Page 115 - BSAVA Guide to Pain Management in Small Animal Practice

BSAVA Guide to Pain Management in Small Animal Practice

VetBooks.ir Chronic pain a reward muscle memory from puppy
training, even if they do not sit properly of
Acupuncture, physiotherapy and hydrotherapy
their own accord . If they cannot sit
are more usually thought of as treatments for
chronic, rather than acute, pain. his is because s uarely because one leg is abducted,
such conditions traditionally cause owners to start with them sitting against a wall
seek out non pharmacological interventions. ■ All limbs
he evidence for acupuncture in veterinary • Steps using two or three shallow steps,
clinical conditions is sparse note not negative, put the dog on the lead and slowly walk
ust very underpowered, poor uality studies them up and down the steps, such that
with many confounding factors . unding for they use each leg individually. If they are
large-scale research into human clinical allowed to go at their own pace they will
conditions has provided evidence to the level of likely hop up the steps and avoid using
systematic review to show that acupuncture the a ected limb. oing down slowly is
works beyond sham for chronic lower back as important as going up. Repeat three
pain, allergic rhinitis, migraine and tension times, twice daily
headache and osteoarthritis in the knee, as well • Slopes use a gentle slope initially and
as postoperative and post chemotherapeutic walk the dog up and down it slowly on a
nausea and vomiting. lead so that it uses each leg separately.
or the conditions discussed below the Repeat twice, once or twice a day.
reader can assume that formal physiotherapy Increase fre uency after 1 month if there
and hydrotherapy are preferred where available, is no worsening of pain.
a ordable and tolerated by the patient.
Stretching
Physiotherapy Stretches can help to reduce pain and sti ness
or any neurological or orthopaedic condition in the muscles and help mobili e oints.
where there is obvious muscle wastage and
weakness the simple physical approaches are ■ indlimbs
• hen the animal is lying on its side or
■ indlimbs back at rest, stroke the ank or belly so
• Sit to stand from a s uare sitting that the dog voluntarily extends the
position, encourage the dog to stand hindlimb or limbs. hen this happens,
with a word, hand gesture or treat. apply gentle pressure against the
Repeat three times, three times daily cranial thigh muscles to maintain that
initially igure 6. 4 . his will work the stretch for seconds, then release
thigh muscles, but only if the dog starts gently and repeat. o the set three
from a proper sitting position. ost dogs times, three times daily for each limb
will sit s uarely if there is a suggestion of igure 6. .

(a) (b) (c)
(a–c) Sit to stand exercises use and strengthen the hindlimb muscles.

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