Veterinary Teaching Hospital Expands Services to Include Physical Therapy and Hemodialysis

Charley, a limping chocolate Labrador Retriever, and Brinley, a Bernese Mountain Dog with congenital kidney disease, were some the first patients to benefit from the Veterinary Teaching Hospital’s new physical rehabilitation and hemodialysis services.

When Charley, a loveable, energetic chocolate Labrador Retriever belonging to Dr. Michael Hiles of Lafayette, came up limping after an all-out, though failed chase to catch a hawk, she found just the help she needed at Purdue Veterinary Medicine’s Veterinary Teaching Hospital (VTH).  She underwent successful surgery to repair a partially ruptured tendon, and then, just like humans recovering from a torn Achilles tendon, began a long road to full recovery, aided significantly by the VTH’s physical rehabilitation service and its underwater treadmill.

The hospital installed the underwater treadmill in 2015 as part of the new rehabilitation service, which was established after Dr. Stephanie Thomovsky joined the faculty.  A board-certified clinical assistant professor of veterinary neurology and neurosurgery, Dr. Thomovsky also is a certified canine rehabilitation practitioner.  “The benefit for dogs using an underwater treadmill is similar to walking under water for humans,” Dr. Thomovsky explained.  “If you walk in the water it’s more difficult due to resistance, but there is less stress on the joints due to buoyancy. The buoyancy makes our patients lighter and puts less stress on dogs recovering from both orthopedic and neurologic surgeries, or those with osteoarthritis.”  Dr. Thomovsky added, “Also, we keep the water warm. It’s usually about 88 degrees, so that will increase blood supply to the limbs. That also helps in the recovery.”

Jessica Bowditch, veterinary neurology/neurosurgery and physical rehabilitation technician, works with Charley using the underwater treadmill, which helps rehabilitating dogs and also can be used for dogs who need a different way to exercise.

Jessica Bowditch, veterinary neurology/neurosurgery and physical rehabilitation technician, works with Charley using the underwater treadmill, which helps rehabilitating dogs and also can be used for dogs who need a different way to exercise.

Charley with her owner, Dr. Michael Hiles, before one of Charley’s underwater treadmill therapy sessions.

Charley with her owner, Dr. Michael Hiles, before one of Charley’s underwater treadmill therapy sessions.

Jessica Bowditch, veterinary neurology/neurosurgery and physical rehabilitation technician, works with dogs using the treadmill, and in most cases, gets in the tank with the canines. “I have had some dogs that sort of have a look like, ‘What is that?’ But, usually, you put them in and they're fine.”  Eventually both Dr. Thomovsky and Jessica hope the College will be able to offer physical rehabilitation as a block that fourth-year veterinary students and veterinary technicians can rotate through and learn things such as how and when to utilize an underwater treadmill for canine patients.

The underwater treadmill therapy was just the ticket for Charley.  After her surgery, Charley initially was fitted with a special orthotic device shaped like a boot to help with her recovery.  After the boot was removed, Charley became one of the first VTH patients to use the treadmill, beginning with treadmill therapy three days per week.  “She had a lot of muscle atrophy, and the therapy strengthened her leg muscles and helped her relearn how to walk normally,” said Dr. Thomovsky.  As Charley reached the point of being nearly fully recovered, her visits decreased to just once a month.  Dr. Hiles was thrilled with the results.  “Without this treatment, Charley likely would have become a three-legged dog,” Dr. Hiles commented.

Charley’s treatment proved to be just another chapter in a long-standing relationship between Dr. Hiles and the Purdue University College of Veterinary Medicine—a relationship that came full-circle with Charley’s surgery.  A 1987 Purdue graduate in electrical and computer engineering, Dr. Hiles earned his PhD in PVM’s Department of Basic Medical Sciences in 1992.  His research involved working on a collaborative team that included Dr. Gary Lantz, PVM professor of small animal surgery.  The team studied porcine small intestine submucosa (SIS), which was found to have a unique ability to regenerate tissue.  The discovery was licensed to Cook Biotech, which Dr. Hiles helped found in 1995 and where he now serves as vice president and chief scientific officer.  Twenty years after the company’s founding, SIS was used in the surgery to repair Charley’s tendon in the Small Animal Hospital.

Hemodialysis Unit Adds Treatment Option

The Veterinary Teaching Hospital also opened its first hemodialysis unit in the Small Animal Hospital (SAH) in the past year.  The unit is run by Dr. Sarah Steinbach, assistant professor of small animal internal medicine, and Dr. Larry Adams, professor and co-section head of small animal internal medicine, with the support of the entire small animal internal medicine team.  The hemodialysis machine was acquired in conjunction with Dr. Steinbach’s faculty appointment in the Department of Veterinary Clinical Sciences last year.

Dr. Steinbach came to Purdue from Germany with the specific goal of offering hemodialysis at the VTH. She already had established a veterinary hemodialysis service at Justus-Liebig University Giessen in Germany, where she worked after completing her residency in small animal internal medicine.  In addition, Dr. Adams previously had undertaken a sabbatical to learn about the process. “I did a sabbatical focused on hemodialysis that involved learning the different options,” said Dr. Adams. “I went to a dialysis unit in Bern, Switzerland where I had a lot of training.”  Both are enthusiastic to offer this treatment option in the SAH to help animals with kidney disease and to advance veterinary knowledge through research in this area.

The Small Animal Hospital’s first hemodialysis patient, Brinley, was cared for by (left-right) Dr. Larry Adams, Dr. Sarah Steinbach, Versa Technologist Debbie Ramirez and Small Animal Medicine Technologist Julie Commons, with the support of all the hospital staff.

The Small Animal Hospital’s first hemodialysis patient, Brinley, was cared for by (left-right) Dr. Larry Adams, Dr. Sarah Steinbach, Versa Technologist Debbie Ramirez and Small Animal Medicine Technologist Julie Commons, with the support of all the hospital staff.

The first patient to receive hemodialysis in the SAH was Brinley, a Bernese Mountain Dog with congenital kidney disease. Brinley was born with renal dysplasia, a defect that causes the kidneys to malfunction and creatinine levels to soar to unsafe levels. To keep creatinine levels in check, Brinley came in every Monday, Wednesday, and Friday morning at 7:30 and got examined and weighed.  Results of this examination and basic bloodwork were used to plan the treatment. Then, once he and the team were ready, he was hooked up to the hemodialysis machine. Through a special catheter, blood would flow through the hemodialysis machine and the artificial kidney (dialyzer). With the help of dialysate, which is produced by the machine using filtered water, unwanted waste products were removed from Brinley’s blood.

Dr. Steinbach said that Brinley was a special hemodialysis patient because of his chronic illness. “Normally when we use hemodialysis to treat patients, it’s for animals with acute kidney injury,” Dr. Steinbach explained. “Animals that are ill with failing kidneys due to leptospirosis, other infectious diseases or toxins can undergo dialysis while the kidneys are regenerating, with the hope that at some point the kidney can take over functioning again.” In Brinley’s case, the kidney function did not recover and his need for hemodialysis was to improve his quality of life. Pet insurance assisted in covering large parts of his treatment.

Though Brinley passed away, his legacy lives on, and Dr. Steinbach said the hemodialysis service was very fortunate to be able to treat Brinley as the unit’s first case. “We learned a lot from his repeat treatments and the recurring hemodialysis sessions also helped us to train staff members and improve our routines. This all will benefit future patients undergoing hemodialysis.”


This story is part of the 2016 Annual PVM Report.

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