Physical therapy for paralysis
Physical therapy for paralysis is designed to help your pet recover lost ability and make the best use of function as it returns. If your pet is paralyzed, you may have been told there is little or no chance your pet will walk again. No one can know if that is true or not, only time will tell how much ability your pet will recover. Experience on the HandicappedPets message board shows that recovery from paralysis continues for at least two years, with small improvements occurring even after that. Physical therapy will help your pet make the best recovery possible. Work with your veterinarian or animal physical therapist to develop a physical therapy program for your pet.
When to begin physical therapy
Your vet or your pet's surgeon will make the decision on when your pet may begin physical therapy. How soon therapy can begin depends on what caused the paralysis. In some cases, such as paralysis caused by a fibrocartilaginous embolism (FCE), you may be instructed to start physical therapy right away. In other cases, such as the medical or surgical treatment of intervertebral disk disease (IVDD), you may be ordered to keep your pet on crate rest first.
Crate rest means your pet is confined for 24 hours a day and forced to rest for up to 10 weeks to permit healing. Crate rest means no activity except what is necessary for toileting. Activity during crate rest can hurt or ruin your pet's chances of recovery. Some people worry that their pet will lose muscle tone during crate rest and they want to begin exercise early. There is no need to worry about loss of muscle tone. It comes back. Work with your veterinarian during the crate rest period to help your pet maintain a desirable weight. Then your pet will be ready for physical therapy when crate rest ends.
Passive range of motion, stimulating the feet, and massage are three exercises that are considered safe for most pets on crate rest, however each case is different and you need to check with your veterinarian first. Do not do ANY of these exercises without asking your vet first.
Passive Range of Motion
Bicycle each paralyzed leg through the full range of motion twice a day. Do a number of repetitions. This will take about 5 minutes. It is important to keep the legs flexible and avoid the development of joint contractures.
Stimulating the feet
Rub, squeeze, and tickle the feet, dig your fingers in between the pads, play with the toes. Do this at intervals throughout the day. This improves proprioception, which is the ability to feel the feet and know where they are in space. Following paralysis, the body needs to remap the pathway from the brain to the toes, and the more you stimulate the feet the more you give it to work with.
Massage the legs to improve circulation and promote healing.
Scratch your pet all over the body hoping to find an itchy spot. Your pet may begin kicking a hind leg in response to being scratched. In any case, your pet will enjoy this exercise!
With your pet lying on one side, press on the bottom of the feet while your pet resists you and pushes back.
Get a large ball or buy a Swiss ball (Physioball, Theraball). Place the ball under your pet's middle so your pet is draped over the ball. Hold onto your pet with both hands for safety and roll the ball forward slightly so the hind feet are just off the ground. Then roll it back so they touch. Repeat. This encourages the instinct to stretch the toes to the floor and provides weightbearing exercise. If your pet is small, use both hands to hold your pet safely in a standing position on top of the ball and move the ball slightly this way and that, forward, backward, side to side, to practice balance.
Put your pet in a standing position and press down lightly on the hips, bouncing the hips slightly while the pet resists. Support your pet with your free hand under the abdomen while doing this if needed.
Put your pet in a standing position and take hold of your pet's hips. Push the hips an inch or two to the right so the pet must support more weight on that side, then repeat the exercise pushing to the left.
Help your pet to stand and walk using a walking harness or homemade sling (such as a bath towel or crib sheet) under the abdomen. It is important not to put too much lift on the extreme rear of a pet with a mid-back injury, so be sure to support the pet properly while walking. Sometimes tail walking is recommended (holding the animal up by grasping the thick base of the tail), however using a harness is easier on your pet's tail and on your back. It also supports the back more evenly and makes you less likely to lose hold and drop your pet's hindquarters.
Placing the feet
Bend over and hold your pet's ankles and place the feet correctly with the paws in a pads down position as your pet walks. This is helpful even if you cannot get the rhythm right. You can also let your pet lie comfortably on its back while you hold the ankles and move the paws in an upside down walking motion as if taking steps.
Find a gentle slope such as a sloping sidewalk or long driveway and start your pet at the top. Encourage solo walking by standing down the slope with treats. This works well with two people, one to start the pet at the top and one to reward the pet at the bottom.
Lay down low obstacles, such as thin pieces of lumber, and help your pet practice stepping over them.
Help your pet to practice turns and build strength on a weak side by walking your pet through a series of figure eights.
Let your pet practice walking on a variety of surfaces, such as pavement, grass, carpeting, and gravel. Be careful on any surfaces where you think your pet may slip or fall.
Hydrotherapy (water exercise) is excellent for pets recovering from paralysis. With hydrotherapy your pet can exercise all of its legs even if it cannot bear weight or has poor balance. Hydrotherapy can be done in a bathtub for small pets, or in a hot tub, pool or lake for larger ones. You can buy a flotation vest (life jacket) for your pet if needed. For instructions on how to do hydrotherapy in the bathtub, see:
Pet PT clinics often have an underwater treadmill or pool for disabled pets to excercise in. Here is a partial listing of pet rehab facilities, but you will find more by doing a web search. Sometimes the keywords "canine sports medicine" or "animal physical therapy" will give results. Your veterinarian may know of physical therapy facilities in your area.
Tips for success
If you are trying to do physical therapy but your pet is more interested in dragging off in all directions and playing games, work some of that energy off first. Give your pet a play session or take your pet for a long walk in a sling or wheelchair before trying to do therapy. Once you have the energy level down, your pet will focus better. This is especially true of a pet who is too excited to slow down and place the feet properly, and eagerly drags forward when you are trying to practice walking.
Your pet will not necessarily begin to stand or take steps again simply because the nerves have healed to a certain point. Following paralysis, your pet no doubt attempted to stand and walk a number of times and could not do it. Therefore, your pet learned it could not use its legs and adjusted and quit trying. Weeks or months may have gone by while your pet has had no use of its legs. Now you are seeing signs that your pet's nerve function has improved, but your pet still is not walking. This is not simply due to loss of muscle tone, and it does not mean your pet is lazy or unmotivated. Your pet has no idea it is becoming able to do things again. Do not assume this will come naturally to the animal. One of the goals of physical therapy is to help your pet unlearn nonuse one small ability at a time. Feel the feet. Stand on the feet. Balance. Take a step. Take several steps. Little by little, help your pet rebuild an awareness of how much it can do.
How long to continue physical therapy
Physical therapy is important for recovery from paralysis. You should continue to do it even if you see little change in your pet's condition. Nerves regenerate very slowly, but healing does occur. Physical therapy may need to be done for weeks or months following an injury to maximize recovery. Keep in mind that working your pet harder will not help your pet recover faster, so be patient. Your pet cannot do more than the nerves are ready for. Therefore, a steady program of daily exercise over the course of time is the key to successful rehabilitation. Your dedication to your pet's physical therapy program will ensure your pet makes the best recovery possible.