Canine and feline physical rehabilitation is more than just underwater treadmills. There are several options available to veterinary practices that are more affordable to use and feasible to acquire. Photo courtesy Dr. Robin Downing Canine and feline physical rehabilitation has come a long way since its inception. Veterinary medicine followed human medicine’s advancements, making adaptations to benefit veterinary patients. Many of the essential tools and techniques used in human physical therapy have been successfully adapted to help dogs and cats improve their comfort, function, and mobility. While many people conjure images of underwater treadmills when they think of veterinary rehabilitation, there is so much more to it. Fundamental physical rehabilitation equipment is both affordable and fun to use—for patients and practitioners. Why is physical rehabilitation important, and who can benefit? At least 20 percent of canine and feline patients across all ages suffer from osteoarthritis.1,2 With age, that percentage increases. Additionally, at any time, most veterinary practices have patients recovering from orthopedic or neurologic surgeries. These are patients whose comfort and function are usually compromised, and those that can benefit from physical rehabilitation. While there are specialty veterinary practices dedicated to rehabilitation, there are not nearly enough to serve all the needy patients. Here are some examples of physical rehabilitation equipment that are fundamental and easy to incorporate into any practice in order to serve this patient population. Balance building Balance is critical to normal gait and to comfortably navigating both indoor and outdoor environments, making balance training an important part of physical rehabilitation. The necessary equipment for balance work is varied, straightforward, and easy to use. A dog balancing on a rocker board. Balance training is essential in physical rehabilitation to help patients with gait and navigating their environment. Photo courtesy Robin Downing Walking, standing, and reaching for treats on an uneven and shifting surface are excellent balance builders. Using a partially inflated camping air mattress is low-tech but highly effective. A rocker board or wobble board can contribute, as well. Inflatable discs, donuts, and peanuts can also provide shifting surfaces to challenge balance in various ways (Figures 1 and 2). Stretching and flexibility Stretching, both passive and active, is important to restoring and supporting normal movement. Passive spine stretching by draping the patient over an inflatable peanut or exercise ball achieves a soothing stretch that the patient cannot achieve on their own. Passive spinal stretching on a peanut. Photo courtesy Dr. Robin Downing Active stretching, for instance, reaching for treats, works both stretching and balance if the patient stands on an unstable surface and shifts their weight as they reach in different directions. This provides a whole-body benefit. A combination of poles and cones with holes at various heights can serve a dual purpose. Poles from cone to cone create a cavaletti pole course (Figures 3 and 4) to encourage the patient to high-step, improving limb and joint mobility. With a quick switch, the poles can be placed upright into the cones to create a weave-pole course. Weaving back and forth works on torso flexibility and challenges foot placement with changing directions. The use of cavaletti poles can help patients improve their limb and joint mobility, as well as their torso flexibility. Photo courtesy Dr. Robin Downing Resistance bands come in various strengths and can be fashioned to provide additional challenges for the patient building function and strength. Adding equipment and finding guidance There are now several companies offering rehabilitation equipment specifically for veterinary use. Additionally, school supply companies are a good source for some items, such as cones and poles. Finally, physical therapy supply companies are a great source of a wide variety of equipment that can be easily adapted for use with cats and dogs. Incorporating physical rehabilitation into primary care practice provides an important strategy to expand services, enhance job satisfaction for the veterinary health care team, and add value for clients and patients. Many fundamental physical rehabilitation techniques and activities are easy to learn and apply with a bit of study and practice thanks to several excellent textbooks as well as online learning. The following texts (not an exhaustive list) provide excellent descriptions of rehabilitation applications and techniques, along with pictures. They provide practical guidance on developing appropriate protocols and plans for specific conditions. In addition, they have websites that provide videos to enhance the ability to learn and apply rehabilitation techniques appropriately. Canine Rehabilitation and Physical Therapy, 2nd ed. Darryl Millis, David Levine, eds. Elsevier Saunders, Philadelphia, 2014. Essential Facts of Physical Medicine, Rehabilitation and Sports Medicine in Companion Animals. Barbara Bockstahler, ed. VBS GmbH, Babenhausen, Germany, 2019. (Available from www.utvetrehab.com ) Physical Rehabilitation for Veterinary Technicians and Nurses, 2nd ed. Mary Ellen Goldberg, Julia E. Tomlinson, eds. John Wiley & Sons, Inc., Hoboken, NJ, 2024. Likewise, online courses are available for deeper dives into veterinary physical rehabilitation. With a very reasonable investment of dollars, time, energy, and practice, dogs and cat patients whose quality of movement and quality of life can be improved have the opportunity to live both better and (potentially) longer. At its core, physical rehabilitation supports the precious human-animal bond—the profession’s central reason for being. Be bold and go for it. The rewards are immeasurable. Robin Downing, DVM, MS, DBe, DAAPM, DACVSMR, is hospital director of The Downing Center for Animal Pain Management. In addition to being a practicing veterinarian, she is a Doctor of Bioethics from Loyola University of Chicago. She has received many regional, national, and international awards including the AVMA's Leo K. Bustad Companion Animal Veterinarian of the Year in 2020, and the Excellence in Veterinary Medicine Award in 2001 from the World Small animal Veterinary Association. Dr. Downing teaches internationally on topics such as pain management, physical rehabilitation, physical medicine, palliative and end-of-life care, and overcoming compliance obstacles in veterinary medicine. References J Feline Med Surg. 2025 Jul 20;27(7):1098612X251347999. doi: 10.1177/1098612X251347999 Open Vet J. 2025 Nov 30;15(11):5461–5465. doi: 10.5455/OVJ.2025.v15.i11.3
