TheraPaws Session Report
917 W. Foothill Blvd., Upland, CA. 91786 WWW.TheraPaws.Pet. (909) 202-7582
Session Date
-
Month
-
Day
Year
Date
Pet/Owner Name
First Name
Last Name
Supervising Veterinarian
First Name
Last Name
Veterinarian
First Name
Last Name
Purpose of visit
20-50-minute session
80-minute session
Other
Objective(s)
Rehabilitation (with veterinarian indirect supervision)
Cold Laser (with veterinarian indirect supervision)
Therapeutic Exercise
Manual Therapy (Massage, Stretch, ...)
Waist Watchers Program
Senior Enrichment
Home Exercise Program
Owner Education/Consult
Wheel Chair Fitting
Zoom Session
Other
Animal physical rehabilitation therapy
Subjective: Owner(s) Observations
Owner Compliance
excellent
good
fair
poor
Specific Barriers to Therapy Outcomes
Body Condition Score (0-9, 9=obese)
2 too thin
3 too thin
4 ideal
5 ideal
6 too heavy
7 too heavy
8 too heavy
9 too heavy
Body Fat Index Risk
Low - 16-25% body fat
Moderate - 26-35% body fat
High - 36-45% body fat
Serious - 46-55% body fat
Severe - 56-65% body fat
Extreme - 65% body fat
Weight
Muscle Condition Score (1-4, 1=marked atrophy)
1 - severe
2 - moderate
3 - mild
4 - normal
Neurologic Grading (0-5, 0=normal)
0-Normal
1-Pain: not severe enough to result in any neurological dysfunction.
2-Paresis with or without pain, proprioceptive deficits.
3-Plegia, total loss of voluntary movement in the affected limbs (and/or tail).
4-Plegia with loss of voluntary urinary function.
5-Plegia with loss of voluntary urinary function and loss of conscious perception of painful stimuli ('deep pain perception') in the affected limbs (and/or tail).
Neurological Gait Assessment
Please Select
5 - normal gait and coordination
4 - minimal paresis/ataxia: can stand and support body
3 - mild paresis/ataxia: can stand and support body but frequently stumbles/falls
2 - moderate paresis/ataxia: unable to stand and support body; able to move limbs
1 - severe paraparesis/ataxia: unable to stand; slight movement when supported
Lameness Scale at a Walk (0-5, 0=normal)
0=normal
1=slight, intermittent lameness
2=obvious weight bearing lameness
3=severe weight bearing lameness
4=intermittent non-weight bearing lameness
5=continuous non-weight bearing lameness
Lameness Scale at a Trot (0-5, 0=normal)
0=normal
1=slight, intermittent lameness
2=obvious weight bearing lameness
3=severe weight bearing lameness
4=intermittent non-weight bearing lameness
5=continuous non-weight bearing lameness
Gait Analysis
Simple Pain Scale (observed from joint palpation, touch avoidance, vocalization, limping or improper gait)
0=no pain
1=signs of mild pain
2=signs of moderate pain
3=signs of severe pain
4=client will not allow therapist to palpate area of pain
Stance Analysis
Stance Analysis: weight bearing % left front/right front/left rear/right rear
Conformation
Conformation of Topline
normal
lordotic
kyphotic
low head carriage
sloped
asymmetric
other (see "Additional Comments")
Conformation of Thoracic Limbs at a Stance
normal
base wide
base narrow
down in pastern
toeing in right limb
toeing in left limb
toeing out right limb
toeing out left limb
reduced weight bearing on left
reduced weight bearing on right
holds left limb up
holds right limb up
weak weight bearing in both limbs
knuckled over left
knuckled over right
scraped nails right side
scraped nails left side
scraped nails both sides
atrophy right side
atrophy left side
atrophy on both sides but worse on the left
atrophy on both sides but worse on the right
camped under
chest too shallow
toeing out, underdeveloped shoulders
overdone shoulders, legs set too far apart
pigeon toes
too narrow, concave chest
down in pastern
other (see "Additional Comments")
Conformation of Pelvic Limbs at a Stance
normal
hip drop right side
hip drop left side
straight (Lateral)
over angulation (lateral)
post-legged (lateral)
straight
stance wide
stance narrow
cow hocked
sickle hocked
down in pastern
toeing in right limb
toeing in left limb
toeing in bilaterally
toeing out right limb
toeing out left limb
slipped hocks
reduced weight bearing on left
reduced weight bearing on right
holds left limb up
holds right limb up
weak weight bearing bilaterally
knuckled over left side
knuckled over right side
knuckled over both sides
atrophy - right side
atrophy - left side
atrophy in both limbs but worse on left
atrophy in both limbs but worse on right
atrophy in both limbs
scraped toes right side
scraped toes left side
scraped toes on both sides
other (see in "Additional Comments")
Range Of Motion (functional assessment, pain, comments)
Range of Motion
normal
limited range of motion cervical spine - left
limited range of motion cervical spine - right
limited range of motion right shoulder
limited range of motion left shoulder
limited range of motion right elbow
limited range of motion left carpus
limited range of motion right carpus
limited range of motion thoracic spine - left
limited range of motion thoracic - right
limited range of motion lumbar spine - left
limited range of motion lumbar spine - right
limited range of motion hip - left
limited range of motion hip - right
limited range of motion stifle - left
limited range of motion stifle - right
limited range of motion hock - left
limited range of motion hock - right
limited range of motion tarsus - left
limited range of motion tarsus - right
Range of Motion (in degrees)
right
flex/ext.
left
flex/ext.
end feel
comments
test position
carpus (32-196)
elbow (36-166)
shoulder (57-165)
tarsus (36-165)
stifle (41-162)
hip (50-162)
Thigh Girth Measurement L/R
Upper Arm Measurement L/R
Gait Analysis
Photographs
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Gait Analysis at a Walk
crossover thoracic limbs
crossing over of affected limb(s)
center tracking
shoulder lameness
short stride with pelvic limbs
short stride with thoracic limb
elbow lameness
elbow circumduction
thoracic limb circumduction
pelvic limb circumduction
weight shifted caudally
weight shifted cranially
head bob, head goes down on the sound limb
hindlimbs tucked under
forelimbs placed more caudally
head/neck extend to offset hind end weight
hip hike, increased vertical motion hip on lame side
painful or stiff in one or more limbs
Inability to walk
right pelvic limb weak or ataxic
left pelvic weak or ataxic
reduced conscious proprioception in pelvic limb(s)
reduced conscious proprioception thoracic limb(s)
knuckling right pelvic limb
knuckling left pelvic limb
knuckling right thoracic limb
knuckling left thoracic limb
right pelvic limb incoordination
right thoracic limb incoordination
left pelvic limb incoordination
left thoracic limb incoordination
lameness
unsteadiness
painful walking
limping while walking
arching of the back
lowering of the neck and head
shift in weight
weakness
staggering walk
swaying on feet
wide stance with pelvic limbs spread far apart
wide stance with thoracic limbs spread far apart
inability to extend pelvic limbs during gait
inability to extend thoracic limbs during gait
crouched gait
skipping a stride
shuffling gait
goose stepping gait
loss of balance
stumbling
paw scuffing
loss of movement control
carrying a limb
right pelvic limb paralysis
right thoracic limb paralysis
left pelvic limb paralysis
left thoracic limb paralysis
toe dragging right pelvic limb
toe dragging left pelvic limb
toe dragging right thoracic limb
toe dragging right pelvic limb
crabbing
bunny hopping
Other (see "Additional Comments")
Gait Analysis: trot
crossover thoracic limbs
crossing over of affected limb(s)
center tracking
shoulder lameness
short stride with pelvic limbs
short stride with thoracic limb
elbow lameness
elbow circumduction
thoracic limb circumduction
pelvic limb circumduction
weight shifted caudally
weight shifted cranially
head bob, head goes down on the sound limb
hindlimbs tucked under
forelimbs placed more caudally
head/neck extend to offset hind end weight
hip hike, increased vertical motion hip on lame side
painful or stiff in one or more limbs
Inability to walk
right pelvic limb weak or ataxic
left pelvic weak or ataxic
reduced conscious proprioception in pelvic limb(s)
reduced conscious proprioception thoracic limb(s)
knuckling right pelvic limb
knuckling left pelvic limb
knuckling right thoracic limb
knuckling left thoracic limb
right pelvic limb incoordination
right thoracic limb incoordination
left pelvic limb incoordination
left thoracic limb incoordination
lameness
unsteadiness
painful walking
limping while walking
arching of the back
lowering of the neck and head
shift in weight
weakness
staggering walk
swaying on feet
wide stance with pelvic limbs spread far apart
wide stance with thoracic limbs spread far apart
inability to extend pelvic limbs during gait
inability to extend thoracic limbs during gait
crouched gait
skipping a stride
shuffling gait
goose stepping gait
loss of balance
stumbling
paw scuffing
loss of movement control
carrying a limb
right pelvic limb paralysis
right thoracic limb paralysis
left pelvic limb paralysis
left thoracic limb paralysis
toe dragging right pelvic limb
toe dragging left pelvic limb
toe dragging right thoracic limb
toe dragging right pelvic limb
crabbing
bunny hopping
Other (see "Additional Comments")
Palpation
Warm-Up
massage
heating pad
PEMF mat
infrared heating mat
cold laser
gentle stretch
active range of motion
passive range of motion
land treadmill
walking
walk uphill
walk in wheel cart
other (see "Additional Comments")
Cool Down
massage
cold laser
PEMF mat
ice pack
frozen lavender towel
gentle stretch
cookie stretches
active range of motion
passive range of motion
walking
walk in wheel cart
treadmill
other (see "Additional Comments")
Photobiomodulation
pelvic limbs
right pelvic limb
left pelvic limb
shoulders
scapulae
right shoulder/scapula
left shoulder/scapula
shoulders/scapulae
elbows
right elbow
left elbow
carpus
right carpus
left carpus
hips
right hip area
left hip area
stifles
right stifle
left stifle
tarsus
right tarsus
hocks
right hock
left hock
cervical spine
thoracic spine
lumbar spine
skin healing
surgical site
acupuncture
thoracic limb
right thoracic limb
left thoracic limb
T12 to L/S junction
T11 to L/S junction
T10 to L/S junction
skin rash
abrasion
skin
other (see "Additional Comments")
Photobiomodulation
Massage Strokes and Stretching
Warm-up massage strokes
Hot stones
Cool down massage strokes
Grade 1-2 mobilizations
Grades 3-4 mobilizations
Cookie stretches
Mulligan method
Strain-Counterstrain
Swedish
Deep tissue
Chinese Tuina
Cranial Sacral
Indian Champissage
Trigger Point
Stress Point
Myofacial
Gua-sha
Tellington Touch or other Touch Therapy
Passive Range-of-Motion
Active Range-of-Motion, cookie stretches
Gentle Stretching
Gentle strokes for geriatric, diabetic, syringomyelia, other sensitive conditions
Effleurage only
Lymphatic massage
Other (See "Additional Comments")
Underwater Treadmill: speed, level, minutes, incline, limb assistance, resistance jets
Land Treadmill: speed, minutes, incline yes/no
Floor Exercises
reach for a treat on stairs
climbing mountain of inflated peanuts
narrow plank to trampoline
trampoline sit to stand
long tunnel
short tunnel
figure 8s
figure 8s with stability disk(s)
reach for a treat
reach for a treat on stairs
reach for a treat on ramp
down-sit-stand
down-sit-stand on stability disk or trampoline
sit-stand
sit to stand with affected leg against wall
sit-stand on stability disk, trampoline, or cushion
balancing/standing on stability disk(s)
weight shifting on stability disk(s)
weave poles at a walk
"S" walking around cavalettis
low cavalettis
low cavalettis with stability disks
low cavalettis in a circle
low cavalettis in a circle with stability disks
peanut/donut balance
peanut/donut balance with sit to stand
peanut/donut balance with weight shifting
peanut/donut balance with 3-leg stand
peanut/donut balance with bouncing
peanut donut balance in prone position
3-leg standing
weight shifting
bouncing/rocking on unstable surface
standing
standing with support/assistance
shake plate
shake plate with sit to stand
shake plate with weight shifting
shake plate with 3-leg stand
shake plate with tummy tickles
plank walking
ramp up, plank, ramp down walking
ramp up, plank, ramp down running
plank sit to stand
plank down-sit-stand
plank with bow
large circles in both directions
small circles in both direction
circles in both directions
trampoline with bouncing
trampoline with sit, stand, shake
trampoline with bow
trampoline with weight shifting
trampoline sit to stand
trampoline with sit, down, sit, stand
walking with Theraband resistance
walking over wobbly surfaces
wobble board
wobble board with thoracic limbs only
wobble board with pelvic limbs only
running up and down ramp
walking up and down ramp
sitting on ramp facing downhill
sitting on ramp facing uphill
fetch
walking up and down stairs
walking with resistance band
walking with bells on pelvic limbs
walking with bells on thoracic limbs
exercise done with assistance
other (see "Additional Comments")
Cryotherapy
ice pack
ice massage
frozen lavender cloth for cool down
other (see "Additional Comments")
Thermotherapy
heating pad
infrared mat
other (see "Additional Comments")
Water Therapy
intro to treadmill with 1" of water
treadmill using
walking in water without treadmill moving
walking on treadmill with wheelchair
lap swimming
lap swimming with resistance jets
walking with resistance jets
3-leg standing
weight shifting
standing
passive range of motion
active range of motion
massage
assisted stomping of limbs
bouncing
circles or turns
walking with limb(s) assistance
fetch
exercises done with assistance
other (see "Additional Comments")
Acupoint Therapy
administered with class IV laser
administered with acupoint laser light
administered with microcurrent
administered with acupressure
administered using combination of laser light, microcurrent, and acupressure
LU 1
LU 2
LU 3
LU 4
LU 5
LU 6
LU 7
LU 8
LU 9
LU 10
LU 11
LI 1
LI 2
LI 3
LI 4
LI 5
LI 6
LI 7
LI 8
LI 9
LI 10
LI 11
LI 12
LI 13
LI 14
LI 15
LI 16
LI 17
LI 18
LI 19
LI 20
ST 1
ST 2
ST 3
ST 4
ST 5
ST 6
ST 11
ST 12
ST 16
ST 25
ST 28
ST 29
ST 31
ST 32
ST 33
ST 34
ST 35a
ST 35b
ST 35
ST 36
ST 37
ST 38
ST 39
ST 40
ST 41
ST 42
ST 43
ST 44
ST 45
SP 1
SP 2
SP 3
SP 4
SP 5
SP 6
SP 7
SP 9
SP 10
SP 13
SP 21
HT 1
HT 2
HT 3
HT 4
HT 5
HT 7
HT 8
HT 9
SI 1
SI 3
SI 4
SI 5
SI 6
SI 7
SI 8
SI 9
SI 10
SI 11
SI 12
SI 13
SI 14
SI 15
SI 16
SI 17
SI 19
BL 1
BL 2
BL 10
BL 11
BL 12
BL 13
BL 14
BL 15
BL 16
BL 17
BL 18
BL 19
BL 20
BL 21
BL 22
BL 23
BL 24
BL 25
BL 26
BL 27
BL 28
BL 29
BL 31
BL 32
BL 34
BL 35
BL 36
BL 37
BL 38
BL 39
BL 40
BL 53
BL 54
BL 55
BL 56
BL 57
BL 58
BL 59
BL 60
BL 61
BL 62
BL 63
BL 64
BL 65
BL 66
BL 67
KI 1
KI 3
KI 4
KI 6
KI 7
KI 9
KI 10
KI 27
PC 2
PE 3
PE 6
PE 7
PE 8
PE 9
TH 1
TH 2
TH 3
TH 4
TH 5
TH 6
TH 8
TH 9
TH 10
TH 11
TH 12
TH 13
TH 14
TH 15
TH 16
TH 17
TH 20
TH 23
GB 1
GB 2
GB 3
GB 4
GB 6
GB 7
GB 11
GB 12
GB 13
GB 14
GB 17
GB 19
GB 20
GB 21
GB 22
GB 23
GB 24
GB 25
GB 26
GB 27
GB 29
GB 30
GB 31
GB 32
GB 33
GB 34
GB 35
GB 36
GB 37
GB 38
GB 39
GB 40
GB 41
GB 43
LV 1
LV 2
LV 3
LV 4
LV 5
LV 6
LV 7
LV 8
LV 13
LV 14
GVT
GV 1
GV 2
GV 3
GV 3a
GV 3b
GV 3c
GV 4
GV 5
GV 6
GV 7
GV 8
GV 9
GV 10
GV 12
GV 13
GV 14
GV 15
GV 16
GV 17
GV 20
GV 21
GV 24
GV 25
GV 26
CV 1
CV 3
CV 4
CV 5
CV 6
CV 7
CV 8
CV 9
CV 11
CV 12
CV 14
CV 17
CV 20
CV 22
CV 23
CV 24
An-Shen
BLADDER MERIDIAN
ASSOCIATION/BACK SHU POINTS
SURROUNDING THE DRAGON (SHOULDER)
SURROUNDING THE DRAGON (HIP)
Other (see "Additional Comments")
Acupoints applied by acupressure, massage, or cold laser for:
Senior Boost (LI 4, ST 36, GB 34, KI 3
Tendons & Ligaments (GB 34, LV 3, TH 5, BL 40)
Respiratory Issues (LU !, LU 9, KI 27, BL 13, CV 17)
Immune System Boost ( LI 4, LI 11, St 36, BL 17)
Skin & Coat (LI 4, LI 11, LU 7, BL 17, SP 6)
Grief & Prolonged Sadness (GV 20, Bai hui, HT 7, LU 7)
Digestion & GI (CV 12, SP 6, ST 36, BL 20)
Muscle Strengthening (SP 3, ST 36, BL 17, BL 18, BL 20, BL 21)
Focus in Training (BL 10, GV 20, ST 36, Yin Tang, CV 17)
Repetitive & Obsessive Behaviors Issues (CV 14,HT 7, ST 40, ST 45)
Depression Issues (GV 20, Bai hui, GV 16, HT 5, PE 6)
Osteoarthritis (BL 11, BL 23, KI 3, CV 6, LI 11)
Physical Endurance and Energy (BL 23, LI 10, ST 36, KI 3)
Fear Issues (KI 27, HT 7, PE 6)
Shoulder (SI 3, GB 21, TH 14 LI 15)
Building Spirit & Trust (HT 7CV 17, PE 1, PE 6)
Edema, Stagnant Chi, or Deficient Chi (CV 12, SP 6, SP 9, ST 36)
Hips (GB 29-GB 30- BL 54, GB 34, BL 40)
Clearing Toxins (LV 3, LV 8, BL 17)
Seizure Disorders (LV 3, GB 20, GV 14, GV 26)
Replenishing Original Chi & Collapse of Yang Chi (KI 27, CV 4, CV 6)
Spine (GV 3, GV 4, GV 12, Bai hui
Cushing's Disease (ST 26, SP 6, KI 3, CV 4, Bai hui)
Diarrhea or Constipation (ST 25, ST 36, SP 6, BL 20)
Stifle (ST 35, ST 36, BL 21, GB 34)
Pre- or Post- Surgery (SP 21, BL 17, BL 60, KI 3, LV 8)
Pelvic Limb Paresis or Paralysis (SP 6, ST 40, BL 40, GB 39, GB 29/GB 30/BL 54, GV 3)
Thoracic Limb Paresis or Paralysis (SI 9, LI 10, LI 11, TH 5, LI 16, PE 6, GB 21)
Liver or Gall Bladder (GB 21, GB 24, GB 25, GB 34, LV 3, LV 5, LV 14,
Kidneys (KI 3, KI 7, KI 10, BL 23, GB 25)
Cervical IVDD (LU 7, LI 15, SI 3, TH 5, BL 10, BL 11, GV 14, GV 16, GV 20, BL 60)
Thoraco-Lumbar IVDD (BL 18-28, GV 4, GV 3a, GV 3b, GB 3c, GV 2, GV 1, GVT, BL 54, BL 40, BL 60, BL 67)
Urinary Incontinence (SP 6, HT 8, BL 23, KI 4, GB 41)
Spring Maintenance (LV 3, GB 40, LV 5, GB 37, LI 1, GB 41, ST 36, SP 3, SP 21)
Summer Maintenance (HT 7, PE 7, SI 4, TH 4, HT 5, PE 6, SI 7, TH 5, HT 8, PE 8, SI 5, TH 6, ST 36, SP 3, SP 21)
Late Summer Maintenance (SP 3, ST 42, SP 4, ST 40, SP 3, ST 36, SP 21)
Autumn Maintenance (LU 9, LI 4, LU 7, LI 6, LV 8, LI 1, ST 36, SP 3, SP 21)
Winter Maintenance (KI 3, BL 64, KI 4, BL 58, KI 10, BL 66, ST 36, SP 3, SP 21)
Healthy Maintenance (GV 20, Bai hui, ST 36, LV 3, GB 34)
Acupoints for Conditions, Issues, Complaints, Maintenance
environmental allergies
allergies
ataxia
muscle weakness
muscles
atrophy
strength
immune system
back and rear weakness
hind end
bladder atonia
cardiac disorders
heart
carpal pain
carpus
cervical pain
cervical spine
osteoarthritis
bones
blood
wobbler's
cognitive dysfunction
cognitive function
pain of thoracolumbar region
thoracolumbar region
pain of lumbosacral region
lumbosacral region
coxofemoral or hip problems
coxofemoral region
distal thoracic limb pain, chronic
thoracic limb
edema
elbow pain or lameness
elbow
fatigue
gluteal muscle pain
gluteal area
hemiplegia
hindlimb weakness
hip dysplasia or pain
hock problems
hock
IVDD
ligament tendon problems
ligaments and tendons
lumbar pain
lumbar spine
lumbosacral pain
muscle spasms or pain
neck pain
neck area
obesity
pain in shoulder and thoracic limb
shoulder and/or thoracic limb
general pain relief
pain
paralysis of anal sphincter
paralysis of the tail
pelvic limb ataxia and weakness
pelvic limb lameness
pelvic limb paresis or paralysis
pelvic limb weakness
pelvic limb
pruritis
skin
qi deficiency
qi
shoulder lameness
shoulder pain
shoulder
spleen qi
stifle pain or lameness
stifle
thoracic limb lameness or pain
thoracic limb paresis or paralysis
thoracolumbar pain
general weakness
weakness
wei qi deficiency
wei qi
wei syndrome
yang deficiency
yang
yin
yin deficiency
paralysis/paresis
spine
tarsus
hock
Source qi
Other Applications
microcurrent
TENS
kinesthetic taping
pulsed electro magnetic mat (PEMF)
Motivators Used
General treats
Owner supplied treats
Green Beans
Carrots
Peanut butter on a tongue depressor or lick mat
Frozen Kong
Frozen applesauce
Frozen pumpkin
Apple pieces
Balls
Other toys
Continence/Marking/Anal Gland Issues
No issues, continent
Client is incontinent
Marking
Continent but defecated/urinated after arriving
Needed evacuating
Needed expressing
Applied waterproof diaper in water
Applied diaper during part/all of session
Diarrhea, no water exercise
UTI, no water exercise
Possible bladder infection, referred to doctor
Anal gland odor
Home Exercise Plan (HEP)
Please Select
Continuing with current HEP
See "Additional Comments"
Home Exercise Plan
Other/Miscellaneous
Current Rentals/Loaners
Leg brace(s)
Back brace
Leg harness
Belly lift
Booties/Socks
Leg Wraps
Cold laser home unit
Pulsed electromagnetic field mat
Wheelchair
Stroller
Additional Comments
Plan of Care for Next Visit
Plan of Care for Next Visit
Please Select
Same
Continuing with 20-50 minute sessions
See "Additional Comments" for therapy changes
Next Appointment
Next Appointment
-
Month
-
Day
Year
Date
Therapist's Name
Therapist
Please Select
Jami Waldrop RVT, CCRP, CERP, CCAT
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