Cavelettis

PROM and Stretching

goniometer measurements

muscle mass measurements

Heat

Why Heat?

• Softening and increased elasticity of connective tissues, allowing ligaments, tendons and muscles to stretch and relieve contracture.
• Vasodilation and improved circulation to tissues relieves cramping and provides needed circulation to damaged tissues for repair.
• Pain control for chronic inflammatory conditions such as arthritis by down regulation of pain receptors and relaxation of muscle fibers.

Therapeutic Ultrasound vs. Hot PACKS

US = heating of Deeper Structures

• Tissue penetration of 0.5-3cm (3.3mHz) to 2-5 cm (1 mHz)
• Can be used for phosphoresces
• Also has some pain modulating effects and may enhance healing

Hot Packs

• 1 cm depth of heating
• Can help with pain and prep for stretching
• Can help desensitize prior to NMES

How Does Therapeutic Ultrasound Work?

• 1-3.3 mHz wavelength
• 0.25-3.0 W/cm2
• heats adn stimulates through sound wave energy absorbed by tissue
• Thermal effect increases collagen extensibility, blood flow, pain threshold and enzyme activity.

Not to be confused with Diagnostic Ultrasound, as diagnostic ultrasound has a wavelength of 2-10 mHz and is designed to measure reflected ultrasound waves to create an image, not produce heat.

Applications for Therapeutic Ultrasound

• Soft tissue shortening: contracture disuse
• Soft tissue shortening: contracture congenital
• Sub acute and Chronic inflammation: tendontitis
• Pain control
• Phosphoresces: Delivery of medications such as corticosteroids thereby avoiding systemic side effects.

Cold

Why cold?

• Decreases edema, reduces blood flow, decreases nerve conduction velocity and therefore pain sensation and decreases cellular metabolism and the induction of the "sensitizing soup" of inflammatory mediators.
• During the acute phase of tissue injury to limit the effects of secondary inflammation.
• After exercise or rehabilitation to limit the effects of secondary inflammation.

Therapeutic laser

CLASSES OF LASERS:

Visible Light

• Class I: grocery store scanners
• Class II: laser pointers
• Class IIIA: laser light shows

Invisible Near Infrared Light

• Class IIIB: therapeutic lasers

Invisible far infrared light

• Class IV: surgical and industrial

How does therapeutic laser work?

Therapeutic laser is light amplification by stimulated emission of radiation, the therapeutic laser is "cold" or low level laser. There is no tissue damage (except retinal). It is a Class IIIB non visible light in red and near infrared spectrum. Gallium Arsenide (GaAs) source of photon emission. the response laser yields 904 nm w/500mW. As opposed to a surgical laser which is a "hot" laser used for cutting. The surgical laser is a class IV laser, used for the thermal destruction of tissue. It is a CO2 source of photon emission and operates in the 3,000-10,000mW range.

What does laser light do?

Photons generated are absorbed in the mitochondrial and cell membranes. This leads to the formation of proton gradients across cell membranes and changes in membrane permeability. It increases ATP (energy) levels and increases DNA production and activation of enzymes.

What are the applications for therapeutic laser?

• Wound care: to increase rate of collagen synthesis; decrease microbial populations; increase rate of vascularization.
• Lick granulomas
• Edema control
• Pain control
• Neurologic disease: accelerates both vascularization and nerve regeneration; degenerative myelopathy, Wobblers, Plexus lesions, IVDD, FCE

NMES (neuromuscular electrostimulation)

Applications:

• Pain control: OA, neurologic
• Muscle strengthening: Disuse atrophy, paresis
• Edema control: post surgical, traumatic
• Iontophoresis: local delivery of anesthetic agents, anti-inflammatories

Splints

Carts

Walkabouts

Stairs

Ramps

PHYSICAL THERAPY OPTIONS FOR OSTEOARTHRITIS (OA)

• Heat to affected joints before stretching or exercise - hot pack or therapeutic ultrasound
• Stretching
• Therapeutic laser for pain control
• Ice to joints after exercise
• TENS for pain control
• NMES for muscle strengthening and supplement weight bearing exercise.
• Exercise as tolerated: water treadmill, ramps, land treadmill, dancing, swimming, sit to stand, theraball and balance board to improve CP's, cavellettis to encourage active range of motion.

REFERRALS

Countryside accepts physical therapy referrals from other veterinary hospitals that do not have on-site canine rehabilitation facilities.

Physical Therapy Referral Form

Physical Therapy New Patient Form

Waiver Form

How do I set up a referral?

• Call our office upon the recommendation of your hospital, to make a physical therapy appointment.
• Please have your hospital forward us copies of your pet's medical history
• Include with the medical history any bloodwork results, radiographs and ultrasound photos pertaining to the issue at hand.

What Happens on my First Visit?

• Plan to arrive approximately 10 minutes early for your pet's physical therapy consult appointment.
• Check-in at our physical therapy check in center located in the retail area of our front office.
• Prior to and at that time we will ensure that we have all of your pet's appropriate paperwork, if not we will contact your referral hospital to tie up any loose ends.

At check in, we will ask you to sign an acknowledgement form that indicates that you understand that we are examining your pet strictly on a referral basis and cannot accept your pet as a Countryside Veterinary Hospital patient (outside of physical therapy services) for the period of one year. This strict protocol is in place to maintain the intergrity of our referral relationship with your pet's referring veterinary hospital. We wish to work hand in hand with your veterinary hospital in providing exceptional care to your pet.

How many visits will my pet need?

The number of visits depends on the why your pet is receiving physical therapy, what condition your pet is in, and how well your pet responds to treatment. This will be determined by your Certified Canine Rehabilitation Practitioner in conjunction with your Physical Therapy Technician.