Case Study

6 Year old Shih Tzus referred for aquatic therapy following Cruciate repair surgery and a suspected Cruciate ligament rupture.

The Shih Tzu originated from China or Tibet, this lovely toy breed is a popular companion animal. The Shih Tzu has always been known as a house pet and “lap dog,” never having been bred for any other known purposes through history. To this day, one of the most pampered and popular of the toy breeds.

Cranial cruciate rupture is the tearing of the cranial cruciate ligament; it is the most common cause of rear-leg lameness in dogs and a major cause of degenerative joint disease (progressive and permanent deterioration of joint cartilage) in the stifle joint; rupture may be partial or complete. Tibial Plateau Leveling Osteotomy (TPLO) This surgery involves creation of an arcuate cut in the top of the tibia and rotation of the plateau segment until the previous slope in the bone is no longer present. The bone is subsequently fixed in this new position using a bone plate and screws.

Aquatic rehabilitation uses therapeutic properties of warm water to positively effect the animal patient. The heated water improves blood circulation which carries oxygen, minerals and nutriments to the organs, tissues and muscles. Due to the natural buoyancy of the water the animal patient is free from weight, providing relief from painful joints. Therapies applied to the animal patient during aquatic therapy sessions aim to provide pain relief, positively effect muscle and fascia, including strengthening, increase the neuromuscular communication, increase core stability and provide an environment where the animal patient can move more freely without the stresses and pain land based activities cause.

The animal patient first attended the clinic on 23/02/16, the animal patient was reserved and timid to start with so a range of body touch and therapeutic touching techniques were used to gain trust and willing participation. The animal patient is now confident in the clinic and the owner reports he gets very exited in the car once he realises where he is going.

The animal patient underwent TPLO surgery at the age of 1 year old to repair a torn cruciate ligament, at the age of 5 the animal patient partially ruptured his other cruciate ligament but no surgical intervention was used.

On the initial assessment it was noted that the animal patient had marked muscle atrophy over his left pelvic limb and hypertrophy over the left triceps with some hypertonicity. This indicated he was offloading from the left pelvic limb on to the left thoracic limb. Heat was also noted through the neck and trapezius muscle. The animal patient also lacked core stability.

From an early age the animal patient had been reluctant to walk for more than 20 minutes and was stiff early mornings and late evenings. Since damaging the second cruciate ligament the animal patient had been lame and was not weight bearing normally through the affected limb.

The animal patient has so far attended 7 treatment sessions and good progress has been made. Given the length of time the animal patient has been suffering from the cruciate problems I wanted to increase the neuro muscular communication to the left pelvic limb. I applied a range of therapies to positively effect the skin, fascia, muscles, joints and nerves over all but paying particular attention to the left pelvic limb. These therapies included: Sensory shower work, re-alignment techniques, motor sequence patterning, rythmatical stabilisation techniques, proprioceptive positioning and postural placing and underwater massage.

The owner has been monitoring the paw imprints the animal patient makes whilst out walking on the beach, prior to treatment barely any imprint from his left pelvic limb could be seen, by the 6th session the owner reported barely any noticeable difference indicating the animal patient is now weight bearing much more evenly. The animal patient has decreased stiffness and exercise has been increased with no adverse side affects.

The treatments we apply and the outcomes we achieve for animal patients suffering from Orthopaedic conditions can significantly improve the quality of lives of these patients. The results noted above were achieved in just 7 treatment sessions.

Case Study

16 Year old West Highland terrier referred for aquatic therapy for management of Osteoarthritis

Osteoarthritis is a degenerative condition that affects joints. It is normally secondary to another problem. It is beneficial to treat the primary problem if known, alongside treatment of secondary Osteoarthritis. The surfaces within the joints become damaged, cartilage covering the joints gradually wear away causing the bone to develop bony spurs. The inflammation process then begins. The purpose of inflammation is to repair the tissue. This causes pain, heat, swelling and reduced function of the affected area.

There is no known cure for Osteoarthritis. Current research primarily focuses on the prevention and management of the disease. Due to age or previous trauma, affected muscles are avoided and used less. These muscles fatigue more quickly and the neuromuscular system is weakened, causing a reduced range of movement within the affected joint.

Aquatic rehabilitation includes a range of therapies and treatments linked to therapeutic properties of warm balanced water. This positively effects the movement and function of the animal patient. The therapies applied improve blood circulation which carries oxygen, minerals and nutriments to the organs, tissues and muscles. Due to the animal’s natural buoyancy when submerged in the water, the interventions the therapist provides enables the animal to move with less force applied to the body as a whole. The therapies used provide pain relief, positively effect muscle and fascia function, including strengthening and increasing the neuromuscular communication. The therapy maximises core stability and provides a setting for the animal were treatment therapies can be safely applied in an enriching environment.

The animal patient first attended the clinic on the 25/02/16. During the initial assessment it was noted the animal patient had a large degree of inflammation surrounding both hips. The animal patient was off loading weight from his right pelvic limb diagonally to his left thoracic limb, this was causing hypertonicity through the trapezius, triceps and pectoral muscles on the left thoracic limb. The animal patient had very little movement throughout his body in relation to his skin, leading me to believe his fascia had hardened. The animal patient was reluctant to go out for walks and the owner felt the animal patient was in pain.

My first goal was to help loosen the fascia throughout and help reduce the inflammation to reduce pain and improve his mobility. Underwater massage was used to positively effect the fascia and muscles. I also wanted to gradually encourage the animal patient to weight bear correctly so a range of therapies were used to rebalance the patient, these included: sensory shower work, re-alignment techniques, motor sequence patterning and rythmatical stabilisation techniques.

The inflammation in the hips has reduced considerably. The owner has reported the animal patient is much more eager to go out for walks and now gets excited and his general demeanour has improved. The animal patients posture during sitting has also improved, his left pelvic limb previously splayed to the side to aid his balance, he is now placing this limb centrally indicating his core stability is increasing. The owner so far is really pleased with all the positive changes the animal patient is displaying.

The outcomes we can achieve really make a difference to the elderly patients and enable them to continue normal daily activities with reduced pain and increased strength. The results noted above were achieved in just 5 treatment sessions.

Case Study

14 Year old Golden Retriever referred for aquatic therapy for management of Osteoarthritis

The Golden Retriever is one of the most popular dogs in the UK, it was bred to retrieve shot game. Over years though the Golden Retriever has adapted many roles, including the role of an assistance dog to the visually impaired, a drug and explosives detection dog, a tracker and an obedience dog. Golden Retrievers are typically energetic, intelligent and affectionate dogs. They are medium sized dogs with a megalocephalic skull shape, they should be balanced and have a level topline. The Golden retriever has a double coat which can be flat or wavy.

Osteoarthritis is a condition that affects joints. The surfaces within the joints become damaged, cartilage covering the joints gradually wear away causing the bone to develop bony spurs. The inflammation process then begins. The purpose of inflammation is to repair the tissue, this causes pain, heat, swelling and reduced function of the affected area.

Aquatic rehabilitation uses therapeutic properties of warm water to positively effect the animal patient. The heated water improves blood circulation which carries oxygen, minerals and nutriments to the organs, tissues and muscles. Due to the natural buoyancy of the water the animal patient is free from weight, providing relief from painful joints. Therapies applied to the animal patient during aquatic therapy sessions aim to provide pain relief, positively effect muscle and fascia, including strengthening, increase the neuromuscular communication, increase core stability and provide an environment where the animal patient can move more freely without the stresses and pain land based activities cause.

The animal patient was referred on the 14th of March 2016 and attended the clinic for an assessment on the 2nd April 2016. The animal patient’s full history was recorded along with a health assessment. The owner stated the animal patient had dramatically slowed down over the last four months and had been having difficulties performing every day tasks, such as climbing on furniture, jumping into the car, more reluctant to go upstairs. Exercise had been reduced from two forty-five minute walks (off lead) a day to three fifteen minute walks a day (on lead). The animal patient was stiff upon raising after rest, and during the last walk of the dag the owner reported the animal patient was slower then the earlier walks.

The animal patient had pronounced muscle atrophy over the Gluteal and bicep femouris muscle (bi-laterally). Muscle quality/tone was poor through-out.

The short term treatment goals for the animal patient are as follows: Pain relief, positively effect muscle and fascia quality, encourage more weight distribution through pelvic limbs, improve posture and strengthen muscle. These goals would help the animal patient during daily activities. Relevant outcome measures were continually used and recorded during each treatment to determine the effectiveness of treatment.

By session four the animal patient was visibly stronger. The owner feedback was positive and it was noted that the animal patient had more energy at home, was more eager to go out for the third walk of the day and had also started jumping up on the furniture again. This indicated the animal patient had increased strength, therapeutic palpation techniques were applied which confirmed an increase in muscle mass and improved muscle tone, particularly over the left pelvic limb.

These improvements dramatically impact the lives of the elderly patient in such a positive way, they enable the elderly patient to continue participating in daily activities comfortably and can prolong life. The results noted above were achieved in just 4 treatment sessions.