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Physical therapy and rehabilitation for cats

Drum MG, Bockstahler B, et al. Feline Rehabilitation. Vet Clin of No Amer: Sm Anim Pract. 2015;45(1):185-201.

Physical therapy and rehabilitation for canines is a growing and well-accepted field, and credentialing is now available for professionals in this discipline.  Cats can also benefit from physical therapy and rehabilitation, particularly when the unique behavioral and physical characteristics of this species are taken into consideration and rehabilitation programs are tailored accordingly.

Unlike dogs, cats have fewer developmental orthopedic diseases.  Recognition and treatment of osteoarthritis and other degenerative joint diseases (DJDs) in felines is still in its infancy compared to the advances made in this area in canines.  Evaluation and identification of chronic pain syndromes in cats is also a challenging new frontier due to the secretive, private nature of most cats.  Cats tend to demonstrate pain via changes in behavior and lifestyle, such as reluctance to jump or elimination outside the litterbox, rather than with overt lamenesses as seen in dogs.  And a cat may have significant DJD without radiographic changes, making diagnosis of this condition less straightforward than in dogs.  Just like dogs, cats suffer from orthopedic problems such as fractures, luxations, strains, and sprains, that are likely to benefit from physical therapy and rehabilitation as well as medical and surgical therapy.  Neurologic injuries and diseases may also be amenable to physical therapy and rehabilitation techniques.

The knowledge and skills developed in the canine rehabilitation field can be adapted for successful use in felines by taking into consideration the unique behavioral and temperamental characteristics of the cat.  In general cats tolerate shorter exercise and treatment sessions than dogs, as they tend to be more easily bored, more independent and less eager to please, and not usually as willing to accept restraint and handling.  Active exercises that employ behaviors natural to the cat such as playing, crawling into small spaces, and hunting,  may be very successful and tolerated for considerable periods of time.  If one therapeutic modality is not accepted by the cat, the therapist must select another that will offer the best medical effect that will be permitted by the cat.

Rehabilitative therapeutic modalities, their indications and contraindications, discussed in this review article include massage, use of heat with either infrared lamps or commercially available hot packs, therapeutic ultrasound, cryotherapy (cold therapy), electrotherapy, including the commonly used transcutaneous electrical nerve stimulation (TENS), and therapeutic exercise.  Laser therapy is mentioned and illustrated with a photograph, but not reviewed in a special section of the article, as was done with other modalities.  Differences in application of these modalities for cats versus how they are used in dogs are reviewed.  Most cats will enjoy massage, as long as they are not restrained more than is absolutely necessary.  Heat therapy is often better received by cats via infrared lamps rather than the application of hot packs, although a low-stress swaddling technique with a towel may allow for successful application of a hot pack.  Electrical stimulation (ES) is used in the treatment of orthopedic and neurologic diseases causing acute and chronic pain and/or muscle atrophy, and according to the authors, is often well tolerated and even enjoyed by many cats.  For cats, ES sessions often require shorter treatment times, lower current intensity, and smaller electrodes than are used in dogs.

Types of therapeutic exercises (TE) discussed include passive range of motion, assisted standing, weight-shifting, and active exercises.  Photos of cats engaged in these types of exercises, using assistive devices, where appropriate, are included in the article.  Also very useful to the feline rehabilitation therapist is a table listing range of motion of various joints of the cat as measured by goniometry in healthy, nonsedated cats.

Aquatic therapy, including underwater treadmill training and swimming, is surprisingly well accepted by some cats, especially if introduction to these modalities is gentle and slow and initial sessions are very short.  Specific breeds such as the Bengal and Turkish Van, are attracted to water and may be good subjects for this modality, as are some nondomesticated pet cats such as servals and Savannah cats.

Physical therapy and rehabilitation techniques for specific injuries or surgeries are also discussed.  The authors provide treatment suggestions for traumatic stifle luxation (formerly known as “deranged stifle”), more common in cats than in dogs, femoral fractures, femoral head and neck ostectomy, articular fractures, spinal cord trauma, and cruciate ligament injury, which in cats is usually secondary to trauma, unlike in dogs. [PJS]

See also:
Jaeger GH, Marcellin-Little DJ, Depuy V, et al. Validity of goniometric joint measurements in cats. Am J Vet Res 2007;68:822-6.

Eminaga S, Palus V, Cherubini GB. Acute spinal cord injury in the cat:  causes, treatment, and prognosis.  J Feline Med Surg 2011;13:850-62.