Animal Physiotherapy Case Study: Rabbit with a Broken Femur
Patient Information:
- Species: continental giant doe
- Age: 18 months old
- Gender: Female
- Weight: 7 kg approx
- Presenting Complaint: Broken left femur.
- Referral: Veterinary surgeon referral for post-operative physiotherapy and rehabilitation.
Background:
History of Presenting Complaint:
This lovely rabbit sustained a femur break. Upon examination by a veterinary surgeon, an X-ray confirmed a oblique break of the left femur. Immediate surgical intervention was necessary due to the nature of the break, and an internal fixation (intramedullary pin) was performed to stabilise the break.
Post-surgery, she was placed on analgesics and antibiotics for infection control and pain management. The veterinarian recommended physiotherapy to aid in recovery, prevent muscle atrophy, and improve weight-bearing.
Physiotherapy Assessment
Initial Consultation:
The initial physiotherapy consultation occurred 7 weeks post-surgery. During the initial assessment, the following was observed:
- Wound Healing: No signs of infection or excessive swelling around the surgical site.
- Pain: She exhibited mild pain response upon manipulation of the left hind limb, though pain was controlled with medication.
- Gait Analysis: she shows a mild limp, with reduced push-off on the left hind leg.
- Posture: Weight-bearing was placed significantly on the right leg.
- Muscle Condition: Initial signs of significant atrophy in the quadriceps and hamstring muscles of the left leg.
Goals for Physiotherapy:
1. Reduce Pain and Inflammation: Manage pain without excessive reliance on medication.
2. Maintain Joint Mobility: Prevent stiffness in the hip, knee (stifle), and ankle (tarsal) joints of the left limb.
3. Prevent Muscle Atrophy: Minimise muscle wasting in the left limb.
4. Restore Weight-Bearing: Encourage safe, gradual return to weight-bearing on the left hind limb.
5. Enhance Overall Mobility: Ensure overall limb coordination and balance are restored as she recovers.
Physiotherapy Plan
1. Pain Management and Reduction of Inflammation:
- Massage Therapy: Light massage of the quadriceps and hamstring muscles was introduced to improve blood circulation and reduce muscle stiffness. This also helped desensitise the area to touch, aiding future exercises.
- Cryotherapy: Cold therapy (ice packs) was applied to the surgical site for 10 minutes, twice daily for the first 5 days post-surgery to reduce swelling and control pain.
2. Passive Range of Motion (PROM) Exercises:
8 weeks post-surgery, passive range of motion exercises were initiated:
- Hip, Knee, and Ankle Joints: Gentle PROM exercises were performed to maintain joint flexibility and reduce the risk of contractures.
- Massage Therapy: Light massage of the quadriceps and hamstring muscles was introduced to improve blood circulation and reduce muscle stiffness. This also helped desensitize the area to touch, aiding future exercises.
3. Strengthening Exercises:
- Weight Shifting: At 9 weeks post-surgery, weight-shifting exercises were introduced. This involved gently shifting her weight from her left hind limb to her right hind limb while she was standing or being supported in a standing position. These exercises encouraged her to begin bearing weight on the affected leg in a controlled manner.
- Static Standing Exercises: With gentle support, she was encouraged to stand on all four legs for short periods (2–3 minutes) to reintroduce weight-bearing on the right leg.
4. Gradual Return to Normal Activity:
- Controlled Exercise: From week 10 onward, she was allowed to move more freely in a controlled, confined area. Short periods of activity were gradually increased to ensure she did not overuse the leg.
- Agility Exercises: At 10 weeks, once Lola was bearing weight on the affected limb, agility exercises around the house. This was introduced to improve coordination and proprioception.
Progress and Outcome
3 month Follow-Up:
She had made significant improvements in mobility:
- Pain: Pain was much reduced, and she was no longer on pain medication.
- Weight-Bearing: she was bearing moderate/normal weight on her right hind limb and showed no signs of compensatory strain on the right side.
- Muscle Condition: There was a noticeable improvement in muscle tone, though mild atrophy was still present and a slightly closer stance from behind.
- Gait: She's moving near normal for a rabbit that has undergone what she has done. Most importantly she's pushing off evenly with both hind legs and the compensatory movement patterns has reduced significantly.
5 month Follow-Up:
She demonstrating near-normal use of her left hind limb:
- Full Weight-Bearing: Lola was confidently bearing weight on the left leg during walking and hopping, with only a slight limp.
- Muscle Mass: Muscle atrophy had largely resolved, and her leg muscle condition was symmetrical with the right leg.
- Activity Level: She resumed her normal activity level, hopping and exploring her environment without difficulty. She could now perform small jumps and exhibited a strong willingness to move.
Radiographic Assessment: X-rays showed satisfactory healing of the femur, with the internal fixation remaining in place and no signs of complications. Her pins were later removed, however, due to some irritation that she was experiencing.
Discussion
Rabbits are highly prone to stress and muscle atrophy when immobilised, making early intervention essential to maintaining mobility and preventing secondary complications such as joint stiffness or compensatory strain on the opposite limb are important factors when rehabbing rabbits from injury.
The combination of passive exercises, manual therapy and consistent check in's with vet and physio helped her regain muscle strength and joint mobility while minimising pain and discomfort. Careful attention to her behavioural responses and gradual increases in activity ensured a safe and effective recovery.
If you would like to discuss your animal's needs with us today and see how we can help then please book in for a free consultation over the phone by texting or calling on 07842412830 or email on loiciajohnson@msn.com.
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