Do you, or have you, taken your dog to physical therapy / rehabilitation?

[Stella]

I have been a 'human' Physiotherapist for 16 years and a canine rehab professional for five years. I am based in Ontario, Canada and, as is also currently happening in California, the veterinary college here is trying to prevent anyone except Veterinarians from being involved in the care of pets. I'm attaching a copy of the info I sent out to my clients. If you are willing, please go to the OVC website and complete the survey, or email them your thoughts if, like me, you believe you don't have to be a veterinarian to provide rehabilitation. Iypt would also be an idea to contact your local vet college / governing body with similar thoughts, it could be your province / state that is affected next. Please help me to keep non-veterinarian rehab professionals involved in the care of your pet.


The College of Veterinarians of Ontario (CVO) is proposing changes to the Veterinarians Scope of Practice, the changes involve the inclusion of Restricted Act that can only be carried out by a Veterinarian. So far so good, right? Unfortunately not, included in these Restricted Acts are many of the skills offered to you by a suitably qualified rehabilitation professional. If these Acts are passed, it will become illegal for anyone other than a Veterinarian to perform tasks such as:

- Communicating a diagnosis, identifying a disorder or dysfunction
- Performing an assessment to determine the fitness or soundness of an animal
- Performing a procedure below the dermis (this includes acupuncture)
- Applying or ordering the application of a form of energy (this includes low level laser)

These rulings will also have implications on the tasks that can be performed by other canine professionals, including trainers, groomers, dentists, massage therapists and chiropractors.

How can you help? I am attaching a letter of response from the Animal Rehabilitation Division of the Canadian Physiotherapy Association, please read this letter the fully understand the situation. Feel free to print and send this letter to the CVO, or to use it to guide your own letter. There is also a survey to complete on the CVO website, again you can use the letter as a guide with your responses.

http://caninefitness.com/index.php?pid=63

http://cvo.org/For-the-Public/Public-Consultations/Scope-of-Practic...

Currently, canine rehabilitation is an unregulated profession in Ontario. I do believe that changes need to be made to make sure that those practicing canine rehabilitation are suitably qualified, but to eliminate all except those that are veterinarians is not the way to go.

Please share thiswith all of your animal owning friends, also feel free to lobby your veterinarian to ask that they support the inclusion of non-veterinarian rehabilitation practitioners in the Restricted Acts.

[Stella]

It was determined through manual clinical testing, and he responded well to manual therapy treatment and exercises specifically aimed at treating that condition :)

[Karen, Jasper and Jackdoodle]

I don't know what "manual clinical testing" means, but if it means no MRI was done, with all due respect, that would simply not be acceptable to me. 

What exact disc is it? Is it herniated or ruptured? Is there nerve compression? Is there inflammation? These are things that I think must be known definitively before any treatment can be decided upon or implemented. You can't even do laser therapy properly without knowing which exact disc(s) is involved.  Nerve tissue doesn't regenerate, and nerve damage is permanent. We need to know exactly what we are dealing with before we start treating it. Some cancers and tumors can cause symptoms which appear to be orthopedic issues, in both dogs and humans. And in many cases, JD's included, the ideal treatment is surgery, which would have been a permanent solution for him instead of years of therapy and pain. 

And what about medication? I've had shoulder, knee and back injuries, all of which required medication in the form of anti-inflammatories (either oral and injected), analgesics, and/or muscle relaxants before physical therapy could even be implemented. I know that is true of many if not most orthopedic issues and injuries in both humans and animals. In the U.S., you need an MD, DDS, or DVM degree to prescribe medication. 

[Stella]

The dog did get pain killers and anti inflammatories after we determined the problem was his back and not his abdomen!

Manual testing involves palpating and mobilization of the joints through the spine (feeling how well they move, NOT manipulating them). A physiotherapist can feel how well the joints move and can note pain reactions at each level. We can also perform tests for neurological function. If there are concerns, then I send the dog back to the vet for further investigation. However, he responded well to manual therapy, traction and exercises so there was no need for imaging.

[Haley, Yeti, and Phin]

This is so off topic but my best friend just brought her year and a half old German shepherd to the vet for the 3rd time for a hind leg problem. The first time it happened was about 6-8 months ago. They figured he just hurt it running or something so they brought him into the vet and got anti inflammatory medicine for him. After the medicine and some R&R he was feeling better. 4ish months ago he started limping on that leg again and the vet again just said it was a strained leg, gave them anti inflammatory medicine and sent them on their way. Last week bear started limping and then eventually wouldn't put any pressure on that same leg. They gave them anti inflamitories and said if this doesn't work they will do an x ray to see if his acl is sprained. They said the x rays aren't always accurate though so they might never know what's wrong without surgery. Does this sound right to you? I feel like something is really off here. I suggested maybe a second opinion however her husband is concivnced he is okay.

[Karen, Jasper and Jackdoodle]

Soft tissue injuries like sprains or strains will not show up on X-ray, so that part is correct. However, they will show up on an MRI. Unfortunately, most people don't want to do that, because it's done under general anesthetic and it costs thousands. 

It sounds "off" to me that after two rounds of meds & rest, and no real resolution, anyone would do that again a third time, but you have to read between the lines. The same husband who is convinced that "he is okay" probably also doesn't want to spend the $ for X-rays or other testing. An exam and more meds is a lot cheaper.  I assure you that most vets are only too happy to suggest Xrays and other tests, but if the client refuses them, there's not much they can do. 
I hope you can convince your friend that she really, really needs to get to the bottom of this and get this properly diagnosed. GSD are probably prone to more orthopedic than almost any other breed, and this is a young dog who deserves to not have to live his whole life with pain or movement restrictions.  I'd also suggest that she get insurance for him if she hasn't already. 

[Haley, Yeti, and Phin]

I totally suggested the insurance but we weren't sure if t would be considered a pre existing condition. And your right he doesn't want to pay for a surgery because "what happens if it happens again" which I understand. I was curious why their vet wouldn't look into it further after the second time in a year. Is it possible for the vet to suggest seeing a specialist without x rays first?

[Stella]

As he has already seen the vet for this issue, it would more than likely be considered pre-existing. X-rays don't show soft tissue, but they are a quick and relatively cheap way of ruling out serious bone or joint pathology, tumours etc etc. Sometimes, they can also see swelling / inflammation on X-ray. MRI is needed to accurately diagnose soft tissue injury, or a skilled rehab therapist can perform clinical testing. Because this problem has reoccurred several times, this dog should be investigated further.

[Stella]

The OVC is trying to pass a whole bunch of Registered Acts (which they basically copied word for word from those already passed for human medicine), I only mentioned here the ones that specifically apply to rehabilitation. There are proposed acts that also relate to touching an animals teeth (more relevant to equine dentists), the ears, penis, rectum, vulva (groomers, cleaning a horses sheath etc), communicating a disorder (could also apply to trainers noting a behavioural disorder) and so on.

You are right that groomers and trainers should not be giving medical advice, but some times they are the first to notice that something is wrong - coat changes indicating thyroid disorder etc etc. The problem is that currently the proposals are too broad, they need to be narrowed down to be more specific to who is allowed to do what, and who is not allowed!

In Canada, and in other countries, 'human' physiotherapists and chiropractors then take postgraduate training before they are allowed to work on animals. They also have to carry significant liability insurance. Many of the musculoskeletal conditions seen in dogs are the same or very similar to those seen in people, as are the recommended treatments. So, once you know the anatomy it isn't that difficult to transfer skills over. Some dogs will very clearly let you know they are in pain (growling, air snapping, biting), others are much more subtle - tightening of the skin around the eyes or mouth, licking the lips, holding their breath when you test the painful area - we are trained in how to recognise these signs of pain as part of the post-grad training.