Important items we wish everyone knew....
We created this blog as a little summary that hopefully helps clarify some of the questions we get from both our referring vets and from our clients!
1) DO WE NEED TO DO X-RAYS
We understand the stress finanically and sometimes physically that getting radiographs puts on everyone. It is not easy to put a 180 lb great dane on an x-ray table. It is not easy to get a puppy to stay still so that great views can be achieved. Working in regular practice for 16 years, I totally understand!! Extreme circumstances exist where getting those radiographs are just not possible, especially if sedation is required. We would rather have no radiographs at all, then have non-diagnostic radiographs or one view that doesn't give us the information we need. However, in most instances, having a good quality radiograph with more than one view, gives us the information that we need to better assess and treat the patient.
2) WATER THERAPY IS NOT REHAB
Water therapy is part of rehab in the majority of cases we see. There are times that after introduction of multiple modalities, or after an assessment that we decide water therapy is the only option for a pet. However, in several cases water therapy is not an option and this does NOT mean that they can not benefit from rehab. Some pets even have rehabilitation sessions that include water for months and then we change the plan. Rehab involves tailoring the treatments and modalities to what is needed. Since conditions change constantly, either in a positive way, or in a progressive way such as with Degenerative myelopathy or Degenerative Arthritis, we may need to change what we do. Remember that when you see a rehabilitation practitioner you are paying for their expertise, not for the shiny toys. It is no different from seeing your own physiotherapist. We also do not put animals in the water treadmill when they have skin infections, open wounds, allergies, incontinence or severe aversion to water.
3) NOT ALL WATER THERAPY IS THE SAME
We often get referrals for swimming, especially for post-operative cruciate repairs. While there are a lot of benefits of swimming, we prefer not to swim some conditions such as post-operative cruciate repairs, however swimming in a controlled environment has amazing benefits for neurologic recovery, strength building, proprioception, and improvement of mobility. We do however feel that there is a lot of benefit to walking in the water to allow for proper gait training in neurologic recovery, or for arthritic or weak patients to allow for exercise and improved mobility, while reducing the impact on sore joints.
4) HARNESS USE VS A SLING
We often, particularly with neurologic patients, see people using slings, or even nothing at all, to assist them in going to the bathroom. However, often because of where the slings sit, it is difficult to support them properly with a sling, and have them be able to go to the bathroom. While slings are an inexpensive option especially in the short term, the use of a harness (a front end portion and a back end portion) is far superior. Not only does this allow for easier elimination, but also gives you a place to attach a leash as well as two handles or areas to help stabilize them. Help em up harnesses are our favorite, but a less expensive alternative is the Solve It harness. Not as user friendly, but we findc it to be a better option than a sling.
5) CONTRAINDICATIONS OF LASER
Other than water therapy, another common referral is for laser therapy. Unfortunately we often find ourselves in the position of finding alternative modalities for referrals because of contraindications.
Here are the following reasons we will opt not to do laser:
- Cancer - whether it is a pet that has had cancer and has recovered, or if it is an older dog without radiographs, laser therapy speeds cellular activity. Sometimes, if there has been no evidence of reoccurance of cancer, or if the patient is markedly arthritic and radiographs are not an option, we will opt to still use the laser but discuss the risks with the owner.
- Puppies/open growth plates - this is controversial but there is a concern for premature growth plate closure with laser therapy. If we can find another modality, we prefer to do that. If I have radiographic evidence that those growth plates have closed, we may opt to use it, depending on the circumstance
- Pregnant uterus - exposing fetuses to laser therapy can have potential affects in their development so we opt not to expose them!
- Eyes - exposure of an eye to a laser beam can cause irreparable damage. The glasses worn for class 4 and 3B lasers are specific to that machine and wavelength, and ONLY protect for scattered beams bouncing back at the eye off a shiney object. They do not protect for a beam directed towards the eye. Avoiding the face and eye is advised.
6) REHAB SHOULD BE STARTED AS SOON AS POSSIBLE
One of the common misconceptions is that rehab often has to wait after injury or surgery for at least 2 weeks, and sometimes we hear recommendations of 4 to 6 weeks! But rehabilitation isn't all water and intense exercises. Range of motion, small joint mobilizations, and massage are easy things that can make a huge difference starting the day of surgery or injury!!! There are good studies to show the earlier that rehab starts, the better and more complete the recovery.
Hope that this helps answer some questions, and if you have any more, please don't hesitate to ask us!!! If you have the questions, I guarantee that someone else does too!
Comments
Post a Comment