About Exercise Physiology-Based Veterinary Rehabilitation, Rehabdeb, Rehabilitation and Conditioning for Animals, and Move2Live
As you may have seen on social media outlets, our Moving2Live interview about Rehabilitation and Conditioning for Animals is now live on the Moving2Livewebsite.
The interview discusses my background and exercise physiology-based veterinary rehabilitation. You may also find the podcast on Apple Podcasts, Google Play, Stitcher, Spotify and other platforms by searching “Moving2Live.”
Move2Live has posted on Instagram, Facebook, Twitter and LinkedIn, so you may find the podcast there. I’m posting on all of my social media outlets as well, so you may find the podcast link there.
Please subscribe to the show on Apple Podcasts or your favorite platform, and please write a review!! This will help the interview get found by others.
You probably already know how the internet works regarding “getting the word out”. Please spread the word if you have benefited from this rehab. It’s a great idea to share the interview with co-workers, friends, and family! You never know who needs the help or who knows someone else who needs rehabilitation and conditioning for animals.
After you listen, please feel free to add your experiences with my rehabilitation services in the comments, below. You are welcome to compare and contrast rehab experiences if you have information about that, too.
I have frequently seen cases where veterinary surgeons performed these two surgeries at the same time, on both knees, so a quadruple whammy. On the one hand, reasoning for doing so includes such thoughts as, “You only have to put your pet (usually a dog) through anesthesia and surgery one time”, and “You *only* have to go through recovery once”, and “We might as well do both surgeries once we open the knee”.
For now, I will tell you basic functional details of this case without the additional info I’d report in a formally published case study for a journal. I’ll put all the additional info into my booklet when I write it.
Feel free to ask questions.
This particular client found me after her dog’s surgery, having been referred to me by a groomer. The client, like most, was at a loss as to how to handle what was a very fragile situation with her best buddy.
Within the first 2 days of working with this little cutie I noticed tissue swelling, redness, and heat in one knee. The other leg was limping along in a fairly average recovery yet also not seemingly infected.
I typed reports, including extensive details about the signs and symptoms of a possible infection in one knee post-surgically, and I faxed them (years ago when we used fax more) to the hospital for the surgeon after my first visit with the dog.
The surgeon didn’t respond to me regarding my observations so I guided the client in solid restriction protocol, including how to help her dog potty, while she waited for her recheck appointment. I also thoroughly explained to the client the discussion she should have with the surgeon or her regular veterinarian to get the knee re-evaluated for possible infection asap and/or rule out other post-surgical complications.
Infection or Activity Level?
At the time of the appointment, instead of recognizing infection, the surgeon offhandedly blamed the owner and rehab for doing too much, saying that was why the knee was red and swollen. I assure you, Dear Reader, that neither the client nor the 1st week of rehab recovery was the problem…not at all! I emphasize this so that if you feel strongly about your or your pet’s health, you don’t feel intimidated when you pursue answers for healing. Politely speak up for yourself and for others. Try to build a bridge while not settling for any answer that belittles you or your thinking, if possible.
Recovery Protocol –
The client had gone above and beyond regarding securing the best recovery she could for her little dog. She frequently worked from home, a multi-level home, and she purchased baby playpens as good recovery pens for her fuzzy kid and put them on each level and in at least one room on each level. The dog was confined to the pens or to a crate.
The client originally hired me to come daily and strictly perform my very basic first week recovery plan just so “it would be done right”. I assured her that the plan was so simple for the first four weeks that she would not mess it up and that she could do it herself, but she really wanted me there daily.
The client was incredibly attentive to *doing everything right* and wanted me to do all the work except for potty breaks and other relevant work I couldn’t perform because I didn’t live with the dog. That turned out to be beneficial for the dog, since I caught signs of infection early.
Outcomes and Results –
The surgeon did not return my communications regarding the signs I noted that pointed to a problem that was likely infection in one knee. He also made the client to feel inadequate when she most very likely had nothing to do with the onset of the infection (based on preventative measures & type of infection), and she did return to have the surgeon address the issue, as anyone should.
You, Human Reader, should have your concerns addressed without your being made to feel inferior by the surgeon. Just so you know that’s a potential great outcome from the encounter, should you have one.
Soon thereafter, the pin the surgeon had placed in one knee as part of the patellar luxation surgery began to remove itself from the knee due to the infection and swelling. The pin notably moved out of where it was placed during surgery to a place that was easy for anyone to feel it poking out.
The client and her regular veterinarian were both timid with regard to “going over the head of the surgeon” and didn’t want to “step on toes” by addressing the now fairly obvious infection. This does happen fairly frequently in some communities.
Activity and Pain –
The Yorkie was in so much pain that he wasn’t trying to bounce around or get out of his confinement(s). I’ve never seen a dog that received this quad-whammy surgery bounce and try to play soon after surgery. They are usually very subdued by the pain of the surgeries. Also, bouncing and playing on a post-op leg usually produces a different type of swelling than infection swelling.
It is my opinion that we need better pain controlfor our pets . We do for humans, too, and you may already know that. Help for pain, especially nerve pain, has been a fave topic of mine for decades.
Is it an Infection?
I have also found that it is often hard to determine whether or not infection is present. We (client & care team) discover sort of anecdotally most of the post-surgical infections I see in cases. These infection areas are not hot and do not cause tissue swelling. These infections are causing pain in the joint. This pain doesn’t go away with combos of the right amounts of the right pain medications.
Dealing With the Infection –
When I suspect infection in a post-op orthopedic case, I recommend the client and vet discuss trying an antibiotic. I base this recommendation on something I learned in about 2006 from a surgeon. I always tell them that it was the surgeon’s idea, not mine. If the limping stops around three days after beginning abx, it is likely that we’ve found infection causing the pain.
I can’t legally diagnose infection, however I may share information about infection and potential treatments to inform the client. I also easily have many conversations with veterinarians to share what other vets might have done in a particular situation. That is collaborative work.
Of course antibiotics are considered only after ruling out the other usual pain scenarios (not enough pain medications, destroyed surgery, etc…) and/or medical reasons the pet cannot take antibiotics. Often this abx (antibiotics) dosing is the cure for continued limping if all else seems okay. I have shared the info from this surgeon with many veterinarians in my area. It has helped a lot of pets.
Usually I also tell the pet’s regular veterinarian about the many situations I’ve encountered where antibiotic treatment has produced the pain relief we hope for. In these cases it has eliminated an infection that wasn’t even suspected. I cannot legally diagnose any medical issues, but I don’t hesitate to relay my findings and experience to veterinarians. By doing that, sometimes we all get to learn and collaborate.
This infection was not the fault of rehab nor of the client and possibly not the fault of the surgeon. Infections like this are actually a common occurrence. I cannot say whether or not this infection could have been avoided. In my experience it seems very difficult to avoid infection under certain circumstances. Let’s just recognize it and deal with it medically on our ends, because we are working after the fact.
If there is swelling in your pet’s knee (or other body area) or if it is hot and red after surgery or injury, please go to your veterinarian or veterinary specialist and have it evaluated sooner than later.
…and the Pin?
This Yorkie’s infection advanced quickly. The surgeon removed the pin from the infected knee after the dog finished a course of antibiotics. In the meantime, the infection did its damage. This Yorkie never gained as full a use of the infected leg as he did in the other leg.
“That’s What I Thought!”
If you feel like your pet has a problem that the surgeon or veterinarian is ignoring, then please go ahead and get a second opinion from another licensed veterinarian. I post information about cases like this because I receive many, many emails from all sorts of people about their pet’s cases, which are similar to what I frequently encounter in my practice. I want to give strength to your voice if you are trying to get to the bottom of a problem with your pet and aren’t sure to trust your gut.
What Else Helps With Infection and Infection Pain?
Ice will not do much to help infection swelling and pain, in my experience and according to research. Usually other time-consuming therapies don’t get rid of the infection, and therefore the pain, either, and waiting for them to help with pain allows the infection to cause additional joint and tissue damage. Bacteria are causing the pain in the case of infection pain and have to be killed for the pain resolution.
Anti-inflammatories and narcotics don’t usually help against infection pain and they don’t kill the infection bugs, either. I never recommend heat compresses or dry heat in general right after surgery or injury. I base that idea on decades of published research that practitioners still argue about. Sometimes heat and/or ice are the best idea, but only in specific cases and not across the board. Sometimes moist heat is great for certain infection cases AFTER infection diagnosis.
Ultimately, there is no “blame” here, especially since that isn’t productive in this case; what there is, however, is discovery and learning through experience. Ultimately the pets health (or yours) needs you to be the best advocate you can be. Trust yourself if things don’t seem right, and push to find a practitioner who listens and collaborates.
Since you got to this page, you are probably hoping to find out more about other’s experiences with these rehabilitation programs. I have three different areas of feedback for you to discover. Click on the bold purple headers below and that will take you to that page of feedback.
It’s a collection of posts made from questions people have asked of me and my answers to them at the time. I have taken time to edit a few answers if my perspective has changed over time or if I think I need to make the information more clear.
I’ve got hundreds more questions on file that I have answered that I might get to make into posts, so stay tuned! Probably easier if you subscribe to this website. If you do, then you’ll receive email notice when I make new posts.
This page directs you to both veterinarian reviews and client reviews of my booklets and programs. I have copied most of the reviews from other business places on the web, such as Amazon. I really need and want to edit my booklets to add more info and photos and such, so, stay tuned, again.
In some cases, veterinarians wrote emails to me when they read my booklet(s) for the first time, and I copied some of the mail into posts for you to read as reviews.
This section has posts I made out of people’s feedback about the programs after they worked on rehab as I directed. In these posts clients tell how this rehab worked for their pet(s).
Social Media –
I completely deleted all of my Facebook pages and profiles in November, 2016, but I did save my files. I also deleted Twitter at the same time, but I have since begun a new Twit account. Once in a while I make a post based on feedback I received on Facebook or my old Twitter. The Twit changed in the time I was off of it, and I don’t have the same engagement type as I used to have, so there’s not a lot on there as of May, 2018. Feel free to engage me on the Twit.
Anyway, you get the idea. My other sm accounts are represented by words or badges in the sidebar or footer of this site. I aim for reciprocal connections.
I am my own social media person, and that takes a backseat to seeing patients, communicating with clients, and improving this website. There is already plenty of feedback for you to read on here, though, so I hope I’ve hit your topic of concern in these web pages.
Want to Comment?
I turned off comments on this site for a long time because I couldn’t keep up with answering people’s questions in what I thought was a timely manner. One of my former WordPress themes even stopped telling me I had comments when people posted them on the site. I have been on the road a lot and was not able to check the site very often. Sometimes people’s questions went unanswered. Not good, imho.
I have comments after most posts turned on now. If you have feedback about this program or a post, you may write that as a comment or contact me with questions using the form on this page.
I have also been working hard on upgrading this site for you. I turned comments on again because I have easily covered info about the most frequent pet rehab questions searched on the web and on this site. I’m hoping people will read and search the site for the basics before asking me in a comment or contact form 🙂
Please be aware that if you have a pet emergency, you really need to contact your veterinarian, a veterinary emergency clinic, or a 2nd opinion veterinarian if need be.
Also, sometimes people do not think they are getting answers they need or want from their veterinarian. I do a lot of patient advocacy and navigation in human medicine and veterinary medicine, and I am a big fan of getting a 2nd (or 3rd or +) opinion on some issues.
People ask very many questions of me in comments and via contact forms about topics I have already covered on this site. Please search and read a lot of the info on this site so that you hopefully have your questions answered more quickly than you will waiting for me.
AND, if you read my basic post-injury or post-surgery information, you will know more details that will save you time if we later get together about your pet!
I am open to working with clients in paid consults from all around the world. I work in person and via phone for consults at this time. You may find out more about my practice by looking at the info on the pages in the first drop-down menu under my main site banner.
Happy Reading, and Happy May Day –
First Published March 9, 2017. Updated May 1, 2018
“Once again, thanks for engaging the veterinary industry and client owners with your work and experience. I enjoy your enthusiasm and passion for the area.”
DVM, ACVS (American College of Veterinary Surgeons), South Texas
“Thanks so much, Deborah! The book is impressive. Maybe you should leave a copy at (some shelters) since they put so many cruciate dogs on the euthanasia list…Great work and thank you!”
DVM, Austin, TX
“Read your book. Excellent job. Now at ACVS they are all for non surgical acl (rehab)…Good job!”
DVM, Austin, TX
“Finished reading “instead of surgery” kindle booklet. Bueno! Great discussion on importance of pain control, in particular. ”
DVM, Austin, TX
“Hi Deborah! I read your book the night I got it. I really like it and have already recommended it to a client last week. I hope she bought it. I will write a review for amazon for you, too. I hope you are really successful in this. I know how hard you work!”
DVM, Kerrville, TX
“Once again, thanks for engaging the veterinary industry and client owners with your work and experience. I enjoy your enthusiasm and passion for the area.”
DVM, ACVS, South Texas
Short notes with instructions for you to follow after your dog has been injured. I do also work on lots of cats as well as a variety of other animals. If you want to know more about cat specifics right now (because I haven’t finished developing the cat pages), please search for cat in the search box 🙂
These recommendations also work if your pet isn’t moving as well as they used to because of arthritis or advanced age, for instance, and you would like to help them.
Please have your pet evaluated by a veterinarian if you have not already, so that we may all work to be on the right track for your pet’s recovery. It is very likely that your veterinarian does not know about this style of rehabilitation, because it is home-based, so feel free to share this site with them. I am available to discuss with your vet and provide teaching seminars for clinics, too!
For more specific info on a particular injury or diagnosis, please see the menu at the top bar or use the search box on this site. For more info on why I don’t have ever injury and recovery ever posted on my site yet, see this page or this page 🙂
Most pet (and often human) orthopedic and soft tissue injuries may be recovered without surgery when there are no broken bones, and some injuries with broken bones recover well without surgery, too! Your veterinarian should be able to help you decide if surgery is necessary for your pet’s broken bones. More on this later-
The information in this booklet also contains a GREAT foundation-building, functional recovery base for older pets that have lost muscle mass & strength and have lost some proprioceptive abilities, lost the ability to maintain balance and know where they are physically in relation to their environment. The 4-week foundational program in the book is often what is needed to help older dogs that are slipping on the floor or having trouble rising or are tripping over the doggie door threshold.
More strengthening and drills should be added after this program. A full 12-week, progressively difficult, program designed by me or a practitioner with a lot of experience and training in exercise physiology program design and functional recovery is what I’m about! For most people and pets, even a little bit of improvement makes everyone happy and makes a big difference in quality of life.
You have to start with a specific foundation, though, at the beginning, to make sure your pet has a solid foundation to help offset additional injury.
Please also pay attention to the discharge instructions your veterinarian has given you if your pet just had surgery or you have received instruction regarding your pet’s injury. Please pay special attention to the part about no running, jumping, or playing. If you follow my booklet instructions, you and your pet will be doing work appropriate to recovery and should not be causing any harm. Still, no running or jumping or playing! You may, however, incorporate the directions I give to you for allowable activity. Otherwise, your injured pet should be restricted!
Right now I only have one bookpublished with information about helping your pet build a foundational base through four progressive weeksof work after injury. This is the book, then, to get you started and the one to order if your pet has lost any degree of function, especially in their hind end.
This book is specifically addressing torn knee ligaments, yet until I am able to publish the books I am working on that deal with hip issues, other knee issues, elbows, old age/arthritis, and spinal issues, the book below will be helpful to you for those situations, too. This book contains the restrictions and advice I would give to get you started after almost any orthopedic injury or diminished functional condition.
Note that your pet’s veterinarian really needs to evaluate most injuries sooner than later, even if you think you know exactly what the problem is. Unless you have a full range of personal experience with diagnostic knowledge and an x-ray machine, you might miss something very important! And even veterinarians can run into orthopedic or neurological problems they aren’t sure how to treat, so joining with a specialist like me builds your pet’s recovery team!
Please do not involve additional work until you have passed the 4-week foundation with gold stars! Please follow all the instructions for the best outcome 🙂 Please do not (again, I say it, because you’d be surprised at how many people think adding other work to this intro recovery system is a great idea)don’t add swimming (no swimming yet), stairs (no stairs yet), hill repeats (no hill repeats yet), poles (no poles yet), cavalettis (no cavalettis yet), or other dynamic activity.
Your pet may seem to be doing great and may seem to you like she/he is healed, especially if they have good pain medication, but I can assure you that biologically the minimum amount of time for soft tissue recovery is on average 8-12 weeks. Some situations take up to a year to heal well (nerve damage, torn muscles, etc…), so please don’t be fooled by appearances or by programs that don’t understand biological recovery science. Best way I know to say it ^^ and I’ve seen complications from hundreds of cases where a proper foundation wasn’t followed 🙂
Being able to walk a mile or around the block a day doesn’t matter if your pet has function problems elsewhere in their life, so get this info, follow it, and establish a solid base. If your pet can walk a mile but can’t get up off the floor, this plan is for them. The book explains more about this approach.
After the base is built, then always there are additional strengthening and proprioceptive drills to be done in order to return your pet to a better quality of movement and lifestyle!
Conservative treatment after torn knee ligament, instead of surgery: