reading

Cover
Title Page
List of Contributors
Acknowledgements
1 Introduction to Physical Rehabilitation for Veterinary Technicians/Nurses
1. What is Rehabilitation?
2. History of Human Physical Therapy
3. History of Veterinary Physical Rehabilitation
4. Specifics About Veterinary Physical Rehabilitation
5. How do Veterinary Technicians and Nurses fit in?
6. Where Can I Become a Certified Rehabilitation Veterinary Technician?
7. What is Involved in Becoming a CCRA, CCRP, CVMRT, CERA, or CERP?
8. Practice Regulations for Veterinary Technicians
9. Working in the Physical Rehabilitation Field
10. Therapeutic Exercises
11. Manual Techniques
12. Physical Modalities
13. Conditions that can Benefit from Physical Rehabilitation
14. Conclusion
15. References
2 Joining a Rehabilitation Team
1. Introduction
2. Becoming a Rehabilitation Technician (Nurse)
3. The Rehabilitation Patient
4. Your Team Role as Rehabilitation Veterinary Technician
5. Working Under Supervision
6. Future Directions for the Rehabilitation Technician
7. Conclusions
8. References
3 The Veterinary Technician and Rehabilitation Pain Management
1. Introduction
2. What are the Benefits of Physical Rehabilitation?
3. Recognition and Assessment of Pain
4. Pain Management Protocols and Education
5. Rehabilitation as a Treatment of Pain
6. Canine Rehabilitation
7. The Link Between Pain and Weakness
8. Environmental Modifications
9. Feline Physical Rehabilitation
10. Equine Rehabilitation
11. Conclusion
12. References
4 Communicating the Treatment Plan
1. Introduction
2. Diagnosis and Progress Assessments
3. Goals
4. The Therapy Prescription
5. Adverse Events and Setbacks
6. Compliance
7. Communication
8. Discussing Finances
9. Follow‐Up
10. Conclusion
11. References
5 Manual Therapy Treatment
1. Introduction
2. What is Manual Therapy?
3. Goals of Manual Therapy
4. Expected Results
5. Preparing the Patient for Manual Therapy
6. Manual Techniques
7. Manual Techniques as Home Exercise Program
8. Conclusion
9. Further Reading
10. References
6 Home Exercises
1. Introduction
2. Assessing the Client
3. Assessing the Patient
4. Assessing the Resources
5. Training the Client
6. Home Exercises
7. Conclusion
8. References
7 Supporting the Client and Patient
1. Introduction
2. The Effect of Pain and Morbidity
3. Aims of Physical Rehabilitation
4. Client Engagement and Compliance
5. Helping the Client to Make a Decision
6. Supporting the Patient
7. Conclusion
8. References
8 Nutritional Counseling
1. Introduction
2. Nutritional Assessment
3. Obesity
4. Evaluating Weight and Nutrition
5. Weight Management Program
6. Osteoarthritis
7. Patient Assessment
8. Key Nutritional Factors
9. Conclusion
10. References
9 Motivating Your Patient
1. Introduction: Why we Need to Motivate the Rehabilitation Patient
2. Understanding Animal Psychology
3. Classical Conditioning Versus Operant Conditioning
4. Understanding Body Language
5. Building Motivation and Value Through Food Rewards
6. Luring, Shaping, and Marking Behaviors
7. Simple Games: Set Up for Success
8. Having Intent and Understanding Trust
9. Home Exercises – Knowing When to Stop
10. Problem Solving and Dealing with Challenging Patients
11. Motivating the Client
12. Conclusions
13. References
14. Resources
10 The Disabled Patient Part 1: Assistive Devices and Technology
1. Introduction
2. History
3. Which Patients Need Assistive Devices?
4. Types of Assistive Devices
5. Custom Orthotics
6. Custom Prosthetics
7. Summary
8. References
11 The Disabled Patient Part 2: The Neurological Patient
1. Introduction
2. Healing of Nerves
3. The Neurological Examination
4. Evidence‐Based Information About Neurologic Rehabilitation
5. Nursing Care of Neurological Patients in Clinic
6. Risks Affecting Hospitalized Recumbent or Neurological Patients
7. Types of Neurological Conditions
8. Establishing Goals
9. Passive Manual Therapies for Dogs and Cats
10. Therapeutic Exercise for Dogs and Cats
11. Therapeutic Modalities for Dogs and Cats
12. A Special Word About Cats
13. Client Education and Support During Home Therapy
14. Conclusions
15. References
12 The Disabled Patient Part 3: Special Considerations for Geriatrics
1. Introduction
2. The Aging Process
3. When Do Dogs and Cats Qualify as Senior or Geriatric?
4. Cognitive Impairment and Other Behavioral Issues
5. Management Strategies to Improve Quality of Life
6. Other Considerations for Geriatric Pets
7. Common Presentation
8. Health Benefits of Rehabilitation for the Geriatric Patient
9. Physical Rehabilitation and Function
10. Manual Therapy the Veterinary Technician/Nurse can Perform
11. Electrotherapy
12. Approach to Exercise Therapy
13. Therapeutic Exercises for Geriatric Patients
14. Special Considerations for Hydrotherapy
15. Physical Medicine and Rehabilitation for Patients in Palliative and Hospice Care
16. Conclusion
17. References
13 The Disabled Patient Part 4: Home Nursing Care
1. Introduction
2. Proper Body Mechanics
3. Goals of Nursing Care
4. Modifying the Home Environment
5. Administering Medications to the Disabled Patient
6. In‐Home Hospice Care
7. Conclusions
8. References
9. Resources
14 Modalities Part 1: Thermotherapy
1. Introduction
2. Purpose
3. Types of Thermotherapy
4. Mechanism of Action
5. Physiologic Effects
6. Veterinary Evidence for Both Hot and Cold Therapy
7. A Word About Cats
8. Conclusion
9. References
15 Modalities Part 2: Laser Therapy
1. Introduction
2. Laser Physics 101
3. Laser Classes
4. Photobiomodulation: Proposed Mechanisms of Action
5. Contraindications
6. Laser Safety
7. Using a Therapeutic Laser in Practice
8. Conclusion
9. References
16 Modalities Part 3: Electrotherapy and Electromagnetic Therapy
1. Introduction
2. Electrical Stimulation
3. Basic Terminology
4. Patient Preparation
5. Precautions and Contraindications of Electrical Stimulation
6. Neuromuscular Electrical Stimulation for Muscle Strengthening
7. Electrode Size and Placement for Neuromuscular Electrical Stimulation
8. Electrical Stimulation for Pain Control
9. Pulsed Electromagnetic Field Therapy
10. Conclusions
11. References
17 Modalities Part 4: Therapeutic Ultrasound
1. Introduction
2. Physical Principles
3. Treatment Parameters
4. Role of the Veterinary Rehabilitation Technician
5. Clinical Applications
6. Clinical Reports
7. Cautions and Contraindications
8. Maintenance of Equipment
9. Relevant Scientific Research
10. Conclusions
11. References
18 Modalities Part 5: Shockwave Therapy
1. Introduction
2. What is a “Shock Wave”
3. Mechanism of Action of Shock Waves
4. Patient Preparation
5. What is the Common Treatment Protocol?
6. Pain Relief
7. Adverse Events and Contraindications
8. Indications
9. Equine Use
10. Clinical Applications
11. Conclusion
12. References
19 Therapeutic Exercises Part 1: Land Exercises
1. Introduction
2. History of Therapeutic Exercise
3. The Role of Exercise Physiology
4. Principles of an Exercise Program
5. Canine Rehabilitation Equipment
6. Control, Supportive, and Assistive Devices
7. Walking
8. Exercise Categories
9. Case Studies
10. Conclusion
11. References
20 Therapeutic Exercises Part 2: Hydrotherapy (Aquatic Therapy)
1. Introduction
2. Evidence
3. Equipment
4. Safety and Maintenance
5. Protecting Staff and Clients
6. Pre‐Hydro Patient Assessment
7. Pool Versus Underwater Treadmill
8. Developing Patient Programs
9. Promoting Your Business
10. Conclusion
11. References
21 Troubleshooting as a Team
1. Introduction
2. Case Management
3. Communicating with Specialists and the Primary Care Veterinarian
4. Communicating with Adjunct Team Members
5. Examples of Case Management
6. Conclusions
7. References
22 Equine Rehabilitation
1. Introduction
2. Therapeutic Plan Development
3. Therapeutic Monitoring
4. Facilities, Equipment, and Personnel
5. Nutrition
6. Patient Environment and Mental Status
7. Therapeutic Modalities
8. Return to Work
9. Conclusion
10. References
23 Adjunctive Therapies Part 1: Acupuncture and Traditional Chinese Medicine
1. Traditional Chinese Veterinary Medicine Basics
2. Five Branches of Traditional Chinese Veterinary Medicine
3. Yin Yang Theory
4. Five Element Theory
5. Acupuncture Points
6. Meridians
7. Methods of Stimulation
8. Clinical Applications Associated with Rehabilitation – Dog and Cat
9. Clinical Applications Associated with Rehabilitation – Equine
10. Safety
11. Role of the Veterinary Rehabilitation Technician
12. Research
13. References
24 Adjunctive Therapies Part 2: Veterinary Chiropractic
1. Introduction
2. A Brief History of Chiropractic Medicine
3. The Role of Chiropractic in Physical Rehabilitation
4. The Vertebral Subluxation Complex
5. The Chiropractic Adjustment
6. Evaluation of the Animal Chiropractic Patient
7. The Chiropractic Adjustment and the Veterinary Technician
8. Chiropractic and Cats
9. Conclusion
10. Further Reading
11. References
25 Adjunctive Therapies Part 3: Myofascial Trigger Point Therapy
1. Introduction
2. Sensory Component
3. Motor Component
4. Autonomic Component
5. How Do Myofascial Trigger Points Develop
6. Perpetuating Factors
7. Evaluation of the Patient
8. Treatment of Myofascial Trigger Points
9. Conclusions
10. References
Index
End User License Agreement

List of Tables

Chapter 03
1. Table 3.1 Species‐specific behavioral signs of pain.
Chapter 05
1. Table 5.1 Commonly used goniometric bony landmarks.
2. Table 5.2 End‐feel guidelines.
3. Table 5.3 Range of motion (degrees) of various appendicular joints measured by goniometry in 16 healthy Labrador Retrievers.
4. Table 5.4 Thoracic limb muscle stretches.
5. Table 5.5 Pelvic limb muscle stretches.
6. Table 5.6 Depending on the goal of the treatment, the amount of force applied and the speed of the oscillations are varied.
Chapter 12
1. Table 12.1 How old is my dog in human years?
2. Table 12.2 How old is my cat in human years?
3. Table 12.3 Feline mobility/cognitive dysfunction questionnaire.
4. Table 12.4 Suggestions for improving the environment and increasing access to resources for elderly cats and dogs.
Chapter 14
1. Table 14.1 Pathophysiologic effects of topical modalities.
Chapter 15
1. Table 15.1 Common conditions treated and protocols used by the authors. At the time of writing, there are no research studies confirming the optimal laser treatment protocols in veterinary patients; the protocols listed are based on WALT guidelines and the authors’ clinical experience. It is important to note that these are guidelines and each patient is treated as an individual, including adaptations of protocols, inclusion of other treatment sites, and in all cases, additional rehabilitation modalities including manual therapy and therapeutic exercise.
Chapter 16
1. Table 16.1 Recommended pulse duration for neuromuscular electrical stimulation in dogs.
Chapter 18
1. Table 18.1 Ranked couplant transmissivities relative to degassed water at 1.1 MHz and 3.4 MHz.
Chapter 22
1. Table 22.1 Example back‐to‐work plan following resolution of injury.

List of Illustrations

Chapter 02
1. Figure 2.1 Your team will have developed strategies for teaching, including handouts with pictures, posters, models, and step‐by‐step instructions. Explain and demonstrate the exercise, then it is time for the client to practice.
2. Figure 2.2 Daily medical rounds are recommended. Parameters are set and recorded for the therapy, when to change the plan, and when it is necessary to consult your supervisor.
3. Figure 2.3 You will have the opportunity to work closely with patients on a relatively long‐term basis. Rehabilitation is a rewarding career.
Chapter 03
1. Figure 3.1 Visual analog scale (VAS) – pain scale.
2. Figure 3.2 Numerical rating scale (NRS) – pain scale.
3. Figure 3.3 Short form of the Glasgow Composite Pain Scale.
4. Figure 3.4 University of Pennsylvania Canine Brief Pain Inventory (CBPI).
5. Figure 3.5 Jenn Panko RAHT, CCRP (COCM) performing underwater treadmill therapy on a cat.
6. Figure 3.6 Horse underwater treadmill at the University of Tennessee.
Chapter 04
1. Figure 4.1 Photo of a patient showing signs of stress during a therapy session (moving away from the therapist, while ignoring a food reward). The therapist is utilizing calming body language of sitting to the side, averting the gaze, and maintaining gentle contact with the patient.
2. Figure 4.2 Reward‐based training as part of a fitness and conditioning program.
3. Figure 4.3 A patient performing a crawl exercise for a treat reward.
4. Figure 4.4 Veterinary technician providing hands‐on instruction in the execution of assisted exercise.
Chapter 05
1. Figure 5.1 Effleurage.
2. Figure 5.2 Petrissage.
3. Figure 5.3 Passive range of motion.
4. Figure 5.4 Glenohumeral extension.
5. Figure 5.5 Goniometer.
6. Figure 5.6 Stifle flexion measurement.
7. Figure 5.7 Biceps stretch.
8. Figure 5.8 Hamstrings stretch.
9. Figure 5.9 Psoas stretch.
10. Figure 5.10 Play bow.
Chapter 06
1. Figure 6.1 Commercial gel packs are relatively inexpensive. The rehabilitation facility may sell them to the client, or they can be purchased at a local drug store.
2. Figure 6.2 Every home therapy should be demonstrated to the client with their pet.
3. Figure 6.3 After receiving instructions, the client practices the home exercise with feedback from the rehabilitation staff.
4. Figure 6.4 The patient can be encouraged to stand in a position that results in active stretching of specific joints. (a) Active stretch on a disc – little dog. (b) Active stretch on a bosu – bigger dog.
5. Figure 6.5 Exercises can be prescribed based on what equipment the client has available. Clients can be instructed how to perform active stretching with no equipment. However, it is important to avoid training the pet to perform any behaviors that may be undesirable. (a) Active stretch on a person – little dog. (b) Active stretch on a person – bigger dog.
6. Figure 6.6 Step‐over exercises can be prescribed using materials that can be obtained cheaply and easily by the client.
Chapter 07
1. Figure 7.1 Improving home activity by practicing the stairs in clinic.
2. Figure 7.2 Client engagement means deep conversations.
3. Figure 7.3 Providing mental stimulation and play as permitted by the animal’s physical condition.
4. Figure 7.4 Elderly dog with frailty syndrome. Muscle loss is seen by evident bony prominences.
Chapter 08
1. Figure 8.1 WSAVA body condition score for cats.
2. Figure 8.2 WSAVA body condition score for dogs.
3. Figure 8.3 WSAVA muscle condition score for dogs.
4. Figure 8.4 WSAVA muscle condition score for cats.
Chapter 09
1. Figure 9.1 Frozen treats take time to consume, allowing the animal to work at the reward.
2. Figure 9.2 Patient undergoing shockwave therapy. He is wearing ear muffs and licking a frozen treat.
3. Figure 9.3 A low matted table for examination and therapy, the table is 40 cm high.
4. Figure 9.4 Poster showing dog behavioral postures.
5. Figure 9.5 Poster showing cat fear and anxiety postures.
6. Figure 9.6 A feline patient being lured into stretch using freeze‐dried meat. Note his left rear extends less. The patient has had a femoral head excision.
7. Figure 9.7 Luring a patient from a sit into a standing position for examination
8. Figure 9.8 International Veterinary Academy of Pain Management (IVAPM) pet pain awareness poster for client education, 2016.
Chapter 10
1. Figure 10.1 Sling for geriatric dog.
2. Figure 10.2 Therapy ball assisting standing.
3. Figure 10.3 Dr. Tomlinson with a patient in a Hoyer lift.
4. Figure 10.4 Assisted standing with a Hoyer list and therapy ball.
5. Figure 10.5 Thermoplastic sheet for devices.
6. Figure 10.6 Neck brace for an Irish Wolfhound.
7. Figure 10.7 Rear, right leg orthosis.
8. Figure 10.8 Front, left leg prosthetic, lateral view.
9. Figure 10.9 Front left, leg prosthetic anterior view.
10. Figure 10.10 Walking with a front left leg prosthetic, anterior view.
11. Figure 10.11 Double limb prosthetics for hindlimbs, lateral view.
12. Figures 10.12 Double limb prosthetics for hindlimbs, rear view.
13. Figure 10.13 Double rear limb prosthetics during exercise.
Chapter 11
1. Figure 11.1 Hemistanding. The therapist uses their legs to support the trunk if needed. Hemiwalking is toward the therapist, support as needed. Level of support is noted.
2. Figure 11.2 Cookie stretch to aid transition. Voluntary movement for a treat is encouraged. Assistance is given as needed and level of assistance noted.
3. Figure 11.3 Lateral to sternal transition as demonstrated by Jenn Panko.
4. Figure 11.4 Sternal to sit transition as demonstrated by Jenn Panko.
5. Figure 11.5 Sit‐to‐stand transition as demonstrated by Jenn Panko.
6. Figure 11.6 Coupage is gentle percussion over the thoracic following the lung field using a cupped hand.
7. Figure 11.7 Coupage on both sides of chest.
8. Figure 11.8 Manual expression of the bladder is a learned skill that the rehabilitation veterinary technician should know and can teach.
9. Figure 11.9 Working on a patient in a Hoyer lift.
Chapter 12
1. Figure 12.1 Callus formation can result in painful weight bearing. A coarse file or sanding tool used lightly can remove callus build‐up for more comfortable weight bearing.
2. Figure 12.2 A frail canine patient. The patient is 15 years old. She has normal blood work and cognition but is weak and slow to move.
3. Figure 12.3 An elderly patient receiving neuromuscular electrical stimulation. The patient has thin skin, poor muscle thickness, and low body fat. The treatment must be applied with great care and the therapist should watch very closely for discomfort.
4. Figure 12.4 Some patients may need assistance with mobility. This patient has weak front limbs and the cart is used to aid mobility for longer walks which enhance quality of life.
Chapter 13
1. Figure 13.1 Use of proper body mechanics.
2. Figure 13.2 Absorbent diaper pads.
3. Figure 13.3 Handmade sling.
4. Figure 13.4 Help ’em Up Harness.
5. Figure 13.5 Correct way to lift a dog in sling or harness.
6. Figure 13.6 Power Paws grip socks.
7. Figure 13.7 Dr. Buzby’s ToeGrips™.
Chapter 14
1. Figure 14.1 Whirlpool bath control.
2. Figure 14.2 Vet Systems whirlpool bath and control.
3. Figure 14.3 Kari Koudelka with a patient in the Bioelectric Whirlpool.
4. Figure 14.4 Game Ready System cryotherapy and compression unit.
5. Figure 14.5 Boot for cryotherapy in a horse.
Chapter 15
1. Figure 15.1 Wavelength‐specific safety goggles. Note the stamp in the upper corner indicating wavelengths the goggles have been tested and approved for.
2. Figure 15.2 This patient would not tolerate safety goggles so a soft, blue e‐collar was used. Ideally the collar should be flipped up to shield the face completely from potential reflection or scatter from laser beam.
3. Figure 15.3 This patient is being treated on a stainless steel table. Blankets and towels have been placed to cover the surface to minimize the risk of laser beam reflection from the steel surface. Ideally this patient should have on safety goggles or other method of protecting the eyes.
4. Figure 15.4 What not to do: This patient’s collar has metallic adornments and tags. The laser is not in full contact with the skin and is angled toward the collar, resulting in invisible but hazardous reflection of radiation. When treating the neck and shoulder you should remove all metallic dog collars and ensure that the laser is held perpendicular to the tissue. Not all lasers can be held in contact with the skin (i.e., those that generate heat should not be used in contact mode).
5. Figure 15.5 The laser probe should always be perpendicular to the target tissue. Lasers that do not generate substantial heat can be placed in contact with the skin/hair and a point‐to‐point method used to administer treatment. Heat‐generating/high‐powered lasers should not be used in contact and may need to be continuously moved (scanning) to avoid burning the tissue. Even with scanning, the probe should remain at a 90‐degree angle to the body surface.
Chapter 16
1. Figure 16.1 A portable NMES unit on a patient. The accuracy of electrode placement is affected by the mobility of the skin at the treatment site – even an electrode taped to skin may move with the skin and not stay over the desired muscle.
2. Figure 16.2 The use of NMES following hemilaminectomy surgery. Notice that a rolled towel may be helpful to support the patient if they can stand.
3. Figure 16.3 Looking down on the placement of the conduction pads. Notice the tube of gel in the right corner of the image that is used for the coupling medium.
4. Figure 16.4 Initial placement of the electrical pads prior to additional tape placement. Notice positive (black wire) and negative pads (red wire) are placed opposite each other.
5. Figure 16.5 Shows use of pads that do not require taping because they have a sticky adhesive on their back.
6. Figure 16.6 Additional view of pad placement without taping.
7. Figure 16.7 Pad placement along stifle and hip.
8. Figure 16.8 Image of an Assisi Loop used for targeted PEMF.
Chapter 17
1. Figure 17.1 A 3 cm sized ultrasound transducer head.
2. Figure 17.2 Ultrasound gel used as a coupling agent.
3. Figure 17.3 Treating a flexor tendon injury with indirect coupling. The patient’s limb is immersed in warm water and the transducer head held 2 cm from the skin surface at the level of the lesion.
4. Figure 17.4 Maya, a 2‐year‐old Cockapoo having her Achilles tendon treated.
5. Figure 17.5 A feline patient undergoing ultrasound treatment of her neck muscles.
Chapter 18
1. Figure 18.1 An electrohydraulic shockwave machine.
2. Figure 18.2 Versatron PulseVet™ next to anesthesia machine used for oxygen during sedation of patient.
3. Figure 18.3 An example of shockwave gel.
4. Figure 18.4 Treatment of canine elbow with probe head.
5. Figure 18.5 Treatment of canine pelvis with probe head.
6. Figure 18.6 Treatment of feline elbow with probe head.
7. Figure 18.7 Treating a horse for “kissing spine” disease.
8. Figure 18.8 Treatment of donkey lumbosacral disease.
Chapter 19
1. Figure 19.1 The patient has all four paws on the BOSU ball to work on balance. Posture is corrected as needed.
2. Figure 19.2 Cavalettis are great for strengthening the forelimbs and hindlimbs and as a proprioception exercise.
3. Figure 19.3 The rocker board pictured is placed against the wall. The dog is lured to place a foot on the board.
4. Figure 19.4 The land treadmill can also be used for advanced exercises as shown here. The dog has front feet on the ball and rear feet on the treadmill.
5. Figure 19.5 Land treadmills can be used with feline patients. Dr. Sheilah Robertson’s cat, Calvin, is on the land treadmill.
6. Figure 19.6 Uneven cushions: This patient is a recovering neurological patient who is working on balance and proprioception with the uneven surface. Core strength is also challenged in this exercise.
7. Figure 19.7 Ball weight shift: This patient is recovering from a fibrocartilaginous embolism and is working on regaining strength in the rear legs. The therapist rolls the ball back and forth.
8. Figure 19.8 Diagonal leg lifts: This is a core strengthening exercise. As the patient’s balance and core muscles improve the legs can be lifted higher.
9. Figure 19.9 Wheelbarrow: Care should be taken when holding a dog for this exercise.
10. Figure 19.10 Sit‐to‐stand on the ball may need two people in the case of a large dog.
Chapter 20
1. Figure 20.1 Pool entry.
2. Figure 20.2 Pool entry side view.
3. Figure 20.3 Dog swimming in pool.
4. Figure 20.4 Weight bearing is reduced by 15% if the water is filled to the level of a patient’s stifle in an underwater treadmill.
5. Figure 20.5 Harness for controlling patient in underwater treadmill and keeping head above water.
6. Figure 20.6 Fender floats prevent patients from placing their limbs on the static side panels either side of the treadmill belt.
7. Figure 20.7 Toys make excellent motivational tools in the pool. Care should be taken to avoid airway impedance.
8. Figure 20.8 Swimming in open water – in this case, a lake.
9. Figure 20.9 If multiple dogs are entering the pool/lake at the same time during a fun swim session it is important that all the dogs are confident in the water, and are wearing appropriate jackets or other flotation aids.
10. Figure 20.10 Whirlpool bath for a neurologically impaired dog.
11. Figure 20.11 Technician Jenn Panko in the underwater treadmill with a feline patient. Even when little support or guidance is required due to the patient having a high level of proficiency, a technician/nurse should remain in the underwater treadmill/pool with these patients.
Chapter 21
1. Figure 21.1 Patient rounds in the clinic of one of the authors (Tomlinson) are 1 hour a day. Round sheets hold written descriptions of daily therapy plan, and digital records are accessed for last therapeutic notes as each case is discussed between doctors and technicians.
2. Figure 21.2 Assistive device to prevent flexion of the rear toes in stance (Therapaw).
3. Figure 21.3 An example of an orthosis which would hold the foot in adequate extension for weight bearing and, in addition, allow for some stifle and tarsal motion.
4. Figure 21.4 A dog with an almost plantigrade stance of the left rear due to Achilles tear.
5. Figure 21.5 An articulating tarsal and foot orthosis (Orthopets) placed on the patient in Figure 21.4.
6. Figure 21.6 Rear limbs crossed over. Natural stance of a neurologic Dachshund.
7. Figure 21.7 Quadriceps stretch.
8. Figure 21.8 Custom cervical brace (Therapaw).
Chapter 22
1. Figure 22.1 Therapeutic monitoring equipment. From top to bottom: goniometer, tape measure, and pressure algometer.
2. Figure 22.2 Cold salt water spa.
3. Figure 22.3 Neuromuscular electrical stimulation application for muscle strengthening.
4. Figure 22.4 Low‐level laser therapy application.
5. Figure 22.5 Whole‐body vibration.
6. Figure 22.6 In‐ground underwater treadmill.
7. Figure 22.7 Ground cavaletti poles laid in random fashion to improve proprioception.
8. Figure 22.8 Ground cavaletti poles laid in a radius to encourage joint motion and improve coordination.
9. Figure 22.9 Therapeutic band application to improve core muscle strength.
10. Figure 22.10 Equine kinesiology taping.
Chapter 23
1. Figure 23.1 Dr. Carolina Medina places acupuncture needles in JimmyCat (Mary Ellen Goldberg’s cat).
2. Figure 23.2 Calming point needle placed on JimmyCat’s head.
3. Figure 23.3 JimmyCat models electroacupuncture needles and machine.
4. Figure 23.4 JimmyCat shows acupuncture needles attached to the electrostimulator machine.
5. Figure 23.5 Jake from the canine case study undergoes acupuncture and electroacupuncture treatment.
6. Figure 23.6 Cricket from the feline case study receives acupuncture treatment for obesity and pain from osteoarthritis.
7. Figure 23.7 Cricket receives electroacupuncture treatment.
8. Figure 23.8 Cricket resting and dozing during acupuncture treatment.
Chapter 24
1. Figure 24.1 Dr. Downing adjusting an equine pelvis.
2. Figure 24.2 Dr. Downing performing adjustment with minimal restraint.
3. Figure 24.3 Hand position for stabilizing the thoracics during an adjustment.
4. Figure 24.4 Adjusting the patient when the table can be used to stabilize the patient.
Chapter 25
1. Figure 25.1 Schematic showing the expanded integrated trigger point hypothesis.
2. Figure 25.2 Example of flat palpation in a dog for the presence of myofascial trigger points.
3. Figure 25.3 Example of flat palpation on a horse for the presence of myofascial trigger points.
4. Figure 25.4 Pincer palpation on a dog.
5. Figure 25.5 Dry needling of a horse for treatment of myofascial trigger points by Mrs. Angela Stramel.
6. Figure 25.6 Dry needling of a dog for treatment of myofascial trigger points by Dr. Douglas Stramel.