Feline Physical Therapy, Take 2

Hello, friends!

After our neurologist appointment a while back, we went to find a place to do some more physical therapy to work on getting Feta Cat’s immobile hind leg a bit more mobile again. This time we headed to Aqua Dogs (& cats!), where they have more equipment (such as a pool and underwater treadmill) to work with.

I didn’t get any pictures (once again, it was a very hands-on session), but we got a tentative diagnosis. Basically, as best I understand it, her nerves are not firing correctly. The wiring has gotten a bit… off. So Feta says, “Hey leg, let’s extend!” and the leg pulls up towards her stomach. Basically, her hamstrings are on strike and not really responding to any calls for action. This problem is compounded by very weak abdominal muscles. Put these together, and we can see why she “scoots.”

This time, in addition to stretches (which were a bit more forceful than we were doing before, sorry, Feta) we tried electrical muscle stimulation, or e-stim therapy. Nerves transmit signals using electricity, so what makes a muscle move is really an electrical current. E-stim therapy uses this principle to make a particular muscle contract. We place two electrodes (to complete the circuit), then the machine sends a pulse of electricity through the electrodes that tells the muscle to contract. This way we’re working the muscle even if the nerves are a little bit out to lunch.

Feta doesn’t seem to mind this treatment at all – in fact, she thinks the electrodes are the best cat toy EVER.

This is what it looks like when her leg starts going.

(You’ll note the bare strip – we had to shave her bum so that the electrodes could get good skin contact. Sorry, Feta!)

We are renting an e-stim machine from the PT office, and are doing the e-stim twice a day for 5 minutes at a time. We are also working on the “scrunching” stretches to get her stifle bending, as well as stretching her leg out behind her to get the hip and muscles going. Finally, we’re practicing her weight-bearing / standing, with particular attention on good posture to activate the abs and light “bouncing” pressure to encourage bend and flexibility. I will try to get some video of this if I can get my phone tripod to work!

The hope is with all of these exercises we can “re-train” the nerves in her leg to work the way they are supposed to. By practicing the correct way of moving and stretching, we may be able to restore those wonky or forgotten neural pathways and get some real movement back in her leg!

If we manage to get that far, we will want to get her on the underwater treadmill. So, her water desensitization continues, though it is taking a lesser role while we focus on our other exercises. She is still on a fairly strict diet, but with all this torture physical therapy she needs a lot of rewards, and there’s only so much kibble she can eat! (The cat food bag suggests 1/2 cup per day, yikes.)

Despite all of this unpleasantness, Feta Cat remains truly delightful, kind, and gentle. All in all, I think she is enjoying life, even if I make her do ouchy exercises and switched her to the “fat cat” kibble!

Reading up on horseback riding techniques in her spare time, apparently.


She really, really enjoys toilet paper roll rings.

A not-so-perfect circle?


“I haz box. Box is GOOD.”


This whole process is extremely time-consuming and very expensive, but darn if I don’t love this ridiculous cat. She’s had a rough road so far, and I’m glad I’m able to help her enjoy some of the finer things in life <3 (like cardboard boxes and toilet paper rolls!)

Feta Cat’s Water Training Continues

Armed with some great ideas from friends, I have started getting Feta over her fear of the tub!

We started trying the clicker training, but it was getting very complicated with the placement of the treats and cat and clicker, and she was very nervous about the whole thing. So, to get her feeling more comfortable, we turned to the one thing that always makes her happy: meals!

First, I put a rubber-backed rug in the tub so she wouldn’t slip. Then, we started off feeding her with a tiny trickle of water going from the faucet.

So far, so good! Except for that leg…

What I love about this approach is that she slides the bowl forward when she eats, so she is naturally pushing HERSELF closer and closer to the water. I am there the whole time praising her and petting her, also.

“Ain’t no bathtub wet enough to keep me away from you, breakfast!”

After a couple of repetitions of that, we increased the faucet flow a little bit. Now it was splashing up a little bit of spray, which ended up getting on Feta’s face as she ate. This was probably increasing the difficulty too fast, as Feta paused a few times to turn around and glare at me. So we dialed it back a little from there. (We want to stay at the edges of her comfort zone, but still firmly within them!)

“Seriously, human???”

Since the noise and spray were not a big hit with the cat, and on the advice of friends who pointed out that standing water would likely be less scary AND more applicable to the underwater treadmill, we moved on to stopping up the tub a bit. First, we started with only a little bit of standing water, so she could eat without getting wet at all. This was easy! We’ve been increasing it gradually since then, and she’s being so brave! Check her out today:

Not so sure about this…
“Ugh, wet paws! But also… food. Hmm.”
“Well. Food is worth Wet. I’m going for it!”


I think we may introduce clicker training again soon, to get her working on stepping into the water on purpose. But for now, for desensitization, this is working great! I am working hard to make sure that she’s not too stressed during the process, and whenever she asks to leave the tub, I take her out and bring her downstairs and turn on her space heater. The whole endeavor is a huge pain in the neck, but she’s had so much trauma already, if water will help her fix her leg then we are going to do it, but also make it a positive experience!

I’m very proud of this brave and patient kitty <3

Clicker Training for Rehab Behaviors!

Feta Cat is continuing along about as before. Increasing her dose of Gabapentin has reduced her toe-biting tendencies (thank goodness), and we are continuing to work on heat therapy (quality time with a heating pad) and massage/stretching to loosen up her gimpy back leg.

Talking to the fabulous Nurse Jenn, who helped with Feta’s initial PT appointment, we are indeed going to try “hydrotherapy” with Miss Feta. In other words, I want to teach my cat to swim.

Like most cats, Feta is NOT a fan of water. So, rather than cart her off to PT and completely traumatize her by introducing her to the whole idea all of a sudden (in a loud and dog-smelling environment, no less!), I am working to train her to be less afraid of water and, if possible, associate water with Good Things Happening.

When working with fear and anxiety, I believe very strongly in using positive-only training methods. (I think corrections can be great if used carefully and kindly in certain situations, but areย  counter-productive when dealing with fear-related behaviors, where the key is to cultivate calm and trust.)

So, since there’s not a ton out there on training cats specifically, I’m primarily brushing up on dog training techniques! In particular, I want to train Feta to accept water (and eventually swim) by using clicker training.

If you’re new to the idea of clicker training, this is a silly but informative video explaining what it is and how it works:

This is a great tutorial on how to get started (and using a cat, no less!):

For more detail on how to be the most effective clicker trainer, this video is great (if not especially exciting!):

This video is specific to training to overcome fears. I haven’t figured out the exact protocol I’ll use with the cat + water, but am going to do something similar to this. I think first approaching the bathtub bravely, then being calm in the dry bathtub, then being calm with a trickle of water, etc. I sure am glad this cat is food-motivated!

What I love about positive reinforcement (like clicker training) is that you can really get it to work with any animal! Modern zoos use clicker training to teach their animals how to do things that are needed for their “doctor visits.” I love this video, as an example:

Some people say, “You can’t train cats!” I say, nonsense, if you can train a rhino, you can train a cat!

Do any of you have any training tips to share?

The Cheesecat Scoots Along

Not too much new with Feta Cat lately! The gabapentin is doing a great job at reducing her toe-biting, and we’re continuing to do her leg-relaxation therapy.

Every morning we do the same routine.

Step one: Obtain cat, heating pad, and soft blanket. Put blanket on lap, followed by cat. Put heating pad under Gimpy Leg.

“Would you hurry up? I require additional coziness.”

Step 2: Wrap heating pad over Gimpy Leg, taking extra care to cover Super Stiff Hip.

“Getting warmer. Literally. But where is my BLANKET?”

Step 3: Comfortably wrap heating pad-wrapped cat in soft fuzzy cat blanket. Make sure you have a good secure wrap around the neck to act as a head rest, or else cat will be Seriously Displeased.

“Okay, I guess this is satisfactory.”

Step 4: Say admiring things like, “You’re such a good kitty!” and, “You are soooo pretty!” while cat activates Purr, followed by Nap.

“I’m totally awake. I.. um… ….zzZZZzzZZzzz”

After about 20 minutes of this, we commence with her leg-stretching exercises, which she likes SIGNIFICANTLY less. Poor baby. I hate causing her discomfort and pain without truly being able to explain why I’m doing it, but I do think at least on some level she understands that I mean well, since she hasn’t tried to bite or scratch me. (She does periodically put her paw on my hand or face and try to push me away while meowing, though!)

“I guess, in balance, my adopted life is okay.”

When I’m not warming or torturing her, she’s having a lot of fun playing with her toys and being her crazy little weirdo self.



“I smells the catnips! WANTS IT!”


“Ferocious Box Kitty prepares to pounce on…. oh, hey! Did someone leave a kibble here?! SCORE!!!!”

The last picture may or may not include the silly cute flowery collar I bought her because WHY NOT. I think it looks fetching! And, as per usual, she couldn’t care less! ๐Ÿ˜€

Next on our agenda is getting Feta some more physical therapy – maybe with professional help we can get her leg a little more un-stuck. Eventually this is going to include training her to like (or at least) accept water, so we can try some swimming. Stay tuned!

Learning About Lasers (data nerds, read on)

Feta Cat’s neurologist suggested that we need to get her leg muscles to relax and loosen up before she will be able to regain strength and, hopefully, use of her remaining back leg.

Among many possible treatments, she suggested “cold laser therapy.” Being a pet owner on a budget, I wanted to know: is “cold laser” therapy supported by legitimate scientific studies, or is it likely to be one more form of medical snake oil marketed to people desperate to feel they are “doing something” to help their pets? (Or, for that matter, themselves – it’s a therapy used in people, too!) Unless it’s quite likely to work, I do not want to pay for it – the money could be better spent on her medication, wheelchair, food, etc.!

Disclaimer: I am not a veterinarian. I do not even play one on TV! I also know that there are important differences between humans and other mammals (and between different species of animals more generally) that cause problems when trying to apply medical findings from one animal to care for another. This is simply a lay-person’s internet research to get a rough idea whether a certain treatment is quackery or may have some therapeutic merit.

Googling on these sorts of topics can be tricky, because a lot of the sources that come up are unreliable – e.g., companies trying to sell you whatever it is you’re researching. So, we approach this carefully.

Also, fair warning: some of the papers do perform research on animals. If this is upsetting for you to read about, I recommend skipping this post!

That said, onwards…

First off, what is “low-level laser therapy” (LLLT) and how does it work? This paper does a great job of explaining the more technical details, though I don’t trust its objectivity in summarizing the data! So, now that we know more or less what it is, let’s see if we can figure out whether or not it works.

One of the best things to do when starting a new research topic is to look for trustworthy research summaries or meta-analyses.

In the case of laser therapy, one place to look is human insurance companies – they tend to be pretty conservative when it comes to treatment and are reluctant to pay for anything that isn’t backed by a large amount of compelling research. On this note, Aetna does not reimburse for laser therapy, saying there is insufficient evidence of its effectiveness. In that statement, they cite a great deal of research to support their decision, and it is a thorough and well-researched summary. Fair enough!

Similarly, a private site devoted to thoroughly researching such claims agrees with Aetna, concluding, “At this writing, the bottom line appears to be that LLLT devices may bring about temporary relief of some types of pain, but there’s no reason to believe that they will influence the course of any ailment or are more effective than standard forms of heat delivery.” (Devicewatch.org, a division of Quackwatch.org)

Those summaries are discouraging, but don’t necessarily say that laser therapy is a scam, simply that there’s not sufficient evidence to draw any firm conclusions. In other words, there’s no significant proof that it does work, but there’s no significant proof that it doesn’t work, either.

With that in mind, I was interested to look at some of the individual research studies / papers.

So, let’s see what PubMed has to say about low-level laser therapy!

Again, we start with a meta-analysis (in other words, an analysis of a whole bunch of other analyses; a research summary).

This one concludes, “This meta-analysis presents evidence that LLLT is an effective treatment modality to reduce pain in adult patients with musculoskeletal disorders. Adherence to WALT [World Association of Laser Therapy] dosage recommendations seems to enhance treatment effectiveness.” In other words, this summary suggests that laser therapy works, but works a lot better if you do it as recommended. Fair enough!

This paper – more of a summary than a meta-analysis, I think, though there’s a paywall for the full paper – also suggests that LLLT can be effective for controlling nerve pain. However, this paper rightly points out that there is a lot of variation in treatment protocols, so more work is needed to determine which wavelengths, treatment frequencies, etc. are the most effective.

Of note: just because something is a meta-analysis doesn’t mean it’s “right” or unbiased. All sorts of decisions go into a summary or meta-analysis, from which studies to include to how to weight the findings. As a result, we sometimes see contradicting meta-analyses on the same topic! Still, going for a summary of a lot of different researchers’ work is more likely to be helpful than relying on one single paper.

Next I wanted to look at a couple of sample individual papers.

These were not selected systematically, but were just ones that seemed relevant, recent, and came up from my first search of PubMed.

This study suggests that laser therapy can reduce pain sensitivity and decrease inflammation in rats that have constriction-related nerve pain (you can think of it as animal sciatica – something is pinching the nerves and causing a lot of pain). For our needs, and especially for mine with Feta and Rascal’s intervertebrate disc compression, this is very relevant!

Similarly, this study found that LLLT improved regeneration of the sciatic nerve as well as the animals’ ability to move normally.

Also note: beware the “file drawer effect”!

What do I mean by this? Basically, scientists are (unfairly, in my opinion) rewarded much more for studies that find a significant effect of something. This is for a number of reasons. You can imagine that you are trying to prove that eating sticks of butter leads to gaining weight. All you need is one good study that DOES show an effect – people who eat sticks of butter gain more weight – to suggest that an effect is there. To think of it another way, all you have to do is see Bigfoot one time, up-close and personal, with very little doubt that it is ACTUALLY Bigfoot, and you’re a Bigfoot Believer!

When research shows a null result, however – essentially, you try one thing and it doesn’t seem to work – there are a million reasons why that could be. If you do a study and find that people who eat sticks of butter DON’T gain more weight, does that mean that butter isn’t fattening? No, of course not. You could have measured poorly. You could have measured at the wrong time. You could have not controlled for some important other influence (what if the butter-eaters were also running marathons every day?). You can’t definitively prove the absence of something. If you go out into the woods for a month and do not see Bigfoot, does that mean he doesn’t exist? Not necessarily. You probably won’t see any snow leopards, either, but other people have some very convincing evidence that snow leopards are, in fact, a thing.

So, when scientists do not find evidence of a thing, people don’t usually get very excited. It’s generally harder to get the research published, and it’s not very beneficial to the scientist’s career. Since it takes a lot of time and effort to get something published, these “null result” studies often go unreported, hanging out in the “file drawer” for a “maybe some day I’ll get around to it” type of publication. In other words, we’re more likely to see papers that do show an effect compared to those that don’t show the effect, but that could be largely due to publication bias. Those “null effect studies” may exist, just not be published.

So, what’s the laser verdict?

Overall, there seems to be very little consensus on the “best” laser dosage and wavelength to use. This makes it difficult to compare across studies, since every one is doing something a little different!

My take-home is essentially: laser therapy may be helpful, but it’s far from guaranteed to work.

So, my totally lay person advice? If you can afford it, go for it. It won’t hurt and may help! However, if you’re on a tight budget, you may be able to skip the laser therapy for some quality at-home time with a heating pad, and save the money for other treatments that are more certain to be effective (e.g., time swimming, physical therapy exercises, medicine, etc.). This is, obviously, something to talk over with your vet and/or veterinary physical therapist! They may have their own biases – medical professionals are people, too, and are just as likely as the rest of us to do things like selectively remember what supports their beliefs while forgetting what contradicts them – but if you have someone whom you trust to help your pet, it’s always a good idea to talk to them honestly about your concerns as well as your finances!

Hope this long diatribe has been helpful – either for assisting others in making an informed decision about cold laser therapy or, more likely, for helping some folks fall asleep ๐Ÿ˜€