Early Physiotherapy in Veterinary Critical Care: A Case Report

Background: Advancements in veterinary medicine have expanded the potential of critical care; however, prolonged immobilization may lead to substantial physical debilitation. While early physiotherapy is crucial in human medicine for preventing and treating intensive care unit-acquired weakness, its application in veterinary practice is less reported.

Materials and Methods: A 12-year-old Miniature Dachshund underwent pericardiectomy to relieve cardiac compression caused by a heart base tumour and developed ARDS-like symptoms postoperatively, requiring mechanical ventilation from postoperative days 2 to 5. Lymphatic drainage and PROM exercises were administered to mitigate oedema and prevent joint contractures. After weaning from the ventilator, oxygen therapy was needed due to reduced oxygenation. Chest physiotherapy was employed to facilitate the expectoration of endotracheal secretions, while exercise therapy was implemented to promote early mobilization ([Fig. 1]). Oxygenation was monitored via SpO₂, and ventilation was assessed through PvCO₂ and resting respiratory rate.

Results: Lymphatic drainage reduced oedema, improved vein visibility and eased venous catheterization. Chest physiotherapy facilitated expectoration, improving SpO₂ levels. Despite a gradual decrease in the oxygen concentration within the ICU, the SpO₂ levels remained elevated. Additionally, both the PvCO₂ and the resting respiratory rate converged toward normal ranges ([Fig. 2]). The dog was initially unable to stand without assistance but was able to ambulate independently at the time of discharge, 13 days postoperatively.

Conclusion: This case highlights the potential feasibility of early physiotherapy interventions in critical care settings, including prevention of joint contractures, oedema reduction, management of secretions, and exercise therapy during rest periods.

Fig. 1 The upper figure illustrates the changes in oxygen levels in the ICU and SpO₂ values, while the lower figure depicts the changes in PvCO₂ and resting respiratory rate. In this case, mechanical ventilation was administered from postoperative days 2 to 5, and oxygen therapy was conducted from days 6 to 11.

Fig. 2 Physiotherapy intervention modalities according to the clinical course. (A) Lymphatic drainage, (B) chest physiotherapy (thoracic squeezing, percussion, huffing, etc.), (C) assisted standing exercises, (D) passive range of motion exercises, (E) assisted walking exercises, and (F) unassisted walking exercises.

Publication History

Article published online:
12 September 2025