Front Matter

140 Canine Sports Medicine and Rehabilitation

Cold packs can also be made in the clinic or
at the patient’s home with crushed ice or a slush
created by freezing a combination of three
parts water to one part alcohol in a sealable
bag. A thin damp towel should be placed
between the cold pack and the patient unless
the hair coat is thick.
For smaller treatment areas or body parts
that are not easily covered with a cold pack, or
when working with smaller patients, ice mas­
sage is useful (Figure 7.5). It can be particularly
effective prior to manual therapy techniques
that may be uncomfortable. Freezing water in
a paper cup provides an easy means for ice
massage as the practitioner’s hand is protected
from the cold, and the paper can be torn away
as the ice melts. Ice popsicles can also be made

by placing a handle, such as a tongue depres­

sor, into the water before freezing.

The depth of the target tissue, ability of

surrounding tissues to conduct heat (Bierman

& Friedlander, 1940; Petrofsky & Laymon,

2009), and temperature of the cooling agent

relative to the target tissue should be consid­

ered when determining the duration of cold

application (Figure  7.6). Deeper tissues and

animals with more adipose tissue, a poor con­

ductor of heat, will require additional treat­

ment time (Otte et  al., 2002; Merrick et al.,

2003a; Petrofsky & Laymon, 2009). Longer

treatment time will also likely be required for

dogs with thicker hair coats. The general rec­

ommendation for treatment duration of ice

massage is 5 to 10 minutes (Sharma & Noohu,

2014). Cold pack treatment time can range

from 10 to 60 minutes (Otte et al., 2002),

depending largely on the intensity of the cold

modality as well as patient tolerance. In gen­

eral, a minimum of 20 minutes of cold pack

application time for target tissues at a depth

of 1 cm or more has been recommended for

canine patients (Akgun et al., 2004; Millard

et al., 2013). Given the time required to achieve

therapeutic cooling with a cold pack, the

author (K.N.) frequently requests that clients

with outpatients perform cryotherapy treat­

ments in the car or at home rather than using

in‐clinic treatment time. This may vary, how­

ever, depending on the goal of the cryother­

apy treatment or the rehabilitation practice

setting (inpatient vs outpatient).

Figure 7.4 Compressive cryotherapy units offer
different wraps to address treatment of various body
parts. Game Ready wrap on a dog’s stifle. Source: Image
courtesy of Game Ready. Reproduced with permission
of Game Ready.

Figure 7.5 Water is frozen in a paper cup to provide ice
massage cryotherapy to a smaller patient.

Muscle (at 4cm)

Subcutaneous

Skin

30

38

32

27

20

7

60

Time (minutes)

Temperature (°C)

90 120

Figure 7.6 Rate of temperature change at different tissue

depths during cryotherapy to the human calf. Source:

Adapted from Bierman & Friedlander, 1940.