On the drive home from rehab, Hank rides in the back of the Outback wrapped in two beach towels like a burrito, a little damp around the edges, completely asleep, snoring loud enough that I turn the radio up. That's after 15 minutes of walking in a tank of warm water, and it wipes him out more than anything he's done since surgery.
His surgeon prescribed six underwater treadmill sessions as part of his recovery from the TPLO on January 8. We've done three so far, on Mondays (one of my days off), at a rehab practice in the north metro. Here's what it looks like, what it costs and how our insurance handles it.
What a session looks like
The treadmill sits inside a glass-sided tank about the size of a small walk-in shower. Hank walks in through a door at one end, the door seals, and warm water fills up from the bottom until it's around his hips. Then the belt starts, slowly, and he walks. The therapist stands beside the tank watching how he places his left back foot, adjusting the speed, and calling to him when he tries to hop instead of step.
The way it was explained to us, the water holds up some of his weight so he can walk with a more normal stride than he can on dry land, and the resistance makes the muscles work harder. His left thigh got visibly thinner in the weeks after the injury, and building that muscle back is a big part of the next couple of months.
Each visit is about 45 minutes in the building: a weigh-in (72 pounds at his second session, which is a separate conversation), a quick look at the incision and how he's moving, a few minutes of stretching on a mat, 15 to 20 minutes in the tank, and then the water drains, he gets toweled off and blown dry with a big dryer he does not approve of, and we head home. At the first session he stood frozen in the tank for a full minute like he'd been betrayed. By the second he'd figured out there were treats waiting at the far end of the glass.
The cost
Each session is $65. Six sessions comes to $390. It's a flat fee per visit at this practice, and the initial evaluation was folded into the first session, which I appreciated. Not every rehab practice does it that way, so if you're pricing this out, it's worth asking whether there's a separate evaluation fee.
I put each visit on the card at checkout and submit it as a claim that evening, with the invoice and the therapist's notes.
How our policy handles rehab
Hank's policy covers rehab and hydrotherapy when a vet prescribes it as treatment for a covered condition. The word "prescribed" matters. Before the first session, I checked that the surgeon's discharge notes actually said "underwater treadmill, six sessions," and asked the rehab practice to keep the referral in their records. Without that paper trail, rehab can look like optional fitness to an insurer. From what I've seen at work, some policies don't cover it at all, and some only cover it with an add-on.
We met our $500 deductible with the surgery claim in January, so these sessions are reimbursed at 90 percent, which is $58.50 back per visit. Across all six, that should be $351 back and $39 out of our pocket for the whole course.
Does it seem worth it?
With insurance covering most of it, the money question is easy for us. Without insurance, $390 is a real number, and I'd want to think hard about it. Here's what I've seen with my own eyes in three weeks: Hank is putting more weight on the leg, his stride looks more even, and he comes home tired in a calm, sleepy way instead of pacing his pen all evening. On crate rest, that last part alone is worth a lot to the people living with him.
Would he have gotten to the same place without the tank? Maybe. I don't know, and I'm not the one to say. Whether rehab makes sense for a particular dog is a question for that dog's surgeon or a certified rehab practitioner, and the answer depends on the dog, the surgery and what's within driving distance.
Three sessions left. The last one lands in early March, after his eight-week X-rays. The therapist warned me he might be bored of the tank by then. I told her she hasn't met Hank, who has never once been bored of anything involving water and a treat at the end.
