Laurie's Blogs.

Part One: Diagnoses in Physical Therapy & Canine Rehabilitation

Canine rehabilitation is a growing field dedicated to improving dogs’ mobility, reducing pain, and enhancing their quality of life. A 2024 survey of 20 animal physical therapists from Canada and the United States sheds light on the types of diagnoses they make and the terminology used to communicate their findings. This information underscores the important role of the rehab diagnosis in guiding effective treatment for dogs.

Physical therapists use a range of terms to summarize their assessments, including “Rehab Diagnosis,” “Clinical Diagnosis,” “Clinical Impression,” “Functional Diagnosis,” “Musculoskeletal Diagnosis,” “Physical Therapy Diagnosis,” and “Pathofunctional Diagnosis.” These terms reflect a comprehensive evaluation of a patient’s condition, based on physical exams, movement analysis, and medical records.

The diagnoses encountered in canine rehabilitation are diverse and include:

•     Dysfunction of movement, joint, spine, muscle, position, posture

•     Lumbar,  thoracic, cervical, sacroiliac dysfunction, joint fixation, asymmetry, deviation, rotoscoliosis, facilitated segment

•     Sprain, strain, tendinopathy

•     Joint laxity, instability, hypermobility, hypomobility, arthropathy

•     Atrophy, weakness, hypotonicity, hypertonicity, myofascial trigger points, myofascial restriction, contusion, compensation patterns, pain, restriction, reduced exercise tolerance, functional limitation

•     Obesity, overweight, underweight, deconditioned

•     Neurologic dysfunction, deficit, or disorder, lower motor neuron lesion, upper motor neuron lesion, multifocal dysfunction, myotomal, dermatomal, neuropathy, paresis, paralysis, plegia, diminished reflexes, proprioceptive deficit

•     Benign paroxysmal positional vertigo

•     Post op _____

•     _____ as per Vet Records with… {problem list}

When a diagnosis requires advanced testing for confirmation, therapists use cautious language such as “Displaying signs of…,” “Suspect…,” “Findings suggestive of…,” or “Presents as….” This is particularly important for conditions like Geriatric Onset Laryngeal Paralysis and Polyneuropathy, Degenerative Myelopathy, Intervertebral Disc Disease, Chiari Malformation Syringomyelia, Neoplasia, Osteoarthritis, Degenerative Disc Disease, Spondylosis, Wobbler’s, Cognitive deficit, Behavioural issues, Cerebellar dysfunction, etc.. This careful communication ensures collaboration with veterinarians for further diagnostics and tailored treatment plans.

In canine rehabilitation, these diagnoses inform individualized treatment strategies, such as therapeutic exercises, hydrotherapy, manual therapy, or modalities, to address pain, restore mobility, and improve function.

Part Two: Categorizing Symptoms to Establish Diagnoses in Canine Rehabilitation

Diagnosing complex conditions in dogs can be challenging, especially since they cannot describe their symptoms. Borrowing from human physical therapy, a practical approach emphasizes thinking in categories rather than chasing specific diagnoses. By grouping symptoms into broad patterns, canine physical therapists can streamline their assessments, prioritize interventions, and develop effective, dog-centered rehabilitation plans.

In canine rehabilitation, categorizing symptoms involves observing clinical signs, reviewing the dog’s history, and performing physical exams to identify patterns that align with specific conditions. For example, a dog’s shoulder lameness can be categorized as:

•  Painful and Stiff: (e.g. osteoarthritis)

•  Painful and Weak: (e.g. tendinopathy or OCD lesion)

•  Painful and Unstable: (e.g. medial shoulder instability or labrum tear) 

These categories help therapists form a working hypothesis early, often based on the dog’s age and history. For instance:

•  Younger Dogs: Not likely osteoarthritis, OCD more likely, or tendinopathy or instability

•  Middle-Aged Dogs (4–8 years): Leaning towards tendinopathy, instability, or labrum tear

•  Senior Dogs (9+ years): More likely osteoarthritis

By shifting your mindset to pattern recognition and categorization, one can build more effective, patient-centered management plans, without getting stuck in the weeds of requiring complex diagnostic imaging and innumerable clinical tests.

Categorization also aids in tracking progress and adjusting treatment plans. By establishing baseline categories (e.g., “painful and unstable hind limbs” or “painful and stiff spine”), therapists can monitor improvements in mobility, strength, or comfort over time. This approach ensures that rehabilitation remains focused on the dog’s specific needs, whether that involves strengthening exercises for weakness, manual therapy for stiffness, or balance training for instability.

Conclusion

In canine physical therapy, functional diagnoses and strategic symptom categorization are key to helping dogs regain mobility and live comfortably. The 2024 survey of animal physical therapists highlights the wide range of conditions they address, from musculoskeletal injuries to neurologic disorders, and the careful language used to communicate findings. By adopting a category-based approach to symptoms—such as painful and stiff, painful and weak, or painful and unstable—practitioners can streamline their diagnostic process and create targeted rehabilitation plans. Whether supporting a young dog with joint instability or a senior dog with osteoarthritis, these concepts empower therapists to deliver compassionate, effective care that gets our canine companions back to wagging their tails and enjoying life.