There are many different therapies that can be used to help your dog feel better when dealing with a musculoskeletal issue. Whether it’s an acute injury or a chronic condition, these holistic therapies can not only improve the quality of life for your dog, but they can actually help to stimulate the healing process. One of these therapies is called neuromuscular electrical stimulation therapy.

There’s a lot to know about electrical stimulation therapy including the types available, the benefits, and what conditions it may help. Here’s what you need to know so you can talk with your doctor to see if electrical stimulation therapy might be right for your dog.

What is Electrical Stimulation Therapy?
Electrical stimulation therapy, also known as electrotherapy or E-stim, is using low-to-mid levels of electrical current in the body. It has been used in humans successfully for years. E-stim was first introduced in racehorses, then in companion animals like dogs.

The primary goals of E-stim are to strengthen muscles that have begun to atrophy, relieve pain (often following surgery or an injury), reduce stiffness and inflammation, and optimize muscle range and motion. It’s commonly used with sporting dogs (who do agility and the like) though it can be used for most dogs. Though this type of therapy isn’t often used in general veterinary practice, it’s frequently used in rehabilitation.

There are two types of electrical stimulation therapies used for dogs: NMES and TENS. Both are non-invasive, non-painful, and safe therapeutic techniques that can be used in conjunction with canine physical rehabilitation techniques like cold laser therapy, heat therapy, therapeutic exercises, and others.

NMES
Neuromuscular Electrical Stimulation (NMES) stimulates muscle contraction using electrical impulses. It stimulates motor nerves in the central nervous system, often the spine. NMES helps to build muscles and has been found to be very effective in rehabilitation.

NMES uses higher frequencies than TENS to strengthen muscles, causing them to contract. It’s often used in patients who are too weak to move certain muscles or muscle groups. This weakness could be due to atrophy from an injury or from a neurological issue. NMES can also be used for preventive therapy for partially or totally immobilized patients.

TENS
TENS stands for transcutaneous electrical nerve stimulation. It’s a type of NMES that involves the use of electrical stimulation to primarily provide pain relief. It is used in lower frequencies and targets sensory nerves to override pain impulses.

To use TENS, electrode pads are placed against the animal’s skin or coat with a conductivity gel. When turned on, the unit delivers a low-level electrical current to the area touching the electrodes. The effect of TENS is short-lived, though, and may only last around an hour or so. It is sometimes used immediately post-operative to help manage pain and during therapy to help work through a potentially painful treatment.

Benefits of Electrical Stimulation Therapy
Electrotherapy, including both NMES and TENS, provides a number of health benefits for dogs since it can be used on both the sensory and motor nerves. It strengthens muscles and can re-educate them, reversing muscle atrophy. Electrotherapy can also provide pain control or relief, a reduction of inflammation, and promote wound healing.

Electrical stimulation therapy causes change at the cellular level and at the tissue level. NMES has been found to rehabilitate muscles, prevent muscle atrophy, and maintain or increase joint mobility. TENS is generally used for pain management. Both also help with lymphatic drainage and overall circulation, providing additional benefits.

E-Stim Sessions
The feeling of e-stim is similar to a tingling sensation and you can ask to try it out to see what it’s like before it’s used on your dog. Most dogs enjoy it once they are used to it and the sessions are comfortable and relaxing. Your dog won’t need recovery time from an electrical stimulation therapy session.

The frequency and duration of electrical stimulation therapy sessions will depend on a number of factors including the type of injury or surgery, the extent of neurological or muscular damage, and your dog’s medical history. Sessions often last between 10 and 20 minutes, and they may be recommended multiple times a week during an acute period (like immediately following an injury or surgery).

Because we don’t have the ability to ask about the sensation during treatment, vets start off low and slowly increase the frequency. The electrical current and duration is adjusted based on the dog’s size,  weight, and response to the sensation.

Should Your Dog Try E-Stim Therapy?
Talk with your vet or your rehab vet to see if electrical stimulation therapy may be helpful for your dog. It’s a safe and effective treatment and one of the great tools in every rehab vet’s arsenal to help your dog live a better, happier, and healthier life.

A word of caution: there are home electrical stimulation therapy kits available. Though you may be able to provide e-stim treatments at home, it’s important to only do so under a vet’s care and instruction to make sure you don’t worsen the issue.

Canine physical rehab can help your dog with a lot of different medical issues due to a medical condition or an injury. Incorporating rehab into the healing process safely promotes a faster return to health for your dog. 

The goal of canine physical rehab is to help your dog live a better life. By improving mobility and decreasing their pain, we can help your dog by improving their quality of life, and sometimes even help them live longer. Here are some of the most common conditions I see in my practice that have great results with rehab.

Hip Dysplasia and Elbow Dysplasia
Hip dysplasia is a genetic condition where the head of the femur (thigh bone) and the socket in the pelvis (the “ball and socket” of the hip joint) don’t grow uniformly. This causes looseness in the joint and eventually degenerative joint disease (DJD) or osteoarthritis (OA). Elbow dysplasia is similar and occurs in the elbow of the front leg instead of in the hip.

Dogs are born with this condition and though it tends to be more common in large-breed dogs (50 pounds or more), it can happen in any dog. Symptoms can present as young as four months of age though most show signs as they age due to osteoarthritis in the affected joint(s).
Symptoms to look out for:

• Decreased activity
• Lameness in the hind end (or in the case of elbow dysplasia, a front leg)
• Decreased range of motion
• Reluctance or difficulty rising, running, or jumping
• Pain, stiffness, or limping
• Swaying “bunny hop” gait
• Loss of thigh muscle mass and enlargement of shoulder muscles due to compensation 
• A grating sound in the joint
  
  

How Physical Rehab Can Help
There are several things we can do to help your dog. First, it’s helpful if a dog with dysplasia doesn’t carry extra weight. We can determine your dog’s ideal weight and work together to reduce it if needed. 

We can also discuss the supplements your dog can take and if medications like NSAIDs (non-steroidal anti-inflammatory drugs) may be appropriate. We can create an exercise regime to help improve mobility and muscle tone. And, we can also work to manage pain with treatments like cold-laser therapy, and others. If your dog does need surgery, we can work to rehab your dog to get him back to health as quickly as possible while helping to manage pain.

ACL Injuries
The cranial cruciate ligament (CCL) is a ligament in the knee that attaches to the femur (thigh bone), runs across the knee, and attaches to the tibia (shin bone). Its purpose is to hold the tibia in place, preventing hyperextension and internal rotation. This ligament is called the ACL, or anterior cruciate ligament in humans.

CCL ruptures are most common in large and giant dogs, however, they can happen to dogs of any size. They are the most commonly seen orthopedic injury in dogs. These injuries are often due to overexertion during high-impact activities, though that’s not always the case. Even a partial tear is extremely painful and a serious injury.

Symptoms to look out for:

• Lameness or limping on one rear leg
• Inability to bear weight on the leg
• Swelling around the inside of the knee
• Difficulty laying down or getting up
• Tenderness near the knee
  
  

How Physical Rehab Can Help
Physical rehab may be an appropriate course of treatment in some cases. The ligament cannot grow back together, however, the dog can build up scar tissue to stabilize the joint to return to normal activity over time.

Treatment will depend on the level of injury and the dog’s condition, but it generally includes rest, anti-inflammatories, cold-laser therapy, and an Assisi loop. We start slowly with short walks and then work up to exercises to strengthen the muscles around the knee. It’s a long and slow process but in some cases, we can avoid surgery. Should your dog require surgery, we can certainly work together to help your dog with healing and improving mobility and strength.

Back Pain and Disc Disease
There are a number of different medical conditions that can cause back pain in dogs as well as nerve-induced weakness in the back legs. These include spinal arthritis, degenerative myelopathy, and disc disease (also known as degenerative disc disease or intervertebral disc disease, or IVDD). 

In the case of arthritis, inflammation or a bone spur in the spine puts pressure on the spinal cord. Degenerative myelopathy (DM) is a genetic disease affecting the spinal cord that results in slowly progressive hind limb weakness and paralysis in older dogs. And degenerative disc disease or IVDD are where the vertebrae bulge or burst into the spinal cord space, causing pain, nerve damage, and sometimes paralysis.

Each of these conditions is different, however, many of the symptoms and treatments are similar. The causes can range from genetics to an injury to aging.

Symptoms to look out for:

• Abnormal gait
• Paralysis, “knuckling,” where the hind paws turn under, or the dog’s hindquarters seem to sway when standing still
• Difficulty getting up from a lying position
• Unwillingness to play or jump
• Reduced activity
• Pain and weakness in rear legs
• Crying out in pain
• Anxious behavior
• The dog falls over easily when pushed from the side
• Loss of bladder and/or bowel control or inability to posture properly to eliminate
  
  

How Physical Rehab Can Help
The treatment will very much depend on the cause of the symptoms. Pain management is a very important part of treatment as well as trying to keep these issues from progressing further. Managing weight to reduce its impact and helping the dog build strength and muscle to counteract these issues are also important. 

Osteoarthritis (OA)Osteoarthritis is a progressively worsening inflammation of a joint that is caused by a deterioration of cartilage (also known as DJD, or degenerative joint disease). The cartilage acts to cushion joints allowing a smooth and full range of motion. The loss of cartilage causes inflammation, pain, and a decreased range of motion.

Any joint can develop osteoarthritis though it’s most commonly the lower spine and limbs. Any dog can develop osteoarthritis, and though it’s more common in aging dogs, young dogs may also have an issue with it. Large or giant breed dogs are more prone to osteoarthritis. 

Other risk factors include genetics, obesity, improper nutrition, injuries or conditions like fractures, ligament tears, hip or elbow dysplasia, and age. It’s also fairly common in athletic dogs due to repetitive stress to the joint(s) from things like agility and flyball.

Symptoms to look out for:

• Reluctance to play, run, and jump
• Weight gain
• Lethargy
• Pain when being touched
• Stiffness, difficulty getting up, lameness, or limping
• Loss of muscle mass around the spine and limbs
• Accidents in the house or difficulty getting positioned to urinate or defecate
• Changes in behavior or irritability
  
  

How Physical Rehab Can Help
We’ll first evaluate your dog’s mobility, weight, supplements, and medications to make adjustments as needed to help improve your dog’s quality of life. We can’t reverse osteoarthritis, but we can try to help it from getting worse quickly and can manage pain.

Then, we’ll work on an exercise plan to strengthen the muscles around the impacted joints. While we do this, we’ll incorporate treatments to help with pain management like cold-laser therapy, and an Assisi loop.

What You Can Do About These Common Conditions
Though I see a wide range of mobility issues in my private practice, these four are what I see most often. If your dog is showing any of the symptoms mentioned, know that there’s hope. As a rehab vet, I have a lot of tools in my arsenal to help your dog live a happier and healthier life. Generally speaking, the earlier you begin treatment, the better off your dog will be. Though many of these issues aren’t curable, they certainly are treatable.

Caregiver fatigue and burnout is a real thing. Ask anyone with a terminally-ill dog or one with a serious health condition, particularly one that affects mobility. The heavy emotional challenge often accompanied by a physical burden can really take a toll on your mental and physical health. 

This isn’t something we like to talk about as it can be an uncomfortable feeling that we can’t always do everything we feel we should for our beloved pet, but it’s something we really need to talk about. This post will help you to identify the signs, understand the causes, and includes some practical tips for dealing with caregiver fatigue.

What is Caregiver Fatigue
First of all, if you are feeling exhausted, frustrated, sore, and isolated while trying to support your beloved dog who is dealing with a significant medical issue, you are not alone. Most of us go through it at one point or another and it’s a really tough time. Not only are our hearts and bodies taking a beating but our minds are as well as we have a tendency to load on guilt when we’re in this situation. We feel guilty for what we can’t do or perhaps that we feel we may not be doing enough.

It’s no different from caregiver fatigue when caring for our human loved ones. When the symptoms aren’t managed, caregiver fatigue becomes caregiver burnout: a state of emotional, mental, and physical exhaustion.
 
What Causes It?
Caregiver fatigue and burnout are typically reported with extreme fatigue, stress, anxiety, hopelessness, and sometimes depression. The caregivers are often so busy caring for their loved ones that they often neglect their own health and it takes a toll. 

Here are some causes of caregiver fatigue and burnout:

• Lack of control — Unfortunately, we’re not always able to control the medical situation of our dog. That may be due to a deteriorating condition and aging, or it may be a financial challenge to provide care. It may be a lack of time or not having the right skills to manage the situation. 

 

• Unrealistic demands — Sometimes we take on too much responsibility that could possibly be shared with other family members. Other times, this burden is placed on us. Additionally, we sometimes place unrealistic burdens on ourselves as to what we can actually do. 

 

• Unreasonable expectations — Sadly, no matter how much we may be willing and able to do, we simply can’t stave off the inevitable. We hope to have a positive effect on our dog’s health and happiness but that’s not always possible. It can feel very personal when this happens when we are giving so much. 

What often happens when people suffer from caregiver fatigue is that they lose the ability to assess their own situation as they are so focused on who they are caring for. This leads to burnout and eventually to an inability to function effectively. Though this is understandable, it does no one any good, particularly the patient.

How to Know if You Have Caregiver Fatigue?
The symptoms of caregiver fatigue are often similar to those for stress and depression. They may include:

• Exhaustion, both emotional and physical
• Loss of interest in activities the person used to enjoy
• Irritability, hopelessness, and helplessness
• Changes in weight, appetite, or both
• Isolation and withdrawal from loved ones and socializing
• Increased illness or possibly physical injuries
• Changes in sleeping, either too much or too little

As fatigue evolves into burnout, the severity of symptoms may increase and more serious symptoms may evolve like feelings of self-harm or aggression. 

Tips for Managing Caregiver Fatigue
Though it may not feel like it sometimes, there are a lot of things you can do to manage caregiver fatigue and to try to keep it from progressing.

Talk to Someone
Find a person you trust that you can share your feelings with. It may be a family member, a friend, or a coworker. Whomever it is, just make sure you can have an open and supportive dialogue. Sometimes just sharing your feelings will help you feel better. 

Consult with a Vet
If you’re feeling burned out by caring for your dog, talk with me or your primary care vet about it. We understand what you’re going through and maybe there are changes you can make or something we can recommend to help you manage the situation better. For example, if you’re having to carry your dog around on bad days, maybe a cart would help ease your back while still helping your dog. It’s important to educate yourself to be sure you understand what to expect and talking with your vet is a great way to do that.

Set Realistic Expectations
Fear of the unknown, or even an unpleasant future, can weigh heavily on you. However, it’s important for you to prepare yourself for what the future may bring. Make sure when you talk with your vet, you get a clear picture so you can set your expectations accordingly. You don’t want to set yourself up for failure by expecting that your assistance will cause dramatic improvement if that isn’t possible.

Ask for Help
You may feel you need to do it all for one reason or another, but that’s not entirely true. It’s important to ask for help when you need it. Maybe it’s a family member or a friend or perhaps it’s paying for a temporary caregiver to help. Know your limits and be honest with yourself.

Take a Break
We all need to get away sometimes and it’s especially important when you’re feeling burned out. See if someone can care for your dog for a couple of days. Or check with your primary vet. Vet techs often offer pet-sitting services and they have medical experience, are familiar with your dog’s issue, and your vet’s cell number!

Take Care of Yourself, Too
Your focus may be on your dog and that’s understandable, but you need some “me time” too. This includes mental, emotional, and physical self-care. Take time to go for a walk or to the gym. Get a massage if your back is hurting or take a hot bath. Do some things you enjoy too so it’s not all about your dog, at least for a little while. And make sure to get plenty of sleep, exercise, and eat well. Make sure to fill your own cup first. Especially when you are taking care of two, it’s important.

Talk with a Professional When You Need
Sometimes we need a little extra help from a professional. That may be a therapist, social worker, or even a clergy member that is trained to counsel people dealing with similar issues. You can also look for groups, either in-person or online, that may be able to provide you with some support when you need it.

Above all, be kind to yourself and accept how you are feeling. This can be a really tough time emotionally and it’s okay to not be okay. It’s okay to feel negative, frustrated, overwhelmed, or angry. It doesn’t mean you’re a bad person or that you’re doing a bad job caring for your dog. 

Taking care of your dog when they are injured or unwell is hard work! It’s tough enough when it’s short-term but when longer-term care is required, it can be really challenging. Try to be positive but realistic as well, and make sure you make it onto your list for care. After all, we can care for others better when we are taking care of ourselves, first. Don’t wait until you are completely burned out and above all, make sure to communicate and ask for help when you need it.