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Physio and Hydrotherapy


CoRayBee
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Hi all,

 

I will try and make a long story as short as I can, I promise! About four and a half weeks ago, Ghillie fractured her knee of all things (her left medial femoral condyle, to be exact.) As you can probably imagine, the injury was rather distressing for her but I think I was a lot more devastated than she was. Fortunately she had surgery within 24 hours of the injury with a local orthopaedic $pecialist. (The bill was pretty $pecial too, but not really unexpected.) She was sent home with hardware in her knee, medication, and list of instructions. I've been strict to the point of paranoia regarding her exercise restriction, but it seems to be paying off because we just had a follow up xray taken, which shows that everything is nice and stable. The surgeon says that her prognosis is very, very good and that there is no reason why she should not be able to have the agility career I'd been dreaming she'd have.

 

To that end I decided to check out canine physiotherapy. There is a clinic not far from me that was recommended, so Ghillie and I went out for a consult two weeks ago. The experience was very positive and I left with a promise from the therapist that she would email a quote for specialized sessions that would include ROM exercises, laser, and hydrotherapy. When I got the email I was unprepared for just how expensive the endeavor would really be. Don't get me wrong- I was rather impressed with the amount of work and equipment they were going to put into Ghillie's therapy, but it's still a large chunk of money for someone who's just spent thousands of dollars on urgent surgery. In my reply I thanked her for the information and told her that if I could somehow raise the funds I would be in touch.

 

Fast forward to today. Ghillie is walking on-leash with practically no limp at all. We are avoiding stairs but her walks are up to 20-30 minutes twice a day, and as far as she's concerned she's fully recovered (which is adding more grey to my hair than I'd like to admit!) I've had more than one person suggest that perhaps hydrotherapy combined with at-home exercises might be an option and that the efficacy of the laser therapy was largely a matter of opinion. So, while all the bells and whistles are appealing, the hard reality of finances also plays a big part in my decision making. I want to give Ghillie every advantage I can in her rehab, but I also would like to still be able to do those frivolous things like pay the bills and, you know, eat. :)/>

 

Finally, to the point of my post! I'm curious to know if any of you have had similar experiences with similar injuries, and how you treated them and what the eventual outcomes were. I've been reading Sue R's post regarding her experiences with Celt and, while it's a remarkable journey, it's unfortunately left me no closer to a decision of my own. Any input you knowledgeable folks would like to offer would be much appreciated!

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If you read Orthodogs (a Yahoo group), you'll notice that in general, they don't seem to be proponents of canine physical therapy (although, oddly enough, they do seem to feel cold laser to be beneficial) - of course, their experiences are just that and not any form of scientific study.

 

Being perfectly honest, I *can*do this at this point in life and our therapist is very reasonably priced. If I couldn't, I would have chosen otherwise. If you did choose therapy, could you choose a plan of fewer visits (to monitor progress, teach you your at-home routines, and do the hydro?

 

There are lots of people who choose to do rehab on their own and seem to be quite successful. Part of that might be the particular procedures they had done and (very important, I think, the condition of the dog going into surgery and (in Celt's case) the effects of the time spent prior to surgery (Celt had spent months or maybe years building "bad" muscle use.

 

Good luck deciding what is best for you both!

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So sorry to hear about your young dog! It was fortunate that the ortho specialist was able to immediately operate.

 

My dog had shoulder surgery (obviously not the same problem as yours), but I did want to chime in WRT post-surgical rehab. My dog's surgeon was 4 hours away, and the 'local' rehab specialist is 1.5 hours away with a 3-4 month wait for appointments. She (the local rehab vet) was great and managed to fit me in about 6 weeks after his surgery, but that was mainly to see how he was progressing, treat with the cold laser and to recommend further at-home protocols based on how he was healing.

 

So, to back up a bit, the surgeon and his practice is used to treating dogs from long-distances (even from Korea), and they will consult with your local vet to help with rehab protocols. They also provided a very detailed timeline of what to do at home with regard to very low-impact rehab. (I am sure they listed idiot-proof exercises so owners don't screw up. :) )

 

So I mainly rehabbed my dog at home (under the advice of the surgeon and my rehab vet) with occasional visits to the rehab vet (maybe 3-4 total?) so she could check on progress and treat with the cold laser. After 8 weeks, he started weekly water treadmill sessions, but I was able to find a local vet that had one and was willing to let my dog come in for his sessions even though he was not her patient.

 

So, I recommend asking the surgeon and/or rehab vet if they could provide specific exercises and a timeline for when to do the exercises and for how long (you don't want to push too fast). Occasional visits to the rehab vet would be beneficial to make sure that your dog is healing well.

 

Re: cold laser. I don't know if any rigid scientific studies have been done, but everyone I have talked to recommends them. I can tell my dog loved it when he had it done because he would relax and close his eyes and almost go to sleep (and he is a go-go-go dog). One time the vet tried to up the strength of the laser, but it was too much for him at his level of healing. He became very fidgety and then relaxed when the level was turned down.

 

Good Luck,

Jovi

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I have no comments on cold laser, but ISTM you ought to be able to work something out where you do rehab exercises at home. When I was rehabbing Jill, I made regular (monthly?, bi-weekly? don't quite remember) visits to the rehab vet for swimming in the endless pool (Jill swam in the ocean/bay in between) and eval. But the bulk of her rehab was done by me at home. At the time, this wasn't a financial issue, but rather a practical one due to distance (and also the fact that this particular vet stays pretty darn busy so is more than willing to instruct patient owners on at-home rehab so that the dogs can make good progress). A lot can be done at home with proper instruction. So if it were me, I'd make a schedule of regular visits and ask for exercises, etc., that can be done daily at home. If cold laser therapy is the most expensive part of it, I think you could do without it, but of course that's coming from someone who hasn't used it. I haven't gone looking for any scientific evidence that says it works, and if I were planning to try it, I would certainly look for data first.

 

But hydrotherapy with at-home rehab exercises is certainly not unheard of....

J.

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Remember, what I do with Celt is a weekly visit with Shari - out of 14 "therapy sessions" a week, we only do one with Shari. I do the other 13 at home myself. She does have clients that only come in on a less-frequent basis, whether it's for financial, travel, need, or other considerations.

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We used cold laser therapy on Lily's leg (or lack of leg) during both healing times, after the FHO and after the amputee. I didn't realize is was so expensive, I was paying on the whole amount without seeing the breakdown. When I finally got an itemized list, I sorta freaked out at the price of the laser therapy. That and the fact it didn't do much for helping Lily. But, I have heard good things about it from others. The vet really pushed to use it as she had major arthritis herself and said it made all the difference to her. But for us, didn't do a darn thing that I could see.

In our situation, I was way over budget but trying to do right by my dog. I would not have done it as often and looking back now, will/would not use it again unless I can see something that could defiantly show improvement from it's use.

Not just a maybe.

Good luck and I count our blessings that Faye broke her leg no where near a joint so the healing is going great and the outcome looks wonderful!

Sending healing thoughts out to Ghillie

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Kenz while recovering from MPL surgery had occasional physio/chiro appointments when I felt them necessary (but certainly no more frequently then monthly) unless things seemed to be a problem or I was starting to stress about a lack of forward progress. I was fortunate enough to have regular email access to both the chiro and the physio (and her original surgeon) and I left it to their discretion as to when they thought appointments were necessary.

 

Physio and Hydro aren't hugely big over here and dogs still seem to recover fine.

 

Like Sue said most of sessions are things you can do at home and if things are progressing fine there is no reason why you couldn't get away with a longer interval between professional appointments.

 

I did end up buying a book of 10 swims at the local dog pool because it was winter and it was difficult to have access to somewhere to swim her.

 

When I was rehabbing her shoulder though it was the middle of summer so we just used frequent trips to the beach.

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Thank you for your input, everyone! I've stumbled (figuratively, not literally) upon some exercises to do at home and I'm going to try the therapeutic swimming. I'm actually quite looking forward to this turkey's first encounter with water. We shall see how it goes! :)/>

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