French bulldog Penelope works through her swimming exercise with Suzanne Border at the FitCanine

Canine surgeries can cost families thousands of dollars, so dog owners in Lincoln are turning to different therapy and exercise routines to reduce the risk of recurrent injuries and improve quality of life after surgeries. 

In Lincoln, dog owners can swim their pet, put them through physical therapy and laser treatment and use acupuncture to propel the pet through recovery and ensure that the expensive surgery continues to help the injury.

Americans spent $31.4 billion on veterinary care in 2020, according to the American Pet Products Association. 

“If you invest this much time, money and effort into this surgery, you want it to work, you want it to be worth something, so if you paid for it, get good use out of it,” said Dr. Cris Macke, canine physical therapist and founder of the Macke Institute of Canine Therapy. 

Macke helps rebuild muscle and mobility in dogs post-operation through a series of laser and physical therapy treatments. Physical therapy for dogs generally costs $40 to $75 each session, though some pet insurances will cover the cost, according to the Animal Performance and Therapy Center in Genoa, New York.

First, Macke lays the dog on a mat with a metal coil that emits electromagnetic waves. Then, she places a laser on the affected area.  

“They both help in similar ways in which they both reduce pain, reduce inflammation and help with tissue healing,” she said of the laser and mat.  

Laser treatment penetrates light deep into the muscle and produces a series of chemical reactions that release endorphins and stimulate cells to heal at a faster rate, according to The Drake Center for Veterinary Care in California. 

Laser treatment is still under-researched and may not be an exact science, said Beth Galles, assistant professor of practice at University of Nebraska-Lincoln veterinary medicine. 

“We often do not know the precise best doses for specific conditions,” she said. “Research is ongoing and there will likely be better guidelines around the use of laser therapy in animals in the future.”

After the laser treatment, Macke massages the muscles and runs the dog through a series of mobility exercises. She recently worked with Dilly, a four-year-old Golden Retriever that underwent ACL surgery in her left hind leg (see video). ACL injuries are one of the most common injuries in dogs, according to Macke.

After surgery, the dog is still hesitant to use the hurt leg, so it puts more pressure on their other limbs. Overcompensation leads to a little more than 50% of dogs who tear their other ACL, Macke said. 

“We’re trying to get her to get back range of motion, rebuild her full strength as soon as possible, so she’s not shifted to the right for the next six to 12 months, and then potentially having to have a surgery for that one as well,” she said. 

As part of Dilly’s treatment, Macke rubs the affected leg to break up the tension and adhesions in the muscles surrounding the hip joint. She also stretches and moves the joint to ensure that Dilly strengthens her leg with a full range of motion. 

“I want her to strengthen within full range,” she said. “If I jump straight to strengthening, then she’s kind of just strengthening within a limited range.” 

Macke also treats Dilly through strength exercises, such as making her stand up from sitting, holding a stand without her back right leg, and moving through cones. 

Macke learned a lot of these exercises from her previous career as a physical therapist working with elderly people. After surgery, for both humans and dogs, the muscles are weaker. It is important not to push the patient too hard right away, as that muscle is still trying to grow back. 

“We don’t want to force them to do the motion because that’s not good for joints either,” she said. 

In order to get Dilly to do the movements, Macke uses certain neurodevelopmental techniques, such as lightly pinching or tickling, to stimulate her into moving. Macke will sometimes tickle or lightly pinch Dilly in order to get her to stand up. 

A trained veterinarian or doctor can also teach the dog owner how to help their pet through the exercises by themselves. Macke takes the time to show the owner what to look for as well as daily, 20-minute exercises that they can do it to their dog alone. 

“That’s the big thing that is our goal in physical therapy is that, like in a human sense, we teach people what to do, what exercises to do because we know that one day a week is not good enough,” she said. 

Overall, Macke said a lot of dogs can benefit from physical therapy, before and after medical intervention. What is common in human practice is overlooked in dogs. Physical therapy during the road to recovery is equally as important in pets as it is in humans. 

“Anytime it’s a musculoskeletal or neurologic injury, (the dog) can benefit from physical therapy,” she said. 

Physical therapy is useful for muscle rehabilitation, but exercise is important for the dog’s recovery as well. Swimming is an exercise that can improve muscular function without significant weight-bearing, according to Galles. 

Suzanne Border owns FitCanine in Lincoln, where she swims dogs for exercise in a small pool. Many animals could benefit from swimming, such as cats and horses, but Border only works with dogs. Underwater treadmill therapy is more often used for rehabilitation after surgery, but swimming can be beneficial as a safe way to exercise. Swimming sessions without a treadmill will usually cost about $20-$45 per session.

Border has been swimming dogs as a form of exercise for 19 years. Swimming is especially helpful in improving endurance and supporting weight loss, she said.  

Border has helped one dog lose 21.6 pounds by swimming and hopes to get the dog to lose 21 more pounds by the summer to reach its target weight.

Swimming does not usually help injuries or increase strength, according to Macke. 

“In terms of strength, what we know from the human research, is that you need gravity resistance land-based exercise,” Macke said. “If I wanted to bulk up, and get more muscle mass and get more stable joints – get stronger – I wouldn’t go swimming, right? You’d have to go to the gym and lift weights. And it’s the same thing with them.”

However, while Border agrees that swimming is not a form of therapy, she argues that swimming is also way to build both strength and endurance in dogs. 

“The best part of swimming is it causes them to open up their frame and they access some of the core muscles that they don’t get into when walking,” she said.  

Swimming is not a functional exercise, Macke said, meaning it does not stimulate muscles used in every-day movements like running, playing or jumping onto the bed. 

Border is self-taught and learned how to swim dogs by taking what she knew from training show horses. She started FitCanine in 2009 and has had regular customers since. 

She works with many dogs who have been swimming with her for several years, she said. 

“For a lot of people it has turned out to be a long-term routine,” she said. “And it’s wonderful that they can do that.” 

For 10-year-old French bulldog Penelope, swimming has helped her avoid pain in her hind legs. Her owner, Ryan Gratopp, was worried that she would lose the use of her back two legs as she got older, but since she started swimming, he has seen a lot of improvement.

“The past four to five weeks have made a huge difference in her mobility and her stamina, her strength, her ability to walk,” he said. 

Penelope had a similar issue to Dilly after injuring her back leg. She was overcompensating by limping and now has very uneven hind muscles. Swimming can help rebuild muscle in the unused leg, according to Border. 

“We’re trying to even that dog out so it can go and be a dog for the rest of its life and it doesn’t have to limp around,” she said.

Border said that with the right nutrition and exercise, dogs will live well past their life expectancy. Swimming is one way to keep dogs moving through the older years. 

“People’s views of elderly dogs has changed,” she said. “If you let them lie around they’re going to die.” 

Besides physical therapy and laser treatments, acupuncture is another way to treat dogs post surgery. Dr. Hank Cerny is the only certified animal acupuncturist chiropractor at Yankee Hill Veterinary Clinic. Canine acupuncture treatments typically cost $65-$120, depending on the size of the dog, according to

Cerny usually works with dogs, but has also treated cats, small rodents and even snakes with acupuncture. He studied a Chinese tradition of acupuncture that deals with the balancing and flow of energy. 

Each needle point can aid in a different way, and although the points can sometimes shift, they are generally in the same spot on every dog. The needles usually stay in the dog for 15 minutes but will fall out if it is a particularly sensitive area.  

Besides the angles in which the needles must enter the dog, this canine acupuncture is very similar to human treatment, Cerny said. 

 The needles he uses are small and flimsy. Typically, he administers this treatment twice a month to dogs, though it can change patient to patient.

Cerny focuses on loosening up the areas and encouraging movement.

“You’re feeling for areas that are stuck, and you’re getting motion back, that’s what you’re trying to do,” he said.

Acupuncture can help with a wide variety of things from pain and inflammation to kidney and liver disease, Cerny said. It restores movement and mobility in joints and tendons that are tight as well. 

“For the kidneys, it doesn’t mean you’re going to fix them completely, but you can improve them drastically with acupuncture,” he said.

For the 15-year-old dog Bindy, Cerny’s acupuncture treatments have helped her drastically improve from her kidney issues. Her owners have seen improvements in her range of motion since the beginning of the treatments, Cerny said. 

Cerny pairs the acupuncture with chiropractic physical therapy and laser treatment. He also recommends swimming as a way to exercise and strengthen the sore muscles. 

“If you have pain in your knee and you take this pill, yeah it’ll help your pain but motion is what you need to do. You need to keep your muscle strong,” he said. 

Galles said that acupuncture is usually paired with other treatments in this way because it is not very effective on its own. 

“Acupuncture in animals is rarely used alone, as we do not always see reliable or significant results from its use,” she said. 

Both Galles and Macke agree that any sort of therapy or rehabilitation should be done under the supervision of a trained veterinarian. 

Macke said many forms of rehabilitation can help a postoperative dog, but it is important to receive help from a professional. 

“I think what’s important is not just the actual exercise, but the skill of the person providing.”

I am a senior journalism and French major at the University of Nebraska Lincoln.