Kirsten Haeusler of Germany is an animal rehabilitation specialist with over a decade of experience in animal physical therapy. At her clinic in Stuttgart, she treats many orthopedic and neurologic cases referred by various veterinary clinics. Part of her research involves applying, improving, and investigating therapies, such as treatment on the underwater treadmill, a regular treadmill, shockwave therapy, pulsed electromagnetic field, and more, to benefit animals in post-illness rehabilitation and recovery treatments.
A 2016 study by Hafner et al. demonstrated that tibial nonunion in humans, when treated with shockwave therapy, was highly efficacious in an astounding 88% of cases. Therefore, this treatment was chosen as a preferred and safe treatment for a small dog weighing 22 pounds diagnosed with delayed nonunion of the canine tibia. Explore her case study with images shown in detail here.
The dog was referred to the clinic from another veterinary practice and presented as follows:
Upon palpation, the dog exhibited mild discomfort on the right hind leg, and swelling on the tibia was present. Examinations and study films revealed:
An outside orthopedic surgeon weighed in with a second opinion and indicated no surgical options were possible. The dog was referred to Dr. Kirsten Haeusler at Tier Physiotherapie for treatment with the focused shockwave.
The initial investigation began with a gait analysis on a pressure-sensitive treadmill. This evaluation helps assess and understand the extent of the impact of such an injury and how the dog’s compensatory movement affects the whole body.
The dog’s owners were informed of the purpose of using the treadmill for gait analysis and how Extracorporeal Shockwave Therapy (ESWT) could help their dog. The small dog was adopted and estimated to be three years of age and otherwise healthy, with good blood labs.
The dog was introduced to the pressure-sensitive treadmill and given appropriate time to get comfortable. Intermittently the dog was given treats to hold his interest, and once speed was increased, measurements began. Comparative measurements were taken at three levels: ground level, incline, and decline.
Upon completion of treadmill walking, the injured hind leg was palpated, and the dog displayed only mild discomfort. Next, the x-rays were reevaluated, and the location of the gap was noted. The treatment area was prepped, and an ultrasound gel was applied. Dr. Kirsten Haeusler utilized the STORZ Medical DUOLITH SD1 device for shockwave treatment. The handpiece was placed on the gap of the nonunion, and treatment began at 6Hz and 0,01 mJ/mm2 and then slowly increased to 0.07 mJ/mm2. In all, 2000 impulses were applied to the treatment area.
Post-treatment instructions were communicated with the dog’s owners, who were told to keep him on a short leash.
During subsequent treatments of 2000 impulses, settings of 0.15 mJ/mm2 were used. Upon completion of the third treatment, gait analysis was conducted. Once again, the owners were sent away with a home treatment plan including:
Gait analysis showed increased loading after three sessions of shockwave treatment and was also confirmed by pet owners. The dog showed vast improvement, including using the hind leg increasingly, accompanied by decreased offloading when standing. Shockwave Therapy freed up movement, and the dog displayed greater agility.
Movement follow-up on the pressure-sensitive treadmill revealed the increased max force of body weight, and compensatory loading decreased. The dog could load the injured right hind limb nearly equal to the left hind.
Despite the complexities linked to fracture healing, Shockwave therapy facilitates the healing of nonunion fractures in dogs. This study demonstrates its efficacy in treating nonunion in dogs and how it can minimize dysfunctional gait and potentially other movement patterns throughout the body.
We can expect more research in veterinary medicine and the use of shockwaves to grow over time.
In addition to treating nonunion fractures in dogs, ESWT has been used in orthopedics in veterinary medicine to treat horses, dogs, cats, and other small animals.
Adding the right technologies can expand your treatment horizons while simultaneously boosting clinic ROI. The more you know about ESWT and other regenerative solutions from CuraMedix, the more seamlessly you can integrate them into your veterinary practice.
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