My three-year-old Labrador just had knee surgery. Is there any sort of physical therapy I should be performing to help him recover?

Amanda
Brooklyn, NY

Physical therapy and rehabilitation are emergent fields in veterinary medicine. Physical therapy has the potential to help cats and dogs suffering from neurological disorders, arthritis, trauma and surgery.

Basic companion animal physical therapy includes procedures such as passive range of motion exercises (in which limbs are gently moved through their normal ranges of motion) and warm or cold compresses.

Advanced physical therapy and rehabilitation may include walking on underwater treadmills (believe it or not, both dogs and cats can perform this activity), electrostimulation of muscles and training with balance boards.

Amanda, your best option is to talk to the veterinarian who performed your dog’s surgery. I am guessing that your dog underwent surgery to correct a cruciate ligament injury. There are several different surgeries available for this injury. In some cases, physical therapy is critical to recovery. In others, physical therapy may actually interfere with healing.

Your vet will know whether physical therapy is appropriate for your dog.

Image credit: Dr. Helmut Steger. Image license: CC

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When a person is in pain, he or she usually makes it clear that something is wrong. Humans can speak, and we can ask for more pain killers. It is generally accepted in human medicine that effective pain control not only makes patients more comfortable. It also helps them heal.

Sadly, animals cannot give clear signals of pain, and they can’t ask for pain killers. But their need for pain management equals that of their human counterparts. This puts them, and the people who want to help them, at a disadvantage.

Years ago, veterinarians questioned whether animals could even feel pain. That ridiculous debate has been put to rest. But later an equally nefarious philosophy evolved. Many veterinarians believed that pain was good for animals. Pain helped keep animals from walking on broken legs. It kept post-operative patients from being excessively active–or so the theory went.

The idea that pain is good in any way has been completely discredited by modern veterinary medicine. All decent vets now agree that animals feel pain, and that pain is bad. It causes stress and interferes with healing. Pain hurts, and it causes suffering.

Veterinary practitioners now recognize that pain management is critical to their patients’ comfort and healing. And we have an ever-widening array of pain management solutions at our disposal.

Options include conventional painkillers such as opiods (related to morphine) and non-steroidal anti-inflammatory agents (NSAIDs). Local anesthetics are useful in some procedures. Rehabilitation and physical therapy are useful in other situations.

Newer pharmaceuticals and nutritional supplements show promise in the treatment of acute and chronic pain. Lasers, stem cells, and extracorporeal shock wave therapy have the potential to help many animals.

The moral of the story is this: advances in animal pain management are occurring at breakneck speed.

If you suspect that your pet is at risk for pain–from dental disease, a surgical procedure, arthritis, trauma or any other sort of injury–talk to your vet. He or she should be willing to discuss a modern, comprehensive pain management protocol tailored specifically to your pet’s needs.

Veterinarians have lots of options for managing pain in their patients. There is no excuse for your pet to suffer.

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What are some of the things we as dog owners can
do to help a dog with hip dysplasia?

Rosie
Humble, TX

Hip dysplasia is a syndrome in which a dog’s (or less often, a cat’s) hip joints do not develop properly. This causes premature arthritis in the hips. Hip dysplasia is most common in large breeds of dogs. It has a hereditary component. Careful breeding has reduced the incidence of hip dysplasia over the last several years.

Hip dysplasia is sometimes confused with age-related arthritis. Many older animals suffer arthritis in their hips that is not related to abnormal development of the joints. However, in either instance the outcome is the same–arthritis that causes pain, stiffness, decreased mobility and a lower quality of life.

There are several techniques (some old, some new) for managing hip displasia and arthritis in pets.

Preventing hip dysplasia is by far the best option. Careful breeding is the most important aspect of hip dysplasia prevention. Less effective, but still important, is to feed at-risk puppies (Labrador Retrievers, German Shepherds, Golden Retrievers and other large breeds) a diet that promotes slower growth. Talk to your vet about this.

For pets diagnosed with hip dysplasia by a veterinarian, several techniques may delay the onset of arthritis. The most effective of these is weight management. Carrying extra weight puts tremendous strain on the hip joints.

Other techniques that can delay the onset of arthritis (or help to ameliorate the symptoms of arthritis after it develops) include administration of oral or injectable glucosamine, oral omega-3 supplementation, and physical therapy (mild exercise, swimming, hydrotherapy, and range of motion exercises). Young dogs diagnosed with severe hip dysplasia may benefit from a surgical technique known as triple pelvic osteotomy.

For the unfortunate individuals that are suffering from arthritis, all of the techniques listed in the preceding two paragraphs (except for triple pelvic osteotomy) can be beneficial. Additionally, treatment with the much maligned NSAID medicines can lead to a dramatic improvement in quality of life. Other, newer pain medicines such as amantadine are emerging as well that may be highly beneficial when used in conjunction with NSAIDs. Some prescription diets may lead to clinical improvement in arthritic pets.

A new generation of treatments for arthritis in the hips is also entering use in clinical practice. These treatments include stem cell injections, stimulation with certain types of lasers, and a technique known as extracorporeal shock wave therapy (it sounds scary, but it’s quite benign).

The treatment of last resort for arthritis of the hips is surgical hip replacement. Recent clinical advances have made this option more attractive than it was in the past.

The long and short of it is that there is a wide array of treatments for hip dysplasia and arthritis in pets. Many of them are new and not widely known. Your best bet is to find a vet who is passionate about comprehensive management of the syndromes. Sit down with this vet and develop a treatment plan that is right for you and your pet.

Image credit: Joel Mills. Licensing information: CC.

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