What To Expect From Your Hydrotherapy Appointment

Before I get into the detail, I just want to make it clear that this post is based entirely on what would happen when you come to my centre for a hydrotherapy appointment. Exact details are likely to vary at different centres.

I understand it can be a bit unnerving coming to your first hydrotherapy appointment - you've heard of hydrotherapy, and either had a recommendation from your vet, or done your research and decided it's a good idea for your dog. The day of the appointment has arrived, and you're a little unsure what to expect. This post will walk you through exactly what happens when you come to visit me.

A cupboard and table filled with dog treats with a brown cocker spaniel sitting in front of them.
Ripley won't greet you, but the treats will be there!

When they first come through the door, most dogs are a mixture of interested and anxious. I think it helps that the first thing they see (and smell!) is a table full of the yummy natural treats that I sell 😂 I try to remember to greet the human first, but sometimes forget as I say 'hi' to your dog! I want them to be comfortable with me, and I use my experience to read them and adjust my actions as needed.

Next up, I'll ask you for a little background about your dog and their current condition. This will include any medication they're on, what their exercise routine is and anything else that may be relevant. If your dog is fairly laid back, I may ask you to just let them off to have a wander around the centre.

If they're a little more wired (I'm looking at you, six-month old golden retriever!) then I will likely take their lead and move with them. All the while, I'm watching them move. I want to see if there's any lameness or peculiarity in their gait, whether they choose to stop in a sit, down or stand, how they stand, which way they prefer to turn and many other things. I'm building up a mental picture of their current state. I often have a camera set up during your first appointment so that I can move your dog into a stand and capture what that looks like - I can repeat this following a number of treatments to see progress.

At this point, I'll ask you what you know about hydrotherapy. Don't panic! Nearly everybody says 'not a lot'. Here we go...

We start with a shower - there are three main reasons for this. To introduce water, to start to warm the dog up and to get rid of any dirt and detritus in the coat.

I have a raised shower area; this is for entirely selfish reasons, as each dog is showered twice and that would be an awful lot of time bending or crouching down with a lower shower! I also find it easier to handle the dogs whilst I'm standing rather than kneeling, so it does have additional benefits. Some dogs are a little nervous the first time we ask them to go up the ramp to the shower, but usually offer to go up readily during the second or third session. Whilst they're in the shower I fit a harness - this will help me to keep some control of their movement once we start treatment.

Whilst I'm carrying out a few health checks and showering your dog, I start the next part of my explanation. Let's start with the underwater treadmill.

There are a number of factors in play - first is the temperature of the water, which is between 28C and 32C. This opens up the blood vessels, allowing the blood to flow more effectively to the muscles. This impact lasts for around 72 hours, meaning that any exercises, etc that you do with your dog in the three days following hydrotherapy will have more of an impact than if they hadn't had the hydrotherapy treatment. The warm water also provides some pain relief benefits.

Next up is the height of the water - the exact height used will depend a lot on why your dog is having hydrotherapy. As a general guide, the water will be at or above the height of the affected limb. For the most part, I generally aim to start with water between knee and hip height.

At this level, the dog is only having to support around 30-40% of their weight - the water is taking the rest. Again, this can help with pain relief as they're not loading the limbs as much as they do on land. High water does also provide challenge to the muscles though - imagine yourself having to walk through water at hip height, it's not so easy! There is definitely a balance to be had between providing enough support without giving too much challenge. Lower water causes more turbulence, which is another challenge - if the water is low enough, some dogs will lift their feet too high in an effort to get them out of water rather than push forward through the water. There's a lot going on there for me (or any hydrotherapist) to monitor, and we haven't really started moving yet!

By the time I've talked all this through, your dog will have had a shower and now be on the way to the treadmill. I talk to them throughout, as well as to you. Once in the treadmill, I'll explain that it's about to get weird... I now start to fill the treadmill - water comes up from under them, and it can be a little alarming!

The next step is to try to get them walking in the treadmill. This is definitely easier for some dogs than others. In my experience, herding breeds tend to crouch as the belt starts to move - with these I make sure to have the water low enough so that they don't end up floating. I start with a slow belt speed, and increase it as their confidence grows. If needed, I'll raise or lower the water level as they move. In this first session, the longest most dogs walk for is 30 seconds at a time. In between the walking, I will do a little bit of bodywork, such as weight shifting. Exactly what will vary from dog to dog, but the main thing is that hydrotherapy isn't all about the swimming or walking.

Golden retriever dog wearing a purple drying coat up over her ears
Isla doing her best seal impression!

Once they've completed their session in the treadmill, it's time for another shower - this time to rinse off the water from the treadmill, as that is chemically treated. I have a 'magic' towel that gets most of the water off their coat, but you can always bring your own towels or a drying coat of some sort if needed.

Let's rewind back to the end of the first shower, and I'll talk about what happens if your dog is going into the pool. Unlike in the treadmill, in the pool your dog's feet don't stay on the floor - they will be completely supported by the water. I'm in there with them, to make sure that they don't panic and have support as needed. This complete weightlessness is particularly good for dogs with chronic pain, such as arthritis. Whilst they're on land there is no way of getting all their weight off one joint or another. You can practically see the relief in the face of a dog that experiences the warm pool water for the first time. They may not be water lovers, but they do love that sensation, and I believe they come to appreciate it. The warm water has the same benefits detailed for the treadmill above.

Lurcher wearing a blue harness being held by a lady in a hydrotherapy pool
I am always in contact with your dog in the pool

When it comes to swimming, the theory is that all dogs CAN swim as part of their innate survival instinct, unlike humans who have to learn to swim. In practice, it doesn't look so good sometimes! If this is their very first time with no feet on the floor, then many dogs throw their legs all over the place! This usually results in me getting very wet... In particular, they try to bring their front legs out of the water, which often has the added result of their bottom sinking. It really isn't a pretty sight, and can take some management to keep things under control. I usually start with some time on either the ramp or a platform in the pool, letting your dog settle and take in the new environment. Some dogs are more keen than others to just dive straight in, but often even seasoned swimmers find the very white pool a bit strange. Ripley loves to swim in the river or the sea, but not so much in the pool - I think because he hasn't quite worked out how to walk in as he does elsewhere.

As with the treadmill, in the first appointment your dog won't be swimming for very long. Often I lift them half a length away from the ramp and get them to swim back, repeating that a number of times. In later sessions we work out how to do turns, etc. For now, it's about building their trust in me and their confidence in the water. I also do some sort of body work with them in between swims. Then it's back to the shower, just the same as after a treadmill session.

Then comes the best bit (for most dogs!) - they get a couple of fish skin cubes. Yum! Finally, I explain that for the rest of the day you should try to keep your dog warm, no big walk (just out for a pee, etc) and nothing to eat for at least a couple of hours. And that's it for your first session, aside from paying and booking your next appointment. In total, most first appointments last for between 30 and 45 minutes.

I really hope that this has been helpful, but if you are left with any questions then please do get in touch.

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