Laurie's Blogs.

Literature review:

Influence of in-house rehabilitation on the postoperative outcome of dogs with intervertebral disk herniation.

Hodgson MM, Bevan JM, Evans RB, and Johnson TI.

Veterinary Surgery. 2017;46:566-573.

Objective: To determine the influence of in-house rehabilitation on the postoperative outcome of dogs with intervertebral disk herniation (IVDH).

Methods:  The researchers conducted a retrospective cohort study, comprised of 248 dogs under 20 kg of weight, with single site, thoracolumbar, Hansen Type I IVDH.  They reviewed the medical records and classified the dogs into 2 groups depending on whether their postoperative management included an in-house rehabilitation program. (87 received in house rehab, and 161 were in the control group.) Preoperative and sequential postoperative modified Frankel scores (MFSs) were recorded. Time to ambulation, time to normal conscious proprioception, final MFS, and complications were compared between the groups.

Results: More dogs returned to full neurologic function (final MFS of Grade 5) when in-house rehabilitation was included in the postoperative management (33% compared to 9%). Normal conscious proprioception and ambulation returned earlier in the control group (42 days and 14 days, respectively) compared to the group with rehabilitation (49 days and 28 days, respectively). The complication rate was higher in the control group (29%) compared with the group with rehabilitation (16%).

Interjection of thought: It should be noted that the Rehab group contained more dogs that were lacking in deep pain perception – which could account for the ‘slower’ return of conscious proprioception and ambulation.  Mind you, the delay was only 1 – 2 weeks, and overall, the end results were better in the rehab group.

Conclusions and clinical relevance: In-house rehabilitation should be included in the postoperative management in dogs after surgical treatment of IVDH to improve neurologic function and reduce postoperative complications.

Inquiring Minds want to know… What did the rehab look like?

More thoughts:  It was noted in the paper that the rehab was not standardized, and that this would / should be a consideration in the future.  I strongly disagree, especially in neuro cases, where a trained therapist should work with the skills and function of the patient in front of them, as compared to a protocol, even a staged protocol.

So, there you go!  Spread this paper around like wildfire and get those post-op IVDH neuro dogs referred to you!