ICE (CRYO) THERAPY

Here is how you do it for some of the best benefits…

Prior to writing a pretty basic icing protocol for widespread use in veterinary rehab almost 10 yrs ago, I examined research papers regarding how well different types of ice worked, including papers that dealt with muscle biopsies as evidence. That being said, for almost 6 years I have not been using ice very often, if at all, on my own athletic injuries, on animal patients, or on others athletic injuries. This is due to there being great evidence from scientific research regarding the benefits of the inflammatory process in most situations and the detriments of stopping that process. Ice stops that part of the healing process. The exception to this “rule” for me is that if the pet does not have pain medication(s) available, at all (which sometimes happens), and the pet is in obvious pain or discomfort and if I think ice will be helpful for the situation. More about pain on my pain post, here.

I currently usually only recommend ice for a pet that has ongoing joint pain issues and is having a lot of trouble with pain resolution and usually only if the pet has been given prescriptions for (and is using them) pain and they aren’t helping enough to enable better function.

I recommend icing directly on the site, using the “pupsicle” method, for 5-10 mins, depending on the size of the animal, prior to walks or drills in order to enable better limb (or other part of the body) use. Meaning that perhaps the ice will dull the pain some, and the pet will use the leg and build muscle, will increase joint use and encourage healing, and will improve overall. Otherwise, see other information I have posted regarding research about ice and the problems with using ice. (4-27-14)

Ice therapy is used to decrease pain and inflammation and to increase healing in some cases. Ice may be effectively applied 2-4 times per day, with 4 times being optimal within the first week after injury/surgery.  Ice may be used in several forms, some of which are as follows:  

     *Frozen vegetables make a tidy ice pack, although the pack is not as cold as other, better options.  This pack should be left on the treatment area for approximately 20-30 minutes without a towel and on bare skin.  Frozen veggies are not cold enough, nor do they retain cold very well or long enough, so that is why extended application times are recommended.

*Slush ice in two zip lock-type baggies, meaning, double-bagged.  This turns out to be very cold and is made with one part water to two parts rubbing alcohol.  If the mixture is too watery, add more water to make it icier.  If the mixture is too hard, add more alcohol to make it slushier.  This ice pack should only be left in place for ten minutes at a time without a towel or twenty minutes on a medium-to-large dog with full fur.  Divide the times in half for small dogs. Fur is a barrier for icing like a towel on a human would be, especially if “colder” icing options are used (pupsicle, slush packs, etc…).  Smaller animals with less dense hair coats will still only need a 10 min. ice application, so try to use good judgment.  Dish soap in sliding zip-locked baggies, double-bagged and frozen, works like the slush pack mentioned above.     

*Pupsicle ice is a cup of ice, made either paper or Styrofoam cups that have been filled ¾ with water and then frozen.  This ice is especially effective and may also accomplish some surface tissue massage at the same time as the cryotherapy.  The ice melts into puddles, so grab a towel.  You should rub this ice over the affected area for approximately ten minutes at a time using circular or stroking motions, as in massage.

Ice, not heat, should be used for at least the first 72 hours post-surgery or injury, and there is generally no need for heat at all in most injury or surgery situations.  This phase is often referred to as phase one inflammation-breakdown or phase one post-trauma.

During the “phase one” time, pupsicle and slush ice may be left on 10 minutes, taken off 10 minutes, and then reapplied 10 minutes.

I am often asked if ice may be used any time, and the answer is yes.  If back muscle spasm episodes occur, if there seems to be pain or inflammation, or even if a new incident of disc rupture occurs, ice may be used even while on the way to the vet.  In these instances, always use ice and not heat.

Ice increases blood flow by cooling and slowing blood while constricting the blood vessels, after which the body reacts by sending more blood to the cold area to warm it and thus increase the flow of body fluids through the area.  This can actually be beneficial in reducing swelling, but, again, reducing swelling can prolong the healing process.

On the other hand, heat increases blood flow by opening up blood vessels.  The opening of the blood vessels by heat early in post-injury phases could cause unwanted swelling and inflammation, so even though heat may seem to feel good, it is not what should be done to help healing at this time.

Rehabilitation and Conditioning for Animals

Deborah Carroll, CCRP, CSCS

copyright 2007