So What Have I Learned?
I have spent an exhausting yet rewarding 23 years in the veterinary field as a technician. During the last four years, my time has been devoted to the area of animal rehabilitation therapy (doggie physical therapy but we can’t call it that due to rules and regulations, blah, blah, blah). This has been a rewarding and challenging area of focus with some triumphs and flat out failures. As a perfectionist at heart, the reality of my new field has humbled me with it’s ups and downs and uncertain outcomes. The technician’s rehab experience will be different than that of a veterinarian or human physical therapist. In my rehab case, I went from being a worker bee (carrying out the doctor’s orders) to being a decision maker and treatment planner. The patient’s outcome rested mostly on my shoulders with the rehabilitation plan that I designed. Talk about a whole new level of stress! Upon reflection of theses last few years, I have come to a few conclusions about rehabilitation therapy.
Pearls of Wisdom That I Have Learned
1. The classes and text books are only small part of the learning process when trying to develop a rehab program or protocol. The real learning begins when you are on your own and managing your own cases. Reality can be harsh but a great teacher. Make your mistakes, learn from them, move on.
2. There are way more tools and modalities then you will ever need or use in general on a daily basis (this is just a practical truth). Pick the ones that you feel will allow you to achieve the most reliable results in the best amount of time. For me, laser and aqua therapy are my core modalities with land exercises (using Fitpaws equipment) coming in third.
3. Your eyes and hands are the most valuable assessment tool that you have. Place your hands on every patient and learn to trust yourself.
4. Some dogs just don’t get better. Rehab is not guaranteed to always have a positive outcome. There are a variety of reasons that this may be true such as surgical complications, progressing disease process, and/or overall body condition. Except this and find a good solution for their needs.
5. Rehab (specifically the underwater treadmill) can’t fix everything. Sometimes surgery or (gasp) plain old rest is a better solution to the problem. In a few cases such as disk disease, exercise can even make the symptoms worse. Continue…
Injury to the cruciate ligament is the most common hind limb injury of the dog. Dogs less than 20 lbs. can often avoid surgery through conservative management, but this is an injury that typically requies surgical repair to avoid rapid arthritis. There are up to five different ways to repair a cruciate tear, but the only the most common two will be discussed here.
Using Lateral Suture Method to Stabilize the Knee
The repair I have been doing for over 20 years is called a lateral suture repair or an extracapsular repair. It entails placing a high strength suture in a way that mimics the damaged ligament. It works well in my hands, but it is not the currently recommended repair for large (over 50 lb) active dogs. The bigger, active dogs place more stress on the artificial suture often times resulting in it breaking. The preferred method of repair in large breed dogs is a Tibial Plateau Leveling Osteotomy (TPLO). Continue…