Hydrotherapy can be used to treat patients with elbow conditions . Positive results have been seen from its use as a complementary therapy in a multimodal approach , alongside the necessary medications and physiotherapy . Referral through a veterinary practice is essential .
Malbec had already had some sessions with a veterinary physiotherapist . As Malbec was quite excitable and enthusiastic in her physiotherapy sessions , there was a concern that , during swimming , she could further damage the elbow joint if she moved rapidly in an uncontrolled manner in the early stages of her rehabilitation . It was therefore decided to use a UTM to improve Malbec ' s core strength and muscle mass in her right forelimb , reduce any lameness and encourage the correct gait pattern and stride length , prior to referring her to the pool for swimming sessions for ongoing global muscle build-up and strengthening .
Although there is a risk of the concussive forces of the treadmill having a negative impact on the joint , it was decided that Malbec needed to be in a controlled environment , where she could be supported and kept calm , to ensure the most appropriate and beneficial therapy could be provided ( Table 2 ).
Session 1 : 3 August 2022
History
The owner reported that Malbec had been doing well at home . She had received a 30-minute physiotherapy session with the on-site veterinary physiotherapist prior to the 30-minute introductory session in the UTM .
Pre-session examination
There was no obvious visible lameness in her right forelimb . There was some palpable muscle atrophy in her hindlimbs due to compensatory muscle wastage resulting from Malbec shifting her weight . There was also slight kyphosis through her lumbar spine . Overall , Malbec appeared comfortable and happy . Her skin , ears , eyes , nose and mouth were all clean / clear and of healthy appearance . Nothing abnormal was detected .
Therapy session
Malbec walked through the dry treadmill on a lead a couple of times , with treats and praise given to motivate her . She was unfazed and confident . A swim jacket was fitted and she was returned to the treadmill .
The doors were closed and the water was filled to a depth of 35 cm . The belt was started at a slow speed of 10 metres per minute ( m / min ) for 30 seconds , then increased in increments – 15 m / min , 20 m / min and 25 m / min – for 30-second sets , while providing treats , praise and bilateral support to Malbec throughout .
Table 2 . The main benefits of using a UTM for Malbec ' s therapy .
Therapy Gait retraining
Warm water and hydrostatic pressure
Semi-weightbearing exercise
Accuracy
Malbec had a relatively good stride length and even protraction and retraction at 25 m / min . She had a reduced range of motion in her hindlimbs bilaterally , so she was provided with some bilateral stifle support . She had a good range of motion in her forelimbs throughout and took even strides .
A ball was used to motivate Malbec to move forward , in addition to her owner ' s encouragement ( Figure 2 ). A centre assistant held the top of her jacket to keep her centred while she found her bearings on the UTM . She tolerated all of the support well and had a very good first session . She walked a total of 45 metres .
Therapy plan
Benefit
Provides right forelimb support to ensure the patient is placing her right forelimb correctly as she walks on the treadmill . The resistance from the water as she walks increases muscle mass and aids muscle memory to encourage her to place the limb correctly when walking on land .
Reduces joint inflammation and provides some additional pain relief where , and if , the affected joint is causing discomfort .
Although this is a form of weight-bearing exercise , the patient is supported by the buoyancy of the water , thereby reducing any concussive forces .
The therapist can observe stride length and consistency and the quality of the patient ' s gait , which can all be fine-tuned as required – using specific speeds , set durations and water levels – to create a customised rehabilitation session .
It was decided to proceed with once-weekly UTM sessions for another five sessions , followed by a physiotherapy review . The review would determine the next stage of the therapy plan and whether Malbec could progress from the UTM to the swimming pool .
28 Veterinary Nursing Journal