Wellness: Healthy Living
A fast-growing rehabilitation option
May 21 2014
In February 2012, cheri wells adopted Duncan, a Rottweiler with lupus, from the Pasco County Animal Shelter in Land O’Lakes, Fla. Thin and frail, Duncan was almost too weak to stand up when he urinated.
Wells, determined to find a way to combat Duncan’s progressive autoimmune disorder, first consulted a holistic veterinarian. The next stop was Rocky’s Retreat Canine Health and Fitness Center in Orlando, where she hoped that hydrotherapy could help her pup regain muscle strength and just generally feel better overall. In choosing this option, Wells (and Duncan) took advantage of a form of physiotherapy long used by humans and more recently applied to animals.
Canine water therapy takes place in either a heated lap pool or a smaller Plexiglas® tank with an underwater treadmill; whirlpools are also sometimes used. In the lap pool, the therapist may swim with the dog, who is usually strapped into a life vest, or manipulate and exercise the dog’s limbs while he or she rests in the warm water. The therapist may also join the dog in the treadmill tank, though here, the role is to guide and keep the dog on track. The dog enters the empty tank via a ramp; once the door is closed, the tank is filled with warm water to a depth appropriate for the dog’s size and therapy needs. The treadmill is then activated, and the dog walks at a steady pace, supported by the water’s buoyancy, which unloads weight on the joints and encourages a full range of motion.
Pool or tank, both approaches effectively increase circulation and joint flexibility and decrease pain. Essentially, fundamental physics makes hydrotherapy effective. Water’s resistance increases the demand placed on the muscles as they propel the limbs through the water, making it effective for building strength. In addition, the viscosity of the water— its frictional resistance—is thought to increase sensation and limb awareness, thus helping a weak dog find his or her balance.
Horses were among the first animals to benefit from hydrotherapy; those in the equine rehab field would swim their patients in large pools to restore them to their former galloping glory. Following their example, Greyhound trainers also employed the method. Today, rehabilitation (much of which focuses on hydrotherapy) is among the fastest-growing areas in vet medicine.
“What we originally thought would be a ‘boutique’ area of veterinary medicine has become very popular. We use it frequently, especially for the treatment of chronic arthritis, cruciate ligament surgery [post-operatively] and neurological deficits. Virtually any neurological or orthopedic problem can benefit from aquatic therapy,” says Darryl Millis, DVM, DACVS, professor of orthopedic surgery and director of surgical service at the University of Tennessee, Knoxville. UT is one of only two educational facilities in the U.S. to offer a certification in canine rehabilitation. (The Canine Rehabilitation Institute in Wellington, Fla., is the other.)
In 1993, Dr. Millis and David Levine, PhD, a board-certified physical therapist who teaches at UT, Chattanooga, began to consider alternative rehabilitation methods. “We were trying to think of ways to incorporate exercise and aquatic therapy for dogs, and we needed an aquatic therapy modality other than swimming, which can be too much activity for an early postoperative patient or a very arthritic dog,” explains Millis.
“We ran across an underwater treadmill for people while searching the Internet for rehabilitation products. I called the company and asked if they would consider making one for dogs. We worked together to modify the human treadmill for canines, and were the first to have a self-contained unit. One of the key concepts that we contributed was the open appearance of the treadmill; dogs will not walk into a solid wall. We also learned that [being able] to closely monitor the water level and carefully control variable speeds were important in the rehab process,” he says.
Marti Drum, DVM, PhD, who works with Dr. Millis at UT, became interested in animal rehab and sports medicine when she was just 12 years old. “I saw some cutting-edge therapies being done on U.S. equestrian-team horses, and it seemed like something I would like to do. I believe that the water is very efficient in providing targeted exercise to the affected limb. In general, a joint has greater overall range of motion when the water level is at or just below the joint,” she says.
Many conditions lead pet owners to try hydrotherapy, among them, issues associated with aging, arthritis complications, paralysis and mobility, chronic pain, pre- and post-surgical rehabilitation, obesity, dysplasia, and behavioral modification. Conditions such as hip dysplasia and osteochondritis can be aggravated by weight-bearing exercise, but greatly benefit from the relative weightlessness of water. Practitioners like Sherri Cappabianca, Cathy Chen-Rennie and Bobbie Werbe utilize Millis’ design daily. Cappabianca, who owns Rocky’s Retreat, worked with Duncan. Since opening her company in September 2011, her growing list of tank triumphs has only strengthened her resolve to promote hydrotherapy in her community.
“We have had incredible success with dogs who were so arthritic when they came to us that they couldn’t walk. Dogs who deal with obesity or suffer from fear and aggression issues benefit immensely from learning to swim. Some clients tell us that we give them their puppies back,” explains Cappabianca.
Chen-Rennie opened The Rex Center in Pacifica, Calif., in 2009 to serve San Francisco Bay Area dogs in need of safe, nurturing exercise options. Onethird of her clientele are elderly dogs. She loves the way they just relax and enjoy the warm water. “You see dogs who used to love to swim. We have a 13-year-old Lab who literally leaps an inch when he sees the pool,” she says. Werbe, who’s an RVT and Certified Canine Rehabilitation Practitioner, is affiliated with Circle City Veterinary Specialty and Emergency Hospital in Carmel, Ind. She and her clients have zero doubt about the restorative, lifechanging power of aquatic therapy. Kim Tikijian took her 14-year-old yellow Lab, Maggie, to see Werbe after her hind legs began failing. Calcifications along Maggie’s spinal column were short-circuiting messages from her brain to her legs. At Circle City, Werbe developed a plan to strengthen the muscles surrounding Maggie’s problem spots.
“Maggie is much stronger than she used to be and only rarely has symptoms of weakness. She naps long and hard after sessions but wakes refreshed and ready to romp with her siblings. I truly believe that Maggie would not [be] able to support her weight if it had not been for Bobbie and the treatment she provides,” says Tikijian. As with most things, people have adapted to this aquatic trend as the benefits and results presented themselves. Millis says that various veterinary schools have begun rehabilitation services at their teaching hospitals within the last five years. “Many colleges have sent technicians and veterinarians to our courses and facilities to learn. In fact, we had administrators and vets come in from Thailand [earlier this year],” he says.
To ensure that momentum furthers progress already made, the next wave of veterinary professionals must embrace rehab and hydrotherapy as a mainstay. Dr. Jennifer Au, assistant professor of small-animal surgery at Ohio State University, says she occasionally runs into people in the field who don’t understand the efficacy of this approach. “As an orthopedic faculty member, I talk to all of my clients about rehab, and I lecture as much as possible about it in classes and at continuing education seminars,” she says.
While education is no doubt the most serious component, UT has its own public-relations poster girl to teach the value of the underwater treadmill. Mabel, a plucky, 67-pound, fiveyear- old Beagle mix, was left at a Knoxville animal shelter in December 2011. Angela Witzel, DVM, PhD, DACVN and chief of nutrition services at UT’s Veterinary Medical Center, adopted Mabel and promptly put her on a slim-down plan that involved both calorie restriction and exercise.
Mabel spends 30 minutes every other day on the underwater treadmill. She initially struggled, but the water helped her drop some of her bulk, and she was able to move more easily. Now, Mabel has lost almost 42 pounds, and her new, lean body has inspired many. She has her own Facebook page, and several local news channels have covered her journey to health. Pictures posted around campus show a happy hound running with smiling students, and videos document a disciplined girl in the tank walking off the pounds that piled on during her days of overeating.
“I am thrilled that people seem to care so much about her story, because [reducing] pet obesity is my passion. Mabel loves to go for walks now,” says Witzel. “We gave her a break from the underwater treadmill and her weight loss plateaued, so it was back to the pool. Let there be no doubt, the UTCVM rehab department works.”
Beyond tank design and the science of motion, hydrotherapists work to restore their patients to optimal health. Worried pet owners, searching for options and answers, turn to this new modality to relieve their dogs’ discomfort. In Duncan’s case, Cappabianca gave Wells four beautiful months with her Rottie before he died of a severe infection. The experience had such a profound impact on her life that she founded LoveyLoaves Rescue (lovey loaves.com), a nonprofit organization dedicated to rehabilitating disabled dogs.
“Every milestone Duncan reached was celebrated, and he was so proud. His life touched everyone he met. You really have to have an experience with aqua therapy in order to believe and appreciate the amazing healing that occurs through the rehab process,” says Wells.
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