Almost immediately after my youngest dog, Sirius, had surgery on both of her knees last year, I brought her to see a physical therapist. This certified animal rehabilitation specialist created a personalized conditioning and rehabilitation plan for Sirius. One of the most useful modalities of treatment that Sirius received was hydrotherapy. It allowed her to maintain all the muscle she had developed in her Rally Obedience and agility training prior to her knee injury – and best yet, she loved the underwater treadmill. Sirius had one physical therapy session per week for eight weeks and was cleared to resume normal activity just 10 weeks post-surgery.
About 10 months later, my 10-year-old Cattle Dog-mix, Charlotte, went from walking multiple miles a day and training in sports to not being able to get up – overnight! We carried her into an emergency vet clinic where she was diagnosed with a herniated disc. We were told she would never walk comfortably again and that we should be thinking about of end-of-life decisions.
Two days later we brought her to the same veterinary rehabilitation specialist who worked with Sirius; we doubted the dire prognosis we had been given for Charlotte and weren’t ready to give up on a dog who had been so vigorous so recently! Through a combination of therapeutic treatment modalities, which included twice weekly hydrotherapy for the first month, Charlotte also made an (almost) complete recovery and was cleared to do everything she loves: hiking, swimming, long walks, trick training, etc.
I credit so much of my dogs’ recovery to hydrotherapy and skilled certified veterinary rehabilitation specialists.
HOW HYDROTHERAPY HELPS
Canine hydrotherapy is a beneficial treatment modality for dogs recovering from many orthopedic injuries, as well as degenerative conditions like arthritis, because allows dogs to move while bearing little or no weight on an injured limb. A less commonly considered benefit of the treatment is increased self-confidence for a dog who is injured or old.
Hydrotherapy isn’t dogs just splashing around in a pool, and the healing potential for injured dogs can’t be achieved by just bringing your dog somewhere for a recreational swim. There are two primary modalities of hydrotherapy treatment that dogs might receive: working on an underwater treadmill and therapeutic swimming. “The added resistance from water is excellent for increasing cardiovascular fitness, while providing low impact resistance muscle training,” says Marti Drum, DVM, Ph.D.
Dr. Drum is a Diplomate of the American College of Veterinary Sports Medicine and Rehabilitation (ACVSMR), a Certified Canine Rehabilitation Practitioner, and a Clinical Associate Professor in the Small Animal Clinical Sciences Department at the University of Tennessee, Knoxville. She is also the acting service chief of the physical rehabilitation service at the University of Tennessee Certificate Program for Canine Rehabilitation – and a huge fan of hydrotherapy!
If your dog is injured or has surgery, chances are your general veterinarian has recommended crate rest to keep your dog quiet. Crate rest might make healing easier for you, but it can significantly decrease the likelihood of your dog returning to normal function. Additional injuries and arthritis can occur if dogs are not appropriately re-conditioned after surgery or injury. While you don’t want a dog running around and causing more damage to an injury, crate rest doesn’t promote optimal healing. Today, humans who have knee or hip surgery are quickly started on physical therapy, and increasingly, veterinary medicine is recognizing the importance of this as well.
We know there are devastating consequences to limb immobilization. Not using a limb for several weeks or months causes changes to the muscle, tendon, cartilage, bone, and ligaments that can make those tissues weaker than normal,” Dr. Drum says. “Encouraging early limb use in the immediate post-operative phase actually benefits most surgical procedures to help stimulate healing, particularly bone healing, and reduce recovery times.
It’s important to note that this is controlled activity under the direct supervision of a veterinary rehab specialist and that dogs who are recovering from surgery or injury will need activity restriction. Allowing your dog to do too much, too soon could result in “catastrophic failure of the repair” Dr. Drum cautions.
The underwater treadmill used by veterinary specialists looks a lot like a fish tank. During treatment, your dog will enter the treadmill (sometimes with a life vest on) either on her own or with a certified technician. The dog enters the glass tank when it’s empty, and then the door is closed and the tank is slowly filled with warm water (between 80° and 94° F).
The depth of the tank is adjusted according to the dog’s size, her specific injury, and how far along she is in the recovery process. If the therapist determines that she should be bearing no weight whatsoever, the tank is filled to a level that enables the dog to float with her paws just barely touching the treadmill. The lower the water level, the more weight she will bear on her limbs.
Once the water reaches the desired depth the treadmill floor begins moving at the speed determined by the specialist. When this happens, most dogs naturally will begin walking – even dogs who are experiencing too much pain or are too weak to walk on land often begin moving in the underwater treadmill because of the support and buoyancy the water provides. Depending on where the individual dog is in her recovery process, jets may be used to add increasing levels of resistance and the speed of the treadmill can be adjusted to support building muscle or to maintain muscle.
In addition, says Dr. Drum, “The treadmill belt itself helps encourage a rhythmic gait to facilitate gait retraining.” This was certainly the case with my Charlotte, who had to be carried into the clinic, but a few days later, was able to walk comfortably in the underwater treadmill.
While walking on the underwater treadmill and walking on land are both low-impact forms of exercise, practitioners see stronger results for dogs who are able to exercise in underwater treadmills. The added resistance from the water helps dogs gain more muscle tone than from walking on land.
The water also supports a dog whose balance has been impaired. The support provided by the water enables and encourages dogs to move their joints in a nearly normal full range of motion. Plus, dogs who need to lose weight can burn more calories by working on an underwater treadmill than they can on land.
The second modality of canine hydrotherapy is therapeutic swimming, where dogs are gently guided into a small, heated pool and supported in swimming by a certified canine rehabilitation specialist. They are generally fitted with a canine life jacket, and dogs who are prone to ear infections may also be fitted with a canine “swim cap” that prevents water from entering their ears.
While beneficial to many dogs, therapeutic swimming isn’t an appropriate treatment for every injury. When swimming, most dogs primarily propel themselves through the water by using their front legs, so it wouldn’t usually be appropriate for dogs who have shoulder or front limb injuries, Dr. Drum says, as it can aggravate those conditions and slow recovery. Hydrotherapy may not be appropriate for dogs with groin injuries (strains of the iliopsoas muscle), either.
Dogs with back, hip, and knee injuries often benefit from hydrotherapy, as do dogs who are recovering from surgical repair of injuries. And hydrotherapy is increasingly recommended as a useful treatment modality for proactively conditioning for canine athletes and working dogs.
But dogs don’t need to have an injury to benefit from hydrotherapy. Dr. Drum says osteoarthritis is the most common condition she sees treated with hydrotherapy. Older dogs who have arthritis constitute about half of the hydrotherapy patients that Dr. Drum sees, and she describes the benefits to these dogs as “profoundly positive.” Senior dogs who suffer from arthritis pain often experience decreased energy and activity, which can result in loss of muscle mass and weight gain – which, in turn, increases the stress on the already compromised joints.
Dr. Drum says, “It is not uncommon that our senior and geriatric patients experience a rejuvenation simply from starting a good hydrotherapy routine,” no more than once or twice a week, but at least once every two weeks. “You have to ‘use it or lose it’ to maintain muscle and cardiovascular fitness,” she says.
When my active, well-conditioned dog Charlotte was recovering from a herniated disc, she was unable to walk on land and quickly grew depressed and even more anxious than she is ordinarily. But during her hydrotherapy sessions, her confidence and happiness visibly increased as she discovered that she could move in the water without pain, and this seemed to give her more confidence as she slowly regained the ability to walk and move on land as well.
Hydrotherapy For Sports Rehab
Hydrotherapy isn’t just for dogs who are aging or injured, it is also a fantastic treatment modality for conditioning canine athletes who train or compete in anything from agility to carting and every sport in between.
Debra Canapp, DVM, is co-owner and Medical Director of Veterinary Orthopedic and Sports Medicine (VOSM) Group, located in Annapolis Junction, Maryland. Dr. Canapp and her staff frequently employ hydrotherapy as a critical conditioning tool for many of their canine-athlete patients. Her clinic sees many hunting dogs and flyball dogs who come regularly for therapeutic swimming during their “off” seasons. Dr. Canapp explains that for these canine athletes, “Swimming is great because we’re taking the impact off their joints while improving cardiovascular conditioning.” This allows these dogs to stay in peak condition between competition seasons without adding high-impact stress to their bodies.
Hydrotherapy is also one of the tools Dr. Cannap utilizes to get these sport dogs back into the game after an injury. Dr. Canapp explained that her state-of-the-art sports medicine clinic models itself after the best practices in human medicine and core to that is the idea that dogs who are injured – especially active, athletic dogs – shouldn’t be kept on strict crate rest. Instead, for optimal healing (including returning to sports training) appropriate and supervised rehabilitation is essential. In human sports medicine, a return to pre-injury level is seen as the definition of success, and VOSM has the same goals for their canine athletes.
Hydrotherapy will likely be only part of the treatment your dog receives. Dogs who are recovering from injury or surgery are likely to need multiple modalities of treatment in order to achieve optimal recovery. Hydrotherapy treatments are often provided in conjunction with structured exercises both at therapy sessions and for owners to follow-up with at home between sessions.
Anti-inflammatory and/or pain medications are usually prescribed, at least initially. Other holistic treatment modalities such as acupuncture and laser therapy may also be offered and provided by your dog’s rehabilitation specialist.
If you think that your dog might benefit from hydrotherapy treatment, you can either ask your general-practice veterinarian for a referral, or schedule a consultation and evaluation with a certified veterinary rehabilitation specialist on your own. If you find a practitioner on your own, however, be aware that not all people who are offering these services have the same amount or type of training.
It’s increasingly easy to find dog trainers, massage therapists, and even veerinary practices who offer “canine conditioning” classes or workshops that include swimming in a therapy pool. If your dog simply needs help with weight loss, zero-impact exercise, or conditioning, these services may be just fine.
But if your dog is recovering from an injury or surgery, her therapy would be best guided by a professional with as much education and hands-on training and experience as you can find. It’s important to utilize hydrotherapy for an injured dog only under the supervision of specialized veterinary professionals who can determine whether the therapy is right for your dog, and to create an individualized treatment plan for your dog’s specific health needs.
If they are not certified specialists, the therapy they provide for your dog may be at best ineffective and at worst cause more injuries or prolong healing. As just one example, a common mistake for those not properly trained is to leave a dog on the treadmill for too long, which can result in the dog becoming sore and prolonging healing.
For injured or post-surgical dogs, look for certified rehabilitation practitioners – people who have completed specialized training on top of their DVM or veterinary nursing degrees. Dr. Drum advises that owners look for specialists with one of the following credentials:
- Certified Canine Rehabilitation Practitioner (CCRP). (Dr. Drum especially likes the program at the University of Tennessee that offers this certification.)
- Certified Canine Rehabilitation Therapist (CCRT). (Dr. Drum favors the University of Florida’s program for this certificate.)
- Certified Canine Rehabilitation Assistant (CCRA) or Certified Canine Rehabilitation Veterinary Nurse. People with this certification can provide services under the supervision and guidance of a rehabilitation-certified veterinarian.
Because hydrotherapy is such specialized treatment, there aren’t certified practitioners in every community and you may have to travel to find appropriate treatment for your dog.
Finally, no matter what services you are seeking for your dog, always ask for (and check) a practitioner’s references, and read any online reviews left by former clients.