Feline rehabilitation Flashcards
Nämn några skillnaden i beteende hos hund och katt som är bra att ta i beaktande när man lägger upp rehabiliteringsplan
”Funktion”:
Katter - jakt, klättring…
Hundar - uthållighet, distans, flockmedlem
Träning
Katter - kort session
Hundar - längre session
Minne
Katter - långt (16 h)
Hundar - kort (5 min)
Hur kan hund resp katt reagera vid stress?
Katter – flyr, tvättar sig, aggression (som sista alternativ)
Hundar – skakar, hässjar, slickar, gnäller, fly/undvikande, aggression som sista alternativ
Hur skiljer sig katters anatomi från hundar?
Katter har:
• No sacrotuberous, supraspinous, or nuchal ligament
• Forelimbs straighter (for impact/landing)
• Hindlimbs longer & more angulated (for propulsion/launching)
Hur ser rörelsemönstret ut i gait (gång/skritt) för katter?
- RR-RF-LR-LF
* 2-3 paws on the ground at any one time
Hur ser rörelsemönstret ut i amle (vanka/lunka)?
- RR-RF-LR-LF
- Moments when three paws are on the ground
- Inefficient gait
Hur ser rörelsemönstret ut i pace (passgång)?
- RF-RR then LF-LR
- Two paws are on the ground
- Center of gravity shifts laterally
- Abnormal gait in dogs
- Primary pattern of “walking” by cats
Hur ser rörelsemönstret ut i trav?
- RF-LR then LF-RR
- Diagonal
- Most efficient
Hur ser rörelsemönstret ut i galopp?
CANTER (mer samlad?)
• Rotary (vanligast) - RR then LR-LF then RF
• Transverse (ovanligare och mindre effektivt) - RR then LR-RF then LF
GALLOP (mer rusande?)
• Rotary (vanligare) - RR-LR then LF-RF then RR-LR
• Transverse (ovanligt) - RR-LR then RF-LF then RR-LR
Hur kan man göra anpassningar på kliniken för att minska stress hos katter?
- Reduce time in the waiting room
- Consider the treatment room & set-up
- Allow the patient time to explore, consider the treatment time (eep sessions short and interesting)
- Consider client interview/education & patient treatment “intervals”
- Consider the carrier
- Bring it up to your height (or get down to the carriers’ level)
Hur kan man anpassa undersökningsrummet för att minska stress hos katter?
- Quiet – minimizing sounds & smells
- Small – fewer chances for hiding places or escape
- Sign on the door: Do not open!
- Pheromone or calming diffuser (Feliway)
- Flooring surface – high coefficient of friction for reduced risk of sliding (ie., dry, textured)
Hur kan man hantera katten under rehab för att minimera stress?
- Let them explore & move as independently as possible
- Less handling is more
- Avoid sudden, rapid movements – this can be seen as a threat
- If necessary, use a harness
- As a last resort, the cat can be “scruffed” – when the cat is gripped on the skin behind the head & neck it will become quiet & passive
Vad vill man ha för subjektiv information från veterinären inför planering av rehab?
• Age, breed, spayed/neutered
• Prior medical history
• Information regarding the presenting condition
- Veterinary clinical history
- Medication history
- Results of diagnostics (imaging, labwork)
- Veterinary referral (remiss)
Vad vill man ha för subjektiv information från DÄ inför planering av rehab?
- What is the cat’s normal lifestyle?
- How active is she?
- How much time does she spend indoors/outdoors? (How does she access outdoors?)
- Where does she sleep?
- What does she eat & how often?
- What physical challenges is she facing?
- Can she groom herself?
- Can she access her litterbox? (Is she having accidents?)
- Can she access her environment? (What is it like? Furniture? Flooring surfaces? Stairs? Access to windows?)
- Is she playful?
- Is she eating?
- Is she sleeping more or less?
- What are your goals?
Vad vill man ha för objektiv information inför planering av rehab (vad är bra att observera innan)?
- Vital signs (HR, RR, BCS, temp, BP)
- Functional mobility & Activities of Daily Living (ADL)
- Gait
- Functional strength
- Balance
- Flexibility & range of motion
- Hands off & hands on assessment
- Neurological screen
- Sensory testing
- Accessory motion testing
- Palpation
- Pain evaluation
Ge exempel på Activities of Daily Living (ADL)
- Transitions/transfers (övergångar/förflyttningar)
- Sit to stand, stand to sit
- Down to stand, stand to down
- Rolling
- Stretching
- Accessing food/water
- Accessing litter box
- Accessing cat door
Vad kan vara tecken på “lameness”?
• Any gait “deviation” (avvikelse) from normal • For example: - Limping - Holding up a paw - Tail to one side - Head bobbing - Hopping or skipping - Lateral sway - Joint “giving way” with weight bearing
Vad kan man göra vid en neurologisk undersökning?
• Examine head, tail, trunk, & all limbs
• Conscious proprioceptive placing test (CP)
- Flip paw into weight bearing on dorsum, pet should actively replace it, weight bearing on plantar surface in <2 seconds
• If CP impaired, further neurological testing &/or neurology referral warranted
Vad kan tyda på att man behöver göra en sensorisk undersökning?
If there are alterations (förändringar) in postures, movements, & behaviors, there may also be impairments in sensation
Varför kan man vilja testa kattens sensoriska förmåga, varför är den viktig?
För att den sensoriska förmågan innefattar:
- Capacity to perceive & integrate information coming from all sense organs, including proprioceptors of muscles & joints
- Proprioception - perception (uppfattning) or awareness of movement of the body
- Kinesthesia - perception or awareness of the position of the body
Vad innebär 4T som man kan ha i åtanke vid palpation?
• 4T’s:
- Tone (trigger point or spasm)
- Texture (tissue adhesion, depth of problem tissue)
- Tenderness (reaction)
- Temperature (heat)
Vad kan katter visa för smärtbeteenden?
- Apprehensive facial expression
- Growl or hiss
- Inappetence
- Hiding
- Stiff or hunched posture
- Lack of grooming
- Increased pulse rate & pupillary dilatation
- Excessive licking or limping
Vad kan smärta hos katter resultera i?
- Pain with movement -> disuse (icke användande) ->functional limitations
- Result in:
- Limitations in range of motion, accessory motion, or flexibility
- Strength impairments & muscle atrophy
- Sensory changes
Vad är Feline Musculosceletal Pain Index (FMPI)?
Clinically validated instrument for diagnosing & monitoring feline chronic pain arising from degenerative joint disorders
Vad vill man ha med i rehab assessment?
Man vill bedöma problem, styrkor, mål (SMARTa), prognos (potential att återfå funktion), samt sammanfatta rehabplanen och strategi.
Vad innebär “impairments”?
any loss of normal physical or mental abilities. Impairments are usually the result of disease, illness, or injury. Impairments occur at the level of tissue, or organs. For example: reduced range of motion at the stifle, muscle atrophy, presence of a surgical incision
Vad innebär functional limitations?
any restriction in the performance of activities resulting from disease, injury, or environmental restrictions. For example: inability to walk on a slippery floor, inability to sit symmetrically
Vad innebär “pathology”?
a physical abnormality or malfunction. A disordered or diseased state of a tissue or organ
Vad innebär “disability”?
a (physical) condition which makes it difficult for an individual to do certain activities or interact with the world around them
Vad behöver man tänka på vid planering av mål och behandlingsplan?
• What are the unique/specific characteristics of the sport or functional activity? (Or of the pet or pet parent?)
- Are the rehab goals addressing these characteristics?
• Consider the patient
- Current level of fitness
- Training experience
- Medical history
• Consider the “needs” to achieve the goal
- Muscular movement patterns
- Cardiovascular endurance
- Flexibility
Ge exempel på strategi och taktik i en rehabiliteringsplan?
Strategy
• Plan of action to achieve a goal
• For example: “strengthening, stretching, facilitating, etc.”
Tactics
• Specific activities or interventions
• Actual means to gain an objective
• For example: “underwater treadmill gait training”
Vad behöver man utvärdera under behandlingstiden?
- Subjective report from client
- Vital signs
- Pain measures/scores/scales
- Functional measures/scores/scales
- Report from recheck with veterinarian or specialist
- What is the plan if/when something goes wrong/not according to plan?
Ge exempel på olika manuella behandlingsterapier för katter
• Massage
• PROM
• Stretching
• Joint & spinal mobilization & manipulation
- By a trained physiotherapist, chiropractor, or osteopath
• Advanced soft tissue techniques (MFR, IASTM)
- By a trained physiotherapist or massage therapist
Hur kan man anpassa massage till katter?
• Use a “heavy hand” as a calming input
• Maintain contact with a “big hand,” distributing pressure over a large area
• Lie a blanket or towel over the cat & massage over the blanket & cat
• Ensure that the environment is quiet with few distractions
- Small room
- “No escape”
• Consider using “skin rolling” techniques
Vad kan man använda för olika modaliteter vid rehabiliteringsbehandling av katter?
- Laser therapy (LLLT)
- Therapeutic ultrasound (US)
- Electrical stimulation (TENS, MENS, IFC, NMES)
- Electromagnetic therapy (PEMF)
- Heat, cold
Vad kan man göra för terapeutiska övningar för att öka funktionell mobilitet/rörlighet?
- Rolling, jumping, gait, climbing, crawling
- Transitions – Down to sit & back, Down to stand & back, Sit to stand & back
- Postures – Down, Sitting, Standing
Vad kan man göra för terapeutiska övningar för att öka styrka?
- Assisted standing exercises
- Incline (lutning) & decline (nedgång) exercises
- Weight bearing & weight shifting exercises
- Assisted squats
- Climbing stairs, hills, ramps
Vad kan man göra för terapeutiska övningar för att öka ROM?
- Step overs/cavalettis
- Underwater treadmill walking
- Swimming
- Shake paw
- Digging
- Climbing
Vad kan man göra för terapeutiska övningar för att öka balans?
- Exercises on challenging surfaces
* Balance board, physioball, physioroll, foam pad, air mattress, balance disc, donut, vibration plate…
Hur kan man motivera katten att göra olika rörelser under rehabiliteringstiden?
- Laser lights
- Toys
- Feathers
- Scratching posts or pads
- Baiting with treats
- Remote-controlled & battery powered toys
- Play & hunting activities
- Catnip (kattmynta, kan ge lugnande effekt om de är över 6 mån och könsmogna)
- The cat carrier or door
Vad är viktigt att kommunicera med DÄ innan påbörjad rehab hemifrån?
- Home modifications, home instructions (do’s & don’t’s), assistive devices, & home exercise/activity programs
- Don’t overwhelm
- Focus on what is important to the owner & pet
- Functional approach
- Keep it simple (stupid)! KISS principle
Vad kan man behöva ändra hemma medan katten går igenom rehab och inte har full funktion i kroppen?
Goal-focused • More independent • More challenging - Weight loss - Strengthening
Function-focused • Climbing • Litter box access (tex lägre kanter) • Food access • Flooring surfaces
