Respiratory physiotherapy methods in veterinary medicine: techniques, physiological rationale, and current evidence base

In the context of persistently high incidence of pneumonia in animals and the limited effectiveness of standard antimicrobial therapy, the search for safe non-pharmacological methods that accelerate resolution of the pathological process is becoming increasingly relevant. One promising area is respiratory physiotherapy, which includes manual and positional techniques aimed at improving mucociliary clearance, re-expanding lung tissue, and normalizing gas exchange. In human medicine, these methods have been used for decades, whereas their systematic study in veterinary practice has begun only in recent years. The aim of this review was to systematize information on respiratory physiotherapy techniques in small companion animals, their physiological rationale, and the current evidence base over the past 5–10 years. The article considers percussion and vibration, postural drainage, passive slow expiratory techniques, and cough stimulation. Data from prospective and randomized controlled studies conducted in dogs with pneumonia and airway fluid accumulation are summarized. The safety of the interventions has been confirmed; passive expiratory techniques have been shown to significantly increase the PaO₂/FiO₂ ratio and increase the proportion of days without oxygen support, whereas percussion-vibration protocols demonstrate a more modest but also favorable effect. The limitations of the current evidence base and prospects for standardizing approaches are outlined.