat that the dog lost, the greater the improvement in vitality.

The research also found that dogs that failed to complete their weight loss programme had worse quality of life at the outset than those successfully losing weight, most notably worse vitality and greater emotional disturbance.

Dr Alex German, Director of the Royal Canin Weight Management Clinic at the University, said: “Obesity is a risk for many dogs, affecting not only their health but also their quality of life. This research indicates that weight loss can play an important role in keeping your dog both healthy and happy.”

Strategies for Combating Obesity –

Dr Penelope Morris, from the WALTHAM Centre for Pet Nutrition, added: “Strategies for combating obesity and keeping dogs fit and healthy include portion control, increased exercise, and diets specifically formulated for overweight pets.”

Established in 2004, the Royal Canin Weight Management Clinic at the University’s Small Animal Hospital, UK is the world’s first animal weight management referral clinic. It was set up to help tackle and prevent weight problems in animals such as dogs and cats.

Veterinary surgeons from any general practice in the UK can refer overweight animals to the clinic. The patients receive a thorough medical examination. Then they receive a specific dietary plan and exercise regimen to follow over several weeks.

Taken from ScienceDaily.com

Thoughts to Ponder –

The results showed that quality of life improved in the dogs that had successfully lost weight. In particular vitality scores increased and the score for emotional disturbance and pain decreased. Moreover, the more body fat that the dog lost, the greater the improvement in vitality.

And, interestingly, the study notes this: “The research also found that dogs that failed to complete their weight loss programme had worse quality of life at the outset than those successfully losing weight, most notably worse vitality and greater emotional disturbance.” …sort of as if the dogs failed the program and not that the owners were partners in this endeavor.

The dogs didn’t fail to complete the program, in reality. The study finding here denotes the close connection and potential issues within the human/animal psychology bond.

Pet Moods –

Lizzie the Golden is a lean and fit elderly dog in this photo. Calvin is working on becoming a dirigible, and he would eat until he passed out if someone let him!

If the lower-vitality dogs came into the study with possible lower quality of life, then I recommend evaluation of the home life of the human, too. Our pets reflect our moods. You may also look for mood changes in a pet to alert you to possible mood changes in their people!

The failed dogs notably had “worse quality of life at the outset” than the ones who ended up succeeding. Most compromised were their vitality and emotional status. We definitely pass our moods, demeanor, and worry onto our animals. Breathe peacefully with your pets 🙂

Contact me if you need a progressive and defined program to follow in order to lose fat and build supportive muscle. Or if you think you are dragging your pet into a dark mood abyss due to lifestyle changes and difficulties.

 

(Published February, 2012. Updated April 19, 2018)

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