SPORTING DOGS – Acute Rehabilitation

Owners and trainers of dogs engaged in competitive activities often expect rapid and complete recovery after orthopedic injuries. Although the same general principles of rehabilitation are followed, the protocols may, at times, be accelerated in sporting dogs. One of the reasons for this acceleration is owner demand, which may be financial if the animal is racing and producing revenue or may be motivated solely by the desire to return to a hobby with the pet. The overall physical condition of a sporting dog is usually much greater than that of a house pet and may allow for this acceleration because of an increase in protective muscle mass, cardiorespiratory health, and motivation. The protocol followed must be developed in close communication with the surgeon and referring veterinarian. The following outlines the major phases of rehabilitation for the sporting dog and guidelines for the acute, subacute, and reconditioning rehabilitation phases.


Acute Rehabilitation

The acute phase of rehabilitation occurs after an injury or surgery. For patients being rehabilitated after surgery, one should first take into consideration the specifics of the patient (age, size, and behavior), the surgery (purpose, strength, and stability of repair), and what activities to avoid to prevent surgical complications. For example, a dog recovering from a tibial fracture stabilized with a bone plate has a low risk of mechanical failure compared with a dog recovering from an avulsion of the common calcanean tendon reattached using suture material. One should also consider contraindications to particular motions (eg, external rotation of the hip after craniodorsal coxofemoral joint luxation repair) and contractions of particular muscles (eg, active contraction of the gastrocnemius muscle after common calcanean tendon repair; Fig. 2). For example, no rotation or torque should be placed on the hock joint of an agility dog recovering from surgical repair of a luxated superficial digital flexor tendon for at least 6 weeks. Premorbid and comorbid conditions also greatly influence rehabilitation and need to be factored into the prognosis. One should consider the anticipated rate and duration of tissue healing for the tissue involved. For skin healing, collagen has approximately 20% strength at 21 days and 70% strength at 1 year. Muscle healing requires more than 6 weeks for adequate strength. Tendon healing leads to 56% tensile strength at 6 weeks and 79% tensile strength at 1 year. Ligament healing leads to 50% to 70% tensile strength at 1 year. The median bone healing rate as judged by removal of external skeletal fixation frames ranged from 5 to 15 weeks in 12 studies. Healing and recovery rates, however, vary with the patient’s age, the severity of injury, and the specific tissue damage. Anemic patients should exercise cautiously. For example, exercise is not recommended in people with a hematocrit lower than 25%, and only light exercise is allowed in patients with a hematocrit lower than 30%. Rehabilitation must also include consideration of how to enhance the patient’s recovery. The acute rehabilitation of a sporting dog differs from the acute rehabilitation of a nonsporting dog in several ways. A dog that is highly conditioned before an injury typically recovers much more rapidly than a poorly conditioned dog, in part, because the increased muscle strength of conditioned dogs helps to support injured joints, resulting in less stress placed on these injured joints during their recovery. For example, a fit dog that has strong epaxial muscles undergoing a hemilaminectomy is likely to function better after surgery and to recover fully more rapidly than a deconditioned dog because of the strong musculature protecting his back. Also, the musculoskeletal tissues of well-conditioned dogs are stronger than the tissues of poorly conditioned dogs. Therefore, loss of strength and stiffness of musculoskeletal tissues after injury and surgery have a relatively lower impact on well-conditioned dogs. Limb disuse may be less likely in well-conditioned dogs because of potential behavioral factors (eg, eagerness to exercise, changes in pain threshold associated with past exercise experiences). Sporting dogs may be required to recover from an injury as rapidly as possible to return to their activity because owners, trainers, or handlers generally want to keep the duration of their inactive period to a minimum. Their rehabilitation may be accelerated just as in human medicine, where athletes accelerate their rehabilitation as much as possible to return to sport as soon as they safely can. The average house pet that has undergone a tibial plateau leveling osteotomy may be rested for 3 weeks before beginning any rehabilitation. A dog actively competing in field trials may spend these same 3 weeks beginning cryotherapy and controlled exercises, such as ROM, short leash walks, and underwater treadmill walking, to prevent muscular and cardiovascular deconditioning and to accelerate the rehabilitation process.