Page 48 - WSAVA2018
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J. Van Dyke1
1CRI, Faculty, Wellington, USA
Janet B. Van Dyke, DVM,
Diplomate American College of Veterinary Sports Medicine and Rehabilitation
Wellington, Florida USA
The physiotherapeutic approach to patient evaluation places an emphasis upon proper and thorough soft tissue diagnosis. Problem solving is emphasized as
are creating and meeting goals that are functional for the patient. As veterinarians, we have been trained to evaluate our patients, using imaging to help us evaluate bones and joints. When a dog presents with a lameness and the radiographs are negative, what can we do? This is where the skills used daily by physiotherapists can assist us. Determining specific soft tissue pathologies allows us to apply focused treatments to patients previously treated with “R&R” (Rest & Rimadyl).
Veterinarians have traditionally used “S.O.A.P. notes to record their thought processes on evaluating patients. Physiotherapists use a similar approach. Subjective
data from the client/pet owner is combined with the medical history from the referring veterinarian as well
as the objective data obtained through the physical examination. A detailed problem list is then created. From this list, an assessment is written. This is a
narrative of the problem list. From this narrative, a list
of functional goals is created. A detailed treatment
plan is then written. As the treatment plan is pursued, the patient is reassessed to determine if goals were
met. The treatment plan is then altered as necessary. The objective data collected includes the usual veterinary physical exam plus the following: Posture, Function, Strength, Gait, PROM/AROM, Flexibility, Joint Play, and Special Tests. Treatment plan development requires that the problem list be prioritized. The acuity and the primary tissue(s) of the injury are determined, leading to proper decision making regarding manual therapies, physical modalities, and therapeutic exercises. Treatments are then carried out, and the results evaluated before planning the next step.Determining
the acuity of the injury requires understanding the
25-28 September, 2018 | Singapore
Complications of obstructions
Gastrointestinal perforation affects the peritoneum
of dogs and cats. Due to this, radiographic and sonographic features of perforation are characteristic of peritoneal disease. Clinical signs include fever, dyspnea, inappetence, vomiting, abdominal pain and possible diarrhea. Causes of perforation of the gastrointestinal tract in dogs and cats include foreign body perforation, perforating ulcer either due to benign or malignant diseases, non-steroidal anti-inflammatory therapy, bullet wound perforation, surgical dehiscence, intussusception, gastric dilatation volvulus.
Free gas in the peritoneal space usually occurs with a perforated intestinal wall. However, chronic erosions of the wall due to neoplasm or chronic foreign body may be walled off and gas may not be evident radiographically. Free gas in the absence of recent laparotomy, trauma
or abdominal perforation usually indicates intestinal perforation as the source. Presence of free air is in
most all cases a surgical emergency. Rupture of the stomach usually leads to large amounts of air while if in the small intestine, the amount is smaller. Radiographic signs of pneumoperitoneum include loss of serosal detail as well as increased visualization of serosal margins due to outlining with gas. Horizontal beam radiography is indicated for suspicion of free gas when only small volumes are present. Free peritoneal air will tend to accumulate adjacent to the diaphragm, have triangular shapes, and may collect adjacent to the ribs and between the liver lobes. Large volumes of free
gas can be more difficult to recognize radiographically than small volumes as they are so generalized over the abdomen they go unnoticed. The loss of serosal detail
in the presence of free air is usually due to peritonitis secondary to the perforation. Radiographically, unless an intestinal mass or a radiolucent foreign body is identified, the site of intestinal perforation often is not identifiable.

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