Newsletter 2 Page 1 Hi Everyone, Can you believe it; we have been open for 1 year now! Where has the time gone? We thought it would be nice for you to hear from some of our clients about the treatment their dogs have received here at Aqua Dogs and the changes they have seen in them. If this isn t enough to convince you of the benefits of hydrotherapy treatment I have also included some extracts from a journal article for you. If you haven t already heard, we are starting a campaign here at Aqua Dogs, whereby a swimming session once or twice a week is used as an extra form of exercise to help dogs shift those excess pounds. We will also keep weekly records of the dogs weight and measurement progress. For more details on this or any of our services please feel free to give us a call to discuss, or arrange a visit to see the facilities in action. On this note Sam Morgan, RCO for the BVNA in South Wales is organising an event at our centre on Thursday 5 th March, 7pm buffet for a 7.30pm start. Myself and Sarah Price will be giving short talks on the benefits of hydrotherapy and physiotherapy, related to weight loss and other conditions, along with a demonstration of the pool and under water treadmill. If she hasn t done so already, Sam will be sending out invites to you all. For more information please contact Sam Morgan at Park Veterinary Group on 02920 382211 or 07711 333023 sammorganvn@hotmail.com We hope to see lots of you there. Contents Page 1: Introduction and news Swim to Slim campaign BVNA night March 7 th Page 2: Busta and Bruce s stories Badger Page 3: Henry and Anya s stories Page 4: Tashi and Duke s stories Angela and Ebony Page 5: Du s Story Page 6: Extracts from paper on and 7 Physiotherapy treatment after TPLO in dogs Page 8: Sponsored Doggie Paddle Day Chip
Newsletter 2 Page 2 So here s some news from our clients Busta Breed: Labrador; Age: 10; Owner: Sarah Trayhorn; Condition: bilateral elbow dysplasia and arthritis; Veterinary Practice: Chepstow Vets Busta has been coming to us since 23 rd June 2008. He was very stiff on his front limbs, especially the left, with decreased range of movement in his elbow and shoulder. We worked with Busta in the under water treadmill starting with water just above his carpus giving him good flexion and extension of carpus and elbow, at a steady walking speed, for only a few minutes. He wasn t too keen on the water going any higher than this so as Busta's confidence has grown we have progressed to water just above his elbow, giving greater flexion and extension, for 15 minutes. He manages this (with a little bit of encouragement from Mum Sarah!) quite easily. He was also seeing Sarah Price for Physiotherapy treatment. With the use of muscle stimulation and a wobble board Sarah was given a routine to carry out at home with Busta to improve the muscle tone in his left bicep muscles. He is now doing so well he no longer needs this treatment and just has weekly treadmill sessions for maintenance, which we will slowly cut down to fortnightly and then monthly sessions. "I would recommend physiotherapy & aquatherapy to any pet owner who has concerns about the mobility of their dog. Busta, my 10+ year old labrador means the world to me and when he started to suffer from arthritis I consulted with my vet to ensure he received all the help he could get. We used a number of nonsteroidal treatments to help with his joints including tablets, special diets and injections of cartrophen - all of these things helped but over time he continued to deteriorate. I had resigned myself that he would continue to deteriorate to a point where he would be in too much pain or immobile and this prospect was awful. Busta has spent his life with a tennis ball or frisbee in his mouth and had always been a bundle of energy. In a final attempt my vet suggested physiotherapy although I am not sure how confident they were - I can tell you the results have been amazing. The combined treatment of the physiotherapist in conjunction with the aquatherapy she recommended has been more successful than anything I could have imagined - it is like turning back the clock 5 years! I do not fully understand why it is so much more effective than straight forward exercise but can tell you with certainty that it is. It has taken time, but he is so much more agile and most importantly happy!! He is back to the cheeky energetic dog I had almost forgotten and I cannot thank all of those involved enough. He used to struggle with a few steps in my back garden, now he jumps up to the lawn over a 3 foot wall! I really think he has forgotten how old he is!! I have been impressed by the genuine concern Angela has shown for Busta, making sure he is not overexerting himself and being infinitely patient when he is obstinate or misbehaving- which seems to happen more often now he is re-energised! If you have a dog who has mobility issues I would recommend this as your first remedy to consider rather than last as it was for us, if only we had known about physiotherapy and aquatherapy benefits earlier." Sarah Trayhorn, November 2008 Bruce Breed: Greyhound; Age:10; Owner: Angela Morris; Condition: Arthritis in hips; Veterinary Practice: St Davids Veterinary Practice, Pentwyn. Bruce has been coming to us since August 2008. On arrival he was very stiff on his hind limbs and quite ataxic. We started work with him in the under water treadmill with water at his hip level to allow him to have a lot of support from the water and get good movement of his hips and stifle joints. With this treatment, regular courses of cartrophen injections and Rimadyl, we are able to keep Bruce s condition under control, at a level where he is happy being Bruce! We are now able to work with less water and can see an increase in his muscle bulk, which in turn is helping to stabilise his hips. My greyhound Bruce has been undergoing hydrotherapy treatment to ease the pain and stiffness caused by arthritis in his hips. We noticed an improvement after 3 or 4 sessions. After 7 sessions his movement has improved significantly and he is now full of beans and full of cheek once again-it s absolutely wonderful! He also has some specific requirements tat Angela and the team have bent over backwards to accommodate. I will never be able to thank them enough for what they have done for us. Angela Morris, November 2008
Newsletter 2 Page 3 Henry Breed: West highland terrier cross Bichon Frise; Age: 9; Owner: Nerys Baber; Condition: cruciate repair on left hind limb in February 2008 along with arthritis in hips and right knee; Veterinary Practice: St Davids Veterinary Centre, Pentwyn. We discovered last year that Henry had arthritis in his hips and knee, which may well have been present since a puppy. He had not shown any signs of being in pain & we were not aware of him having arthritis until Christmas 2007 when he could not get up off the floor. After further investigation is became apparent that he had also shredded his cruciate ligament and it required re-constructive surgery. His recovery wasn t too bad but the once loveable and gentle dog had slowly over time become grumpy, depressed and shy. The Vet suggested that Henry attended hydrotherapy as part of his rehabilitation. At first he wasn t too sure but by the third session Henry loved it. It was brilliant to see him so lively in the water and happy. I thought it would help him physically but I never imagined how it would help in other ways. The difference is incredible and even his fur appears to be in better condition. He loves swimming and if he ever misses a session he sits at his towel and nudges it (and people say dogs are stupid!) I know it sounds strange but it s like he s returned to his old self and I ve got our loveable Henry back. I can t thank Angela and the team enough for their understanding, care and patience, especially at the beginning when he was still shy and scared of people touching him. My friends and family have all commented on how it s great to see the old Henry again. Aqua Dogs has given Henry a second chance at life. As Nerys says Henry was a very nervous little dog when he first came to us on 15 th April 2008. It seems hard to believe now that he didn t even like the pool! He has progressed from 2x 1min swimming twice a week to 20 minutes once a fortnight. The muscle bulk that he had lost on his left leg is all back and he comes now for fun more than anything else (although in this cold weather it is helping his arthritis). Nerys Baber, December 2008 Anya Breed: Labrador; Age: 10; Owner: Jacky and Philip Gold; Condition: suffers from arthritis and weight loss required ; Veterinary Practice: Heath Vets, Rhiwbina. Anya, our 10 year old labrador had a lipoma surgically removed from under one of her forelegs as it was impeding her walking. After the operation she was still limping badly and although she still managed her food (she is a labrador!) she had lost her zest for life and barely wagged her tail. We thought it might be the beginning of the end... We saw a card for Aqua Dogs on the desk at the vets and on one of our check ups asked whether aquatherapy would ameliorate her condition. The vet agreed it could certainly do no harm, and as part of a weight loss programme, the exercise should give her a better quality of life. I was walking with her every day about a mile to our business and we would get about a third of the way before she visibly tired and slowed down. The first trip to Aqua Dogs she went into the pool as she normally loved swimming but she was only exercising her front legs so it was decided that the treadmill would be the best form of therapy. Anya first visited us on 15 th March 2008. She has become a new dog since starting her hydrotherapy sessions. In the early days she used to struggle to keep up, but now she can manage 20 minutes at a fast walking speed with no problem at all. After several weeks on the aqua treadmill - we have our old dog back again! Her eyes are bright, her tail wags, her appetite is keen again and she walks the mile to work easily with energy to spare. She looks forward to her trips to aquatherapy and loves Angela and her Mum...and the biscuit tin at the end of the session! The sessions are getting longer and longer and tire her out but she is still enthusiastic and has learned to breathe in when she gets on the scales!! Thank you Aqua Dogs! Jacky Gold, January 2009
Newsletter 2 Page 4 Tashi Breed: Tibetan Terrier; Age:9; Owner: Kim & Paul Marshall; Conditon: Stiff in hips and spine, possibly neurological leading to strange gait pattern. Had cruciate surgery on left hind a couple of years ago; Veterinary Practice: Barry Health Centre On recommendation by our vet, Tashi, our Tibetan Terrier, received hydrotherapy treatment at Aqua Dogs, Cardiff to try and rectify his irregular gait, curved back and also to assist healing after a cruciate ligament operation. Tashi initially did hydrotherapy 2 times a week over a 10 week period followed by an additional 11 sessions 2 times a week. He enjoyed his walks in the water treadmill immensely as he was able to walk at a good pace for up to 15 minutes. His gait has almost returned to normal and he seems comfortable on walks and able to romp much more freely. We have also noticed Tashi s confidence has returned and he is much more happier. Together with our vet we have noticed a huge difference in his recovery with the support of the hydrotherapy. The staff at Aqua Dogs, Cardiff have been wonderful, supportive and knowledgeable and I recommend this as a valid and helpful treatment process. Kim Marshall, November 2008 Tashi started coming to us in May 2008. He has a very unusual gait pattern, where he looks stiff in his back and spine, with loss of muscle bulk in his hind limbs. We started treatment with Tashi in the pool, but as he wasn t actually moving his back legs we moved to the under water treadmill. In here he has come on extremely well. Tibetan Terriers have a prance which Tashi will only do when he picks up some speed. At slow speeds he paces. In the treadmill we are able to control the speed that he walks at to see exactly when this transition takes place. With deep water he will do this prance at a normal walking speed but as you lower the water he begins to pace again. This indicates that he has some pain somewhere in his back or hind limbs. He has recently started physiotherapy treatment with Sarah to try and work on these sore spots. He definitely still has some weakness in his left hind limb as a result of his cruciate surgery. Duke Breed: Labrador; Age: 13; Owner: Ken Langley; Condition: Chronic right hind limb lameness. Walking on toes of foot and twisted medially. Not walking on pads; Veterinary Practice: Park Vet Group, Sanatorium Road. Duke has been coming to us since March 2008. His condition is better treated in the under water treadmill as we want to encourage a normal walking pattern, but as he loves to swim so much we let him do a bit of both. When Duke first started in the treadmill his proprioception on his affected limb was very poor which meant in deep water he wasn t aware of where his foot was. Over the months this has improved so much so that he can now walk with a nearly normal gait with water at his hip level. Duke over compensates with his front end and so suffers with pain in his shoulders. He has monthly physiotherapy treatment with Sarah Price where she will work on his sore spots. She has also given Ken exercises to do at home with Duke on the wobble cushion to help strengthen the muscles in his hind quarters. During the time that Duke has been attending there has been a marked improvement in his condition and he looks forward to every visit. Ken Langley, December 2008
Newsletter 2 Page 5 Du Breed: Labrador; Age: 4; Owner: Ann Carryer; Condition: Lumbar and lumbosacral arthritis (spondylosis); Veterinary Practice: Park Veterinary Group, Sanatorium Road Du was in so much pain that he was unable to walk properly and even refused to go outside. Du is a four-year-old black Labrador Retriever, who is normally full of life as you would expect from a dog of his age. We originally thought it was due to some injury but when Du s x-rays showed he had arthritis of the spine it was very upsetting. We were advised that because of his condition, he would probably have to take courses of anti-inflammatories on a regular basis to ease the pain for the rest of his life which was not an attractive prospect. Also jumping up and chasing balls was to be avoided. After discussing the options with our vet, Andy, he agreed to let us try water therapy. Du started his sessions with Angela on the 1st September 2008 and started with twice weekly sessions on the water treadmill. Du gradually built up to 15 minutes and after ~ 8 weeks of twice weekly this has now dropped down to once a week. It is now the beginning of December, and since starting the treadmill sessions, Du has not required any anti-inflammatories. He does sometimes over do it (as you might expect from a 4 year old!!) and this is evident when he starts the treadmill session. Amazingly though after about 5 minutes you can see the change in his posture and he starts walking much more normally. Du loves his time at Aqua Dogs, but I m not sure if it s the exercise he enjoys or the kindness and affection that Angela and her mum, Ruth, always show him. We would like to say a big THANK YOU to Angela and Ruth. Although Du will never get better, our trips to Aqua Dogs mean that Du can lead a normal healthy happy life, still enjoying his walks in the fields and paddling in the stream. Here s to many more happy doggy years!! Many Thanks Aqua Dogs Ann Carryer, December 2008 Du s first session with us was on 1 st September 2008. He was noticeably lame on his left hind on land. In the treadmill with water at elbow level he had a shorter stride length with his left hind and was leaning on his right side. He came to us twice a week and after 7 sessions both hind legs were straight with even stride length and weight bearing. We have now decreased sessions to once every 10 days and he is doing just fine. If he ever over does it at home we can notice he is a bit stiff when he comes in, but within 5 minutes in the treadmill he will be back to normal again.
Newsletter 2 Page 6 The following is a summary of an article on Effects of early intensive postoperative physiotherapy on limb function after tibial plateau leveling osteotomy in dogs with deficiency of the cranial cruciate ligament Michelle L. Monk, MAnimSt; Christopher A. Preston, BVSc; Catherine M. McGowan, PhD AVJR, Vol 67, No. 3, March 2006 Deficiency of the CCL is the most commonly diagnosed stifle injury in dogs. It results in lameness, muscle atrophy, and ongoing poor limb function even after surgical correction. There have been numerous studies investigating the benefits of various surgical procedures for CCL deficiency. However, only in a few studies has attention been paid to the importance of postoperative rehabilitation. Several authors have documented the benefits of postoperative physiotherapy in the recovery of dogs after extracapsular surgery to stabalise the CCL. The TPLO is a relatively new and innovative surgical treatment for CCL-deficient stifles. To our knowledge, there have been no investigations of the effects of physiotherapy after TPLO surgery for CCL deficient dogs, although a rehabilitation program that includes under water treadmill exercise has been suggested to allow exercise with reduced weight bearing stresses while the osteotomy heals. Use of UWTM exercise in the rehabilitation if dogs is increasingly popular because of the ability to exercise dogs during weight bearing with reduced loading as a result of the buoyant force of the water. Exercise on a UWTM can increase joint range of movement when the water level is higher than the joint of interest. Ongoing muscle atrophy after CCL surgery is a common problem in dogs. In 1 study, thigh muscle mass continued to decrease for up to 5 weeks after transection of the CCL and began to increase only at 10 weeks after CCL transection, despite immediate stabilisation of the joint after CCL transection. Thus it seems crucial to commence physiotherapy in this early postoperative period and continue it for at least 6 weeks. Therefore the objective of the study reported here was to investigate the effects of an early intensive postoperative physiotherapy program (including UWTM exercise) and a home-exercise program on limb function after TPLO surgery for CCL deficiency in dogs. The study involved 8 dogs being split into 2 groups of 4, with one group receiving the intensive physiotherapy treatment program and the other a home exercise program. Initial measurements of thigh circumference (TC), range of movement (ROM), tibial plateau slope angle (TPA) and lameness score were recorded before surgery and then at time of discharge on the first day after surgery, at day 10 after surgery (day of suture removal), and at the end of weeks 3 and 6 after surgery. The 2 groups were treated in the following ways: Physiotherapy Ice pack used 2 hours after surgery on stifle joint for 20 minutes, followed by flexion and extension passive ROMs on the stifle for 30 repetitions. Short leash walk to defecate and urinate. After discharge instructions were given to owners to keep dogs restricted inside the house for the first 6 weeks. No unsupervised exercise; no running, jumping, or climbing of stairs; assisted when getting in and out of car. A progressive program of physiotherapy was initiated including massage of the thigh muscle, passive ROM of the stifle joint, functional weight bearing exercises, use of ice packs and controlled walking on a leash from weeks 1 to 6 after surgery. (Appendix 1) Dogs returned to surgery for physiotherapy 3 times/wk for 6 weeks, where the physiotherapist would perform one of the exercises for that day and monitor how the owner was doing. After suture removal on day 10 after surgery progressive under water treadmill (UWTM) exercise was completed at each physiotherapy session in place of walking on a leash for that day. The tank was filled to the level of the greater trochanter and operated at a comfortable walking speed.
Newsletter 2 Page 7 Appendix 1 Time after surgery (wk) Treatment 1 2 3 4 5 6 Massage (min)* 5 5 5 5 5 5 Stifle flexion and extension (repetitions)* 30 30 30 30 30 30 Ice pack (min)* 15 - - - - - Sitting to standing (repetitions)* - 5 10 15 15 20 Weight shifiting (min)* - 1 2 - - - 3 legged standing (10 repetitions)* - - - 3 5 10 Leash walking (min) + 5 10 15 20 25 30 Figure 8 s (repetition) - - - - 10 10 Steps (repetitions)+ - - - - 10 10 UWTM (No of sets x min) ++ - 3x3 2x5 2x7 1x15 1x20 *completed 3 times/day. + performed 2 times/day ++ number of sets per session times the number of minutes per set. Home-exercise treatment at time of discharge owners were given the same instructions as the physiotherapy group, to keep the dog contained in the house. No unsupervised exercise; no running, jumping, or climbing of stairs; assisted when getting in and out of car. Walking program was identical to that of the physiotherapy group; 1 st week after surgery, 5 minutes of controlled walking on a leash twice daily to be increased by 5 minutes/walk each week up to a maximum of 30 minutes by week 6. No other exercises were instituted. On day 10 after surgery dog returned for suture removal and physiotherapy examination where measurements were taken. This was then repeated at end of 3 and 6 weeks. All 8 dogs were chosen on the basis of having unilateral CCL deficiency, lack of any other neurological or orthopaedic injuries or disease, body weight between 20 and 40kg, and body condition score between 5 and 7 (scale 1 to 9, with 1 being emaciated and 9 grossly obese). Dogs were aged between 3 and 8. Results Table 1. Comparative measurements before and 6 weeks after TPLO surgery for physiotherapy and home exercise groups. Measurement Physiotherapy Group Home Exercise Group Before surgery 6 weeks after Surgery Before Surgery 6 weeks after Surgery TPA 27.5+/-6.6 0 5.2+/-1.5 0 28.5+/-0.6 0 5.0+/-0.8 0 TC (cm) 41 43.75 37.5 37 ROM (extension of stifle) 0 145 155 151 138 ROM (flexion of stifle) 0 50 41 45 57.5 Lameness 2.75+/-0.5 2.0+/-0.82 2.5+/-0.58 2.0+/-0.0 Willingness to bear weight on affected limb 2.75+/-0.5 2.0+/-0.0 2.5+/-0.54 2.0+/-0.36 while standing Willingness to life the contralateral limb 3.0+/-0.82 2.25+/-0.96 3.0+/-0.0 2.5+/-0.58 Variables were scored on a scale of 0 to 5 (lameness) or 1 to 5 (willingness to bear weight on affected limb while standing and willingness to lift the contralateral limb). Values reported above are mean values. Analysis of results of the study reported here revealed that early intensive physiotherapy after a TPLO for CCL deficiency in dogs was more successful in increasing TC and flexion and extension ROMs of the stifle joint, compared with results for a home exercise program. No differences were found between treatment groups for lameness scores, willingness to bear weight on the affected limb, or willingness to lift the contralateral limb. Muscle atrophy was completely prevented with values for TC measurements after 6 weeks being similar to those of the nonaffected limbs. Prevention of atrophy and restoration of muscle strength are essential for restoring the knee to normal function and preventing reinjury. Therefore, commencing a program of intensive physiotherapy on the first day after a TPLO in dogs may hasten restoration of function and reduce discomfort by preventing atrophy and increasing muscle strength. Here at Aqua Dogs with combined Hydrotherapy and Physiotherapy treatment we hope to be able to work with you and the dogs owners to get all dogs back on their feet again as soon as possible.
Newsletter 2 Page 8 Aqua Dogs News Sponsored Doggie Paddle 2008 We held a Sponsored Doggie Paddle Day on Sunday July 20 th 2008, where 19 of our dogs either swam or walked in the treadmill for 10 minutes. Their owners collected sponsorship money on their behalf and we are pleased to announce that we raised just over 2300 for The Guide Dogs for the Blind Association and The Dogs Trust. It was a wonderful day. So much so that we plan to make it an annual event. All Dogs were given a certificate and rosette for their hard work! Sharon in the treadmill Badger enjoying his swim! Zac and Barney John, Jennie, Verna, Pete and Sharon enjoying a cup of tea in the sunshine Cheque presentation to The Guide Dogs and The Dogs Trust