After an injury or surgery, we’ll work diligently to rehab your pet back to health.
Rehabilitation is a treatment or treatments designed to facilitate the process of recovery from injury, illness, or disease to as normal a condition as possible. Dr. A is a certified canine rehabilitation practitioner.
The purpose of rehabilitation is to restore some or all of the patient’s physical, sensory, and internal capabilities. It is prescribed after many types of injury, illness, or disease, including arthritis, cancer, cardiac disease, neurological problems, orthopedic injuries, spinal cord injuries, and strokes.
Our rehabilitation programs are tailored to the individual patient’s needs and can include one or more types of therapy. Rehabilitation can include physical, acupuncture, electroacupuncture, tui-na, therapeutic whirlpool, nutrition, laser therapy, prolotherapy or other therapies.
Family members are encouraged to become actively involved in the patient’s rehabilitation program. It not only provides encouragement and comfort to our patients but also helps pet owners to see the progress made over time using various therapies.
It is a natural therapy (holistic medicine) used to reduce or eliminate musculoskeletal pain due to traumatic injury or chronic degeneration. This is a relevant treatment for arthritis, hip dysplasia, chronic lumbar and sacral subluxations, spinal disc injury, spinal osteoarthritis, and cruciate ligament instability. Surgery is not the only solution to disc, hip or anterior cruciate ligament (ACL) problems.
The technique requires small injections of prolotherapy solution at the sites of pain and injury, to stimulate the pet’s own natural healing mechanism. The goal of this holistic therapy is to rebuild and repair injured connective tissue into a stronger, more supportive tissue, with less pain.
Most pain drugs are anti-inflammatory. However, since they reduce inflammation, they also reduce healing. These drugs are a quick fix for pain, their effect is temporary, and they delay or prevent healing.
With Prolo therapy, the end result can be tissue and ligament strength that is stronger than before initial injury. The side effects are minimal and the benefits are highly beneficial.
Laser Light Therapy
Cold Laser Therapy
Cold laser therapy is an important tool that we offer as an adjunct to a multimodal approach to healing and pain management. This treatment utilizes light to reduce inflammation and increase healing to damaged tissue. It is often utilized at the practice in conjunction with other therapies such as acupuncture for management of musculoskeletal disease (arthritis, ligament disease, soft tissue strain).
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Cryo & Heat Therapy
Ice packs or cryotherapy are generally more effective in terms of depth of penetration than other superficial thermal modalities. Intramuscular temperatures can actually be reduced by 3-7 degrees C. This is helpful in reducing local metabolism, inflammation, and pain. The analgesic effects of ice result from a decreased nerve conduction velocity along pain fibers and a reduction of the muscle spindle activity responsible for mediating local muscle tone. It is usually most effective in the acute phase of treatment ( usually the first 72 hours) , though the client can use it for their pet after physical therapy or the home exercise program to reduce pain and the inflammatory response. It is applied over an area for 15-20 minutes, 3-4 times per day initially and then on an as-needed basis.
Superficial heat can produce heating effects at a depth limited to 1-2cm. Deeper tissues are generally not heated due to the thermal insulation of subcutaneous fat and the increased cutaneous blood flow which dissipates heat. It has been found to be helpful in diminishing pain and decreasing local muscle spasm. Superficial heat, such as the hydrocolater pack, should be used as an adjunct to facilitate an active exercise program. It is most often used during the acute phases of treatment when the reduction of pain and inflammation are the primary goals. Heat therapy is used later in the healing process to increase blood flow, increase muscle flexibility, decrease pain and increase healing.
Thermal energy is used in ultrasonic therapy. When sound is propagated through tissues, the degree that any medium is exposed to heat depends on the tissue thickness. Muscle and bone have been found to absorb more energy at interfaces with other heterogeneous tissues, because at these surfaces, the longitudinal waves of ultrasound are reflected and transformed into transverse waves, creating a heating effect. This happens commonly in the areas in between the muscle and bone or between the muscle and tendon. By applying ultrasonic waves to these areas it can reduce inflammation and increase mobility in the joints.
Ultrasound is a deep heating modality that is most effective in heating tissues of deep joints. It has been found to be helpful in improving the distensibility of connective tissue, which facilitates stretching. It is not indicated in acute inflammatory conditions where it may serve to exacerbate the inflammatory response and typically provides only short-term benefit when used in isolation. It is perhaps best used to improve limitations in segmental spinal range of motion following recurrent or chronic low back pain as an adjunct in facilitating soft tissue mobilization and prolonged stretching.
Animal chiropractic is a modality based on the biomechanics of the spine and nervous system, which is used to relieve chiropractic subluxations. The characteristics of a chiropractic subluxation include loss of motion in the joints between the vertebrae, pain on pressure of the vertebrae, increased or decreased tone of the muscles surrounding the vertebrae, may include changes in temperature, swelling or scar tissue. The goal of animal chiropractic is to restore normal joint motion with an “adjustment”, and to aide in neurologic reprogramming. Neurologic reprogramming can be thought of as an improvement of the message that one nerve sends to another.
A chiropractic adjustment involves a controlled, high-velocity thrust over a specific joint, most commonly involving the joints between the vertebrae (backbones). Depending upon the duration and severity of the subluxation pattern, a series of adjustments allows gradual restoration of the biomechanics and neurologic function. Animal chiropractic is commonly thought of for back and neck pain but is often quite useful for animals with an abnormal gait, which can be caused by a limb injury or pain (i.e. arthritis).
Myofascial Trigger Point Therapy
Muscles constitute over 50% of body weight in both dogs and cats. Because of this, pain from MPS can easily become chronic and widespread. At the Center for Veterinary Pain Management and Rehabilitation, treating MPS is a very important part of the care of both chronic-pain patients and rehabilitation patients. Inserting an acupuncture needle into a myofascial trigger point, known as trigger point dry needling (TrP-DN), or trigger point injection (TrP-injection) causes the trigger point to release, and so vastly reduces the pain.
By combining acupuncture with myofascial trigger point therapy, we find we can provide significant pain relief for numerous musculoskeletal and neurological conditions in dogs and cats.
Neuromuscular Electrical Stimulation
NMES increases blood flow to the muscles in which fibers are atrophied. NMES can also be used to treat muscle atrophy and joint mobility problems, such as contractures; circulation inadequacies; disuse atrophy; spasticity (tone abnormalities) and gait abnormalities. NMES has also been used for orthopedic rehabilitation for pets that have musculoskeletal dysfunction (e.g., disuse weakness, joint restrictions, edema, and spasms). This therapy is used to strengthen muscle tone and improve functional abilities. Neuromuscular electrical stimulation (NMES) for the prevention and/or treatment of disuse muscle atrophy following immobilization, injury, or surgery is considered medically necessary if the medical appropriateness criteria are met.
Passive range of motion exercises is performed to help patients with awareness of neuromuscular structure and function. These exercises help maintain and improves joint mobility and can improve the flexibility of muscles & tendons as well as ligaments.
Assisted exercises help the patients with the awareness of where their feet are placed. This is crucial to pets that are regaining the ability to use their limbs and where to place them as they walk. We often use physio balls as well as the balance boards to develop muscle contraction and weight shifting. These exercises also help to re-develop balance when standing.
Active exercises can be used at home as well as at Squibnocket Animal Center. These include treadmill exercise, dancing, leash walks for a specific period at a slow speed, wheelbarrowing, and pole weaving. The goal is to re-develop muscle mass so our patients can regain the strength and function of their legs.
Stem Cell Therapy
Stem cells are the body?s repair cells. They have the ability to divide and differentiate into many different types of cells based on where they are needed throughout the body. Stem cells can divide and turn into tissues such as skin, fat, muscle, bone, cartilage, and nerve to name a few. They even possess the ability to replicate into organs such as the heart, liver, intestines, pancreas, etc.
What are the different types of stem cells?
There are two basic types of stem cells; embryonic and somatic (adult).
Embryonic stem cells are found in the placenta and embryo. These cells are called totipotent, which means they have the ability to reproduce into any mature cell type. While embryonic stem cells offer the greatest potential in healing, there are obviously moral and ethical concerns in harvesting these cells.
The second type of stem cell is the adult stem cell. These stem cells are called multipotent, which means they can differentiate into closely related cell lines, but they are not capable of creating a complete organ. Adult stem cells are found in the bone marrow, adipose tissue (fat), skin, liver, blood vessels, and neurons. Contrary to embryonic stem cells, there are no moral or ethical concerns in harvesting these cells, activating them, and reintroducing them back to the patient in areas where healing and regeneration is needed.
So why do we take the cells from adipose (fat) tissue?
Adult stem cells are highly concentrated in the fat tissue. There are 50 to 1,000 times more stem cells in the fat than the bone marrow. At this concentration, it is no longer necessary to culture the stem cells to acquire the necessary cell numbers to make a healing impact. The procedure to extract fat from the patient is much quicker and less invasive than a spay. The stem cells are contained within a pool of cells in the fat termed the Stromal Vascular Fraction (SVF). The SVF may impart anti-inflammatory effects, add bioactive peptides, and contribute to reformation and architectural organization. These are benefits lost once stem cells are cultured.
So what can we do with the stem cells?
Adult stem cells are capable of dividing into many different cell types. With this capability, we can use them as a treatment for joint injuries, ligament and tendon damage, and fractured bones. Research and clinical trials currently support the use of stem cells in these conditions. Ongoing research is targeting other areas of the body for treatment and the preliminary results are very encouraging.
So how will the procedure work?
The day of the procedure, we will anesthetize your pet. We will surgically remove a couple tablespoons of fat. This is a quick and simple procedure that is generally easier than performing a spay. They will then process the fat to remove the stem cells. Processing generally takes a couple of hours. After the stem cells have been collected, your pet will generally be sedated and the stem cells will be administered into the affected joints and/or into the bloodstream. It is important that you do not feed your pet the night before the procedure.
When will I see results?
We expect you to see results! While we know every animal is different and there are no guarantees, we have seen positive clinical improvement in 95% of the arthritic cases performed nationwide. Some owners have even reported seeing a difference in as little as a week! While quick results are possible, we expect you to begin seeing improvement within the first 90 days following treatment. Really bad arthritis may require multiple injections, so banking your extra cells is always a good idea!
Is this procedure safe?
As with any procedure that involves anesthesia, there is always a risk. However, the stem cells are coming from your pet and are being re-administered back to your pet. There is no risk of an allergic reaction. In rare cases, there might be a mild immune reaction in the injected joint that should subside within a day or two.
Platelet Rich Plasma Therapy
When tissue is injured, the inflammatory response is triggered. This is necessary even though the heat and swelling are unpleasant. Inflammation stops the spread of infection and clears away damaged tissue. However, healing of the tissues cannot take place until the inflammation process is switched off. The fact that platelets play a role in the control of both of these processes forms the rationale behind PRP treatment. Most everyone thinks of blood platelets as being responsible for blood clotting after injury, which is true. What many people do not know is that blood platelets serve two other important functions. Blood platelets are responsible for bringing the white blood cells to the injured area to clean up the remains of dead and injured cells. Most importantly to this discussion, blood platelets release growth factors that are directly responsible for tissue regeneration. These substances are called cytokines and include platelet-derived growth factor, epithelial growth factor, transforming growth factor, insulin growth factor, and other important growth factors. By ultimately inhibiting inflammation, platelets form part of the mechanism that switches the process off and stimulates healing by producing the various tissue growth factors mentioned above which stimulate new blood vessel growth. It is for these reasons that PRP treatment has been promoted for tendon, ligament, muscle, and joint injuries, which have been historically normally slow to heal.
Platelet-rich plasma, or PRP, is derived from blood that is drawn from the patient and runs through a special centrifuge, which separates the blood less dense components from its heavier ones. This process distills a portion of the blood to a platelet concentration level that is much richer than regular blood. At the same time, it helps to remove both red and white blood cells from the platelet rich part of the plasma.
Plasma containing this concentrated level of platelets provides an abundance of the previously mentioned growth factors, which are the proteins in the body that stimulate cells in the tendon, ligament, muscle, or joint to start the healing process. When is PRP injected into damaged tendons or ligaments, cells in the tissue along with new cells circulating in the blood are stimulated to bring even more new cells to the injured site. Therefore, the growth factors derived from platelets initiate connective tissue healing, bone regeneration, and repair, promote the development of new blood vessels, and generally stimulate the wound healing process by accelerating epithelial and epidermal regeneration. Because of the patient’s own blood is used to make the specialized plasma?this is known as an autologous process there is no risk of the treatment being rejected, as it might be if the blood had been provided by a donor.
?Although PRP technology is considered cutting-edge technology, it was initially developed 20 years ago for heart surgery to aid with wound healing and blood loss. Its benefits are now being applied towards the facilitating of healing of muscle, tendons, ligaments, articular and meniscal injuries. PRP has also been utilized for bone repair; it can be added to harvested autogenous bone or to a mixture of autogenous bone and freeze-dried bone/alloplastic material to improve the consistency for handling during surgery and minimizing particulate migration as well as to add increased platelets (i.e., increased growth factors) into the area to stimulate healing.
PRP has been directed towards Achilles tendon injuries, cruciate ligament injuries, complicated orthopedic fractures and delayed bone healing, and degenerative joint disease of the shoulder, elbow, hip, knee, and ankle. The number of injections performed depends upon the severity and type of condition being treated. The use of certain anti-inflammatory drugs is not recommended during PRP therapy as they may diminish the success of the procedure by interfering with the initial inflammatory reaction induced by the platelets. The use of omega 3 and six essential fatty acid fish oil supplements and other natural anti-inflammatory agents do not seem to work the same way as the non-steroidal anti-inflammatory agents and are therefore not restricted in use throughout the platelet facilitated the natural healing process. Depending upon the condition being treated, the pet may require nothing more than a local anesthetic for the administration of PRP or may require a twilight anesthetic. A real advantage to PRP therapy is that it may not only facilitate the healing process, but it may also in certain cases provide an alternative to surgery.
While platelet rich plasma therapy offers a promising solution to accelerate the healing of bone, muscle, tendon, ligament, and joint conditions naturally without subjecting the patient to invasive surgical procedures and significant risks, there is no one, standard protocol . Frequently, chronic injuries require more than one injection. In both acute and chronic injuries, injections may be combined with an exercise or physical therapy program, acupuncture and/or Class IV laser therapy to enhance the success of the treatment.
Using the natural properties of water, the underwater treadmill creates a low impact workout that helps pets increase muscle strength and endurance. It also allows for an easier range of motion.
Treatments can be customized through variable water heights, accommodating different sized dogs and can be adjusted for various weight-bearing exercises. Water buoyancy reduces gravity during exercise. The limbs bear less body weight in water, reducing pressure on painful joints during therapy. Water pressure also helps to reduce swelling. Warm water (84 degrees) is used to assist in pain. Aquatic therapy provides the opportunity for many of our patients to perform exercises in water, using their limbs, that due to circumstances they would not be able to perform.
Overall, this is a great method of rehabilitation, providing our patients with the opportunity to strengthen muscles without pressure on their joints. Important benefits of the hydrotherapy include muscle strengthening, increased cardio-vascular stamina, neuromuscular re-education, earlier return to function, overall conditioning and weight management.
Pulse Magnetic Field Therapy
Pulsed magnetic therapy is a form of Canine Rehabilitation offered at Valley Veterinary Hospital and Squibnocket Animal Center in CT. Pulsed Electro Magnetic Fields influence cell behavior by inducing electrical changes around and within the cell. Improved blood supply increases the oxygen pressure, activating and regenerating cells. Improved calcium transport increases absorption of calcium in bones and improves the quality of cartilage in joints, decreasing pain dramatically. Acute and even chronic pain -also caused by osteoporosis- may disappear completely. It is used for the treatment of arthritis, rheumatoid arthritis, and other injuries. It has no side effects and is used extensively in Europe on humans as well as animals. There are many scientific studies on the degree of effectiveness of Pulsed Magnetic Field Therapy. It was found that disturbances in blood circulation and in metabolism play a key role in the development of diseases.
This form of therapy helps to return the regenerative capabilities by repairing any disturbances. It allows an increase of proteoglycans and collagen to aid damaged cartilage. Application of pulsed electromagnetic energy is based on more than 30 years of worldwide research carried out by renowned scientists. The treatment protocol is nine consecutive treatments, each lasting for thirty minutes. Improvement with this type of therapy lasts for several weeks.
- Stimulate peripheral nerves for the purpose of providing pain relief
- Stimulate motor nerves for the purpose of providing muscle re-education
- Used for chronic pain conditions
- Adjunctive treatment of post-traumatic pain syndromes
- Management and symptomatic relief of chronic (long-term) pain
- Adjunctive treatment in the management of post-surgical pain problems
- Relaxation of muscles spasms
- Prevention or retardation of disuse atrophy
- Muscle re-education
- Increasing local blood circulation
- Immediate post-surgical stimulation of the calf muscles to prevent phlebothrombosis
- Maintaining and increasing range of motion
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