ptanddm

DAILY PHYSICAL THERAPY AND THE DM DOG

Lila Lippow

I would like to summarize a study done on the effects of daily physical therapy on dogs with Degenerative Myelopathy. It was published in the Journal of Veterinary Internal Medicine. The authors were I. Kathmann, S. Cizinauskas, M.G. Doherr, F. Steffen, and A. Jaggy.

There were 50 dogs in the study- all with degenerative myelopathy. They were evaluated whether their survival time was significantly affected by physical therapy. It was found that the dogs that recieved intensive therapy had longer survival time (mean 255 days), compared with the dogs that had moderate therapy (mean 130 days) or no therapy (mean 55 days). Also the results indicated that affected dogs which received therapy remained ambulatory longer than did the animals that did not receive and physical treatment.

Affected breeds among the 50 dogs with DM included German Shepherd Dog (13), mixed-breed dog (13), Hovawart (7), Bernese Mountain Dog (4), Kuvasz (4), Collie (3), Belgian Shepherd (1), Giant Schnauzer (1), Labrador Retriever (1), Borzoi (1), Soft-coated Wheaten Terrier (1), and Mastiff (1). The average age at onset was 9.1 years (range, 6–13 years). Twenty-eight male and 22 female dogs were affected. A sex predilection was not found.

The neurologic examination identified paraparesis, ataxia, and proprioceptive deficits in both pelvic limbs in all dogs. Lateralization of the neurologic deficits was seen in almost half of the dogs Wearing of the nails was seen in 20 dogs, and hypermetria of the pelvic limbs was evident in 11 dogs. Results of myelography, CT, or MRI performed in all dogs were normal. Dogs with myelographic results suspicious for mild disk protrusion were not included in the study.

I think it is of great interest what was done with these dogs to help increase their life span. The following is what was the recommended physical therapy in the study:

Prescribed Therapy for dogs with Degenerative Myelopathy

	Instructions	Duration and frequency
Active exercise	Slowwalking If needed, knuckling is prevented by a sling wrapped around the paw and pulling the dog’s limb by each step with it * Frequent exercises preferred to long exercises Exercise has to be adapted to animal’s condition Dog sits and gets up several times * Assistance with a sling if needed * Attention is paid to correct placement of the paws * Weight shifting while standing: making the dog bear his weight once on the left, then on the right side by pushing him gently at the level of the hip * Changing of ground (grass, asphalt, sand) * Stair climbing, walking uphill	5–10 minutes at least 5 times/d

	Instructions	Duration and frequency
Passive exercise	* Gentle, slow extension and flexion of each joint of articulation both hind limbs(starting distally, manipulating of each joint performed separately) * Maintaining the range of physiologic motion of each joint * The limb is always fixed proximally to the joint and the distal part is moved	3 times/d, 10 times in each

	Instructions	Duration and frequency
Massage	Massage is started and finished with stroking Gentle massage (kneading) of the entire paravertebral muscles and the limbs, starting from distal to proximal	3 times/d

	Instructions	Duration and frequency
Hydrotherapy	* If available, walking on underwater treadmill; otherwise, swimming or walking in water depending on dog’s ability * Adaptation to animal’s condition is important * Assistance with a sling as needed * Weight shifting while standing in water: making the dog bear its weight once on the left, then on the right by pushing him gently at the level of the hip	At least once a week, 5-20 minutes

	Instructions	Duration and frequency
Paw protection	* With a bandage or socks and shoes	While walking

Considering the results of this study, survival time was positively associated with the degree of physiotherapy. Simultaneously, mean survival time and degree of physiotherapy performed were similar in the groups categorized by the severity of neurologic deficits at the time of diagnosis. This finding suggests that, even in dogs with severe neurologic deficits at time of diagnosis, physiotherapy may result in longer survival time even in comparison with that of dogs with minor neurologic deficits that did not receive physiotherapy. The degree of neurologic deficits and age did not seem to influence owner compliance because significant difference in age was not found among groups with different levels of physiotherapy.

Physical therapy is an important part of rehabilitation in dogs affected with most neurologic diseases, and it improves the quality of life of the animal. In chronic progressive neurodegenerative diseases such as DM, physiotherapy seemed to be an effective supportive therapy that increased survival time.

reprinted with kind permission from Lila Lippow

The above information is simply informational. It's intent is not to replace the advice of a veterinarian nor to assist you in making a diagnosis of your pet. Please consult with your own veterinarian for confirmation of any diagnosis. Your pets life may depend on it.