Physical therapy for animals increasingly seen as viable treatment option
posted September 15, 2009
Hydrotherapy can help reduce joint pain and swelling and
Over the past 10 years, pet rehabilitation has emerged from a boutique service to what is fast becoming a mainstream treatment option within veterinary medicine.
With animal rehabilitation services becoming increasingly commonplace, more and more clients are recognizing that physical therapy is not just for people but can also mean pain relief, increased mobility, and an improved quality of life for pets as well.
Horse owners have long understood the value of rehabilitation in restoring an injured animal to health as have sporting dog enthusiasts. It's only recently, however, as pet owners in general have come to expect their companions will have access to the same medical options they themselves have, that the interest in physical therapy for pets has exploded.
The expectation really isn't all that surprising, according to Dr. Hilary M. Clayton. "A lot of people, after injury or surgery, get physical therapy, so it's natural to expect that might be available for pets," explained Dr. Clayton, the McPhail Dressage Chair in Equine Sports Medicine at Michigan State University College of Veterinary Medicine.
Dr. Clayton is part of an organizing committee that's been working with the American Board of Veterinary Specialties over the past few years to make sports medicine and physical therapy an AVMA-recognized veterinary specialty. Sports medicine is becoming a huge field in veterinary medicine, Dr. Clayton said, and a specialty college would advance the science and practice of veterinary rehab considerably.
A decision on the proposed specialty board—the American College of Veterinary Sports Medicine and Rehabilitation—is expected from the ABVS by the end of the year, according to Dr. Clayton.
While many veterinary colleges have rehabilitation clinics and several have expanded their curriculums to include rehab or are planning to, most current animal rehabbers have completed one of the nation's two most recognized programs.
Nearly a decade ago, Dr. Darryl L. Millis and a physical therapist friend started a certification program in canine rehabilitation, which is now offered at the University of Tennessee College of Veterinary Medicine.
"When we started the Certificate Program in Canine Rehabilitation, I had initially expected it to be more of a niche service," Dr. Millis, a professor of orthopedic surgery at the UT veterinary college, said. "But 10 years later, I'm surprised that interest has remained so strong."
Approximately 350 people have earned their certification from the UT program so far, Dr. Millis said, and more than 1,500 people have taken some of the courses. Only veterinarians, veterinary technicians, physical therapists, and PT assistants can take courses. Subject matter ranges from canine anatomy and how to design and implement a rehabilitation program to pain management and the use of lasers to improve joint mobility. The program has become so successful that it's taught in Europe and will soon be introduced in Japan.
Dr. Debra A. Canapp attended the nation's other top rehabilitation certification program—the Canine Rehabilitation Institute in Wellington, Fla.—where she earned the designation of "certified canine rehabilitation therapist" in 2006. Dr. Canapp, who had previously worked in emergency medicine and private practice, saw rehabilitation as an emerging field in veterinary medicine, and she wanted to be one of its forerunners.
A year prior to her certification, Dr. Canapp and her husband, Sherman, a board-certified veterinary surgeon also certified in canine rehabilitation, opened the Veterinary Orthopedic and Sports Medicine Group, now in Annapolis Junction, Md. The practice is dedicated to veterinary orthopedic surgery and rehabilitation and employs a large staff of veterinary professionals, even a veterinary sports trainer to help dogs quickly return to their sport.
Dr. Canapp and her husband believe rehabilitation is a logical part of orthopedic medicine. "We've always thought that dogs should receive the same care as humans, and that's the human model: You are seen by an orthopedic surgeon and then you go to physical therapy," she said.
And it's not just dogs getting the attention at the clinic. Despite the focus on dogs, Dr. Canapp has also treated cats—"If you work in the cat time frame, you've got about 20 minutes to chase them around the room with a cold laser," she joked—and a duck and a rabbit.
Business has been "very, very good," at least until recently when the recession started cutting into the number of surgery patients the clinic typically sees, according to Dr. Canapp. The physical therapy portion of the practice has been untouched, however, and the appointment schedule is booked for a month and a half.
"Our rehab practice has actually boomed," Dr. Canapp said. "People are looking at the big-ticket item of surgery and trying to hold off on that, so they're opting for the less expensive rehab."
One reason veterinarians are offering rehabilitation is that it's another way of protecting the human-animal bond. And the results can be immensely rewarding for everyone involved. Dr. Julia E. Tomlinson, owner of the Twin Cities Animal Rehabilitation Clinic in Burnsville, Minn., and a graduate of the UT rehab program, said many clients come to her thinking there's nothing more that can be done for a severely disabled or pain-wracked pet. A colleague has even called her clinic "the last hope veterinary hospital."
"I've been an emergency vet, I've been a surgeon, I've been an equine vet, and I've been a researcher, and rehab is singularly the most rewarding thing I've ever done. Just to watch an elderly dog play again ... people are so delighted they can go on a little walk with their dog again."
—DR. JULIA E. TOMLINSON, OWNER,
TWIN CITIES ANIMAL REHABILITATION CLINIC
Several pet insurance companies cover rehab when it's recommended by a veterinarian, Dr. Tomlinson noted.
In addition to her clinical work, Dr. Tomlinson is president of the American Association of Rehabilitation Veterinarians, which she started in 2008 with about 50 members. Today, the roster has grown to 130 and includes several veterinary students. The AARV, she said, is striving to be the voice for veterinarians in rehab.
"We feel like (pet rehabilitation) is not something fully accepted in the veterinary community, but it's getting there," Dr. Tomlinson said. The AARV talks to veterinary boards on the association's policies and the ways in which rehab should be practiced as a form of veterinary medicine. The association is also surveying its members regarding the rehab services they provide.
The ongoing debate within the physical therapy community is over who is qualified to practice pet rehabilitation. In Nevada and Colorado, for instance, the veterinary practice acts were amended to allow physical therapists access to animals when working with a referring veterinarian.
Dr. Tomlinson says the AARV's position on the matter is animal rehabilitation is part of the practice of veterinary medicine and a veterinarian should be directly involved in an animal's rehab program. In addition, while the association supports working with nonveterinary professionals in the rehabilitation process, it opposes allowing them direct access to animal patients.
"Veterinary involvement in rehab brings more to the table than does the nonveterinarian working alone. We're very happy to work with these professionals; we just think a veterinarian should be involved," she said.
Part of the examination process for the UT Certificate Program in Canine Rehabilitation requires students to explain how providing pet rehabilitation complies with their respective veterinary and physical therapist state practice acts, according to Dr. Millis, who worries about attempts to expand practice acts to nonveterinarians.
"We want to be sure that there's no misunderstanding on our students' part," Dr. Millis explained.