In this blog post, we have compiled the key takeaways from the session titled “Physical Therapy and Rehabilitation in Small Animals”, presented by Dr. Pınar Can, held as part of VetSummit 2025: New Horizons in Veterinary Clinical Sciences, sponsored by the Kito Healthy Pet Nutrition Ecosystem. We would like to thank our speaker for the presentation.
Veterinary Physical Therapy: No Longer an Extra Service, but a Core Part of Clinical Practice
Veterinary physical therapy is no longer a “luxury add-on” in clinical practice. It is steadily becoming one of the main pillars of modern veterinary care.
The presentation by Dr. Pınar Can clarified both the theoretical framework and the practical applications of veterinary physiotherapy. Through real clinical cases, she provided concrete answers to the key questions clinicians often ask: why, how, and to what extent should we use physical therapy?
First, the Big Picture: What Is Veterinary Physiotherapy?
Dr. Can began with a very clear statement:
The definition of physiotherapy in veterinary medicine is essentially the same as in human medicine — the only difference is that our patient is not human.
According to the American Physical Therapy Association (APTA)
Physical therapy includes examination and evaluation in order to determine diagnosis, prognosis, and the appropriate treatment protocol for patients with functional impairments.
According to the World Confederation for Physical Therapy
It aims to restore the highest possible level of movement and functional ability in individuals whose mobility has been affected by aging, injury, disease, or environmental factors.
When we translate this definition into veterinary medicine, the goal remains the same:
👉 To restore and maximize mobility and quality of life.
Why Do We Use Physical Therapy?
Dr. Can summarized the main goals of veterinary physiotherapy in three key points.
1. Restoring or improving mobility
If movement has been limited due to orthopedic, neurological, or cardiovascular disease, the objective is to restore the highest achievable functional level.
2. Reducing pain
Pain is both:
- a cause of reduced movement, and
- a result of prolonged immobility.
Physical therapy is a powerful tool for breaking this cycle.
3. Preventing injuries and improving performance
In athletic animals such as sled dogs, racing greyhounds, and performance horses, the goal is not only treatment but also injury prevention and performance enhancement.
The Physiotherapy Toolbox: Four Main Approaches
The theoretical backbone of the session focused on four major groups of physiotherapy techniques.
1. Electrophysical Modalities
These methods are generally used for pain control and preparing tissues for exercise.
Examples include:
- Superficial thermal therapies (heat and cold applications)
- Therapeutic ultrasound
- Electrotherapy (such as TENS)
- Laser therapy
- Extracorporeal shock wave therapy (ESWT)
- Static or pulsed electromagnetic field therapies
2. Manual Therapy
Manual therapy techniques include:
- Massage
- Soft tissue mobilization
- Joint mobilization
These techniques help:
- reduce pain
- improve circulation
- increase joint range of motion.
3. Therapeutic Exercise
This is one of the most important components of rehabilitation.
Examples include:
- Passive range of motion exercises (PROM)
- Active or assisted-active exercises
- Balance and proprioception training
Dr. Can emphasized an important point:
👉 Electrophysical modalities alone are not enough.
Real functional recovery requires exercise.
4. Aquatic Therapy
Water provides several advantages in rehabilitation:
- buoyancy
- hydrostatic pressure
- the muscle-relaxing effect of warm water
These factors allow animals to move with less pain and greater control.
Which Patients Benefit from Physiotherapy?
Veterinary physiotherapy can be used in a wide range of conditions, including:
- Orthopedic diseases
- Neurological disorders (paresis, paralysis, coordination problems)
- Obesity
- Cardiovascular diseases
- Sports medicine and performance conditioning
An Important Difference in Türkiye: Who Is Authorized?
Dr. Can highlighted a critical point.
Unlike human physiotherapy, where physiotherapists form a separate profession, animal physiotherapy in Türkiye is legally performed only by veterinarians.
This means veterinarians must be competent in:
- neurological examination
- orthopedic evaluation
- cardiovascular assessment
Some therapies may be contraindicated in certain patients.
For example:
👉 Electrotherapy should not be used in animals with pacemakers or severe heart failure.
Clinical Cases: From Theory to Practice
The most educational part of the session involved real clinical cases.
Each case carried an important practical message.
Case 1 – Köpük
Severe Hip Osteoarthritis + L7–S1 Disc Protrusion
Presenting complaint
- 12-year-old dog
- reluctant to walk
- aggressive when touched
Diagnosis
Under anesthesia imaging revealed:
- severe bilateral hip osteoarthritis
- L7–S1 disc protrusion
The aggression was pain-related.
Five-Part Osteoarthritis Management Strategy
1. Pain control
NSAIDs ± opioids ± gabapentin
2. Weight management
3. Nutritional support
Omega-3 fatty acids, MSM, chondroitin, collagen, etc.
4. Physical therapy
5. Environmental modification
- warm and dry living environment
- soft bedding
- morning heat therapy and massage
- covering slippery floors
- limiting stairs and intense activity
- ramps if necessary
Clinical Tip
Applying TENS individually to multiple joints would take too long.
Instead, electrodes were placed at:
brachial plexus myotomes
lumbosacral plexus myotomes
This produced analgesia throughout the limb.
Treatment Plan
First 4 sessions
- heat therapy
- laser therapy
- wearable PEMF
- environmental modifications
At home
- daily 30-minute TENS
After pain reduction
- underwater treadmill (5 → 20 minutes)
- proprioception and balance training
Outcome
- major improvement after 20 sessions
- booster sessions after 8 months
- about 2.5 years of good function
(The dog later died due to a splenic tumor unrelated to physiotherapy.)
Clinical message:
Control pain → build trust → introduce exercise → maintain long-term management.
Case 2 – Pati
Lumbosacral Disc Protrusion + Prostatic Hyperplasia
Complaint
- 10-year-old Pointer
- progressive hindlimb ataxia for 6 months
- dropped tail
- difficulty defecating
Diagnosis
CT revealed lumbosacral disc protrusion with cauda equina compression.
Additional finding: prostatic hyperplasia
Clinical reminder:
👉 In older male dogs with defecation difficulty, always examine the prostate.
Treatment Strategy
Since the dog was still ambulatory:
Initial treatment
- gabapentin
- prednisolone (15 days)
No improvement → surgery
- dorsal laminectomy
- disc fenestration
Postoperative Physiotherapy
First 3 days
- cold therapy
Then
- heat therapy
- massage
- PROM / assisted exercises
After suture removal
- TENS
- therapeutic ultrasound (must be applied dynamically)
Additional support
- PEMF
Outcome
Approximately 25 sessions led to full functional recovery.
The dog remained well for one year before developing another disc problem, and lived until 15 years of age.
Clinical message:
If the patient is still ambulatory in LS disc disease, consider medical management and physiotherapy before surgery.
Case 3 – Mülayim (Cat)
“Tilted Window Syndrome”
Complaint
- 5-year-old male cat
- trapped in a tilted window
- non-ambulatory paraplegia
Prognostic Factor
👉 Presence of deep pain perception
This indicates a good prognosis.
Pathophysiology
The primary damage mechanism is not arterial ischemia but:
👉 interruption of venous return
Even short compression can cause severe spinal cord injury.
Treatment
- TENS
- PEMF
- manual therapy
- PROM
Later
- underwater treadmill
- balance exercises
- motivation with toys and rewards
Outcome
Complete functional recovery after about 10 sessions over 4–5 weeks.
Clinical message:
Physiotherapy in cats can be challenging, but cooperative patients may recover surprisingly fast.
Case 4 – Hera
Post-FHNO Non-Use of Limb + Dilated Cardiomyopathy
Complaint
- 5.5-year-old Rottweiler
- previous femoral head and neck ostectomy
- refusing to use the limb
- severe muscle atrophy
Additional condition:
👉 Dilated cardiomyopathy
Some therapies were therefore contraindicated.
Imaging Findings
- irregular osteotomy surface
- bone protrusions contacting the acetabulum
- chronic pain
Treatment
Early sessions
- heat therapy
- TENS
- laser therapy
Later
- underwater treadmill
- acupuncture
After 20 sessions
- ESWT (3 sessions every 10 days)
Purpose:
👉 convert chronic pain into an acute healing response.
Outcome
Weight bearing started as early as the second session.
Eventually the dog returned to normal activity.
Clinical message:
Even poorly healed surgical cases may dramatically improve with appropriate physiotherapy.
Case 5 – Helen / Gümüş (Cat)
L3 Vertebral Fracture
Complaint
- 6-month-old cat
- fall from height
- non-ambulatory paraparesis
Critical Decision
The fracture was:
- stable
- not compressing the spinal cord
Therefore surgery was not required.
Treatment
- supportive bandaging
- medical management
After bandage removal
- TENS
- EMS for paraspinal strengthening
- laser therapy
- underwater treadmill
Outcome
Walking ability returned after 25 sessions, and the cat was completely normal within three months.
Clinical message:
Not every vertebral fracture requires surgery.
Case 6 – Bobi
Multiple Diseases, Meaningful Improvement
Diagnoses included:
- Chiari-like malformation
- cervical syringomyelia
- severe mitral valve disease
- choroid plexus tumor
Initial status:
- non-ambulatory tetraplegia
- deep pain perception present
Contraindication Management
Due to cardiac disease:
- full-body PEMF was avoided
Instead
- localized PEMF
- low-intensity TENS
- dry treadmill exercise
Aquatic therapy was not tolerated.
Outcome
Within four months:
- pain significantly reduced
- appetite improved
- sleep improved
- patient regained ability to stand and take steps
Later euthanasia was performed due to tumor progression.
Clinical message:
Even when full recovery is impossible, physiotherapy can significantly improve quality of life.
A Key Takeaway from the Q&A Session
Physiotherapy in Thromboembolism
In cases such as feline aortic thromboembolism:
Electrophysical modalities are contraindicated, because they may increase inflammation and worsen reperfusion injury.
Recommended approaches include:
- passive and active range-of-motion exercises
- therapeutic exercise
- manual therapy
Heat therapy, TENS, and laser therapy should not be used.
We will continue sharing key highlights from VetSummit 2025: New Horizons in Veterinary Clinical Sciences, sponsored by the Kito Healthy Pet Nutrition Ecosystem. See you in our upcoming content that will support your clinical practice.
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