Physical Therapy and Rehabilitation (Certified Canine Rehabilitation Practitioner)
Advances in veterinary medicine have been phenomenal in the last 20 years. Our cherished canine friends have benefited in a great way. One of the most recent advances we have seen is in the area of Physical Rehabilitation. Research indicates that loss of muscle mass begins within 24 hours following surgery or serious injury. An increase in swelling occurs, in addition to loss of muscle control and stiffening of joints, when rehabilitation is delayed. Gone are the days of performing surgery or putting on a cast, and discharging a patient without rehabilitation.

We are excited to be able to offer our community the latest in Canine Rehabilitation Therapy. Our goal is to combine accepted physical therapy methods with an individual home controlled exercise program to safely return pets to their active lives.

Post-Operative Uses
Common surgeries for which rehabilitation may be helpful include TPLO, cruciate ligament repairs, total hip replacements, fracture repairs, back and neck surgeries, femoral head and neck ostectomies (FHO's), patella luxations, elbow surgery/arthroscopy, and other orthopedic-related surgery.

Post-Injury Uses
There is potential in all dogs and especially those that are very active or susceptible based on breed for injuries that include but are not limited to knees, shoulders, hips, backs, and necks. Dogs who have suffered injury affecting the muscles, bones, ligaments, or tendons may benefit from rehabilitation.

Obesity & Weight Mgmt
The main goal of obesity and/or weight management is to provide a safe means of exercise in addition to whatever nutritional and medical care the dog is already receiving.

The primary means of exercise is hydrotherapy so the dog can exercise without the added joint stress secondary to obesity. The program will be monitored for the dogs' tolerance. This is also convenient for the owner, particularly for the owner who is physically unable to walk themselves.

Geriatric Physical Therapy
Geriatric physical therapy covers a wide area of issues addressing normal adult aging. Many conditions that affect humans also affect pets as they age and include but are not limited to: Arthritis, osteoporosis, cancer, hip and joint replacement, balance disorders, incontinence and more.

Geriatric physical therapy helps those affected by such problems in developing a specialized program to help restore mobility, reduce pain, increase fitness levels and more.

Hydrotherapy
Water is a fabulous environment in which to exercise. The principle of buoyancy combined with that of resistance make this a most unique and safe method of rehabilitation. We have an underwater treadmill that provides an opportunity to strengthen muscles with little to no pressure on the patient’s joints. The warmth of the water helps to increase flexibility and mobility of muscles, tendons, ligaments that surround the joints as well as enhance circulation.

It is not unusual for an animal that is not using a limb on land to use it when walking in the water. They often use it in an exaggerated motion which adds to the therapeutic benefits of hydrotherapy.

We can adjust variables of speed, duration of treatment and water level during each treatment to maximize our treatment plan.

Benefits:

• Comfortable Movement
• Earlier Return to Function
• Muscle Strengthening
• Increased Cardiovascular Stamina
• Neuromuscular Re-Education
• Weight Loss
• Increase in Patient’s Self Confidence

Low Level Laser Therapy (Harmony MLS Laser Therapy)
LLLT is used to increase quality and strength of tissue repair, decrease inflammation and give pain relief. The effects are photochemical, not thermal and happen at the cellular level. Benefits include faster wound healing, increased vascular activity, stimulated nerve function, reduction of scar formation, and decreased inflammation.

How does laser therapy work? Click Here-Link to Laser Handout (includes the following headings in blue)

Laser-Tissue Interactions
The wavelengths of photons determine their effect on the tissue. The smaller the wavelength, the greater its ability isto penetrate tissue. Lasers affect tissue because the photons delivered to the cells and tissue trigger biologic changes and biochemical reactions. Photons are absorbed by cytochromes (respiratory chain enzymes) within the cell mitochondria and the cell membranes. This leads to ATP and DNA production, stimulating cellular metabolism and growth, potentially accelerating tissue repair and cell growth of structures. Lasers can be used to provide analgesia through the release of endorphins and enkephalins, help with wound healing and improve bone and cartilage health.

The MLS Harmony Laser has a proprietary and patented hand piece that delivers two wavelengths in a synchronized fashion. The 808 nm wavelength provides anti-inflammatory and anti-edema effects via a continuous wave delivery. The 905 nm wavelength provides analgesic effects, with some of the same effects of the 808 nm wave length. The 905 nm wavelength is delivered using pulsed mode laser energy.

Advanced Veterinary Care Group is one of the first three sites in the Midwest for this exciting new therapy.

Indications for Laser Treatment

• Wounds
• Arthritis
• Pain
• Trigger Points
• Tendonitis
• Edema
• Lick Granulomas
• Post-operatively (especially metabolically compromised patients)
• Muscular injuries

Specific Treatments
Improvement is often seen after 2-5 treatments. Generally, acute conditions require a closer interval, but fewer total treatments. For example, 2-3 treatments in the first two weeks, 1-2 in the following weeks, then once weekly until resolved. Chronic conditions usually require more treatments, but they can be less frequent. For example, two treatments weekly for the first 2-4 treatments, then once weekly for a few weeks, then every other week for a few weeks until a maintenance schedule is reached. The patient's condition may temporarily worsen 6-24 hours after laser treatment as the healing process is stimulated. This is more likely to occur with chronic conditions.

Wound Healing
Laser treatment for wounds promotes healing and reduces pain. The speed of granulation, scar tensile strength and healing time are enhanced. Post-surgical healing times can be reduced, especially in old or debilitated animals like diabetics.

Arthritis
Laser therapy helps by the reduction of pain and swelling. There can be noticeable improvement in range of motion as well. Laser energy influences synovial fluid and membranes as well as articular cartilage. Conditions may temporarily worsen 6-24 hours after treatment during the healing process.

Analgesia
Laser treatment can be used for painful conditions to assert and analgesic effect. Painful areas are treated along with trigger points. Identified trigger points include infraspinatus, quadriceps, pectineus, iliocostalis lumborum, pereneus longus, semimemranosis and -tendinosis, tensor facia latae and gluteus medius.

Intervertebral Disc Disease
When owner cannot or will not opt for surgery, laser therapy can lessen pain, swelling and inflammation to affect a positive response in return of neural function. Treatments need to be daily at first, then 1-3 times weekly until satisfactory results are achieved.

Biological Effects of Laser Therapy
Anti-Inflammation: Laser therapy has an anti-edema effect as it causes vasodilatation, but also because it activates the lymphatic drainage system (drains swollen areas). As a result, there is a reduction in swelling caused by bruising or inflammation.

Anti- Pain (Analgesic): Laser therapy has a high beneficial effect on nerve cells which blocks pain transmitted by these cells to the brain and which decreases nerve sensitivity. Also, due to less inflammation, there is less edema and less pain. Another pain blocking mechanism involves the production of high levels of pain killing chemicals such as endorphins and encephalin from the brain and adrenal gland.

Accelerated Tissue Repair and Cell Growth: Photons of light from lasers penetrated deeply into tissue and accelerate cellular reproduction and growth. The laser light increases the energy available to the cell so that the cell can take on nutrients faster and get rid of waste products. As a result of exposure to laser light, the cells of tendons, ligaments and muscles repair faster.

Faster Wound Healing: Laser light stimulates fibroblast development (fibroblasts are the building blocks of collagen, which is predominant in wound healing) in damaged tissue. Collagen is the essential protein required to replace old tissue or to repair injuries. As a result, laser therapy is effective on open wounds and burns.

Improved Vascular Activity: Laser light will significantly increase the formation of new capillaries in damaged tissue which speeds up the healing process, closes wounds quickly and reduces scar tissue. Additional benefits include acceleration of angiogenesis, which causes temporary vasodilatation, an increase in the diameter of blood vessels.

Increases Metabolic Activity: Laser therapy creates higher outputs of specific enzymes, greater oxygen and food particle loads for blood cells. Trigger Points and Acupuncture Points: Laser therapy stimulates muscle trigger points and acupuncture points on a non-invasive basis providing musculo-skeletal pain relief.

Reduced Fibrous Tissue Formation: Laser therapy reduces the formation of scar tissue following tissue damage from cuts, scratches, burns and surgery.

Improved Nerve Function: Slow recovery of nerve functions in damaged tissue can result in numbness and impaired limbs. Laser light will speed up the process of nerve cell reconnection and increase the amplitude of action potentials to optimize muscle action.

Immunoregulation: Laser light has a direct effect on immunity status by stimulation of immunoglobulines and lymphocytes. Laser therapy is absorbed by chromophore (molecule enzymes) that react to laser light. The enzyme flavomononucleatide is activated and starts the production of ATP (adenosine-tri-phosphate), which is the major carrier of cell energy and the energy source for all chemical reactions in the cells.

Therapeutic Exercises
We evaluate each patient and design a set of exercises that are most effective in that patient’s rehabilitation. These are designed to achieve the goals set for that patient’s recovery. Exercises may be directed at helping the patient with strengthening specific muscles or stretching to increase flexibility or learning how to regain the feeling and use of a foot or limb. We demonstrate each activity in our hospital and teach our clients to perform these at home on a prescribed schedule. We try to incorporate the special needs and skills of patients and their families.

Heat and Cold Therapy
If appropriately timed in the rehabilitation process, cold and heat can be very beneficial in decreasing pain and inflammation.

Initially, in the first 72 hours, we use cold therapy to decrease the pain and inflammation associated with surgery or trauma. This occurs by decreasing pain perception, decreasing blood flow and decreasing inflammation.

Heat therapy is used later in the healing process to increase blood flow, increase muscle flexibility decrease pain and increase healing.