FHO POST SURGERY REHABILITATION SCHEDULE

WEEK 1 - Beginning the night after Suture removal – emphasis is on anti-inflammatory control and increased limb use.
• Suture removal and reassessment of patient.
• Massage – massage helps the muscles feel less painful and increases circulation. Massage can be done once or twice a day depending on how painful patient is. The more painful the patient, the more often the massage is required. Listed below are the usual massage techniques used and in the recommended order.
o Stroking: - 2 – 3 minutes
 Use at the beginning and at the end of the massage
 Stroking is usually applied from the top of each limb and stroke downwards towards the end of the foot.
 Begin at the top of the head and stroke backwards toward the tail.
 Place entire hand in contact with the skin
 Maintain a gentle but firm pressure.
o Effleurage – 2 – 3 minutes
 Following initial stroking – increase pressure (medium pressure) but begin at the toes and move upwards toward the body and from tail upwards towards head.
o Compression 4 – 5 minutes
 Begin at toes and work towards the body, when limbs are done, begin at head and work down back.
 Make full contact with the skin and apply even pressure to skin into superficial tissues (muscles).
 Make a sweeping movement to the top of the area, molding to the contours and maintaining the same depth of pressure throughout the stroke. Remember Do Not cause undue pain or discomfort. 
 Finish the stroke over the lymph nodes or to the nearest body part. Lymph nodes can be found in groin region, armpits, under jaw, at base of spine near hips and between shoulder and neck.
 Bring the hands towards you as you work, using the heel of your hand.
 Overlapping strokes are used, continuing until the entire body is covered.
o Finish massage with gentle stroking – patient should be very relaxed and sleepy.
• Passive range of motion (PROM) and ice packs to the region of the incision or injury three times a day. A complete range of motion should occur. If the joint is painful, flex only as much as is comfortable for the animal. Each day try to flex the joint slightly further until a complete range of motion can be done. Signs that the patient is in discomfort include tensing the limb, moving, vocalizing, turning the head toward the therapist, or trying to pull away. Do Not cause undue discomfort.
o Affected limb
 This can be done with the dog standing or lying down. Gently supporting entire limb, slowly begin to move and flex each joint, beginning with the toes and moving upwards towards the hip. Only flex one joint at a time. A complete range of motion of each joint should occur (move leg forward and backwards as much as possible at each joint). If the joint is painful, flex only as much as is comfortable for the animal. Each day try to flex the joint slightly further until a complete range of motion can be done. Signs that the patient is in discomfort include tensing the limb, moving, vocalizing, turning the head toward the therapist, or trying to pull away. Do not cause undue discomfort.
o Thoracic and lumbar region (chest and lower back)
 While patient is standing or lying down gently flex then extend each limb joint. Begin at the toes and work upwards. Try to flex each joint until a full range of motion occurs. Follow with extending the joint until a full range of motion occurs. If painful to patient, go only as far as patient will allow comfortably. When you get to the shoulder or hip, extend the leg out in front of the patient as far as patient will allow then backwards as far as patient will allow, then, move the limb away from the body as far as is comfortable for the patient. Lastly move the limb in a circular pattern. If any movement is painful to patient, move only as far as patient will allow comfortably.
 Set up two chairs or obstacles that will allow enough space for you and the patient to walk around. Keeping the patient close to you, slowly walk patient in figure eight pattern. Keep the pattern very small to force the patient to bend the body gently left then right. Keep the patient close to your body on a short leash. Continue this for 2 – 3 minutes. 
 Slowly walk patient in a tight circle. While keeping patient on a leash and close to your body, slowly walk around towards your left then towards your right for 2 – 3 minutes.
 Pole weaving – weaving between vertical poles helps to promote side bending of the patient’s trunk. The distance between poles should be adjusted so that sufficient side bending results. In general, the distance between poles should be slightly less than the body length of the patient. Set up any obstacle that could be a pole (i.e. chairs or boxes) and walk the patient in and out of the course. There should be at least 5 “poles” for the patient to walk around. Continue for 2 – 3 laps through the poles.
• Short leash walks at a very slow gait on a flat surface three times a day for bathroom privileges only.
• No stairs, slippery floors, no running, no jumping, no rough play, no long walks or rough play.
• Ensure pet gets all medication.

WEEK 2 – Emphasis is on strengthening muscles.
• Sit – to – Stand exercises and sit – to – lay down exercises continue two to three times daily for 5 – 10 minutes.
• Increase activities listed in Week 2 to 5 – 10 minutes.
• Leash walks 10 - 15 minutes.
• Decline walking (walking down a gentle slope) once daily, if possible.
• Stairs – 3 stairs up and 3 down twice a day.
• Continue PROM listed in Week 2 for 10 – 15 minutes.
• ± Ice packs and gentle massage at end of each exercise session.

WEEKS 3 & 4 – Emphasis is on muscle strengthening.
• Continued muscle strengthening and development with sit-to-stand exercises and short episodes of trotting 5 minutes once to twice daily.
• Leash walks for 20 – 30 minutes twice daily.
• Decline walking 10 – 15 minutes twice daily.
• Incline walking 10 – 15 minutes twice daily.
• Stairs – 6 up and 6 down twice daily, if possible.
• Continue PROM listed in Week 2 for 10 – 15 minutes.
• ± Ice packs and gentle massage at end of each exercise session.

WEEKS 5 – 12 - Emphasis is on muscle-specific therapeutic exercises.
• Continued muscle strengthening and development with sit-to-stand exercises and short episodes of trotting. Lengthen period of trotting to 15 – 20 minutes if possible.
• Leash walks for 40 - 60 minutes twice daily.
• Figure eight walking for 10 minutes during leash walks.
• Decline walking 20 minutes twice daily.
• Incline walking 20 minutes twice daily.
• Stairs – 8 up and 8 down twice daily.
• Swimming once daily for 10 – 30 minutes. (seasonal)
• Continue PROM listed in Week 2 for 10 – 15 minutes.
• ± Ice packs and gentle massage at end of each exercise session.

WEEK 12 – FINAL REASSESSMENT - please make an appointment for repeat back radiographs (x-rays) at this time and recheck appointment.
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LogoCatapuss Veterinary Services, LLC
dba Adamson Veterinary Services
375 W. State Street
Salem, OH 44460
(330) 332-1880

 

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