HEALING BY DESIGN

Sports medicine can speed up recovery time for pets too

by Electa Draper

It’s no coincidence, as the saying goes, that man’s best friend can’t talk.

Yet it makes diagnosing their medical problems hugely challenging. Whether it’s a dog or cat — couch potato or athlete — these animals can’t tell their human companions or veterinarians exactly what’s hurting them and what’s helping them after an injury or surgery.

While sports medicine and rehab has a long history among human and equine athletes, Colorado State University is helping pioneer this offshoot of orthopaedics for dogs and cats, using a design mindset to resolve complex medical issues.

CSU’s Small Animal Sports Medicine and Rehabilitation service – established just a few years ago – offers an array of surgical and nonsurgical treatment options to improve patient comfort and speed up recovery time. The program also strives to more successfully manage chronic conditions, such as osteoarthritis in older pets and hardworking dogs.

“To some degree, what we are trying to do is to invent and define what sport rehab is in small animals,” says Dr. Nic Lambrechts, faculty member in Small Animal Orthopaedics and Sports Medicine at the James L. Voss Veterinary Teaching Hospital. “We’re becoming more demanding in our outcomes and the best ways to achieve them.”

Lambrechts, board certified by the European College of Veterinary Surgeons and the American College of Veterinary Sports Medicine and Rehabilitation, is only half-joking when he says some therapies that appear effective are more art than science.

“What we’re trying to do is identify and understand and localize the individual’s disease – drilling down into the context, extent, nature, physiology, and history of an injury or illness,” Lambrechts says. “If the owners are willing, we’ll keep on working until we get a diagnosis. If we really understand the mechanism, then we can decide on the most appropriate treatment.”

Designing goals for recovery

Once veterinarians diagnose an injury or condition, more design thinking comes into play. Along with therapists and pet owners, veterinarians set specific recovery goals. Together, they observe the patients. They determine medical treatment and a rehabilitation plan, carried out at the clinic and at home. They undertake specific assessments at key intervals to monitor progress. They modify the program as needed to improve results.

“We need to be able to demonstrate that what’s being done is useful,” Lambrechts says. “We need to pool our data into a cogent whole. We need big numbers to see if this working for lots of dogs.”

Gathering data

Dr. Felix Duerr, the orthopaedic surgeon leading the Small Animal Sports Medicine and Rehabilitation service, is dedicated to evaluating objective measures of treatments and therapies.

Duerr and the team use “objective gait analysis” to help determine if there is real improvement in lameness. The Tekscan Animal Walkway System consists of a low-profile mat with grids embedded with thousands of pressure-sensitive sensors that electronically capture each paw imprint as the dog moves. Data is then available on stance, stride time, force, and symmetry.

Duerr is also investigating other methods of gait evaluation, including a harness system fitted with inertial measurement units, or sensors that can capture joint-motion data outside the laboratory – in the dog’s natural environment where he or she can move freely. This method is less expensive than the optical instrumentation used in labs.

Pressure sensors have also been used to determine the best dimensions and placements for casts and braces to avoid irritation and sores, Duerr says.

CSU researchers have evaluated activity monitors that attach to a dog’s collar to obtain real-time data on movement and exercise while the animal is behaving as he or she normally would at home.

“The technology is evolving so quickly, veterinary science is taking huge steps in obtaining more accurate, objective data on animals in their natural environments,” Duerr says. “That is the goal.”

TOOLS AT THE READY

While a relatively new service compared with the equine counterpart, CSU’s Small Animal Sports Medicine and Rehabilitation’s diagnostic and therapeutic tool chest is already massive, and this is only a partial list:

  • Diagnostic and therapeutic ultrasound
  • Magnetic Resonance Imaging (MRI)
  • Computed Tomography (CT)
  • Positron Emission Tomography/Computed Tomography (PET/CT)
  • Stem cell therapy
  • Platelet-rich plasma (PRP)
  • Arthroscopy
  • Cold laser therapy
  • Extracorporeal shockwave therapy
  • Electrical stimulation
  • Underwater and land treadmills
  • Therapeutic exercise using fitness equipment
  • Manual therapy
  • Lite gait training supporting the body with a sling
  • Game Ready dry cold compression
  • Sports conditioning

Rehab builds on surgeons’ work

Zirks, a sweet-faced, golden-furred 3-year-old Chinook sled dog from Eagle, who also pulls her humans on skis, has been experiencing recurring pain in her shoulder and lower spine. She’s come to the vet teaching hospital for a checkup.

Sasha Foster, the hospital’s certified canine rehabilitation therapist, gently handles and probes Zirks’ trouble spots. She notes the dog’s tells, including some lip-licking and small spasms, as she tenderly manipulates bones, muscles, and tendons. They sit together on a large raised, padded platform in a small room in the “gymnasium.” Zirks is relaxed, even cuddly with Foster, who is known for calm energy and touch.

Zirks is also slated for diagnostic ultrasound to assess any tendon tears and progression of osteoarthritis in her shoulder. That news is mostly positive. Foster discusses with Zirks’ people the results and describes best stretching and strengthening exercises for their high-performance athlete at this stage of her program.

The clients, Deb Meese and Tom Goldthwait, report to Foster in great detail what is going on at home with Zirks and her older “sister,” 8-year-old Qivi, another powerful Chinook working dog.

“What I really like about coming here is that they’re willing to work with us. They listen to us,” Meese says. “I think the rehab here is truly helping. Zirks and Qivi love the exercises. They get lots of attention. We see their improvement.”

Foster works next with Jack, an older dog recovering from surgery after an accident that damaged his hip socket. It’s tricky designing a rehab program for Jack.

“We have to get him using his muscles without ruining the surgeon’s work stabilizing the socket,” Foster says.

Much thought goes into choosing the right treatment modality, the duration of the program and proper assessment schedule so treatment can evolve to best effect.

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