By Ruth (USA)
A pleasant drive in the country today brought me to Prairie Animal Hospital in North Prairie, Wisconsin. From the outside the clinic looks like any other small rural animal hospital, but exciting things are happening there, because of the enthusiasm of Dr. Gretchen Jaeger, D.V.M. who believes in the power of physical rehabilitation therapies to improve the lives of dogs and cats. She is a veterinarian who trained with the Canine Rehabilitation Institute and is certified to perform physical rehabilitation therapy on dogs, but she also works with cats. She cannot call what she does ‘physical therapy’, since she is not a physical therapist and does not provide treatment for humans, but her techniques would be familiar to anyone with experience in human physical therapy.
Dr. Jaeger’s enthusiasm for her work was evident as she described her training. She said that the study of anatomy in vet school is all about which muscles to cut when doing a surgery. Studying anatomy in order to do physical rehabilitation was all about learning the function of muscles.
Dr. Jaeger uses modalities commonly found in human physical therapy on pets, including heat and cold, e-stim, and low level laser therapy. Ultrasound is not used as much because most people don’t want to have their cat shaved, but the cat’s hair would interfere with absorption of the ultrasound. The low level laser therapy does many of the same things as ultrasound, including increasing circulation to the injured area, reducing inflammation, and facilitating the release of endorphins (the body’s natural pain killers). The laser therapy can also be used to facilitate wound healing. She mentioned specifically its usefulness in treating cats with injuries from car fan belts/ blades. Electrical stimulation is used to facilitate muscle contractions, but not for pain relief, though in humans it is used for both purposes.
Just as the practice of human physical therapy is not limited to modalities, the same is true of physical rehabilitation of animals. Prairie Animal Hospital employs a rehab tech, involved primarily in teaching therapeutic exercise for animals. She, like Dr. Jaeger, trained with the Canine Rehabilitation Institute. She teaches people how to do PROM (passive range of motion) on their cats and dogs when it is needed to prevent contractures (a joint becoming stiff because the animal can’t move it) and to help reduce pain and stiffness in the good leg. If a dog or cat has trouble bearing weight on a rear leg, the opposite front limb will get sore from taking the extra burden. Unique challenges exist when treating animal patients. They can’t tell you where it hurts! But Dr. Jaeger said that palpation (touching the animal) can tell her a lot and sometimes just petting seems to make the animal feel better. She performs gentle joint mobilizations on animals, but these are very small motions, not to the level human patients might experience at their typical chiropractic appointment. Dr. Jaeger performs glides, compressions, distractions and movements of the joints and muscles, which provide pain relief, and restore function.
Designing HEP’s (home exercise programs) for pets can be challenging, but Dr. Jaeger enjoys the chance to be creative in her work. She actually enjoys treating animals with neurological conditions even more than the orthopedic patients. For cats with neurological problems Dr. Jaeger has incorporated rhythmic muscle contractions and having the cat walk on various types of soft surfaces, starting with something as simple as walking on the bed. This improves the ability of the nervous system to provide proprioceptive (postural/positional) feed back. Dr. Jaeger says she has had a lot of success with neuro patients, including healing a paralyzed orange tabby cat with a fibrocartilaginous embolism, which was putting pressure on his spinal cord. The use of the low level laser helped the cat’s body to dissolve the embolism and reduced inflammation in the area. The cat was walking within a week and, within 6 weeks, he was back to normal. Without Dr. Jaeger’s courage to try the laser therapy (at no charge to the client) the cat would have been put down. The laser can even stimulate nerve healing so long as the nerves were compressed and not severed. Sometimes cats will develop cauda equina issues—pain at the very base of their spinal cord. This is caused through an accident (or abuse) where the cat’s tail was pulled very hard, usually through being caught in something or run over by a car. These cats will jump and react as if someone is pulling their tails even when no one is nearby. The low level laser can provide some relief for these cats, though generally not a total cure. She has also had good luck treating dogs with disc problems in their backs. However, she said in some ways cats are easier to treat, because the caretaker can hold the paralyzed cat up to provide normal circulation and can more easily help the cat to the litter box. Large dogs are obviously more difficult to handle.
Dr. Jaeger said the job market for therapists able to provide canine physical rehab is very good. What seemed like such a new, revolutionary concept to me is actually rapidly gaining in popularity. Rehab for pets may seem like an expensive luxury, but when it can take the place of surgery, it can actually be the cheaper option. Humans are usually required to try conservative treatments such as physical therapy before they are scheduled for surgery. Why should we not take a similar approach for animals? Dr. Jaeger said that the cost for rehab for pets at her clinic is $43 per unit, and a unit can be laser therapy, e-stim, joint mobs or therapeutic exercise, etc… She admitted that in any treatment session the pet will probably get some joint mobs since as she palpates it’s impossible to not also be treating to some degree. Pets with neurological issues may be seen every day or every other day initially, but over time the frequency decreases, with longer intervals between sessions. Many pets are eventually discharged from rehab, but some continue to be seen, such as older, arthritic dogs who gain pain relief from rehab therapy. Any animal having orthopedic surgery will automatically have 5 to 8 visits post operatively. Pets with orthopedic problems or soft tissue injuries will be seen less frequently than patients with neurological issues (two to three times a week at most) and will also be discharged from rehab after their healing is complete. Dr. Jaeger is constantly reassessing each animal’s plan of care and if within three visits something isn’t getting better changes are made, so that the pet’s healing is always progressing. House calls are available for cats if their coming to the clinic is too stressful.
Note: Read about Athena on Flickr. A special needs cat who was hit by a car, rescued by Tree House Humane Society and who received rehabilitation therapy in 2008.