Rehabilitation of Intervertebral Disc Disease (IVDD)

Conservative Management of IVDD

There are many dogs diagnosed with intervertebral disc disease that do not require surgery. These dogs can be effectively managed with rehabilitation. Early intervention and support is vital as is a thorough assessment and implementation of a staged rehabilitation treatment plan.

Physiotherapy Aims

In the initial stage following diagnosis of IVDD the aims of physiotherapy will be to:

  • Reduce inflammation
  • Reduce pain and spasm
  • Maintain soft tissues flexibility
  • Improve core strength
  • Stimulate sensory input
  • Re-train postural responses

 

These above aims continue and progress with time depending on your dogs progress. Aims will ultimately develop to include the following:

  • Further strengthen core stability
  • Facilitate effective gait
  • Increase exercise tolerance and overall cardiovascular fitness
  • Return to normal function

 

Physiotherapy Options

Many different physiotherapeutic modalities can be employed when rehabilitating a dog undergoing conservative management of IVDD. Possible options might include – laser, or and cold therapy, massage, range of motion exercises and stretches, muscle stimulation, hydrotherapy, home exercise program and advice re injury prevention.

The following table is an example of a rehabilitation programme our chartered physiotherapists may use with your dog:

 

Time Scale Physiotherapy Aims Physiotherapy Treatment options
0-4 weeks Reduce inflammation Electrotherapy – Laser
Reduce muscular guarding
Improve core stability Home exercise program
Increase strength
  • Home exercise program
  • Neuromuscular electrical stimulation
  • Hydrotherapy
  • Under Water Treadmill
Increase sensation and awareness of body position Home exercise program
Maintain soft tissue length and flexibility Home exercise program – passive movements and stretches
Management at home
  • Exercise restriction
  • Advice regarding flooring,
  • Advice regarding walking with a mobility aid e.g. harness and sling if required
4-6 weeks Continue as above Progression of home exercise program to challenge balance, body awareness and strength
Advice on maintaining restricted exercise when dog feeling better
6 – 12 weeks Increase exercise tolerance Increase exercise level
Continue to increase core stability Home exercise program
12 weeks + Return to full function Progress to off lead exercise and previous exercise level

 

Post-Operative Management of IVDD

Rehabilitation has a very important role to play during the recovery of a patient following surgery for intervertebral disc disease. Early intervention is crucial. The aims and treatment approach will vary depending on the level of disability your dog has and also the timescale following surgery. The key aims and treatment options are listed below. Your dogs chartered physiotherapist will constantly re-evaluate progress and adjust the program accordingly.

 

Physiotherapy Aims

Initial phase post op:

  • Reduce inflammation
  • Reduce muscle spasm
  • Maintain soft tissue flexibility
  • Increase sensory awareness
  • Increase strength
  • Advise owners of home care management requirements

Weeks 4-6:

  • Activate core muscles
  • Progress with the above aim
  • Improve balance and coordination
  • Enhance gait patterns

Week 6 ongoing:

  • Increase exercise tolerance and cardiovascular fitness
  • Increase core stability and strength
  • Return to normal function

 

Physiotherapy Options

Similar physiotherapeutic modalities to conservative management of IVDD can be employed when rehabilitating a dog following surgery. Possible options might include – laser, hot and cold therapy, massage, range of motion exercises and stretches, muscle stimulation, hydrotherapy, home exercise program and advice re injury prevention.  The following table is an example of a rehabilitation programme our chartered physiotherapists may use with your dog

 

Time Scale Physiotherapy Aims Physiotherapy Treatment options
1-2 weeks Reduce inflammation
  • Electrotherapy – Laser
  • Ice massage
Reduce muscular guarding
  • Electrotherapy – Laser
  • Soft tissue massage
  • Heat therapy
Maintain soft tissue length and flexibility Exercise program – passive movements, stretches, joint mobilisations
Prevent  bed sores (decubital ulcers) if recumbent Regular position changes
Increase sensation and awareness of body position Exercise program – proprioceptive stimulation
Increase strength
  • Exercise program
  • Neuromuscular electrical stimulation
  • Hydrotherapy
  • Under water treadmill
Improve independence with postural sets Exercise program – Lying, Sitting, standing with support if required
Improve Core stability Exercise program – Balance challenges, baited stretches
Assist Owner with Management at home A discharge appointment with a chartered physiotherapist will be arranged to explain about keeping your dog confined, assisting to walk and to demonstrate exercises to continue at home
2-4 weeks Progress strengthening
  • Exercise program
  • Hydrotherapy
  • Under Water Treadmill
Improve balance and co-ordination Exercise program – Balance challenges, baited stretches
Ensure correct movement patterning Exercises to address any movement compensations
Maintain full passive range of movement at all joints and soft tissue flexibility Exercises and stretches
Improve mobility Gait re-education
4-6 weeks Continue as above
6-12 weeks Increase exercise tolerance
  • Exercise program
  • Circles
  • Hills
  • Hydrotherapy
  • Under Water Treadmill
12 weeks + Return to previous exercise level Advice re progression of exercise aiming to off leadAdvance strengthening and proprioceptive training specific to dogs functional needs

 

Hydrotherapy Options

Hydrotherapy is invaluable when rehabilitating patients following surgery. The buoyancy of the water supports the patient against gravity and allows effective exercise to take place. The warmth of the water provides a source of relief for any discomfort present and the hydrostatic pressure assists in swelling reduction.

Fitzpatrick Referrals