CanineHydrotherapyCanine Hydrotherapy. Study of a seven month old Labrador withsevere hip dysplasia and narrowing of the disc space causing muscleatrophy of the hind limbs and caudal lumber muscles.

Zak was seven months old whenhe was referred to us by his vets.He was a quiet, gentle andextremely affectionate Labradorwho was experiencing problemsthat were becoming more obviousas he grew. Zak was very long in theleg, there was very noticeablemuscle atrophy of the hind limbsand lumbar muscles and his hindlimb gate was unstable. He carriedhis hind limbs so closely togetherthat his feet crossed on occasions.Zak also had an arched lumberspine (lumbar kyphosis).This wasnot the picture you would expect ofa “bouncing” young Labrador. In fact,Zak did not bounce, he wiggledvigorously to show his pleasurewhen made a fuss of, but wasotherwise quiet and a little subdued.

Zak was born in March 2004, andCharmaine, Zak's owner, firstnoticed problems when Zak wasfive months old. He started to archhis back when walking and whengoing to sit he would put all hisweight on his front legs, then tuckhis hind legs underneath. He wasquiet and lethargic, content to lie onhis back and play and not runaround. Most noticeable of all werehis underdeveloped hind legs.WhenZak did run, he bunny hopped bothhind legs together.

Zak was x-rayed and the x-raysthen forwarded to a specialist

orthopaedic referral centrefor further diagnosis.Theseshowed Zak had eight lumbarvertebra, a congenital

abnormality where the first

sacral vertebra is lumbarised, thearticulation between this vertebraand the rest of the sacrum wasdistorted and narrowed and theventrodorsal view showed a vestigiallateral process on the right handside. Further X-rays of the pelvisshowed severe hip dysplasia, withboth femoral heads lying outside theacetabulae. Both acetabulae werepoorly formed and there wasflattening of the opposing surface ofthe femoral heads, possibly causedby abnormal wear on the dorsalacetabula rim.

It was decided that at this stage thelumbar sacral deformity was notnecessarily a clinical problem.Although degenerative changescould be enhanced in this area bythe abnormality and cause problemslater on, this was to be monitored.

The hip dysplasia was Zak's mainproblem and he was showingmarked pain in this area.Total hipreplacement was the most

preferable surgical route to take, butZak was too young for this, undertwelve months. Zak was also possiblytoo small for the smallest femoralstem. It was decided to followconservative treatment for the timebeing, whilst Zak matured. He was puton an ongoing course of NSAID’sand referred to us for hydrotherapy.

We first saw Zak in October 2004and after an initial assessmentstarted him on a course ofhydrotherapy. His first session wasunremarkable after being lifted intothe pool and attached to our harnessline he splashed and circled in thewater till he orientated himself andthen settled to swim for just twominutes.At this stage we restrictedZak’s normal exercise to five minutelead walks, twice a day. He was soreand wobbly and it was crucial weknew if any increased lameness wascaused by the swimming orinappropriate exercise.This way wecan monitor dogs very closely.

After three sessions Zak gained hisconfidence and started to walk up theramp into the pool rather than beinglifted in.Things didn’t go without ahitch and at the fourth session Zakcame into us more lame. Charmainereported his exercise hadn’t changed,but he was more playful and may havetwisted on that leg at home.Weswam Zak for the same time againand he recovered progressing well ateach session thereafter.After fivesessions he started swimming withoutsupport floats. In this short time, justtwo and a half weeks, he had gained alittle more strength and looked less

pre opp x-ray

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wobbly. By the sixteenth session,Zak had reached his full swim fitnessand was swimming on full jetcurrent and full air.This jet currentand air flow makes swimming moreof a challenge.We call it powerswimming.

Zak continued to swim weekly untilthe end of January when by thistime he had built more muscle, andwas looking stronger and fitter. Hewas full of himself, playing more andbecoming more of a challenge to hisowner. His lead exercise wasincreased and we all felt he had agood chance of making a quickrecovery if he underwent surgery.At the beginning of Februarysurgery for an excision arthroplastyof the right leg was undertaken.Charmaine collected Zak from thevets the next day, he was only usingthree legs, but three days later hewas back on all four. He metCharmaine at the bottom of thestairs, Robert Jones bandage in hismouth. Charmaine told me “I amsure he was expecting hismorning walk”.

Everyone was cautious and Zakremained off swimming for fourweeks and I would have liked tohave swum him sooner. Zakreturned to us on 5th March,starting again for just two minutes,but this time with no need forsupport floats. He progressedquickly again, swimming twice aweek reaching thirteen minutes bythe time he had his second excisionarthroplasty on 23rd March. Duringthis time, Zak was unable to swimon jets (we only introduce jetswimming as the dogs reach asuitable level of fitness). He becamelazy and started to float, weintroduced toys and games to keephim moving and got him swimmingin circles instead. By 23rd March, hewas confidently bearing weight onhis right leg just six weeks postsurgery, partly due to thehydrotherapy pre surgery and alsodue to a strong mental attitudefrom Zak.

After the second operation, Zakwalked out of the vets on all fourlegs, returning to swimming on 8th

April after just seventeen days, andeveryone was more confident thistime. He progressed well with onlyone relapse after six weeks showingas intermittent non-weight bearingof the left hind leg.A course ofNSAID’s helped and by 7th June Zakwas back to full swimming fitness, hismuscle build up was noticeable andhe was so keen to swim, we nowneeded to keep a tight hold of himto prevent him hurtling up the rampand leaping into the water from thetop. He was discharged from thespecialist vets care, eleven weeksafter the second operation and wasbeing monitored carefully by hisregular vet.

He no longer needed NSAID’s andCharmaine was finding him strongand wilful. His full character wasnow shining through.

Zak was never going to be able toavoid surgery, but his recovery eachtime has been remarkable.

Swimming pre surgery has manybenefits;

Introducing a dog to the indoorpool environment early allows themto become familiar with theirsurroundings and those handlingthem and they become confidentswimmers.This introduction towater is not always easy andbecomes stressful for all concernedwhen undertaken post surgerywhen the dog is most vulnerableand in discomfort.

Dogs that are confident in the waterand have gained full swimming

post opp x-ray

fitness pre surgery will get fit morequickly again afterwards, allowing usto advance them sooner to thestage of healing, recovery andmuscle gain.

Post surgery it is generallyacceptable to swim dogs oncesutures have been removed andthere is no risk of infection.However this needs to be wellcontrolled under strict supervision.Swimming soon after surgery hasbenefits mentally, giving dogs theknowledge they can still move freelyand with less discomfort.This keepsthem bright and positiveencouraging them to use injuredlimbs sooner and with confidence.

As you can see from the phototaken of Zak in July this year, fifteenweeks after his second operation.We still have a way to go, but theimprovements we have seen in eightmonths have been immense. Hisspinal abnormality still gives concernfor the future, but at this time thereis no evidence of clinical problems.Zak continues to improve and stillswims weekly.We as hydrotherapists hope thatsuch a recovery is always possible.All that we ask is that we are giventhe chance to try. However, what wemust never forget is that none ofthis would ever be possible withoutthe dedication, encouragement andof course the love that the ownergives to their dog.I would like to thank theorthopaedic vets concerned fortheir considerable help with Zak andthis article, also Charmaine and abouncing Zak.

www.meadow-farm.com Tel 01359 250310

Zak – fifteen weeks after his second operation