Objective: To critically evaluate the evidence for rehabilitation interventions following surgery for cranial cruciate ligament disease (CCLD) in dogs.Study design: Systematic review.Methods: Google Scholar and Pubmed databases were searched for studies evaluating postoperative CCLD rehabilitation interventions from 1990 until March 2020 per the international Prospective Register of Systematic Reviews (PROSPERO). Each study was assigned a level of evidence score from I to IV and a risk of bias (RoB) score by 2 reviewers, and by a third reviewer, when consensus was not reached.Results: Nineteen studies met the inclusion criteria. Twelve comprised randomized, controlled trials (Level II), 6 were nonrandomized or nonblinded (Level III), and one was retrospective (Level IV). Nine studies had high RoB scores. Sixteen studies yielded positive results. Therapeutic exercise had the most studies with positive results but all had high RoB. Cold compression therapy had 3 supporting studies (2 Level II, low RoB). Extracorporeal shockwave yielded 2 positive Level II studies (low‐moderate and high‐moderate RoB) and photobiomodulation had 1 positive study (Level II, low RoB) with objective outcomes. A negative outcome was noted in 1 photobiomodulation study. There was 1 supporting study on electrical stimulation and there was none on low‐intensity pulsed ultrasound.Conclusion: This systematic review supports the use of rehabilitation interventions in recovery of postoperative CCLD in dogs; however, many studies had a high risk of bias.Clinical significance: There is a lack of class I level evidence in veterinary rehabilitation. This study supports therapeutic exercise and cold compression therapy for postoperative CCLD rehabilitation. Existing studies on other modalities are limited and demonstrate conflicting results.

Intervertebral disc disease is one of the leading causes of paralysis in dogs. Pulsed electromagnetic field (PEMF) therapy has been advocated for improving wound healing and pain reduction; however, robust clinical trials are lacking. The present prospective, double-blind, placebo-controlled trial evaluated targeted PEMF therapy administered to 53 client-owned dogs who underwent hemilaminectomy for naturally occurring disk extrusion intervertebral disc disease. The dogs were randomized to receive either targeted PEMF (n = 27) or placebo treatment (n = 28). Wound healing, evaluated by visual analog score and wound evaluation scale, was significantly improved at 6 wk postoperatively in the treatment compared with the control group ( P = .010 and .023, respectively). Pain medications were administered less frequently in dogs receiving PEMF treatment during the 7 day postoperative period compared with the control treatment group ( P = .010) with codeine administered 1.8 times more frequently in the control group. No untoward effects were recorded in either treatment group. More frequent evaluation of outcome measures with larger patient numbers, as well as histologic samples, may be useful in future studies. Dogs receiving PEMF therapy following postoperative hemilaminectomy demonstrated improved wound scores at 6 wk and reduced mean number of owner-administered pain medications compared with the control group therapy.

Objective: To evaluate changes in superficial temperature of hindlimb muscles before and after a 6-min walk in healthy dogs. Methods: Two infrared thermographic images were captured of the proximal and distal hindlimbs of 11 healthy dogs before and after a 6-min walk. Orthopedic exam and objective gait analysis confirmed the healthy status of study subjects. Superficial temperatures of the gastrocnemius, biceps femoris, and gracilis were assessed. Analysis of images was performed using 2 different methods of region of interest (ROI) selection. ROI were selected first using one point (single pixel) in the muscle and then separately by selecting a line (LN) corresponding to many points of each muscle belly from which an average was taken. P < 0.05 was considered significant. Results: There was no significant change in temperature using point ROI before and after 6 min of walking of the gastrocnemius, gracilis, and biceps femoris muscles (p = 0.273, p = 0.349, p = 0.351, respectively). Using linear ROI, both biceps femoris and gracilis muscles exhibited significant increases in temperature (p < 0.0001, p = 0.032, respectively). There was no significant increase in temperature of gastrocnemius muscle for both point and linear ROI selection (p = 0.273, p = 0.448, respectively). The right biceps femoris temperatures were higher compared to left biceps femoris using the linear ROI before and after walks (p < 0.0001). The overall (left and right limbs pooled) standard deviation of point selected values were greater than LN selected values of the biceps femoris (1.35 and 1.11) and gastrocnemius (1.51 and 1.23). In contrast, standard deviation for the gracilis measurements were decreased using point selection vs. LN selection (1.09 and 1.3). Conclusions: The biceps femoris and gracilis muscles demonstrated significant increases in surface temperature after 6 min of walking using the linear method of ROI. Measurement of numerous points along the entire length of the biceps femoris and gastrocnemius muscles may provide a more accurate assessment of the increased vascularity within the tissues resulting from work compared to single point selection. Clinical Significance: Prior activity and ROI selection method should be considered when interpreting thermography results.

OBJECTIVE To identify patterns of referral to US small animal rehabilitation facilities, document referring veterinarians’ perceptions of rehabilitation services, and examine factors that encouraged and impeded referral of veterinary patients to rehabilitation facilities. DESIGN Cross-sectional survey. SAMPLE 461 completed surveys. PROCEDURES Referral lists were obtained from 9 US rehabilitation facilities, and surveys were emailed or mailed to 2, 738 veterinarians whose names appeared on those lists. Data obtained from respondents were used to generate descriptive statistics and perform χ² tests to determine patterns for referral of patients to rehabilitation facilities. RESULTS 461 surveys were completed and returned, resulting in a response rate of 16.8%. The margin of error was < 5% for all responses. Most respondents (324/461 [70.3%]) had referred patients for postoperative rehabilitation therapy. Respondents ranked neurologic disorder as the condition they would most likely consider for referral for future rehabilitation therapy. The most frequently cited reason for not referring a patient for rehabilitation therapy was perceived cost (251/461 [54.4%]) followed by distance to a rehabilitation facility (135/461 [29.3%]). Specialists were more likely than general practitioners to refer patients for rehabilitation therapy. The majority (403/461 [87.4%]) of respondents felt that continuing education in the field of veterinary rehabilitation was lacking. CONCLUSIONS AND CLINICAL RELEVANCE Results indicated a need for continuing education in small animal rehabilitation for veterinarians. Improved knowledge of rehabilitation therapy will enable veterinarians to better understand and more specifically communicate indications and benefits for pets receiving this treatment modality.

The objective of this study was to assess the functional outcomes of dogs wearing nail grips in the first 2 weeks following tibial plateau leveling osteotomy (TPLO). Thirty dogs were included (n = 13 nail grips and n = 17 sham grips). Visual lameness scores (VLS), total pressure index (TPI), and client-specific outcome measures (CSOMs) were obtained by blinded observers on day 1 and day 14 +/− 3 post TPLO. CSOMs were also obtained on day 7. There were no differences in VLS and TPI between the treatment and sham group on day 14 (p = 0.44 and p = 0.59, respectively) or at any time point. CSOMs assessing walking on slippery flooring, ability to rise, and consistent use of surgical limb on a 5 min walk were also not different between groups (p = 0.78, p = 0.80, and p = 0.63) at any time point. Nail grips were well tolerated in dogs after orthopedic surgery. This study did not demonstrate a benefit for dogs wearing nail grips during the first two weeks after TPLO; however, further studies are warranted.