Animal Physiotherapy E-Book

• Herausgeber: John Wiley & Sons
• Kategorie: Fachliteratur
• Sprache: Englisch

Seitenzahl: 1347

Veröffentlichungsjahr: 2016

Beschreibung

A thoroughly updated edition of this essential reference guide for physiotherapists and physical therapists, looking to apply the proven benefits of physiotherapy to the treatment of companion and performance animals.

• Seven new chapters provide greatly expanded coverage of practical treatment and rehabilitation
• Includes reviews of different physiotherapy techniques, drawing on both human and animal literature
• Discusses approaches in small animal medicine as well as for elite equine athletes
• Provides applied evidence-based clinical reasoning model, with case examples
• Now in full colour with many more illustrations

Leseprobe

Animal Physiotherapy

Assessment, Treatment and Rehabilitation of Animals

Second Edition

Edited by

Catherine M. McGowan

Professor of Equine Internal Medicine Head of Equine Division and Director of Veterinary Postgraduate Education Institute of Ageing and Chronic Disease Faculty of Health and Life Sciences University of Liverpool, UK

Lesley Goff

Lecturer, Equine Science School of Agriculture & Food Sciences University of Queensland, Australia and Director Active Animal Physiotherapy Toowoomba Queensland, Australia

This edition first published 2016 © 2016 by John Wiley & Sons Ltd. First edition published 2007 © 2007 Blackwell Publishing.

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ISBN: 9781118852323

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CONTENTS

Contributors

Chapter 1: Introduction

Chapter 2: Applied animal behaviour: assessment, pain and aggression

2.1 Introduction

2.2 Pain

2.3 Aggression

2.4 Conclusion

References

Further reading

Notes

Chapter 3: Applied animal nutrition

3.1 Applied small animal nutrition

3.2 Applied equine nutrition

3.3 Conclusion

References

Notes

Chapter 4: Applied canine biomechanics

4.1 Introduction

4.2 Joint biomechanics

4.3 Biomechanics of the vertebral joints

4.4 Canine vertebral column

4.5 Canine peripheral joints

4.6 Biomechanics of locomotion: the dog

4.7 Conclusion

References

Further reading

Notes

Chapter 5: Applied Equine Biomechanics

5.1 Introduction

5.2 Joint biomechanics

5.3 Biomechanics of the equine vertebral joints

5.4 Equine peripheral joints

5.5 Biomechanics of equine locomotion

5.6 Gait

5.7 Considerations in sport-specific pathology

5.8 Biomechanics of the equine foot

5.9 Conclusion

References

Further reading

Notes

Chapter 6: Comparative exercise physiology

6.1 Introduction

6.2 Principles of exercise physiology

6.3 The pathway of oxygen

6.4 Cardiorespiratory function during exercise

6.5 The effect of training

6.6 Detraining

6.7 Applied exercise physiology

6.8 High-altitude training

6.9 Maximal performance and factors limiting maximal performance in the horse

6.10 Training the sled dog (Husky)

6.11 Training the racing Greyhound

6.12 Conclusion

References

Chapter 7: Equine lameness

7.1 Introduction

7.2 The lame horse

7.3 Manipulative tests

7.4 Diagnostic analgesia: nerves and joints

7.5 Diagnostic imaging

7.6 Selected orthopaedic diseases

References

Further reading

Notes

Chapter 8: Canine lameness

8.1 Introduction

8.2 Examination

8.3 Thoracic limb

8.4 Pelvic limb

References

Notes

Chapter 9: Small animal neurological and muscular conditions

9.1 Introduction

9.2 Neuroanatomy

9.3 Neurological examination

9.4 Gait, proprioception and reflexes – spinal lesions

9.5 Diagnostic techniques

9.6 Neurological disease in small animals

9.7 Neuromuscular disease

References

Chapter 10: Equine neurological and muscular conditions

10.1 Introduction

10.2 Neuroanatomy

10.3 Neurological examination

10.4 Interpretation of the gait and posture examination

10.5 Further diagnostic techniques

10.6 Equine neurological diseases

10.7 Equine intrinsic muscle disease

References

Notes

Chapter 11: Physiotherapy assessment for animals

11.1 Introduction

11.2 Clinical reasoning

11.3 Physical assessment

11.4 Special considerations in canine physiotherapy assessment

11.5 Assessment and palpation of canine extremities

11.6 Special considerations in equine physiotherapy assessment

11.7 Equine palpation

11.8 Conclusion

References

Notes

Chapter 12: Manual therapy

12.1 Introduction

12.2 Technical aspects of manual therapy

12.3 Manual therapy in practice

12.4 Dogs

12.5 Horses

12.6 Conclusion

References

Notes

Chapter 13: Electrophysical agents in animal physiotherapy

13.1 Introduction

13.2 General principles of electrophysical agent decision making and application

13.3 Modalities to influence healing and tissue repair

13.4 Modalities to influence muscle function

13.5 Modalities to influence pain

13.6 Conclusion

References

Chapter 14: Aquatic therapy

14.1 Introduction

14.2 Physical properties of water

14.3 Physiological responses to exercising in water

14.4 Evidence for effectiveness of hydrotherapy

14.5 Benefits of hydrotherapy for animals

14.6 Assessment of the small animal patient for hydrotherapy

14.7 Types of hydrotherapy for animals

References

Chapter 15: Acupuncture and trigger points

15.1 Introduction

15.2 Traditional acupuncture

15.3 Acupuncture analgesia

15.4 Clinical effectiveness of acupuncture

15.5 Use of acupuncture in animals

15.6 Trigger points

References

Notes

Chapter 16: Small animal treatment and rehabilitation for cardiorespiratory conditions

16.1 Introduction

16.2 Involuntary canine recumbency

16.3 Description of the short-term effects of recumbency in dogs

16.4 Tolerance and effects of the administration of continuous positive airway pressure during recovery from general anaesthetic in dogs with brachycephalic airway obstructive syndrome

16.5 Tolerance and short-term effects of manual chest physiotherapy in dogs with aspiration pneumonia

16.6 Conclusion

References

Chapter 17: Small animal treatment and rehabilitation for neurological conditions

17.1 Introduction

17.2 Principles of neurological rehabilitation

17.3 Physiotherapy for small animals with neurological disease

17.4 Current evidence base for neurological small animal physiotherapy

17.5 Physiotherapy for horses with neurological disease

17.6 Case studies

17.7 Conclusion

References

Notes

Chapter 18: Canine treatment and rehabilitation for orthopaedic conditions

18.1 Introduction

18.2 Soft tissue lesions: muscle, tendon and ligament

18.3 Additional concepts regarding soft tissue injury

18.4 Osteoarthritis

18.5 Postoperative rehabilitation

18.6 Fracture healing

18.7 Hip dysplasia

18.8 Conditioning canine athletes

References

Notes

Chapter 19: Assessment and treatment techniques of the equine head, neck and thoracic limb

19.1 Introduction

19.2 Technical aspects of manual therapy

19.3 Anatomical regions – head

19.4 Anatomical regions – cervical spinal joints

19.5 Anatomical regions – thoracic limb proximal

19.6 Anatomical regions – thoracic limb distal

19.7 Conclusion

References

Notes

Chapter 20: Assessment and treatment techniques of the equine thoracolumbar spine, pelvis and pelvic limb

20.1 Introduction

20.2 Assessment of the axial skeleton

20.3 Reflex motion to palpatory pressure

20.4 Central core structures and associated pathology

20.5 Lumbar spine

20.6 Lumbosacral junction

20.7 Sacroiliac joint

20.8 Sacrococcygeal segments

20.9 Peripheral joints

20.10 Conclusion

References

Notes

Chapter 21: Equine sports medicine and performance management

21.1 Introduction

21.2 Physiotherapy in equine sports medicine

21.3 Neuromotor control – rehabilitation and performance management

21.4 Stretching for injury prevention and rehabilitation

21.5 Assessment of the horse and rider unit

21.6 Conclusion

References

Notes

Chapter 22: Outcome measures in animal physiotherapy

22.1 Introduction

22.2 Physical dysfunction and its outcome measures

22.3 Pain assessment

22.4 Motion assessment

22.5 Assessment of swelling and inflammation

22.6 Overall functional assessment

22.7 Conclusion

References

Index

EULA

List of Tables

Chapter 2

Table 2.1

Table 2.2

Chapter 3

Table 3.1

Table 3.2

Table 3.3

Table 3.4

Table 3.5

Table 3.6

Table 3.7

Table 3.8

Table 3.9

Chapter 4

Table 4.1

Chapter 5

Table 5.1

Chapter 6

Table 6.1

Chapter 7

Table 7.1

Table 7.2

Chapter 9

Table 9.1

Table 9.2

Table 9.3

Table 9.4

Table 9.5

Table 9.6

Chapter 10

Table 10.1

Table 10.2

Table 10.3

Chapter 12

Table 12.1

Table 12.2

Chapter 13

Table 13.1

Table 13.2

Table 13.3

Table 13.4

Table 13.5

Chapter 15

Table 15.1

Chapter 16

Table 16.1

Table 16.2

Chapter 18

Table 18.1

Table 18.2

Table 18.3

Table 18.4

Table 18.5

Table 18.6

List of Illustrations

Chapter 3

Figure 3.1 Dog in a flyball competition.

Source:

Photo courtesy of Päivi Heino.

Figure 3.2 Body condition scoring for dogs.

Source:

The Body Condition System is used with permission of Société des Produits Nestlé S.A.

Figure 3.3 Body condition scoring for cats.

Source:

The Body Condition System is used with permission of Société des Produits Nestlé S.A.

Figure 3.4 Weighing a horse on a weighbridge.

Figure 3.5 Ideal fat score – neck 3, middle 3, bottom 3.

Figure 3.6 Fibre: forage should provide the foundation of the nutrient provision.

Chapter 4

Figure 4.1 Directional terminology for the dog.

Source:

C. Riegger-Krugh, Canton, OH. Reproduced with permission from C. Riegger-Krugh.

Figure 4.2 (a) Skeletal anatomy of the atlas and axis from a craniolateral view. (b) Skeletal anatomy of the atlas and axis from a cranial view. (c) Skeletal anatomy of the C5 vertebra from a craniolateral view.

Source:

C. Riegger-Krugh, Canton, OH. Reproduced with permission of C. Riegger-Krugh.

Figure 4.3 Orientation of canine caudal lumbosacral articular facets – cranio-oblique view.

Figure 4.4 Iliac articular surface of canine sacroiliac joint.

Figure 4.5 Example of a T12–13 disc extrusion on MRI in the sagittal plane.

Source:

A. Komitor, Loveland, CO. Reproduced with permission from A. Komitor.

Figure 4.6 Photograph of a dog prepared for data collection, demonstrating kinematic reflective marker attachment sites and donning EMG equipment. Wireless EMG transmitter is depicted by the green box attached to the dorsum of the thoracic harness and electrode leads attached to the dorsum of the pelvic harness. Note also surface EMG electrode placement on left thigh musculature (

blue ovals

).

Source:

Photo courtesy of Dr Caroline Adrian.

Figure 4.7 Example of a typical force-plate tracing. The most common data collected includes vertical forces (

red line

) and cranial-caudal forces (

green line

) for the thoracic and pelvic limbs, respectively.

Figure 4.8 Picture of a whippet illustrating the extreme ranges of motion at a gallop.

Source:

Photo courtesy of Dr Robert Taylor.

Figure 4.9 A typical EMG tracing of the canine biceps femoris muscle at a trot.

Source:

Courtesy of Dr Caroline Adrian.

Chapter 5

Figure 5.1 Equine cervical spine C3–4: dorsal view.

Figure 5.2 Orientation of equine thoracic spine articular facet: dorsal view.

Figure 5.3 Equine lumbar vertebrae and lumbosacral junction showing the broad transverse processes of L1–6. There are fusions between the L5 and L6 transverse processes and pseudoarticulations at the transverse processes of L4 and L5, bilaterally. The lumbosacral divergence is at L6 and S1 in this specimen.

Figure 5.4 Equine caudal lumbar sacral spine disarticulated at the lumbosacral joint: dorsal view.

Figure 5.5 Variations in the number and orientation of the equine lumbar vertebrae exist, particularly at the lumbosacral junction. This horse demonstrates the common L5–6 divergence where L6 is orientated with the sacrum. Note the interspinalis muscle present only between the level of greatest divergence of spinous processes (here L5–6).

Figure 5.6 Variations in the shape of the articular surface of the equine sacroiliac joint: (a) a right sacral surface; (b) and (c) are both left sacral surfaces. All these joints were from Thoroughbred racehorses.

Figure 5.7 Dressage biomechanics.

Chapter 6

Figure 6.1 The oxygen transport chain.

Figure 6.2 The relationship between VO

2

and speed in a horse during incrementally increasing speed.

Figure 6.3 The relationship between VO

2

and time at a set speed (calculated to be 115% VO

2max

) in a horse demonstrating energy partitioning during exercise as well as VO

2

kinetics. This figure shows the typical partitioning of energy in a horse performing supramaximal exercise (exercise >100% VO

2max

). The area under the curve represents the aerobic contribution to exercise. Note the large anaerobic contribution in the first seconds of exercise. However, this horse reaches close to VO

2max

by 20 sec into exercise.

Figure 6.4 Schematic relationship between heart rate and VO

2max

in the horse showing that 50% VO

2max

is approximately 70% HR

max

and 80% VO

2max

is approximately 88% HR

max

.

Source:

Data from Evans and Rose 1987.

Figure 6.5 The typical relationship between blood lactate concentration and speed.

Figure 6.6 Schematic of the performance response to repeated stresses and the resultant adaptation or overload training principles.

Figure 6.7 Siberian Huskies at rest.

Source:

Photo courtesy of Päivi Heino.

Figure 6.8 The Greyhound.

Chapter 7

Figure 7.1 Application of hoof testers to determine if there is an area of pain within the hoof.

Figure 7.2 Palpation for rotation and shear of the distal interphalangeal (coffin, P2 P3) joint. It is important to stabilise the fetlock and pastern to isolate the movement.

Figure 7.3 Swelling of the palmar pouch of the lateral aspect of the fetlock joint in a horse.

Figure 7.4 Palpation of the superficial and deep digital flexor tendons with the limb non-weight bearing.

Figure 7.5 Evaluation of the carpus non-weight bearing with the carpus flexed to open up the antebrachiocarpal and midcarpal joints.

Figure 7.6 Pain on carpal flexion is determined by pulling the pastern proximally lateral to the elbow and pushing down on the antebrachium.

Figure 7.7 Palpation of the biceps tendon.

Figure 7.8 Tarsocrural joint effusion or bog spavin.

Figure 7.9 Examination of the stifle: marked medial femorotibial joint swelling.

Figure 7.10 (a) Trotting on a hard surface in a straight line. (b) Lunging on a soft surface in both directions.

Figure 7.11 Inertial sensors attached to the poll (a) and the pelvis (b) to measure asymmetry of vertical movement when trotting.

Figure 7.12 Flexion of the fetlock joint. Note this flexes all the phalangeal joints. It is important to ensure the carpus is not flexed at the same time.

Figure 7.13 Magnetic resonance imaging (MRI) image of the flexor tendon region before (a) and after (b) intraarterial injection of contrast agent, showing a lesion within the deep digital flexor tendon that takes up contrast (

arrow heads

).

Figure 7.14 MRI image (T1 weighted) of the deep digital flexor tendon region from a dorsal (a) and transverse (b) plane with an area of increased signal in the medial lobe of the tendon (light grey area).

Figure 7.15 Swelling of the superficial digital flexor tendon associated with tendon strain.

Figure 7.16 Severe osteoarthritis of the carpus with periarticular bone modelling.

Figure 7.17 Generalised swelling of the hock due to cellulitis with joint sepsis.

Chapter 8

Figure 8.1 Surface anatomy of the carpus showing medial aspect of left limb and lateral aspect of right limb. The black star is over the radial styloid process, blue star over the ulnar styloid process, yellow star over the dew claw and red star denotes the accessory carpal bone, with the carpal pad overlying slightly distally.

Figure 8.2 Surface anatomy of the shoulder. The red star is over the acromion and blue star denotes the greater tubercle.

Figure 8.3 Surface anatomy of the elbow. The red star is over the olecranon; blue star over the humeral epicondyle and black star over the radial head.

Figure 8.4 Bony anatomy of the hock. The red star is the calcaneal tuber of the left hindlimb; yellow stars are the lateral (left hind) and medial (right hind) malleoli; green star is the base of fifth metatarsal; blue star is head of fifth metatarsal.

Figure 8.5 Surface anatomy of the stifle. The white star indicates the patella; yellow star indicates tibial tubercle; blue star the fabella; and red star the head of fibula.

Figure 8.6 Cranial draw test. The arrow denotes cranial drawer direction of the tibia relative to the femur.

Figure 8.7 Tibial compression test. The arrow denotes direction of thrust.

Figure 8.8 Surface anatomy of the pelvis. The blue star is over the ilial wing; red star denotes ischial spine; black star denotes greater trochanter. Hip joint should fall ventral to an imaginary line drawn between the iliac wing and ischial spine (in red).

Chapter 9

Figure 9.1 (a) A 5-year-old crossbreed presented with a right-sided head tilt due to idiopathic vestibular disease. (b) A 3-year-old Yorkshire terrier presented with a right-sided head turn due to meningoencephalitis of unknown origin.

Figure 9.2 General proprioception pathway to the cerebral cortex.

Figure 9.3 Proprioceptive positioning being tested in the right pelvic limb.

Figure 9.4 Hopping response being tested on the left pelvic limb.

Figure 9.5 Withdrawal reflex being tested in the right pelvic limb.

Figure 9.6 Patellar reflex being tested in the right pelvic limb.

Figure 9.7 Horner's syndrome in the left eye. This syndrome describes the following ophthalmic changes: miosis (constricted pupil), enophthalmos (sinking of the eyeball), protrusion of the third eyelid and ptosis (drooping) of the upper eyelid.

Figure 9.8 MR images of a dog with a vertebral body tumour. (a) Sagittal T2WI showing the large mass arising from the vertebral body of L2, causing marked ventral displacement of the aorta (

arrowheads

). (b, c) Transverse T2WI through the region of the mass allowing identification of invasion of the vertebral canal and spinal cord compression (b) as well as extension of the mass to the dorsal lamina of L2 (c). (d) Dorsal T2WI; this view is most important for localisation of the lesion and assessment of nerve roots.

Figure 9.9 Lateral projection radiograph of the thoracolumbar spine of an English Bulldog. Note the obvious vertebral anomalies at T7 and T8 causing marked spinal kyphosis at that level.

Figure 9.10 MR images of type I disc disease. (a) Sagittal T2WI showing a large disc extrusion between L3 and L4; note that the degenerate (

black

) disc material is inside the vertebral canal. (b) Transverse image through the disc extrusion; the disc material is occupying approximately 50% of the vertebral canal and is on the left side of the spinal cord; this information is essential for surgical planning.

Figure 9.11 MR images of type II disc disease. (a) Sagittal T2WI showing intervertebral disc protrusions at T13–L1 and L1–2. (b) Transverse image through L1–2 showing moderate spinal cord compression due to bulging of the disc; also, note the presence of marked spondylosis ventral to the disc (

arrowheads

).

Figure 9.12 Lateral projection radiograph of a fracture-luxation at the level of T13–L1 causing marked vertebral displacement.

Figure 9.13 ‘Three-column system’.

Figure 9.14 Neck brace used for medical management of a traumatic atlantoaxial subluxation in a young crossbreed.

Figure 9.15 MR images of a Doberman with cervical spondylomyelopathy. (a) Sagittal T2WI showing significant spinal cord compression secondary to an intervertebral disc protrusion at C6–7. Note the associated spinal cord atrophy at that level and the presence of hyperintensity (brightness) inside the spinal cord (

arrowhead

); this is thought to represent ischaemic damage. (b) Transverse T2WI through the protruded disc showing the marked spinal cord compression and associated nerve root compression (

arrowheads

).

Figure 9.16 MR images of lumbosacral degenerative stenosis. (a) Transverse T2WI showing foraminal stenosis causing marked compression of the left L7 nerve root. (b) Transverse T2WI showing an intervertebral disc protrusion at the level of the LS junction causing compression of the cauda equina.

Figure 9.17 Sagittal MR image (T2W) of a dog with a fibrocartilaginous embolism. Note the intramedullary hyperintense (bright) lesion at the level of L2.

Figure 9.18 Lateral projection radiograph of a dog presented with thoracolumbar pain. Note the irregular bone lysis and sclerosis of the vertebral endplates of L1 and L2 and mild spondylosis at that level; these findings are compatible with discospondylitis.

Chapter 10

Figure 10.1 Lateral view of the cervical vertebrae of the horse. Vertebrae C1 (the ‘atlas’) and C2 (the ‘axis’) are different shapes from C2–7.

Figure 10.2 Lateral view of the 18 thoracic, six lumbar and five fused sacral vertebrae.

Figure 10.3 Tongue tone is assessed by pulling the tongue out of the interdental space, which the horse should replace easily. The horse in this image presented for dysphagia, and had markedly reduced tongue tone.

Figure 10.4 Pulling a horse's tail to the side while it walks as a test for UMN weakness and ataxia. The resistance to lateral pull and its recovery on releasing the tail are both assessed.

Figure 10.5 Walking down (and up) a slope will often exacerbate abnormalities in conscious proprioception (especially if the head is concurrently raised), weakness and gait abnormalities (hypermetria or hypometria).

Figure 10.6 Picking up one forelimb results in increased weight bearing on the contralateral limb, causing exacerbation of signs associated with extensor weakness such as trembling. If the horse is not overtly weak then the examiner pushes the horse away, eliciting a hop.

Figure 10.7 A lateral radiograph of cervical vertebrae C3–5. Note the vertebral canal, marked by double arrows.

Figure 10.8 A lateral radiograph of the lumbosacral spine and pelvis of a foal. Note the superimposition of the abdominal contents on the vertebrae. This foal presented with neurological signs in the hindlimbs. There is a radiolucency in the cranial vertebral body of the first sacral vertebra, caused by a septic physitis.

Figure 10.9 A lateral myelogram of C5–6 of a yearling Thoroughbred showing narrowing of the vertebral canal at C5–6.

Figure 10.10 A caudal view of a volume-rendered, 3D CT reconstruction of the skull and hyoid apparatus in a horse which presented for left-sided facial nerve paralysis and vestibular signs. The left stylohyoid bone is markedly thickened, consistent with a diagnosis of left-sided temporohyoid osteoarthropathy.

Figure 10.11 Collection of cerebrospinal fluid from the lumbosacral space in a standing, sedated horse.

Figure 10.12 A horse with severe forebrain signs, demonstrating head pressing. The horse had forebrain dysfunction secondary to liver disease (hepatic encephalopathy). Thirty minutes before head pressing, the horse was only mildly obtunded.

Figure 10.13 A horse with left-sided facial nerve paralysis. Note the drooping left ear and upper eyelid and muzzle deviation to the right.

Figure 10.14 The left eye of the horse in Figure 10.13. There is a fluorescein-positive corneal ulcer with secondary anterior uveitis, caused by the facial nerve paralysis. This horse had left-sided temporohyoid osteoarthropathy.

Figure 10.15 A horse with left-sided peripheral vestibular dysfunction. Note rotation to the left of the poll around the spine (left-sided head tilt), and the wide-based stance.

Figure 10.16 Unilateral left-sided sweating over the face and left-sided ptosis caused by Horner's syndrome.

Figure 10.17 Sweating to approximately the level of C2 caused by perivascular injection of xylazine. The horse also had left-sided ptosis and miosis consistent with Horner's syndrome.

Figure 10.18 A horse with a traumatic thoracic spinal cord lesion being managed using a sling. Splinting of the pelvic limbs and bales of straw and shavings were also used in an attempt to support the mare.

Figure 10.19 Horse with brachial plexus injury of 4 weeks' duration. Note the marked atrophy. This horse recovered fully with extensive teamwork rehabilitation by a veterinarian and physiotherapist.

Figure 10.20 Chronic trigeminal nerve paralysis causing marked neurogenic atrophy of the muscles of mastication on the right side. This horse also had total loss of sensation to the right side of its face, consistent with loss of trigeminal nerve function.

Figure 10.21 A Thoroughbred with Australian or pasture-associated stringhalt. Note the hyperflexed left pelvic limb.

Figure 10.22 A horse with equine motor neuron disease (EMND) exhibiting diffuse muscle atrophy and generalised weakness, demonstrated by his narrow-based stance, elevated tail head and low head carriage.

Figure 10.23 A horse with tetanus showing characteristic protrusion of the third eyelid, anxious facial expression and difficulty in opening the mouth to replace the tongue.

Chapter 11

Figure 11.1 A clinical reasoning form.

Figure 11.2 (a) Preparing to measure craniocervical rotation via goniometer placed along midline of maxilla. (b) Recording the amount of midcervical lateral flexion with a tape measure.

Figure 11.3 Facilitated active neck movements: (a) midcervical lateral flexion; (b) midcervical flexion; (c) cervicothoracic flexion; (d) flexion with lateral flexion.

Figure 11.4 Rounding reflex.

Figure 11.5 (a) Dorsoventral accessory translation of thoracic vertebral level. (b) Rotational accessory translation of thoracic vertebral level.

Figure 11.6 Obliquely directed translation over costotransverse joint.

Figure 11.7 Combined movement assessment of flexion and left lateral flexion of equine thoracolumbar spine (using unilateral rounding reflex and overpressure with physiotherapist's left hand at desired level of vertebral column).

Figure 11.8 Combined movement assessment of flexion and left lateral flexion of canine thoracolumbar spine. Physiotherapist's left thumb is palpating approximation of spinous processes in a relatively flexed position.

Figure 11.9 Test for unilateral hindlimb stability – horse is displaced toward the left by the physiotherapist. Note, this horse demonstrates hindlimb stability as there is no increase in lateral displacement of the pelvis over the weight-bearing hindlimb.

Figure 11.10 Neural provocation test of canine sciatic nerve.

Source:

Babbage

et al

. 2007. Reproduced with permission from Elsevier.

Figure 11.11 Lateral accessory translation of C3–4.

Figure 11.12 (a) Palpation of cranial rotation of ilium relative to sacrum via hindlimb retraction. (b) Palpation of caudal rotation of ilium relative to sacrum via hindlimb protraction. Fingers palpate the sacral spine and ilium.

Figure 11.13 Lateral excursion test to examine dental/temporomandibular joint movement.

Figure 11.14 Flexion test to examine jaw movement relative to head position.

Figure 11.15 Passive physiological assessment of equine atlantoaxial (C1–2) joint.

Figure 11.16 Oblique dorsoventral translation at C3–4. Near hand is applying translation to C4 vertebral body while far hand is stabilising C3 contralaterally.

Figure 11.17 Use of reflex to induce left lateral flexion at thoracolumbar spine. Physiotherapist localises the lateral flexion at desired level with hand.

Figure 11.18 Palpating relative iliosacral motion at tuber sacrale and sacrum via movement of hindlimb. (a) Neutral; (b) in protraction; (c) in retraction.

Figure 11.19 Assessing movement of ilium on sacrum: (a) cranial rotation; (b) oblique rotation.

Figure 11.20 Lateral translation of sacrum relative to the ilia – physiotherapist's right hand stabilises against right tuber sacrale and left hand glides sacrum laterally towards the right.

Figure 11.21 Assessing cranial translation of the humerus at glenohumeral joint – left hand is palpating the joint line, while cranial translation of humerus is applied along the humeral longitudinal axis via the physiotherapist's forearm.

Figure 11.22 Assessment of carpal extension via overpressure.

Figure 11.23 Accessory translation of distal phalanx (PIII) on middle phalanx (PII). Left hand stabilising proximal phalanx (with joint in neutral) as right hand applies translation.

Chapter 12

Figure 12.1 (a) Flexion of canine metacarpophalangeal joint. (b) MWM (flexion/external rotation) of canine metacarpophalangeal joint.

Figure 12.2 Neural provocation tests of canine sciatic nerve – hip flexion, stifle extension, hock flexion and digit extension.

Source:

Babbage

et al.

2007. Reproduced with permission from Elsevier.

Figure 12.3 Cranial drawer test of canine stifle.

Figure 12.4 (a) Passive physiological right lateral flexion of T7–8, stabilising T7 and moving T8. (b) Stabilising T8 and moving T7.

Figure 12.5 (a) Right lateral flexion passive accessory translation of T7–8 (left thumb is applying translation to T8 spinous process relative to T7). (b) Hand position for passive accessory translation in caudal thoracic vertebral column.

Figure 12.6 Extension with overpressure for equine metacarpophalangeal (fetlock) joint.

Figure 12.7 Craniocaudal accessory translation of the equine metacarpophalangeal (fetlock) joint – left hand stabilising distal metacarpal, right hand directing glide of proximal phalanx.

Figure 12.8 Accessory lateral flexion glide of equine cervical vertebral. (a) Right hand directs glide to C4 towards the right. (b) Forearms are positioned perpendicular to vertebral body level.

Chapter 13

Figure 13.1 Graphical representation of the dose–response curve related to the use of electrophysical agents.

Figure 13.2 Basic model proposed for electr physical agents in practice.

Source:

Watson and Young 2008. Reproduced with permission from Elsevier.

Figure 13.3 Ultrasound therapy treatment of the superficial digital flexor tendon to stimulate collagen fibre orientation and therefore the functional capacity of scar tissue during remodelling. The area can be shaved and extra gel/70% alcohol in water used to improve contact if necessary.

Figure 13.4 Application of ultrasound therapy using a gel contact technique. For smaller limb segments, immersion of the limb segment and the ultrasound treatment applicator in a bowl of water can help to eliminate contact issues.

Figure 13.5 Laser treatment (

visible red cluster

) for acute trigger point stimulation. Protective goggles should be worn by the physiotherapist and handler and the animal's eyes should be protected.

Figure 13.6 Laser therapy applied to treat a periarticular inflammatory lesion.

Source:

Reproduced with permission from Omega Laser Systems Ltd.

Figure 13.7 Microcurrent therapy (applied with small electrodes due to limb size) to the tarsal area following acute injury.

Figure 13.8 Microcurrent therapy applied for a soft tissue injury in the region of the cannon bone.

Source:

Reproduced with permission from Peter Bulman, Expo Life.

Figure 13.9 NMES used for neuromuscular reeducation of the shoulder flexor, elbow extensor muscle group.

Figure 13.10 Interferential therapy as a treatment for established back pain in a small dog.

Chapter 14

Figure 14.1 (a, b) Comparison of dogs swimming with different buoyancies.

Figure 14.2 Dog pool.

Figure 14.3 Underwater treadmill.

Figure 14.4 Horse pool.

Figure 14.5 (a, b) Horse aquawalker.

Figure 14.6 Buoyancy vest.

Chapter 15

Figure 15.1 The Bladder meridian in the horse, which is commonly used in clinical practice.

Source:

Xie and Preast 2003. Reproduced with permission from John Wiley & Sons.

Figure 15.2 The Bladder meridian in the dog, which is commonly used in clinical practice.

Source:

Xie and Preast 2003. Reproduced with permission from John Wiley & Sons.

Figure 15.3 A Border Collie receiving acupuncture for treatment following carpus surgery.

Chapter 16

Figure 16.1 CPAP feed delivered via hood using an Elizabethan collar.

Figure 16.2 Please note that CPAP machines improve respiratory parameters with the application of room air, but that seriously unwell dogs can have supplementary oxygen supplied in addition to CPAP.

Figure 16.3 Analysis for visual analogue scale of demeanour by time point.

Figure 16.4 Analysis of visual analogue scale of quality of respiration by time point.

Chapter 17

Figure 17.1 Modified walking frame/cart used as a ‘foal-walker’, built for a foal rehabilitating from tetanus.

Figure 17.2 Neuromuscular electrical muscle stimulation of quadriceps, biceps femoris and tibialis cranialis of Irish Wolfhound with fibrocartilaginous embolism and paraparesis.

Figure 17.3 Theraband being used to aid left hindlimb clearance during swing and protraction for Irish Wolfhound with fibrocartilaginous embolism.

Figure 17.4 Case 1. Irish wolfhound, male, 4 years old, 80 kg, 3 years post fibrocartilaginous embolism showing a balanced stance.

Figure 17.5 Case 2. Left lateral view: obvious atrophy of the left forelimb following traumatic brachial plexus injury.

Figure 17.6 Case 2. In addition to the contracture and atrophy of the left front limb, the compensatory position of a three-legged stance is seen.

Figure 17.7 Case 2. The assistive device, a cart, used for the American Bulldog with brachial plexus injury.

Figure 17.8 Case 2. Use of an assistive device. The dog is in a stable and balanced stance with a front cart. Independently and actively mobile, not overloading the musculoskeletal system.

Chapter 18

Figure 18.1 Cross-leg/diagonal-leg standing exercise.

Figure 18.2 Step-up exercise.

Figure 18.3 A cat with contracture after right hindlimb immobilisation and surgery showing reduced hip and stifle range of motion under general anaesthetic.

Figure 18.4 Same cat as Figure 18.3 showing (a) myofascial release, (b) passive extension of hip, performed under general anaesthesia.

Figure 18.5 Radial shockwave application to an arthritic elbow.

Figure 18.6 Use of NMES on the quadriceps muscles while concurrently lifting the unaffected leg off the ground.

Figure 18.7 Radiographs of a 6-month-old Belgian Shepherd, Salter–Harris Type II fracture of her medial distal femoral condyle. The fracture was internally fixed by reconstructing the medial ridge of the femoral condyle with three lag screws via a medial approach to the distal femur.

Figure 18.8 Three-legged squats: raising and lowering using one rear leg on a step.stool while the front feet are elevated.

Chapter 19

Figure 19.1 Correctly fitted chambon.

Figure 19.2 Dissection of the nuchal ligament showing the lamellar attachment at C2.

Figure 19.3 TMJ lateral translation. The left hand is fixing the nasal bones and exposing the incisors, the right hand glides the mandible laterally.

Figure 19.4 Upper cervical spine baited neck exercise – nose to shoulder.

Figure 19.5 Lower cervical spine baited neck exercise – nose to stifle.

Figure 19.6 Upper cervical extension.

Figure 19.7 Fractured withers – note the patchy sweat (

arrow

) on the cranial aspect of the spine of scapula.

Figure 19.8 Scapula retractions to enhance thoracic flexion and pelvic limb load.

Figure 19.9 Suprascapular nerve palsy (Sweeney shoulder). Note atrophy of the supraspinatus muscle cranial to the spine of scapula (

arrow

).

Figure 19.10 Proprioceptive chains for tactile stimulation.

Figure 19.11 Combined biceps stretch.

Chapter 20

Figure 20.1 Pelvic asymmetry. (a) Caudal aspect, demonstrating asymmetry of tuber sacrale. (b) Lateral view. This demonstrates the poorly developed gluteal musculature in this horse with pelvic asymmetry.

Figure 20.2 (a) Thoracic spine lateral translation away from the physiotherapist. The therapist's left hand and right hip are translating the thorax away, with the right hand ‘catching’ the lateral sway. (b) Thoracic spine lateral translation towards the physiotherapist. The therapist ‘scoops’ the thorax towards them with the right hand, supporting the translation with the left hand and right hip.

Figure 20.3 (a) Starting posture before abdominal stimulus. (b) Abdominal reflex into dorsal flexion – abdominal lift achieved.

Figure 20.4 Pelvic rounding reflex showing thoracic, lumbar and pelvic dorsal flexion and activity of abdominals.

Figure 20.5 Equine slump test. (a) The horse takes a treat from between the carpus, to maximally flex the neck and thoracolumbar region. (b) Hindlimb protraction may be added to the neck flexion to further tension neuromechanical tissue and myofascia during the slump test.

Figure 20.6 Use of training aids – Equiami in use.

Figure 20.7 Horse going over raised walk poles.

Figure 20.8 A 14-year-old thoroughbred gelding, 2 weeks following dorsal spinous process resection surgery of four levels (T10–18), after removal of stitches.

Figure 20.9 Mobilisation over the left tuber coxae. The force is applied in a dorsoventral direction, here via the therapist's left hand.

Figure 20.10 Tuber sacrale lateral transverse glide.

Figure 20.11 Testing the ability of the horse to functionally load-bear in unilateral hindlimb stance. Relative motion of the tuber coxae compared to the sacral DSPs may be palpated during this test.

Figure 20.12 Tail traction.

Chapter 21

Figure 21.1 Kinesiology taping to the scapular region and biceps of the horse.

Figure 21.2 Use of poles, walking horse uphill.

Figure 21.3 (a) Walking horse up a slope. (b) Walking horse down a slope.

Figure 21.4 Shifting horse's weight to the pelvic limbs, uphill, to engage the musculature of the pelvis and hindlimb.

Figure 21.5 Proprioceptive facilitation techniques. (a) Taping technique for unridden exercise. (b) Taping technique for ridden exercise. (c) Stretch-band technique.

Figure 21.6 Use of proprioceptive chains around the pastern region.

Figure 21.7 Simple application of kinesiology tape designed to facilitate activity in the semitendinosus muscle.

Figure 21.8 Hindlimb stretch.

Figure 21.9 Rounding reflex.

Figure 21.10 Slump stretch.

Figure 21.11 (a) Assessment of the rider's pelvic position from the side. (b) Assessment of the rider's posterior superior iliac spines.

Figure 21.12 Assessment of the rider in motion with the horse – note that horse has kinesiology tape applied to the sacroiliac region and abdominal musculature.

Chapter 22

Figure 22.1 Palpation of the brachiocephalicus muscle in a horse and observation of the response (absence of a pain response in this case).

Figure 22.2 Assessment of the mechanical nociceptive threshold in a dog with a pressure algometer.

Figure 22.3 Assessment of mechanical nociceptive threshold in a horse with a pressure algometer.

Figure 22.4 Assessment of weight distribution in a cat by use of a pressure-sensitive mat.

Source:

Photo courtesy of Cecilia Ley.

Figure 22.5 Assessment of the circumference of the canine elbow joint with a spring-tension tape measure.

Figure 22.6 Assessment of equine muscle mass with a spring-tension tape measure.

Figure 22.7 Assessment of the passive joint range of motion with a goniometer.

Figure 22.8 Assessment of the fetlock joint with a slide calliper.

Figure 22.9 Assessment of the canine elbow joint with a slide calliper.

Figure 22.10 Assessment of fetlock joint swelling with a spring-tension tape measure in a figure 8.

Guide

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Contributors

Caroline Adrian PT PhD CCRPNational Director of Rehabilitation Services VCA Animal Hospitals Los Angeles, USA and Director, Physical Therapy Services VCA Veterinary Specialists of Northern Colorado Loveland, USA

Anna Bergh BSc(PT) DVM PhDSenior Lecturer Department of Anatomy, Physiology and Biochemistry Swedish University of Agricultural Sciences Uppsala, Sweden

Harry Carslake MA VetMB DipACVIM MRCVSSenior Lecturer in Equine Internal Medicine Philip Leverhulme Equine Hospital University of Liverpool Liverpool, UK

Rosalind Carslake BVetMed MANZCVSc MVSc MRCVSDirector, Small Animal CPD Veterinary Postgraduate Unit University of Liverpool Liverpool, UK

Emma Dainty MSc MCSPChartered Veterinary Physiotherapist Lecturer and Examiner School of Veterinary Sciences Faculty of Health and Life Sciences University of Liverpool, UK

Laurie Edge-Hughes BScPT MAnimSt (Animal Physio)Canine Fitness Centre Ltd Calgary, Canada and Four Leg Rehab Inc. Cochrane, Canada

Lesley Goff PhD, MAnimSt (Animal Physio) MAppSc (ExSpSc) GDipAppSc(Manip Physio) BAppSc(Physio)Lecturer, Equine Science School of Agriculture & Food Sciences University of Queensland Gatton, Australia and Director Active Animal Physiotherapy Toowoomba, Australia

Rita Gonçalves DVM MVM DipECVN FHEA MRCVSRCVS & European Specialist in Veterinary Neurology Senior Lecturer in Veterinary Neurology University of Liverpool Liverpool, UK

Brian Hampson B Human Movement Studies, B Appl Sci (Physiotherapy)Sunshine Coast Equine Podiatry Valdora, Australia

Teresa Hollands BSc(Hons) MSc(Animal Nutrition) PhD RNutrSenior Teaching Fellow (Nutrition) School of Veterinary Medicine University of Surrey Guildford, UK

Heli Hyytiäinen BScPT MSc in Veterinary Physiotherapy PhDPhysiotherapist Specialised in Animal Physiotherapy Veterinary Teaching Hospital University of Helsinki Viikintie, Finland

Katie LawrenceJusto Development Ltd Oxford, UK

Brooke Marsh BPhty MAnimStAnimal Physiotherapist Director Holistic Animal Physiotherapy Maroochy River, Australia

Catherine M. McGowan BVSc MACVSc DEIM DipECEIM PhD FHEA MRCVSProfessor of Equine Internal Medicine, Head of Equine Division and Director of Veterinary Postgraduate Education Institute of Ageing and Chronic Disease Faculty of Health and Life Sciences University of Liverpool Liverpool, UK

Daniel Mills BVSc PhD CBiol FSB FHEA CCAB Dip ECAWBM(BM) MRCVSProfessor of Veterinary Behavioural Medicine School of Life Sciences University of Lincoln Lincoln, UK

Michelle Monk BPhysiotherapy(Hons) DipMyoTher MAnSt(Animal Physiotherapy)Director/Animal Physiotherapist Dogs in Motion Canine Rehabilitation Moorabbin, Australia

Philip A. Moses BVSc Cert SAO FANZCVS CMAVADirector, Veterinary Specialist Services Brisbane, Australia Associate Professor University of Queensland Gatton, Australia

Helen Nicholson BPhty MAnimSt PhDDirector Spring Forward Family Centre Penrith, Australia

Bruce Smith BVSc MS FANZCVSc (Surgery) DipACVSRegistered Specialist Small Animal Surgery Veterinary Medical Centre School of Veterinary Science University of Queensland Gatton, Australia

Tim Watson PhD BSc FCSPProfessor of Physiotherapy Department of Allied Health Professions and Midwifery School of Health and Social Work University of Hertfordshire Hatfield, UK

Chris Whitton BVSc FANZCVS PhDHead of the Equine Centre, Associate Professor of Equine Medicine and Surgery Specialist in Equine Surgery University of Melbourne Melbourne, Australia

Fiona Williams MADirector Dogs at Donyatt Canine Hydrotherapy Ilminster, UK

Lance Wilson BVSc (Hons) MANZCVSc (Surgery)Surgical Registrar Veterinary Medical Centre School of Veterinary Science University of Queensland Gatton, Australia

CHAPTER 1Introduction

Catherine M. McGowan

University of Liverpool, Liverpool, UK

The aim of this book is to provide physiotherapists and interested others with a broad base of information on animal physiotherapy; the assessment, treatment and rehabilitation of animals. Physiotherapy (called physical therapy in some countries) is an established, independent profession with an excellent reputation for evidence-based practice. In the medical field, physiotherapists form an essential part of musculoskeletal, neurological and cardiorespiratory care from paediatrics to geriatrics and sports medicine. Physiotherapy research has led human medical advancement in areas such as back and pelvic pain, whiplash and women's health. The positive perception of physiotherapy in the human sphere, together with an increased awareness of options and expertise available for animals, has resulted in a demand for physiotherapy for animals.

Animal physiotherapy is an emerging profession, representing physiotherapists qualified to treat humans, who are applying their skills on animals. Physiotherapists, when working with animal patients, work on referral from a veterinary surgeon rather than autonomous first contact practice as with human patients. This presents the ideal situation where veterinarians and physiotherapists continue to practise within, and be regulated by, their own profession but work together as a multidisciplinary team in the assessment, treatment and rehabilitation of animals. This situation is also essential in an emerging profession where the evidence base is necessarily largely drawn from the medical field, and as such, physiotherapists when working with animal patients must draw upon their knowledge and experience in people in order to appropriately translate that knowledge to animals.

This new area of expertise has been embraced by both physiotherapy professional bodies and registration boards, as well as educational institutions. Leading universities in the United Kingdom and Australia have led the way in providing postgraduate university-based training for physiotherapists to specialise in treating animals. Formalised, special interest groups (SIGs) of animal physiotherapy have been established by many physiotherapy professional groups around the world, represented by the official subgroup of the World Confederation for Physical Therapy (WCPT), the International Association of Physical Therapists in Animal Practice (IAPTAP; www.wcpt.org/iaptap).

In this text we have used the terminology animal physiotherapy to designate the professional assessment, treatment and rehabilitation of animals by physiotherapists (or physical therapists). In some countries, the terminology veterinary physiotherapy is also used, but we have continued with animal physiotherapy in accordance with the WCPT.

Physiotherapists provide a functional assessment to identify pain or loss of function caused by a physical injury, disorder or disability and they use techniques to reduce pain, improve movement and restore normal muscle control for better motor performance and function. Physiotherapists can provide equivalent levels of care and follow-up treatment for their animal patients, as they can for people. In small animal surgery, the demand for postoperative physiotherapy has paralleled the increase in surgical options for small animal patients. Elite equine athletes and their riders now access a team of professionals including the veterinarian–animal physiotherapist team. More and more people prefer to opt for treatments where they can see progressive results, professional teamwork and high levels of care and expertise.

The text begins with essential applied background information on animal behaviour, nutrition, biomechanics and exercise physiology. Following this are chapters focusing on the assessment of the musculoskeletal and neurological systems in animals from both a veterinary and physiotherapy perspective, including chapters on lameness and neurological conditions in the dog and horse and physiotherapy assessment. The next section reviews physiotherapy techniques, drawing from both the human and animal literature in their discussion. The final chapters apply this information to an evidence-based clinical reasoning model describing the physiotherapy approaches to treatment and rehabilitation of animals, giving case examples. The last chapter outlines outcome measures in animal physiotherapy, reminding us all that assessment and reassessment of physical dysfunction, with accurate measurement of the response to treatment, are fundamental principles of physiotherapy.

This textbook is not a handbook of physiotherapy but rather a text aiming to cover the scientific and clinical principles behind animal physiotherapy. For animal physiotherapists, it will be a valuable reference text in their profession. For veterinarians and others who work with animals, it will be a valuable insight into the profession of physiotherapy and what it can achieve.

CHAPTER 2Applied animal behaviour: assessment, pain and aggression1

Daniel Mills1 and Fiona Williams2

1University of Lincoln, Lincoln, UK

2Dogs at Donyatt Canine Hydrotherapy, Ilminster, Somerset, UK

Summary

It is important for the animal physiotherapist to understand animal behaviour both in terms of the assessment of signs of pain and the safe and appropriate delivery of physiotherapeutic interventions. Here we discuss the importance of considering both genetic and environmental factors when assessing animal behaviour in general as well as factors influencing the identification and assessment of pain more specifically. The mechanisms underlying pain and pain management are also considered with reference to their relationship with behaviour. Finally, we discuss aggression in terms of potential triggers and its management whilst administering treatments.

2.1 Introduction

Understanding animal behaviour is important for animal physiotherapists to ensure safe handling of animals that may be in pain and therefore aggressive, and to facilitate a more complete and accurate assessment of the animal's pain. Often, we only know that an animal is in need of physiotherapeutic intervention because of its behaviour. The behaviour may be overt, such as a non-weight-bearing lameness, or more subtle, such as a decline in activity or in the vigour of the activity. In either case, the challenge may be to distinguish pain from a pain-free loss of physical function or mobility.

In horses, pain may manifest as training problems or poor performance. If we wish to address the cause of this behaviour (rather than simply contain the problem), then we need to be aware of the full range of potential factors that interact with and influence behaviour. This involves at least some appreciation of many diverse branches of zoology as well as various branches of psychology, veterinary medicine, animal management and nutrition. This might seem a bit daunting, and is why it is often most effective to work as part of a multidisciplinary team, with everyone respecting each other's expertise.

Since there are two elements to the expression of pain, that is, a sensory-discriminative component (i.e. processing of the nature of the aversive stimulus and its bodily location) and an affective-motivational component of pain (i.e. the emotional and behavioural response to pain or its anticipation) (Craig 2006), it is important to recognise their differing behavioural expression. The former will largely relate to local changes such as lameness and local sensitivity to interference, whereas the latter will be expressed in more general behavioural changes such as increased aggressivity and avoidance.

Therefore, the animal physiotherapist should be aware that some animals might need behavioural therapy in order to treat the affective-motivational aspects of pain before the sensory-discriminative component of pain can be effectively addressed. Although animal physiotherapists are not expected to be behaviour specialists and should not be tempted to practise beyond their own knowledge base and skill, a solid grounding and appreciation of the subject are essential to avoid putting themselves and others at risk of harm and to avoid threatening the well-being of their animals. Animal physiotherapists who have moved into the field from the human discipline may have a substantial awareness of the psychological effects of chronic pain, but it is important to understand the biological and cognitive differences that exist between humans and non-human animals and not assume that what applies to one species necessarily applies to another. Anthropomorphism (ascribing human characteristics to animals) may lead to superficial and/or inaccurate assessments with consequently inappropriate treatment. It is therefore important to always be thorough and assess all of the available information objectively in the light of the biology of the species being considered.

In this chapter, we begin with an initial guide to the principles that underpin the assessment of animal behaviour. Behaviour, like physiology, is a mechanism and expression of an animal's attempt to adapt to or cope with its environment. To survive and be successful within an evolutionary context, animals must be as efficient as possible, since those able to adapt most appropriately will outcompete those less efficient. Accordingly, the behaviour of a given individual should be viewed as an attempt by the animal to behave most appropriately in the current circumstances given previous experience.

There are three major considerations to the evaluation of an animal's behaviour: the nature of the individual concerned; its previous experience; and its current circumstance. Consideration of all three is fundamental to a complete understanding of why an animal is behaving in a particular way. After discussing these three considerations, we move on to discuss the concepts of pain, pain assessment, pain management and aggression within a context that is relevant to the animal physiotherapist.

2.1.1 Assessment of animal behaviour

As previously mentioned, there are three major principles that should be included in one's thought process when trying to evaluate an animal's behaviour.

The nature of the individual is influenced genetically at many levels.

Previous experience has both general and specific effects on behaviour.

The current circumstance of the individual refers to both its general motivational state and the internal and external factors which cause this state to dominate the animal's behaviour.

Genetic influence

Genetic effects lay the foundation for both species-typical behaviour but also individual differences within a given species. Species-typical behaviour refers to those activities that define a dog as a dog and a horse as a horse. One species is a predator-scavenger and the other a prey species. In order to reduce the risk of predation, natural selection is likely to have favoured a greater capacity to mask, where possible, the signs of pain, injury and disease in horses compared with dogs. In other words, by the time a horse appears overtly sick or lame, its welfare is often already seriously compromised. Similarly, during treatment and rehabilitation, a horse might be expected to stop showing these signs before it has fully recovered, increasing the risk of relapse if the animal is returned to an inappropriate level of work too rapidly or too abruptly. The animal physiotherapist plays an essential role in ensuring that this does not happen and that the build-up to full fitness is appropriately managed.

It is also essential to be aware of the normal behaviours of the species in order to appreciate if something is genuinely disease related; for example, an inexperienced owner might mistakenly think that their cat is in pain because she is intermittently meowing with great intensity and rolling around on the floor, when in fact this is normal behaviour for a female cat in oestrus. It is not possible to go into detail here about species-typical behaviour patterns of companion animals, so the reader is referred to the many texts available on the different species and breeds, which should be essential reading according to the species being treated by the individual concerned.

There is also a large genetic contribution to the enormous variation that occurs within a species, for example between breeds and within a breed itself. So, although some generalisations about breeds may be easy to argue, such as selection favouring greater stoicism in breeds which are used to fight live game (e.g. terriers), it is important to appreciate that the variation within a breed may be greater than the variation that exists between breeds, i.e. it should not be assumed that because an individual is of a certain breed that it will necessarily be more or less stoical than an individual from another breed. Expressions of individual variation arise as a result of the interaction of different genetic and environmental factors throughout life; this serves to shape the temperament of the individual (Scott & Fuller 1965) and the way it perceives the world around it, including the personal significance of events (Weisenberg 1977). So whilst it is important to appreciate breed characteristics, they should not be rigid points of reference, especially when it comes to an individual's response to pain.