The most common neurologic condition seen at veterinary physical rehabilitation facilities is thoracolumbar Intervertebral Disc Disease (IVDD) followed by Fibrocartilaginous Embolism (FCE). Generalised central nervous system inflammatory disorders such as Granulomatous Meningoencephalitis (GME) and polyradiculoneuritis are also encountered. Brachial plexus avulsions and radial nerve paralysis do also find their way to rehabilitation facilities. Vestibular syndrome and other balance disorders are far less common but physical rehabilitation has a role to play in their management.
The benefits of consulting a physical rehabilitation practitioner for a patient with a neurologic condition are many. Rehab practitioners allocate sufficient time to explain to clients the best way to manage a paralysed or compromised dog. Issues to consider include prevention of decubital ulcers and management of patients with compromised bladder and bowel function. Much time is spent questioning the client about lifestyle and environment and assisting them to find a solution to the intense care their companion will require, hopefully only for a limited period before they improve. Many people struggle to confine or restrict their beloved companions. Rehabilitation practitioners support the clients by teaching skills, giving behavioural advice and offering moral support. Some practices can assist with kennelling or day care options.
Lots of guardians are unaware of how to move a paralysed dog and are afraid to do so in the event that more damage may be caused. Rehab practitioners are well versed in this area, as well as being able to advise regarding full body harnesses, slings and possibly mobility carts. Soft or rigid supports may be needed for distal limbs and rehab professionals have been trained in casting and using thermomoulds to create a rigid support which is affordable in the short term when compared to custom-made braces. These, too, can be recommended.
The importance of requesting rehabilitation treatment early in the course of neurologic condition cannot be emphasised enough. IVDD and FCE dogs show the best recovery if introduced to neurologic rehabilitation early in the course of the disease. After spinal injury there is a 6 – 8 week window period to influence neural plasticity to the greatest extent possible. If patients begin with neurologic rehab after the 8 week period progress can be made but recovery often takes longer and is perhaps not as complete.
Dogs with brachial plexus avulsions and radial nerve paralysis need to have neurological patterning stimulated as soon as possible after the injury. Braces for distal limbs and management of wounds caused by the condition, or by self-mutilation, form part of our scope of practice. These injuries often carry a grave prognosis but the sooner the dog begins rehabilitation the greater the chance of influencing the neural repair and eventual outcome. Even though the recovery may be incomplete, early rehab can influence and hopefully regain at least partial function of the limb.
Next time you are faced with a neurologic patient consider working in partnership with a veterinary rehabilitation practitioner to enhance the recovery and outcome of your patient.
Your clients will thank you for it.