Veterinary Rehabilitation and Hydrotherapy

Saska Young – cruciate rupture (TPLO)

History

Saska, a German Shepherd rescue bitch, suffered an acute episode of lameness after jumping out of her owner’s car onto a gravel surface. The symptoms didn’t subside after rest and anti-inflammatories. Veterinary investigations revealed bony outgrowths and swelling of the right knee, and diagnosed a ruptured cruciate ligament. GP Tadley Vets referred her to James Grierson, Specialist in Small Animal Surgery at Anderson Moores. The decision was made to proceed with surgery. A tibial tuberosity advancement operation was performed, together with removal of fragments of cartilage from a meniscal tear. The nurses at Anderson Moores carried out the basic postoperative physiotherapy. However, because this was a complex case, James Grierson contacted Kennel & Paddock and asked for specific rehabilitation plan to be devised for Saska.

Assessment

On assessment, Saska tended to unload the limb at rest and try to hop in walk. Range of movement of her joints was largely quite good, but she had muscle wastage and increased tone of her right-side quadriceps, moderate knee-joint swelling and tightness (causing reduced mobility), and increased left forelimb loading.

In functional positions, sit-to-stand and lie-to-stand were slow due to altered use of the hindlimb.

Treatment

Saska’s treatment included electrotherapy to quadriceps and hamstrings, soft-tissue massage, passive movements to the hind limb and lumbar spine, and ice massage together with soft-tissue stretches. Functional exercises included sit-to-stand practice/weight-transference exercises. The owners were taught simple treatment and massage techniques, exercises and positioning to aid Saska’s recovery.

Within a month, Saska became noticeably stronger in her normal functional daily activities, and she began to weight-bear on the limb for short periods. The owners reported several occasions where Saska cleanly stepped over the exercise poles and guttering. Consequently her exercise programme was progressed, adding incline exercises as well as hydrotherapy, with her owners participating fully in her ongoing rehabilitation schedule.

Outcome

Two months post-op, Saska was discharged from the surgeon with positive outcomes because the operation had been very successful. Despite residual weakness of end-of-range functional movements, Saska was conditioned using the land-based treadmill to increase stride length and pace, so she could walk further with increasingly challenging exercises. Return to full strength and balance will take time, however.

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