Rehabilitation of vestibular disease

Rehabilitation has an important role to play when caring for a pet affected by vestibular disease. Our chartered physiotherapist initially undertakes a thorough assessment of your dog and then formulates treatment aims and goals which is compiled into a rehabilitation treatment plan uniquely designed for your dog. The degree to which an individual is affected can vary from patient to patient, possible aims and treatment options are listed below. It is essential that ongoing evaluation and adjustment of the care programme takes place.

Aims of rehabilitation

In the initial days following diagnosis of vestibular disease:

  • Provide supportive management of postures and transferring from one position to another
  • Increase sensation and awareness of body position
  • Maintain soft tissue flexibility

Following on from this and depending on your pet’s progress, the aims might include:

  • Improve core stability
  • Further raise awareness of body position and posture and posture
  • Advance functional transfers of weight
  • Facilitate supportive gait patterns

Once good recovery is established further aims are defined:

  • Continue to strengthen core muscles
  • Further enhance gait patterns including pace
  • Enhance exercise tolerance and cardiovascular fitness
  • Return to normal function or how to manage any residual disabilities

Physiotherapy treatment options

A major component of physiotherapy treatment is the advice that can be given especially in the initial phase after diagnosis. Handling techniques, home environment advice, exercise restriction and the use of assistive devices are essentials and will be taught and demonstrated by your pet’s physiotherapist.

Soft tissue massage and sensory stimulation are key and can be taught so you are able to perform them at home. In addition, an appropriate home exercise program (HEP) can be invaluable even early on. Specific exercise therapy allows stimulation of body awareness and strengthening of essential muscle groups. Hydrotherapy can be introduced for strengthening, gait re-education, core stability promotion and improving cardiovascular fitness.

It is necessary however that your pet’s home exercise and physiotherapy programme is assessed and adjusted frequently to ensure the correct treatment plan and care is being provided. This will be performed throughout your pet’s hospitalisation (should that be required), or through our outpatient rehabilitation centre here at the hospital.

The following table gives an example of a rehabilitation plan which may be designed for the management of a patient with vestibular disease:*

TimescalePhysiotherapy aimsPhysiotherapy treatment options
0-2 weeksManagement (if at home) including support posture and transfersCorrect positioning. Advise owners about correct handling techniques. Advise re: floor surfaces if at home, advice re: slings or walking aids if required/exercise restriction.
Increase sensation and awareness of body positionSoft tissue massage, proprioceptive facilitation
2-4 weeksImprove core stabilityHome exercise programme
Progress awareness of body position, maintaining soft tissue length and flexibility.Home exercise programme to progress proprioceptive facilitation and sensory input techniques e.g. brushing, massage, tapping, passive mobilisations and stretches.
4-6 weeksIncrease sensation and awareness of body position and improve gait.Home exercise programme to include gait and balance challenges such as weave poles, steps and gradients.
6-12 weeksIncrease exercise toleranceAdvise re: progressive exercise, increasing exercise levels, consider land and water-based exercises.
Continue to increase core stabilityHome exercise programme
12 weeks +Return to full function or advise re: management of residual deficits described by neurologist.Progress to off-lead exercise and previous exercise level

*Please note that rehabilitation plans should only be followed under the guidance of a qualified rehabilitation professional, who will be able to provide a tailored plan based on the individual patient’s rehabilitation needs.

Fitzpatrick Referrals