Physical Therapy & Rehabilitation

Physical Therapy & Rehabilitation

Getting your dog into rehab is the single most important thing you can do.

I walked into the Animal Rehabilitation Center of Michigan carrying Max in a carrier on October 5th, 2023, less than two weeks after his stroke. I had no idea what to expect. I did not know what the vet would say, or if he would ever walk again. Six months and 28 PT sessions later, he walked out at approximately 80% recovered.

Formal rehab, in combination with cold laser therapy, and acupuncture, was the backbone of Max’s recovery. Everything else–supplements, nutrition, home exercises, supported it.

Why rehab must start immediately, and why “crate rest” is the wrong call for FCE

This is important enough to say plainly: the standard advice many vets give for spinal injury–crate rest, limit movement– is appropriate for IVDD. It is the wrong approach for FCE.

For FCE, the imperative is the opposite. The nervous system responds to stimulation. Getting your dog moving activates the remaining nerve pathways, promotes neuroplasticity, and prevents the muscle atrophy that makes recovery harder the longer it’s delayed. I pushed back on the crate rest advice I received and worked to get Max into rehab immediately. I believe that decision shaped his outcome.

Do not wait to see improvement before starting rehab. Start rehab to create improvement.

What happens in a canine rehab session

Every dog’s program will be tailored to their specific deficit and grade of injury. Max’s program at ARC Rehab Michigan included a combination of:

Hydrotherapy / underwater treadmill

Water reduces the effects of gravity and allows a dog to practice walking movements their legs cannot yet perform on land. The buoyancy supports body weight while the resistance of the water builds muscle. This was central to Max’s early sessions.

Manual therapy and massage

Targeted massage to maintain circulation, reduce muscle tension, and preserve range of motion in affected limbs. Also performed passively on joints that the dog cannot yet move voluntarily.

Passive range of motion (PROM)

The therapist manually moves the joints through their full range of motion. This maintains joint health, prevents contracture, and keeps neurological pathways stimulated even before voluntary movement returns. This is also something you can and should learn to do at home between sessions. (Home exercise guide — [link])

Balance and proprioception work

Wobble boards, balance discs, cavaletti poles. These challenge the dog’s nervous system to relearn where its limbs are in space — a critical component of FCE recovery where proprioception (body position awareness) is often severely disrupted.

Therapeutic laser (photobiomodulation)

Low-level laser therapy applied to the spine and affected limbs to reduce inflammation and promote tissue healing at the cellular level. (Full guide to laser therapy for FCE — [link])

Electrical stimulation (NMES / TENS)

We didn’t end up using this for Max mostly because of his behavorial (fear aggression/reactivity) issues, but this method can be very helpful in more severe cases. Neuromuscular electrical stimulation sends gentle electrical signals to muscles, causing them to contract even when the dog cannot do so voluntarily. Particularly useful in the early stages to maintain muscle mass and stimulate nerve pathways.

An electrical toothbrush is a good way of stimulating the nerve endings on the feet and body if you don’t have access to an NMES/TENS machine.

Max’s session breakdown

Over six months, Max completed 28 PT sessions. Here is a summer of how it progressed:

The first three months brought the most dramatic change. By the end of December 2023 (roughly three months in), Max was at approximately 80% recovered. After that, progress became incremental: roughly 5% per month. The 80/20 principle, applied to neurological recovery.

Around February, I tried increasing from one session per week to two. It didn’t help. There wasn’t enough recovery time between sessions, and he wasn’t fully utilizing the second one. We went back to once weekly.

There were moments of real frustration. I won’t pretend otherwise. Some days and weeks felt like regression. It would seem like he was improving, but then the following day or week, he would look worse. And then the following week, there would be a new milestone.

The milestones I watched for:

  • Hind paws beginning to flip forward without assistance
  • Standing without full support
  • Puppy bow without collapsing
  • Left leg making better contact with the ground
  • Sitting up in “thank you” pose
  • Hind legs no longer collapsing when his lower back was touched

Though easily overlooked by others, these incremental improvements are the things that kept me going when I was feeling frustrated with Max’s progress.

Frequency: how often should you go?

Most rehab specialists will recommend 1–2 sessions per week in the acute phase, tapering as your dog progresses. Based on my experience, once per week with dedicated home exercise in between seems to be the sweet spot, at least for Max. Your rehab vet will guide you based on your dog’s specific presentation.

Finding a certified canine rehabilitation specialist

Look for a CCRP (Certified Canine Rehabilitation Practitioner) or CCRT (Certified Canine Rehabilitation Therapist). These are the two main credentialing pathways in the US.

If you are in Michigan: I cannot recommend Stephanie at ARC Rehab [arcrehab on Instagram] highly enough. Max arrived growling and biting. She was unfazed. And Stephanie soon became one of his favorite people. Which is saying a lot, because I can count those numbers on one hand, ha.

If you are not near a specialist, telehealth rehab consultations are increasingly available. A remote therapist can evaluate video of your dog walking and design a home program. It is not the same as in-person, but it is significantly better than nothing.

Not medical advice. All information reflects one owner’s personal experience. Consult a licensed veterinary rehabilitation specialist for your dog’s specific situation.