Pulse - January 2024 - 18

PULSE SPECIAL SECTION
Tissues Have Timelines
& Timing is Everything
Lauryn Harker, CCRP, RVT, CAPM & Tiffany Downing, RVT
" T
here are no rehabilitation emergencies. "
It's one of those sayings we
hear like, " can't fix crazy " or " it must be a
full moon. " In Veterinary Physical Rehabilitation
it's how we explain that there
is never an immediate, drop-everything
urgency to rush into Rehab for Passive
Range of Motion and 200 yards of Hydrotherapy
STAT! However, there are Rehab
cases that are more time sensitive than
others and failure to initiate therapy at
the proper time can be a hinderance to the
patient's return to function.
Veterinary Medicine has rarely recommended a " one size
fits all " approach and Physical Rehabilitation is no different.
Since all tissues have different timelines of healing, the
decision of when to begin Rehabilitation services and which
modalities to use is based on what disease or injury occurred,
what repair was performed (if any), comorbidities, lifestyle,
age, and condition of the patient. Delaying therapy on a timesensitive
condition can be a significant detriment to recovery
with potential complications including soft tissue contracture,
permanent neuropathy, surgical failure, or even re-injury
while patients that begin therapy prematurely are more susceptible
to implant failure, infection, unnecessary increases in
pain, and wound dehiscence.
So, who needs Rehab first?
Neurological cases generally require more prompt attention,
especially since most neuro cases have a limited window
for therapy to support maximum recovery (approximately
6 months from event) and meaningful improvements are
unlikely beyond this window. For this reason, it is best to
communicate this limited timeframe to clients who might
otherwise delay seeking Rehabilitation services. Goals for the
neurological patient include re-establishing neural pathways,
pain relief, and reducing secondary complications.
Post-op Laminectomy cases benefit from beginning
LASER, Electrostimulation, Massage, Passive Range of
Motion (PROM), and Cryotherapy before even being discharged,
ideally within 48 hours post-op. Owners of these
patients should be instructed to perform stretching and
positional exercises at home before the first surgical recheck
18
Luna began Rehabilitative Therapy 1 week post-op right thoracic limb
amputation for osteosarcoma in addition to a history of bilateral TPLO
and OA in the left shoulder. She presented non-ambulatory and was being
cared for as a recumbent patient. By 3 weeks post-op, Luna was able
to stand unassisted and at 4 weeks post-op, she was walking on her own.
exam and formal Rehab therapy should begin as soon as the
incision is sealed. By contrast, Medically Managed IVDD
patients are typically prescribed 3+ weeks of strict confinement,
followed by formal Rehab services pending severity.
Patients with Fibrocartilaginous Embolisms and Ischemic/Hemorrhagic
Strokes are proven to have a greater
likelihood of neurological return to function when therapy
begins as soon as the patient is stable, usually within 2-5 days
of event. For Swimmers Syndrome or Degenerative Myelopathy
patients, quickly providing consistent and frequent Rehab
can be pivotal during considerations for Quality of Life and
Euthanasia. Beginning a persistent regimen of Underwater
Treadmill Hydrotherapy as soon as possible has been
JANUARY 2024
PULSE
Pulse - January 2024

Table of Contents for the Digital Edition of Pulse - January 2024
