Topical Review Small Animal Massage Therapy: A Brief Review and Relevant Observations Maira Rezende Formenton, DMV, MSC a,b,c,n , Marco Aurélio Amador Pereira, DMV, MSC c , Denise Tabacchi Fantoni, DMV, PHD c Keywords: massage therapy dogs physiological effects pain a Fisioanimal Veterinary Rehabilitation Center, Bioethicus Institute, São Paulo, Brazil b Graduated in Massage Therapy at the Bergovist Institute, São Paulo, Brazil c Surgery Department, Veterinary School, São Paulo University, São Paulo, Brazil n Address reprint requests to Maria Rezende Formenton, DMV, MSC, Fisioanimal Veterinary Rehabilitation Center, Bioethicus Institute, Bergovist Institute, Surgery Department—Veterinary School, São Paulo, Brazil. E-mail: mairaformenton@gmail.com (M.R. Formenton) Massage therapy is becoming increasingly popular in human and animal physiotherapy and rehabil- itation. Wider application of the technique led to research efforts aimed at providing scientific support to anecdotal beneficial effects, particularly pain relief. Recent studies have shown that massage therapy alters dopamine and serotonin levels, decreases noradrenaline levels, and modulates the immune system. Psychological effects such as reduction of stress and anxiety, with improvement of depressive patients, have been reported in humans. This article set out to review the major aspects of massage therapy based on recent publications on the topic, and to extrapolate concepts and practical aspects described in human physiotherapy to the veterinary patient, particularly the applicability of different techniques in Small Animal Medicine. Indications of massage therapy in small animals include pain relief, orthopedic rehabilitation, Canine Sports Medicine, intensive care, and management of nonspecific edema. Techniques described in this article were originally intended for use in humans and scientific data supporting anecdotal, beneficial effects in domestic animals are still lacking; this fruitful area for research is therefore open to veterinary professionals. & 2017 Elsevier Inc. All rights reserved. Introduction In a broader sense, massage therapy can be defined as the systematic manipulation of soft tissues using rhythmic pressure and strokes to prevent injuries, develop, maintain and rehabilitate function, and to promote pain relief. 1 Massage therapy is among the first treatment modalities ever described, with the oldest references to the technique dating from 2500 BC. Although first described in China, ancient Greeks, Indians and Romans have adopted massage therapy. Defined by Hippo- crates as “the art of rubbing,” the therapy was specifically indicated for treatment of sports and war injuries, gaining great popularity in the Roman Empire. 2,3 Following a decadence period during the Middle Ages, the publication of the “Du Massage” treatise in 1863 gave rise to the modern massage therapy era; this treatise introduced the categorization and standardization of the technique that are the basis of the terminology and method- ology employed to this day. 4 Massage therapy is enjoying increasing popularity in Veteri- nary Medicine as a valuable ancillary treatment, particularly in Equine Sports Medicine, and is thought to improve performance in athletic horses. 5,6 Increased target tissue blood flow and lactate clearance have been demonstrated in recent studies, suggesting improved postexercise recovery. 7 The benefits of massage therapy are not limited to Sports Medicine and include reduction of muscle tension and soreness, relief of postexercise muscle spasms, increased flexibility and range of motion, and improved general well-being; beneficial effects on myofascial pain relief and trigger point treatment have been highlighted. 6,8 Literature concerning small animals is scarce. However, tech- niques originally described for humans and horses can easily be extrapolated to these patients and are thought to induce similar physiological responses. 9 Major indications in dogs and cats include control of postoperative swelling and edema, support to intensive care patients, osteoarthritis and orthopedic rehabilita- tion, chronic pain, palliative care of geriatric and cancer patients, treatment of secondary muscle injuries, and Canine Sports Med- icine. 9-11 Massage therapy plays an important role in treatment of musculoskeletal conditions in humans. 12 The technique is thought to be safe in the hands of expert professionals and has few contraindications. Massage therapy should be avoided in areas of skin lesions, during the acute stage of viral and other infectious diseases, and in cases presenting with shock and fever; also, it should be employed with caution in cancer patients and in patients suffering from acute inflammatory conditions (Table 1). 11 Despite the well- explored calming effects of massage therapy, animals manifesting excessive reaction to touch or aggressive, particularly aggressive cats, are not amenable to treatment with this therapeutic modal- ity; rather, alternative therapies should be employed, at least initially, and massage therapy reintroduced following adaptation and improvement of antisocial behavior. Massage therapy is a widely used ancillary treatment modality in Small Animals Medicine; still, scientific evidence of anecdotal benefits observed in clinical practice is lacking, which should encourage research efforts in the field (RAMEY; TIIDUS, 2002). 13 This article reviews the fundamentals and benefits of massage therapy, with special focus on small animal applicability. It is http://dx.doi.org/10.1053/j.tcam.2017.10.001 1527-3369 & 2017 Topics in Companion Animal Medicine. Published by Elsevier Inc. Topics in Compan An Med ] (2017) ]]]–]]]