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| Rehabilitation | Acupuncture | Chinese Herbal Medicine | Chiropractic |
 Rehabilitation and Physical Therapy |
| Veterinary rehabilitation utilizes the same physical therapy techniques as those used for humans. The purpose of rehabilitation is to return the body to normal function as quickly as possible following disease, injury or surgery, and to relieve acute or chronic pain.
The benefits of physical therapy are pain relief, early restoration of the neuromuscular system, reduction and prevention of muscle atrophy, improved muscle strength and flexibility, improvement in joint biomechanics, stimulation of blood circulation, improved cardiovascular function and weight reduction. |
| Rehabilitation Techniques |
| Hydrotherapy using the FERNO Underwater Treadmill: The center uses the FERNO underwater treadmill for hydrotherapy. Hydrotherapy uses the principles of buoyancy and heat which decreases concussive and compressive forces on the joints. The warm water helps increase blood circulation, increases flexibility of muscles and joints and relieves pain. Water resistance helps to build muscle mass, strengthen limbs, and provide a cardiovascular workout. Underwater treadmill therapy provides continuous effective rehabilitation progress because of the ability to change the speed, resistance and depth of water in the treadmill. Exercise programs are individualized for each patient. |  |
 | In the dog, hydrotherapy is primarily used for muscle strengthening and reeducation of the limbs. During hydrotherapy, multiple muscle groups can be worked simultaneously, and patients unable to stand or place full weight on their legs are able to exercise effectively because of the waters buoyancy, resistance and heat. This is especially important in the paralyzed patient. |
| Geriatric, post-surgical and obese animals can exercise without injury for longer periods of time in the underwater treadmill than they could on land. The geriatric patient can rebuild muscle mass and prevent muscle atrophy, the post-surgical patient can have an earlier return to exercise and thus full function, and an overweight animal will experience a decrease in weight and an increase in overall fitness.
Canine life vests or lifejackets made for dogs are used in the treadmill. The vests have handles that can be used to guide the dog. The therapist may also get into the treadmill with the dog to support the animal as it walks or swims. Most dogs, even if uncertain about being in water, typically accept hydrotherapy after 1-2 sessions without any problem. Hydrotherapy is usually combined with other physical therapy methods such as soft-tissue therapy and passive ROM exercises. |  |
| Cryotherapy: Cryotherapy is typically used to reduce pain, bleeding and inflammation. By decreasing muscle spasm and pain, the need for analgesics is reduced and rapid healing is enhanced.
Cryotherapy methods include: ice cubes in plastic bags, ice-filled paper cups, packages of frozen peas, iced towels, cold whirlpool baths, continuous surface-cooling blankets, and commercial reusable cold packs and wraps. Cryotherapy works best if used within the first 24 to 72 hours following orthopedic surgery or an injury. |
 | Massage Therapy: Massage therapy is the manipulation of soft tissues with the hands to improve the circulation of blood and lymph, reduce inflammation, prevent muscle spasms, relieve pain, loosen up adhesions and stretch contracted tissues. Myofascial release is included in this category, which is a technique where the focus is on the connective tissues surrounding the muscles and joints. Heat Therapy: Heat provides pain relief, causes muscle relaxation and increases joint flexibility. Heat improves blood circulation, which increases oxygen and nutrition to the surrounding tissues and carries toxic products away, which helps to speed the healing process. Heat therapy methods include: hot towels, circulating hot water blankets, warm baths or whirlpools, and commercially made hot packs, wraps and gel wraps. |
| Electrical Stimulation: Neuromuscular electrical stimulation (NMES) is the most commonly used form of electrical stimulation and uses a pulse generator and electrodes placed over selected muscle groups to cause muscle contraction. Pulse amplitude, rate and cycle length can be chosen and varies depending on the type of injury and tissues stimulated.
The most common use of NMES is immediately after surgery or an injury to prevent loss of muscle mass, increase muscle strength and joint range of motion, reeducate muscle, and decrease pain and swelling. |  |
| Range of Motion Exercises (ROM):
In passive ROM exercises, all the joints of the limb are flexed and extended through their normal ROM. After each joint is treated with passive ROM exercises, the entire limb is moved through a range of motion similar to that of normal walking.
Passive ROM exercises are used following a traumatic injury or orthopedic surgery to reduce joint stiffness, improve flexibility, reduce scar tissue and adhesions, and to prevent muscle, tendon and ligament shortening. Passive ROM is used in the paralyzed patient to help with limb reeducation. Passive ROM exercises improve the circulation of blood and lymph and helps the animal to know where their limbs are in space. Passive ROM exercises are usually started immediately after orthopedic surgery or injury and continued for up to three weeks. Clients are frequently asked to participate in this form of physical therapy at home. |
 | Therapeutic Exercise:
Therapeutic exercise improves muscular strength, endurance, cardiovascular function, balance and coordination while reducing joint stiffness and muscle atrophy. For most dogs, therapeutic exercise is usually started in the second to third week following surgery. Therapeutic exercises include: standing, walking, trotting, stair climbing, wheelbarrowing (for front legs), dancing (for rear legs), sit-to-stand exercises, pulling/carrying weights, ball playing, taping an object to the bottom of the good foot, walking and trotting across poles spaced out on the ground at a low height, and walking with resistance applied with flexible latex tubing tied around chosen limbs. Therapeutic exercise is introduced slowly and is gradually increased over time. Most owners will be asked to participate in a home physical therapy program which includes many of these exercises. |
| Therapeutic Ultrasound:
Ultrasound therapy is the use of high energy sound waves using an ultrasound probe to send these sound waves into the desired tissues, which absorb the waves and converts them to heat. Ultrasound therapy works similar to heat therapy. The main difference is in the depth of tissue heating: heat therapy is used for more superficial tissues and ultrasound is used to treat deeper tissues.
Ultrasound therapy improves circulation and increases the pliability of muscles, ligaments and tendons. It is frequently used to heat and break down scar tissues around joints which prevent the joint from obtaining its full range of motion. |
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| Veterinary Acupuncture |
| Acupuncture is a branch of Traditional Chinese Medicine (TCM) which has been practiced for over 5000 years. Traditional Chinese Medicine theory holds that Qi (vital energy) flows throughout the body along energetic channels called meridians. Each meridian is also associated with a specific internal organ which reflects the physiological and pathological conditions of that organ. The meridians connect the exterior of the body with the interior. Acupuncture points are located along these meridians, and when stimulated can relieve pain and restore normal body functions. Acupuncture points have specific locations and effects and have been documented over millennium. |  |
| From a Western perspective, acupuncture has been shown to stimulate a variety of sensory nerves in the body that transmit the signal through the nervous system to the brain, which then releases various chemicals that produce multiple physiologic effects that activate the body's homeostatic regulatory mechanisms. |
| Acupuncture Techniques |
| 1. Acupressure (manual): The stimulation of acupoints using finger pressure to maintain or improve the acupuncture treatment an animal receives. It is often taught to pet owners to use at home.
2. Acupuncture (needles): Sterile disposable filiform stainless steel needles are typically used. The length and gauge used is determined by the size of the animal, needling technique, and location of the acupoints being treated. |  |
 | 3. Moxibustion (heat): Artemesia vulgaris, or moxa, is a Chinese herb that has been used for centuries to heat acupuncture points. It is used either directly over the acupuncture point without touching it or indirectly attached to the top of a needle. The heat travels down the needle and into the acupoint to stimulate it.
4. Aquapuncture (injection): Stimulation of acupoints by injection using various solutions. Solutions injected include vitamins (especially B12 and C), sterile water, physiologic saline, electrolyte solutions, antibiotics, herbal and homeopathic extracts, analgesics, steroidal and nonsteroidal anti-inflammatory agents. |
| 5. Electroacupuncture (electrical current): Electronic alternating current devices provide very strong stimulation to acupuncture points. Acupuncture needles are placed and then electrical leads that fit around the needles are attached. The strength of the stimulus is adjustable. EAP is typically used for acute and chronic pain, and is the technique of choice for intervertebral disc disease with paralysis and other cases where nervous tissue damage is present.
6. Laser Acupuncture (LAP): The use of cold, low intensity lasers to stimulate acupuncture points is achieved by the use of two types of laser: helium-neon gas tube and gallium-arsenite diode (an infrared light emitter). LAP can be done rapidly and is especially useful for acupoints that are in sensitive or dangerous areas of the body. |  |
| 7. Gold Beads (implantation): Long term stimulation of acupuncture points can be achieved by implanting gold beads or wire. In general, it is reserved for severe conditions in which other acupuncture techniques have failed and/or Western medicine is not effective. It is also recommended for use in animals that won't tolerate regular acupuncture treatments, or those that have advanced osteoarthritis. Gold beads are also used in the treatment of epileptic seizure patients. |  |
 | 8. Cupping (vacuum): A cupping jar is a small glass bottle with a smooth and rounded mouth used to create a partial vacuum over the skin. The cup is firmly placed over the acupuncture point. The Chinese use this technique to improve blood circulation and relieve pain.
9. Plum Blossom (cutaneous): This technique consists of tapping the skin lightly with a hammer shaped instrument that has a group of needles on the end. One can tap along an entire meridian or tap at a specific acupuncture point. Plum Blossom technique is often used in China to treat chronic dermatologic conditions. |
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| Chinese Herbal Medicine |
| Traditional Chinese medicine (TCM) has been used in China for over 2000 years to maintain health in humans and animals. TCM includes herbs, acupuncture and massage. Herbal therapy and acupuncture are typically used together, as the combined effect is greater than using one of them alone.
TCM herbal prescriptions are not available over the counter; they are prescribed the same as Western pharmaceuticals. The herbs used in these prescriptions are from the same companies as those used to treat humans. They have been tested for purity and quality. TCM herbs are safe and effective and can be used for long periods of time with minimal to no side effects when prescribed and used appropriately. |  |
| Chinese herbs can be used to treat most conditions recognized by conventional Western medicine. They can be used alone or combined with other therapies for an enhanced effect. Often a TCM herbal and a conventional prescription will be used together.
TCM herbs are especially helpful in the treatment of chronic diseases, and diseases of the geriatric animal. They can be used to relieve pain, help improve and restore organ function, as well as strengthen and support the immune system. TCM herbal prescriptions are specific for the individual patient and are directed at the root cause of an illness to correct it, and are not given to control symptoms alone. In general, TCM herbal prescriptions must be given for longer periods of time than pharmaceutical drugs, but the benefit lies in their natural ability to gradually return the body to a state of balance and health, without side effects. Clinical results from TCM herbs can be seen in 3 days to 2 weeks depending on the formulation, full effect can take longer. Herbs must be given regularly two to three times a day to see any therapeutic effect, just as with conventional medications. Modern herbology research is currently working to identify and document the active chemical constituents of many of the herbal formulas used today. Herbal medications come in a variety of formulations: pills, tablets, capsules, liquids, topical, and concentrated herbal extracts in powder or granule form. The formulation used depends on the type of condition treated and the animal. To review the IVC Chinese Veterinary Herbs General Use Guidelines, click here. |
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| Chiropractic Therapy |
 | Human chiropractic principles and philosophy have been in existence since the 1800's and have contributed to the health and healing of millions of people. The use of chiropractic for animals has been around for almost as long. Dr. Palmer, the founder of human chiropractic, also developed and operated several animal chiropractic clinics. However, it wasn't until 1985 when Dr. Sharon Willoughby, DVM, DC, founded a school to train veterinarians and chiropractors alike in the application of chiropractic techniques for animals. Chiropractic techniques were formulated that were different than those applied to human beings to adapt to the changes in animal anatomy and take into account differences between animal species. After completion of the course requirements, which includes an externship and case studies, veterinarians and chiropractors are required to take a qualifying examination and are then certified in veterinary chiropractic. |
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For the veterinarian, it is important to understand the scientific basis of chiropractic, develop the clinical skills necessary for adjusting animals, and incorporate chiropractic care into veterinary practice. It is equally important for the chiropractor to understand the differences in quadruped anatomy, physiology, pathology and behavior before applying chiropractic techniques to animals. The practice of chiropractic utilizes the hands-on skills of the chiropractic doctor to manually manipulate joint dysfunctions that impede mobility and lead to degenerative conditions and illness. These manipulations are called adjustments and are typically directed to individual spinal segments. Adjustments can be performed on the other joints of the body as well. Most adjustments utilize a high velocity, low amplitude thrust directed to the affected spinal segment which frees the joint from mechanical and neurological dysfunction and stimulates a natural healing response to return the body to homeostasis. For more information, please continue to Chiropractic Therapy: How it works, when to use |
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