If you think your pet has a respiratory condition that might benefit from coupage, seek advice as soon as possible from your veterinary surgeon or veterinary physiotherapist.
Coupage is a form of chest physiotherapy that when performed correctly can be beneficial in loosening and removing excess secretions from the lungs. Many respiratory conditions result in an accumulation of secretions (also called mucous, phlegm, sputum) within the lungs that the patient cannot easily clear. This can result in difficulty breathing, poor gas exchange, collapse of lung segments and infection.
The lungs naturally produce mucous as part of their natural defence mechanism. When there is a chest infection, and occasionally with other conditions, the mucous increases and becomes thick and sticky. In the normal situation, these secretions are removed by coughing, but if the animal has lung disease or weakness, this is not always possible. The use of antibiotics can control any infection but they do not remove the secretions. Some will be absorbed naturally into the body but some will remain within the lungs.
Excess secretions provide a good environment for infection to develop as well as causing breathing difficulties. They block the airways and prevent the passage of oxygen from the inspired air to the blood stream, so having a detrimental effect on gas exchange. It is important therefore to remove the secretions to allow more effective and efficient breathing and increase the amount of oxygen getting into the body.
It is certainly possible for you to perform coupage on your pet as long as you have received training from an appropriately qualified veterinary professional. Coupage is a specialised technique. However, veterinary professionals will be adequately trained to perform it. In particular, chartered physiotherapists will have undergone extensive training in all chest physiotherapy techniques.
In many cases, coupage is more effective when used in combination with other techniques such as postural drainage and vibrations, and if appropriate you will also be advised about these.
- Hands should be formed into a ‘cup’ shape (with your fingers and thumb held closely together).
- Keeping your wrists loose you should flex and extend them whilst you gently pat your pet’s chest wall in a rhythmical manner. Your hands should pat the chest alternately, moving around the area being treated. Do not use too much force when performing this technique as the momentum developed in your wrists is sufficient, and too much force can be uncomfortable and may be detrimental to your pet.
- The coupage technique sends shock waves to the lungs which loosen the secretions and allow their transfer from the small airways to the larger airways where they can be cleared by coughing.
- Coupage can be performed using a one-handed or two handed technique and at a slow or fast speed, but you should be taught the correct technique for your pet by your veterinary professional.
- The technique should be performed through a sheet or thin towel to prevent too much stimulation to the skin. If your pet is small you can perform the same technique with 2 or 3 fingers from one hand.
- In most cases, coupage should be continued for 30 seconds to one minute. You should perform the technique continually during the advised time period.
- The hands are positioned on the chest wall over the affected part of the lung, and the chest is vibrated. During each vibration the hands gradually move towards the head end.
- Vibrations are only carried out whilst your pet is breathing out (during the expiration phase), so each vibration lasts for approximately 3-6 seconds.
- Generally 4-6 repetitions are carried out before allowing the animal a short rest period and then resuming coupage.
Postural drainage involves getting your pet into the best position to allow secretions to drain from the affected part of the lung. There are positions appropriate to all parts of the lung, and if appropriate you will be taught the postions that should be adopted for your pet.
When the techniques of coupage, vibrations and postural drainage are used in combination, the optimal chest physiotherapy regime is as follows:
Your pet should be positioned in its postural drainage position for 10-20 minutes, during which time the following should be carried out as in the example below:
- Coupage for 30 seconds to 1 minute
- Vibrations for 4-6 expirations
- Rest period of 1-2 minutes to allow drainage of the now loosened secretions
- Repeat several times over the 10-20 minute period*
*The number of repetitions, times, etc. will be determined by your veterinary professional (treatment is individual for the patient).
Coupage dislodges the secretions, vibrations move them towards the large airways, and the postural drainage position then allows the secretions to drain during the rest periods. Your pet may cough during its treatment, thereby clearing some of the mucous from its airways. It is common however for animals not to cough during treatment, but to cough 15-20 minutes later once they are walking around. Sometimes the secretions are swallowed rather than being coughed up, but at least they are out of the lungs.
Chest physiotherapy should never be done straight after a meal or drink, and you should wait at least one hour before starting the treatment.
Chest physiotherapy treatment involving coupage, vibrations and postural drainage should only be carried out when excessive secretions are known to be present. This may be once a day or it may be 4-5 times a day, but you will be advised on this. It is often more beneficial to do it after periods of rest (e.g. first thing in the morning) when the animal has been relaxing and the secretions have been draining naturally.
Performing these techniques on animals that have no secretions can be detrimental to that animal’s overall condition. Your pet should therefore be reassessed regularly during the treatment period, so you can receive updated guidance from your veterinary professional as to the appropriateness of continuing this therapy.