Physical Rehabilitation

Animal Rehabilitation & Fitness (ARF) at Charleston Veterinary Referral Center is proud to offer state-of-the-art care in the area of physical rehabilitation. We have the ability to provide a full range of therapeutic modalities including underwater and land based treadmills, cold laser therapy, neuromuscular and transcutaneous electrical stimulation, therapeutic ultrasound, and thermal therapy. We also have unique equipment to assist our patients with balance, coordination, and strength training, including physioballs, balance boards, wobble boards, balance discs, and cavaletti rails. Our advanced rehabilitation center functions under the guidance of staff members specially trained and certified in canine rehabilitation (CCRT/CCRP) and canine therapeutic massage (CCMT).  

People undergo physical rehabilitation for a variety of disorders but mostly to restore function, increase mobility, promote balance, decrease pain, encourage healing, facilitate circulation and return to a normal lifestyle.  The same is true for your pet! 

Physical rehabilitation is a non-invasive methodology used to improve the recovery of patients with both acute and chronic conditions.  Most commonly used for patients that underwent orthopedic surgery or those with neurologic conditions, rehabilitation therapy can also be used for weight loss, conditioning of agility and sporting dogs, pain control, osteoarthritis, nonsurgical management of orthopedic conditions, and wound management.

What is an emergency/specialty hospital and how is it different than my primary veterinarian?

A specialty hospital does not offer any routine or preventative care.   Our veterinarians have advanced training in specific disciplines such as surgery, oncology, internal medicine, emergency and critical care medicine, physical rehabilitation and neurology among others.  We also have equipment that most primary veterinarians don’t have such as CT scans, MRI, endoscopic equipment, and specialized surgical tools.  We work closely with your primary veterinarian to offer these services to you.

What conditions may benefit from physical rehabilitation? 

  • Orthopedic injuries and repair such as cruciate disease
  • Fractures
  • Spinal cord injuries such as intervertebral disc disease
  • Neurologic conditions
  • Traumatic injuries
  • Chronic pain
  • Osteoarthritis
  • Wounds such as burns and abrasions
  • Obesity
  • Increasing strength and maintaining the condition of working and sporting dogs

What should I expect during my initial visit?

If you are a new client to CVRC, we encourage you to fill out our New Patient Registration Form ahead of time online, or bring the form with you. Otherwise, please arrive to your appointment approximately 10 minutes early to complete this form in our office.

At the initial rehab visit, we will discuss the options available for rehab, assess muscle mass and range of motion, evaluate gait and mobility, obtain stance analyzer measurements, and assess pain level. A customized plan of treatment is developed to address the particular challenges of your pet. The initial rehab visit will take approximately 1.5 hours. We will discuss management options with you to determine a schedule of visits. Postoperative patients may initially be managed as inpatients, but the majority of treatments are performed on an outpatient basis.

The education of owners to perform simple strength and coordination exercises at home is an important component of therapy. The response to rehabilitation is closely monitored and your pet’s program will be adjusted accordingly.

What should I bring to my initial rehab consultation?

First and most importantly, bring your pet to all visits.  Records, including recent laboratory work, can be faxed or emailed to us from your primary care veterinarian prior to the appointment. If your pet has had any x-rays taken recently, please bring those with you as well.  We can request records and digital x-rays on your behalf from your family veterinarian once you have scheduled a visit with us. 

What should I expect during my rehabilitation sessions?

The rehabilitation session lasts approximately 1 hour, and is centered on various exercises and therapeutic treatments that are targeted specifically to the goals of your pet’s rehabilitation plan.  Each session is fully inclusive of all the treatment modalities that we have available and are appropriate for your pet.  The rehabilitation nurse or doctor is actively tracking your pet’s progress during all rehabilitation sessions, ensuring that the exercises are appropriate and we are making progress towards our goals. At the end of the session we will go over any change to the home exercise plan and may prescribe new exercises. At the completion of a series of sessions, all measurements will be repeated to help evaluate progress.

What should I bring to my rehab sessions?

Bring your pet, and please arrive 5-10 minutes early to fill out history paperwork for your pet. If your pet has food allergies or dietary restrictions we encourage you to bring the appropriate treats or food with you so they can be rewarded during their therapy.

May I stay with my pet and observe or participate in the rehabilitation session?

We will do our best to accommodate your request to observe your pet during a rehabilitation session. However, we have found this can often be more of a distraction.  We have windows outside the rehab room that are available for viewing, if appropriate.  Availability will depend on how many patients we have, the time of day, etc., and is at the discretion of the rehab staff.

Do I need a referral?

Yes, please have your veterinarian send us a referral with a diagnosis of your pet's issue. We will then reach out to you to schedule a rehab assessment. If you need help obtaining a referral, feel free to contact us. 

Will you keep my family veterinarian informed of the care my pet receives at CVRC?

We will communicate with your primary veterinarian during this process to ensure a collaborative treatment plan for the care of your pet. A full report will be sent to your family veterinarian the same day as your visit. We welcome your progress reports, questions, and concerns any time, and will maintain an ongoing relationship with your primary care doctor to ensure the best experience for you and the best care for your pet.  Your primay vet may also have the ability to access an online portal into your pet’s medical record.

How many treatments will be needed?

The number of sessions required depends on many factors.  Your rehabilitation clinician will tailor a plan to meet your pet’s and your individual needs.

What treatment modalities are offered?

  • Cold Laser Therapy
  • Under Water Treadmill
  • Land Treadmill
  • Therapeutic Ultrasound
  • Electrical Stimulation (e-stim) both neuromuscular and transcutaneous
  • Hot/Cold Therapy
  • Massage
  • Therapeutic Exercises

What is cold laser therapy?

Laser therapy is used to increase quality and strength of tissue repair, decrease inflammation, reduce edema and give pain relief. The effects are photochemical, not thermal and happen at the cellular level. Benefits include faster wound healing, increased vascular activity, stimulated nerve function, reduction of scar formation, decreased pain, and decreased inflammation. Laser therapy is beneficial for wound management, soft tissue injuries, inflammation, chronic pain, arthritis, and acupressure points.

What are the applications for laser therapy?

  • Wound management
  • Soft tissue injuries
  • Inflammation
  • Chronic pain
  • Arthritis
  • Acupuncture

What is underwater treadmill therapy?

Water is an excellent environment in which to exercise. The principle of buoyancy combined with that of resistance make this a unique and safe method of rehabilitation. We have an underwater treadmill that provides an opportunity to strengthen muscles with little to no pressure on the patient’s joints and is beneficial for neuromuscular re-education.  Walking on the treadmill improves cardiovascular stamina and is a key component of most weight loss programs. The warmth of the water helps to increase flexibility and mobility of muscles, tendons, and ligaments that surround the joints as well as enhance circulation. In addition, our treadmill is enhanced with therapeutic jets that can be used for massage, like a whirlpool, or provide increased resistance for conditioning. Hydrotherapy has the overall benefit of earlier return to function for many of our patients and also helps to increase self-confidence.

It is not unusual for an animal that is not using a limb on land to use it when walking in the water. They often use the limb in an exaggerated motion which adds to the therapeutic benefits of hydrotherapy.

We can adjust variables of speed, duration of treatment, and water level during each treatment to maximize the therapeutic results.

What are the benefits of underwater treadmill therapy?

  • Comfortable movement
  • Earlier return to function
  • Muscle strengthening
  • Increased cardiovascular stamina
  • Neuromuscular re-education
  • Weight loss
  • Increase range of motion
  • Increase in patient’s self confidence

What are the applications for underwater treadmill therapy?

  • Orthopedic injuries and repair such as cruciate disease
  • Fractures
  • Spinal cord injuries such as intervertebral disc disease
  • Neurologic conditions
  • Traumatic injuries
  • Chronic pain
  • Osteoarthritis
  • Obesity
  • Increasing strength and maintaining the condition of working, sporting, and agility dogs

What is the difference between underwater treadmill (UWTM) therapy and swimming?

While both therapies are beneficial for cardiovascular fitness, the UWT provides total body therapy by working both the front and rear limbs while allowing for control of the water level, treadmill speed, and water resistance. When animals swim, they typically use the front legs, but may either rudder with the back legs, keeping them tucked under their body or sporadically kick, but not in a controlled manner. For this reason, we primarily use the underwater treadmill for walking/trotting in our rehabilitation regiment here at CVRC although swimming is appropriate in certain cases.

But, my dog doesn't like water? And he doesn't know how to swim?

We begin with a slow introduction to the underwater treadmill that involves a lot of positive reinforcement. We will never rush this process and will take whatever time is necessary to be sure your pet is comfortable in the UWT before proceeding. If your pet is one of the rare patients that does not tolerate working in the UWT, there are a number of other activities that we can do to help your pet recover from injury or surgery.  While some dogs are able to swim in the UWT, the majority will not. As mentioned earlier, walking in the UWT provides a more controlled exercise environment for our patients and is often preferred over swimming while your pet is recuperating from surgery/injury.

Will my dog be wet when I pick him up?

We will do our best to get your pet as dry as possible before he goes home. We have grooming dryers to supplement towel drying after the UWT session and in most instances your pet will be dry.

What is therapeutic ultrasound?

Therapeutic ultrasound produces both thermal and non-thermal effects. The thermal effects of a therapeutic ultrasound occur through warming of tissues and can be very beneficial in treating soft tissue injuries. It can be used to increase the flexibility of muscles while decreasing muscle spasm and scar tissue. We have also found it can increase circulation and minimize inflammation of damaged tissues. The non-thermal effects aid in tissue regeneration, soft tissue repair, bone healing along with reduction of swelling, muscle spasm, and pain.  Using ultrasound to increase extensibility of collagen can help increase joint range of motion. Therapeutic ultrasound is beneficial for many conditions including orthopedic injuries and fractures, wound healing, chronic pain, osteoarthritis, and tendon injuries.

What is electrical stimulation (e-stim)?

Electrical Stimulation (e-stim) is the application of electrical impulses to a muscle or muscle group stimulating their contraction.  Neuromuscular electrical stimulation (NMES) can be used to prevent atrophy of a muscle or muscle group, particularly in neurologic cases. NMES is also helpful in reducing swelling, inflammation, and edema, as well as overcoming muscle reflex inhibition and assisting in tendon and fracture healing.   Transcutaneous electrical stimulation (TENS) aids in pain management.

What is massage therapy?

Massage is a focused, intentional, and deliberate touch using a variety of strokes. Massage is a non-invasive way to improve your pet’s health and utilizes soft tissue manipulation to achieve different goals such as relaxation, stimulation, and relief of muscle problems. It allows the body to function efficiently by helping to restore muscle tone. Massage increases circulation bringing oxygen and nutrients to the tissues and provides relief from many common ailments as well as enhances performance. With regular massage therapy sessions, we often see improved muscle function, flexibility and range of motion, as well as decreased pain, soreness and stiffness. We utilize massage in many of our patients including those recovering from surgery and sports injuries, geriatric patients with arthritis and weakness, and neurologic patients recovering from or living with debilitating disease.

What are therapeutic exercises used for?

We evaluate each patient and design a set of exercises that are most effective in that patient’s rehabilitation. These are designed to achieve the goals for that patient’s recovery. Exercises may be directed at helping the patient with strengthening specific muscles or stretching to increase flexibility or learning how to regain the feeling and use of a foot or limb. We demonstrate each activity and teach our pet owners to perform these at home on a prescribed schedule. We try to incorporate the special needs and skills of patients and their families.

What is hot/cold therapy and when is it used?

Appropriately timed in the rehabilitation process, cold and heat can be very beneficial in decreasing pain and inflammation.

Initially, in the first 72 hours, we use cold therapy to decrease the pain and inflammation associated with surgery or trauma. This occurs by decreasing pain perception, decreasing blood flow and decreasing inflammation. Cold therapy may also be indicated following exercise sessions to manage exercise induced inflammation and pain.

Heat therapy is used later in the healing process to increase blood flow, increase muscle flexibility decrease pain and increase healing. Heat therapy is also appropriate as a warm up to some exercises.  The therapy team will direct you when to use hot or cold therapy for your pet.

My pet is overweight or out of shape.  What can I do?

Unfortunately, many pets are overweight or have poor conditioning.  This makes it more likely for them to develop a variety of health conditions, such as arthritis, diabetes, ligament injuries, and dysfunction of body systems such as the circulatory, digestive and excretory systems.  Conditioning, fitness, and weight loss are goals that can be obtained with a comprehensive plan from our physical rehabilitation department.

My dog doesn't have an injury. Can he/she still benefit from rehab?

Definitely! Just like people, pets can benefit from a regular exercise program. If you are interested in setting up a conditioning program for your pet, please contact us to schedule an initial consult. This will allow us to evaluate your pet and make sure there are no contraindications to your pet beginning our conditioning program.

Can my pet receive rehabilitation while hospitalized?

Depending on your pet’s condition, rehabilitation is often introduced during the initial hospital stay after surgery or injury.  Our rehabilitation team will collaborate with your primary doctor at CVRC to discuss and offer rehabilitation if it is appropriate for your pet’s condition.

Can I leave my pet for the day?

We are currently unable to offer full-day boarding. We will do our best, however, to be flexible with scheduling your pet's rehab session.

Will I need to do exercises at home?

Results of therapy are much better when a home exercise plan (HEP) is followed.  We evaluate each patient and design a set of exercises that are most effective in that patient’s rehabilitation. These are designed to achieve the goals for that patient’s recovery. Exercises may be directed at helping the patient with strengthening specific muscles, stretching to increase flexibility, or learning how to regain the feeling and use of a foot or limb. We demonstrate each activity and teach our pet owners to perform these at home on a prescribed schedule. We try to incorporate the special needs and skills of patients and their families.

What if I don't have time to work with my pet at home?

The home exercise program (HEP) is meant to complement your pet's rehabilitation sessions performed here at CVRC. We recognize that your lifestyle and time constraints may not be conducive to performing all the additional exercises at home. We will work with you to develop a program that will fit your schedule while still benefitting your pet. Please let us know what you feel you can perform and our rehabilitation team will work with you to make this a positive part of your pet's rehabilitation experience.

I cannot come to CVRC for routine rehabilitation appointments, is it beneficial to come for an appointment for a home rehabilitation plan?

Absolutley!  After assessing your pet, we can form a rehabilitation plan that works logistically for you and your pet.  This can be a plan where most of the activity is done at home, with only an occasional visit to CVRC for reevaluation.

Is it normal for my pet to be sore or tired after therapy?

It is very common for your pet to be tired after rehabilitation, especially early on in the treatment plan.  This should improve over time as your pet’s physical condition improves.  If your pet seems sore or uncomfortable, please let us know so that we can adjust the rehabilitation plan, or prescribe medications if needed.

Should my pet have physical rehabilitation after an injury or surgery?

Consultation with your pet’s surgeon, or family veterinarian, review of history, full physical examination, and discussion with you will dictate the necessity of physical rehabilitation.  Many patients respond very well to physical rehabilitation and have a faster return to function after injury or surgery.  We have several certified rehabilitation specialists who collaborate with our surgical team to ensure the best outcome for your pet.