Issue 18 : simplebooklet.com

2Animal Therapy Magazine | ISSUE 18Supply and Service of Medical Devicestrimbio offers a vast range of products all at very competitive pricesAnimal Therapy Products Vetkin-Tape® Kinesiology Tape A robust tape with good ventilation. Vetkin-Tape® has 25% increased adhesiveness to other tapes. It is 20% larger than Human tapes and gives maximum results for animals.Anatomical ChartsEquine and Canine Skeleton or Muscular charts with German, English and Latin text. 50cm x 70cm printed on 200gsm art paper, with attachable plastic rods for hanging.£6.25 +VAT£13.95 +VATExtra Large Wobble CushionThis large wobble cushion (55cm dia.) is ideal for animals as £36.95 +VATNEW Digital Vet H-WaveThe new Vet H-Wave has been upgraded with xed and adjustable frequencies, a backlit screen and a lighter battery. The Vet H-wave uses a signal £1750.00 +VATIntelect Mobile Ultrasound with Pro Carry BagThis unit is ideal for animal therapy where the unit can be powered by battery whilst in its carry bag, and be protected from the elements. Call for latest pricing offerHand Held LaserA hand held system that does not require protective glasses and runs off standard AA batteries. The unit is extremely hard wearing, portable and effective within supercial and soft tissue injuries.Intelect Mobile Laser PackagesThese packages are ideal for all Animal Therapy Practicians as we can mix and match the probes & clusters to suit the required eld of treatment.Neurotrac Sports Muscle StimA dual channel muscle stim unit which has 15 preset programmes and the option to store 3 of your own custom programmes.£69.95 +VATBiomag 2 Base UnitThe Biomag 2 unit has a range of frequencies offering a range of treatment options from soft tissue injuries, fracture repair enhancement and pain relief.Prices start from £495.00 +VATthat is natural to the body. It emulates the H wave form found in nerve signals and therefore enables greater and deeper penetration of a low frequency current, whilst using signicantly less power than other machines.£295.00 +VAT2 limbs can be easily placed on the cushion, for balance and proprioception work.01403 597597 www.trimbio.co.uk sales@trimbio.co.ukCall for latest pricing offeranimal therapy ad 10 19 artwork.indd 1 10/10/2019 11:54

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3 Animal Therapy Magazine | ISSUE 18GET IN TOUCH:Hannah Ashton – Editorhannah@animaltherapymedia.co.ukGeorgia Keegan – Editorgeorgia@animaltherapymedia.co.ukBeth Lorraine - Sales Manager info@animaltherapymedia.co.ukDonna Boddie - Account Manager donna@animaltherapymedia.co.ukTony Nevin - Podcasts and Research tony@animaltherapymedia.co.ukM A G A Z I N EAnimalerapyISSUE 18Issued Quarterlywww.animaltherapymedia.co.ukWhile every eort has been made to ensure that information is correct at the time of going to print, Animal Therapy Media Ltd cannot be held responsible for the outcome of any action or decision based on the information contained in this publication/website. The publishers or authors do not give any warranty for the completeness or accuracy for this publication’s content, explanation or opinion. No part of this publication and/or website may be reproduced, stored in a retrieval system or transmitted in any form without prior written permission of Animal Therapy Media Ltd and/or the authors of the articles within. Permission is only deemed valid if approval is in writing.Front cover image: Mabel was one of a kind, such an honest, sweet natured little cocker with the biggest 'go' attitude. She was a hard working dog (and hard work!), but a great best friend. We completed so many adventures in the short time together, we all miss her dearly. Photographer: Richard WarehamWelcome!Welcome to Issue 18 - we hope you enjoy this issue.Don't forget you can subscribe to receive our online copy for just £10 per year.As we approach the end of the year, we wish all our readers, writers and advertisers a very Merry Christmas and a Happy New Year. from all at Animal erapy MediaAnimal Therapy Magazine’s soleaim is to inform professionals and owners of current and pioneering treatments and techniques. Featuring interviews with top professionals in the eld, real life case studies and news and reviews. • Quarterly publication• Circulated nationwide• Online version• Targeted audience and distribution• Course and CPD information• Editorials written by highly regarded industry professionals• Case studies• Professional proles• Product reviews• InterviewsDon't forget to keep a close eye on our website for press releases, articles and hot o the press industry informationSUBSCRIBE NOW You can subscribe to read our online copy for just £10 per year.Further information can be found on our website animaltherapymedia.co.ukLeucillin _____________5Vet Festival 2020 ______7Equinenergy _________8Vet Rehab Summit ___ 10Big Dog Bed Co ______12Choosing an Electrotherapy device _____________13Equine Excercise Rehabilitation _______18Benets of Boswellia _20SPATEX 2020 ________22Tony Nevin: Animal Osteopathy _________24Tissue Healing & Electrotherapy ______25Racehorse to Dressage Horse ______28Canine Osteoarthritis _32Levi’s Blog __________ 35Part 2: Cervical Spondylomyelopathy 36Understanding the needs of Riders ___________38Mary Bromiley ______42CONTENTS

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5 Animal Therapy Magazine | ISSUE 18BACTERIAL skin infections represent some of the most common infectious diseases globally. Prevention and treatment of skin infections can involve application of a topical antimicrobial, which may be an antibiotic or an antiseptic.The skin is one of the rst lines of defence against microbial invasion. Breaches in the skin, whether accidental i.e. trauma or insect bite, or intentional (surgical incision), can allow incursion of bacterial pathogens and can lead to skin and soft tissue infection.Leucillin is an eective and reliable rst aid, sanitizing and skin management tool. Out-performing other antiseptic products with unbeatable Log710 99.99999% results, Leucillin kills pathogens that can cause infection.Leucillin, a Hypochlorous acid (HOCl) based antiseptic solution is one on the highest performing formulations of stable Hypochlorous; it is skin pH neutral at 5.5 - 6.0 pH. Stabilised Hypochlorous is a revolutionary breakthrough in healthcare with many 100 times the eectiveness of standard antiseptics while proven to be 100% safe.Suitable ears, eyes, sensitive and allergy prone skin types, Leucillin’s soothing and calming formula helps manage the symptoms of allergy suers and prevents infection. Leucillin has a wide and varied range of uses and capabilities within all areas of animal healthcare and is suitable for mammals, birds and reptiles.Why choose a liquid antiseptic over a cream or gel:An antiseptic product is more eective as a biocide when administered in a liquid form. A topical antiseptic will have an active ingredient(s), which must come into contact with the infecting pathogen to be able to kill it. LeucillinUsing a Topical Antiseptic for Skin TraumaAnimal Skincarewww.leucillin.co.ukLeucillin Animal Skincare is a high efficacy topical antiseptic solution.With a wide range of uses and benefits this incredibly versatileproduct provides protection against infection caused by invadingmicroorganisms or pathogens (bacterial, viral and fungal.)Dramatically reduces bacterial loadMinimal contact timeSafe for all mammals, birds and reptilesSkin pH neutralSafe for ears and eyesBroad Spectrum antisepticStraight to use, user-friendly applicationThe latest test conducted by The NHS Laboratories at The Queen Elizabeth HospitalTest facility; EN 13727 Leucillin achieved a class leading 99.99999% (Log7) ormaximum measurable reduction in bacteria.Call today to find out more about Leucillin,order direct or through Centaur Services or Henry ScheinProud Associate Sponsors of Edition Dog Live, the UK’s only Holistic Dog ShowANTIBIOTICRESISTANCE;THERE ISTOPICALASSISTANCELiveAssociate SponsorFP_MAY19:Layout 1 21/10/2019 16:28 Page 1continued overleafA spray function does has the added benet that the very action of spraying will ush pathogens from the wound bed. Dosage requirements for a Topical AntisepticStong antiseptics require precise dilution, if not and can cause irritation if they’re left on the skin for long periods of time, this kind of irritation can lead to prolonged recovery time or irritant contact dermatitis.Leucillin contains HOCl, which is a naturally produced chemical within the mammalian body by Leukocytes or Neutrophils to ght infection caused A liquid will the capability to transport the active ingredient, (Leucillin’s active being HOCl), with ease into the infection site, this will allow the solution to run over surface of the skin and ow into all corners which bacteria are present. A free owing solution will have a much higher probability to coming into contact with an infecting pathogen. In a gel or cream, the active is suspended within a viscous solution and is therefore unable to come into contact with further pathogens once applied. They can act as an eective barrier to further infection, but can also have the potential to seal in infection; this can lead to bacterial mutation and resistance, rendering an antiseptic ineective.Thoroughbred mare, ank tear injury sustained whilst out. Vet stitched, antibiotics prescribed orally, only Leucillin applied topically. After two weeks all but three stitches removed, three weeks for full recovery.LEUCILLIN

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6Animal Therapy Magazine | ISSUE 18by invading pathogens (bacterial, viral and fungal.) Leucillin is straight to use, it is skin pH neutral, non-toxic and a non-irritant, the body recognises Leucillin as the natural chemical to its own immune system safely working in harmony with it. Leucillin does not cause detriment to living tissue and is recommended for liberal use upwards of 2 to 3 times daily, there is no risk of over-dosing.Other antiseptics which use a caustic chemicals as their active, for example Chlorhexidine based antiseptics, can cause severe irritation, tissue damage and in some cases deafness in felines, it is important to always carefully read the manufactures instructions for applying any product.How does product ecacy protect against pathogen resistanceLeucillin is a revolutionary breakthrough in healthcare with many 100 times the eectiveness of standard antiseptics. Whilst other antiseptics struggle to achieve the 99.999% ecacy required for a Standard EN13727 test, Leucillin achieves 99.99999% ecacy; a 100 fold improvement in ecacy, whilst still remaining non-toxic, non-irritant and skin pH neutral.Products with a lower ecacy are not capable of killing all pathogens present within an infection; this can allow pathogens to grow and multiply between applications. Repeat applications of products with an active which requires a long exposure time to kill the pathogens may also contribute to resistance, rendering a product potentially ineective. Because Leucillin has such a high level of ecacy and has the ability to kill pathogens on contact with no lengthy exposure time required, there can be no opportunity to develop resistance; there is no risk that bacterial strains will become resistant to Leucillin. Leucillin’s usages against microbial invasionCuts, wounds, stubborn infections, rashes and skin irritations, dry, itchy, aky or smelly skin problems, ear and eye infections, burns and abbess, and the management of the symptoms of allergies are just some of the many uses of Leucillin, and of course as a general purpose antiseptic. Leucillin can be used to help maintain healthy skin; it acts as a topical wound wash, as a skin safe anti-microbial biocide which promotes skin healing by reducing potential for infection and is a preventative solution. To nd out more about Leucillin or for trade enquiries please call 0345 548 9800 email: info@leucillin.co.uk or visit the website: www.leucillin.co.ukLeucillin RRP50ml Leucillin Dropper £4.99150ml Leucillin Spray £7.50250ml Leucillin Spray £9.99500ml Leucillin Spray £14.99LEUCILLINPut the spring back in your dog’s step withResults you can see & your dog can feel in just 1-3 sessionsAre you seeing any of the following:• Lameness / limping / stiffness• Difculty going up or down stairs• Performance issues in sporting dogs• Orthopaedic conditions: Arthritis, Hip Dysplasia• Problems getting in / out of the car• Slowing down or disinterested in walks• Hopping or skipping on back legs • Slowing down before their time• Gait or posture irregularities• Neck / back / shoulder issues• Reluctant to be handled• Biting or nibbling hind limb / wrists• Change in behaviour: snappy, depressed• Crying pain or yelping• Nerves or anxietyProudly assisting Sparsholt & Winchester universities with the world’s rst ever clinical trials on clinical canine massage therapy.@www.Visit our website for more information and to find your local therapist today!

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7 Animal Therapy Magazine | ISSUE 18As more and more physiotherapists are attached to a veterinary practice, it’s now more common place for rehabilitation to be included as part of a small animal patients’ care. It often plays a vital role in a patient’s recovery, both following an injury and when suering the eects of a specic condition. It’s really refreshing to have an event like VET Festival actively demonstrate how closely rehabilitation can be aect and inuence a complete veterinary plan.Which brings me onto Hydrotherapy, which plays a vital part in a patients’ rehabilitation and is often able to achieve very specic benets that are otherwise challenging on land. VET Festival 2020 will be giving hydrotherapy the attention it deserves. Lectures will cover topics such as movement techniques, balance and coordination, as well as elderly care as elements of water-based therapy – all of which will give delegates the tools to use in the day to day profession. The Veterinary Rehabilitation world is one that is increasingly expanding. As a Physiotherapist myself, I understand the dedication coming out of physiotherapists and hydrotherapists who are working to develop our profession within the veterinary world using evidence based theories and current techniques. The educational platform that VET Festival provides I can condently say supports our industry and those within it.by Fiona Doubleday, Physiotherapist at Fitzpatrick ReferralsBook your place at VET Festival 2020 today. Visit: www.vetfestival.co.uk for more information.Readers get an exclusive 15% o with code ATM15Rehabilitation at VET Festival 2020VET FESTIVALDelegate feedback from VET Festival 2019:”Inspiring with fantastic speakers”Physiotherapist “A wide variety of specialist speakers that present information in a fun way in a great environment”Vet Physiotherapist“Excellent CPD in a relaxed atmosphere”Clinical Director“Perfect CPD venue for quality ongoing training in a fun and compassionate setting” Physiotherapist7-8 June 2019 | Loseley Park, SurreyVETERINARY EDUCATION TOMORROWCOMING back for its sixth year, VET Festival is set to return to Loseley Park in leafy Surrey on Friday 5th and Saturday 6th June 2020. The event acts to provide the veterinary community with inspiring and pioneering CPD in a beautiful outdoor setting. This year’s event featured over 35 speakers across 12 educational streams, so with already something for everyone it’s incredible to hear the VET Festival team are planning another six education streams added to the mix. The rehabilitation stream is where you’ll nd me at VET Festival 2020. The tent will be showcasing an amazing series of lectures with new speakers, as well as welcoming back incredible speakers from past years with new material. You can expect an integrative approach at the 2020 event. The way that clinical practice and rehab integrate is critical within our eld, and the education at VET Festival reects that by combining veterinary surgeon and physiotherapist lectures to put the spotlight on the benets of rehabilitation in overall Veterinary medicine. The speakers will cover topics relating to both the orthopaedic and neurological patient, in specic detail from the veterinary surgeon’s perspective and the therapists as well. Each Vet talk will lead directly into a practical therapy information session.7 Animal Therapy Magazine | ISSUE 18

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8Animal Therapy Magazine | ISSUE 18 ww.equinenergy.com T: 07548 789 713 ʻto be the best, learn from the best! Equinology Inc. Equine and Canine Body Worker®certification - beyond sports massage - evidence-based EEBW/CCBW certificationmultiple courses, all taught by veterinariansand specialistsbuild YOUR career in animal sports therapyand rehabilitation! There are many competing equine and canine sports massage programmes, but which course is the best choice for your certication?STUDYING to become an equine (EEBW) or canine (CCBW) body worker involves more than learning a new skill set. You have to demonstrate your talent for this profession to everyone in the equine or canine world, and Equinenergy Ltd teaches you how to do just that! Since 1999, in conjunction with Equinology, Inc., we have raised the bar in continuing education. The courses are taught by veterinarians and specialists in the eld: rst-hand information only! The evidence-based EEBW and CCBW certication courses are the global gold standard for equine and canine sports massage education. Since 2003, we have partnered with Writtle University College, and the EEBW and CCBW courses form the professional qualications for students on the BSc Equine/Canine Sports Therapy degree programmes!Certication is more than just a “piece of paper”: anyone can attend a short sports massage course and buy a certicate. Please do not be fooled by “online” courses, short courses, and courses that do not require case studies and formal testing following onsite training. Many such courses are neither recognised nor respected by professionals in the animal health care eld. You may walk out with a certicate, but will you have the skills you need to be an eective practitioner?Being awarded your certication from Equinenergy Ltd/Equinology, Inc. means that you have completed a prerequisite anatomy study, as well as an intensive residential course integrating both theory and practical skills. It means that you have that you have assimilated the course material: you will have completed case studies and passed a theoretical and practical examination following the residential course. Our Equine and Canine Body Worker programmes are not for everyone: graduates earn their certication through rigorous study! Student and graduate body workers can join the International Equine Body Worker Association (www.iebwa.com).We have over thirty dierent courses and four levels of certication, geared toward those who are joining the animal body worker profession and want to gain a recognized certication, as well as to Licensed Professionals who are seeking the highest standard of continuing education. Veterinarians, chiropractors, physiotherapists and osteopaths regularly attend our courses!Our educational programme is highly recommended by veterinarians and other professionals in the animal health care industry. They appreciate the depth of our course content, and they are condent that you will have a strong ethical approach as you step into this profession. To be successful in this profession, you need to be a knowledgeable, condent team player. Our course delivery oers the key to this approach!www.equinenergy.comEquinenergyEQUINE & CANINE SPORTS MASSAGE

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10Animal Therapy Magazine | ISSUE 18AT Onlinepethealth, we focus on more than just continuing education. For us, this is how we help you change the world. We want every Vetrehabber to feel part of a community, to make a success of their business, and to continue to push the boundaries in learning, growing and innovating all the time. CommunityWe believe that community should be free, inclusive and supportive. It is through community that we share our stories, challenges and questions, and how we receive support, recognition and help from like-minded professionals. In a small, niche industry like ours, we should never feel alone. In order to create, uphold and maintain community, we have three Facebook groups – Small Animal Onlinepethealth VetrehabbersVetrehabbers, Equine Vetrehabbers and Hydro Vetrehabbers. These Facebook communities are open to all professionals working in the industry; in these communities we ask and answer questions, and seek and receive advice and support, all without judgement or criticism. We LearnOur absolute passion and mission is to keep improving our own and your knowledge, striving to do this in various ways. Our weekly podcasts and blogs are free to everyone in the industry. We use them to encourage fellow Vetrehabbers, share stories and experiences, chat about dierent areas of progress and growth, and share knowledge on new and novel procedures, conditions and modalities – anything that seems valuable and interesting! We also run a members’ platform, where we broadcast multiple webinars every month from lecturers all over the world. We are really striving to ask those all-important clinical questions and deepen our knowledge and understanding of various areas of interest in our profession. The platform is registered for CPD with the SAVC. We love research; we have a passion for evidence-based practice, and believe there is only one way to become more evidence based in our practices – by reading published research papers, nding the clinical relevance and value in them, and then taking things further by doing more research. Every month we have a ‘Research Refresh’ for our members, where we do the hard work of reading and understanding a paper, then summarising it in somewhat more digestible form so that our members easily benet from it. We succeed! If there is one thing we all know, it is that we often know very little about business. This can be a real obstacle for us as Vetrehabbers. At Onlinepethealth, we are passionate about your success – to us, the success of each individual Vetrehabber is the success of the industry, of the profession and of Onlinepethealth. We oer various business training’s on our members’ platform every month, to ensure that vetrehabbers are learning what they need to learn to become successful at marketing, growing their practice, hiring employees, managing them, and so much more. We are fully invested in you! Onlinepethealth members and Vetrehabbers are a truly special bunch. We are humble, we live, we learn, and we are so epically passionate about our patients and our profession that it can be truly scary. So – are you a Vetrehabber? VET REHAB

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11 Animal Therapy Magazine | ISSUE 18Learn more at www.backontrack.com/UK®Back on Track’s own unique Welltex fabric works by reflecting the body’s infrared heat due to the infused ceramic particles in the textile, helping to support circulation and ease muscle tension. Stockists needed - Call now on 07766 463099 or email georgia.keegan@backontrack.com for informationprepareperformFreedom of Movement for DogsATM_Autumn2019_190x134_BOTdogagility24 October 2019 18:53:12Animal Therapy Magazine | ISSUE 16Lauren Aston, Exeter, UK. Tel: 07875 951632 kate@PickPocketforagers.com www.PickPocketforagers.comLauren Aston, Exeter, UK.Recommended by canine professionals and vetswww.pickpocketforagers.comEMAIL kate@PickPocketforagers.comTEL07875 951632My young border collie Thessie LOVES her PickPocket For-ager. It occupies and mentally stimulates her and is helping to improve her nose work skills ready for competition. As a canine behaviourist and nose work competitor, I strongly recommend these to all dog owners. David Svennelid, canine behaviourist & trainerSwedish Dog Academy | www.swedishdogacademy.comThe puppies in my class LOVE exploring the PickPocket Forag-ers – one even ate his evening meal from it! In my grooming salon, the PickPocket Forager helped to make puppy Angel’s first visit really enjoyable and she happily snuled in the pockets while being combed. This made her first grooming experience really positive.Karen Backhouse, APDT trainer & groomerGuiding Paws Training | www.GuidingPaws.co.ukI purchased the PickPocket floor forager as I love the idea of gentle foraging to keep Digger, my Dachshund, engaged. When it arrived, I was amazed at the quality of the product and also love that it can be washed and dried easily. I would highly recommend whole range of PickPocket Foragers!Claire Bradford, Dog owner Sophie never tires of her PickPocket Foragers! She has a floor forager, a crate forager and a set of pouches. Foraging is obviously so very rewarding and no maer how often we use them, they are always met with the same happiness and excitement, and no frustration. They are easy to use and yet can be adapted each time to make them a lile dierent. I think Sophie loves the soft feel of the fleece too, as she of-ten sticks her nose in the pouches and rummages about just for pleasure! And I love the fabric - it feels so soft, washes so easily, dries so quickly and looks so prey.”Sherri Steel, Dog ownerenriching dog’s lives through foragingForaging fun!Mentally stimulatingDeeply enrichingBoredom-bustingPerfect for all ages & breedsCase studies BLINDNESSScout was rescued as a puppy after being found wandering the streets of County Durham. He carries the double-merle gene, an unhealthy combination causing serious hereditary problems. Scout is blind in one eye and has limited vision in his other - but his disability has never stopped him. Scout has won many accolades including his Bronze Good Citizens Award and is a Pets As Therapy (PAT) dog. Scout’s ‘mum’ vet nurse Tracey explains how foraging helps Scout:EXERCISE RESTRICTIONGolden retriever Sophie unfortunately sustained cruciate ligament injuries, which take months to heal. As Sophie was on restricted exercise and confined to a puppy pen, her owner gave her a PickPocket for mental stimulation and to assist with rehab. Initially Sophie foraged lying down but progressed to standing to forage with the Pickpocket crate forager tied to the pen at nose height. This introduced gentle weight-bearing exercise for a few minutes. Happily Sophie is now making an excellent recovery – but still loves her daily PickPocket-ing! GENERAL ANXIETYCute cockerpoo Harry needed distracting from some unwanted behaviour. Canine behaviourist Lucy Aalders of Leaps & Hounds explains: “I recommended a PickPocket to Harry’s owner and Harry immediately loved it! Of the many interactive toys we tried, the PickPocket was the most successful in diverting Harry’s aention away from barking, chasing, jumping and licking, and the foraging motivated him to eat more.” “Scout’s eye problems mean he cannot chew for long periods of time as pressure builds up in his ‘good’ eye. This is why I really appreciate the benefits of forage enrichment with PickPockets as they are completely safe for him – and I love hearing him happily snuling!”.Tracey Ison, RVN, Dog owner & Vet Nurse“Sophie’s PickPocket was a real life-saver! She desperately needed something to occupy her without placing strain on her knees and the PickPocket was ideal. The PickPocket real-ly helped with her rehab – and the cats liked it too!”Alders, Leaps & Hounds, East Devon, UK“Lovely Lucy recommended your PickPockets and we’re de-lighted. We hit a milestone recently when the doorbell rang and instead of constantly barking and running madly around, Harry only barked once and continued with his PickPocket! I was amazed (and a very proud dog-mum!). Thank you!”Lauren Aston, Exeter, UK.Case study1Case study2Case study3Recommended by canine professionals and vetsForaging fun!Mentally stimulatingDeeply enrichingBoredom-bustingPerfect for all ages and breeds• Easily ties onto crate• Available for small,medium & largecrates• Keeps dog in standfor grooming, clippingnails and cleaningears etc• Lies flat on the floor• Perfect for deliveringyour dog’s dry(kibble) dinner• Available in small &large sizes with deepor shallow pockets• Set of three pouchesnest inside each other • Vary levels ofdiiculty by how youfold, arrange or filleach pouch• Handy for travel• Easily ties onto crate• Available for small,medium & largecrates• Keeps dog in standfor grooming, clippingnails and cleaningears etc• Lies flat on the floor• Perfect for deliveringyour dog’s dry(kibble) dinner• Available in small &large sizes with deepor shallow pockets• Set of three pouchesnest inside each other • Vary levels ofdiiculty by how youfold, arrange or filleach pouch• Handy for travel• Easily ties onto crate• Available for small,medium & largecrates• Keeps dog in standfor grooming, clippingnails and cleaningears etc• Lies flat on the floor• Perfect for deliveringyour dog’s dry(kibble) dinner• Available in small &large sizes with deepor shallow pockets• Set of three pouchesnest inside each other • Vary levels ofdiiculty by how youfold, arrange or filleach pouch• Handy for travelenriching dogs’ lives through foragingEasily ties onto crate or penAvailable for small, medium & large cratesKeeps dog standing for grooming, clipping nails and cleaning ears etc.Set of three pouches nest inside each otherVary levels of difculty by how you fold, arrange or ll each pouchHandy for travelLies at on oor with pockets perpendicular to each otherPerfect for your dog’s dry (kibble) dinnerAvailable in small & large sizes with deep or shallow pockets• Easily ties onto crate• Available for small,medium & largecrates• Keeps dog in standfor grooming, clippingnails and cleaningears etc• Lies flat on the floor• Perfect for deliveringyour dog’s dry(kibble) dinner• Available in small &large sizes with deepor shallow pockets• Set of three pouchesnest inside each other • Vary levels ofdiiculty by how youfold, arrange or filleach pouch• Handy for travel• Easily ties onto crate• Available for small,medium & largecrates• Keeps dog in standfor grooming, clippingnails and cleaningears etc• Lies flat on the floor• Perfect for deliveringyour dog’s dry(kibble) dinner• Available in small &large sizes with deepor shallow pockets• Set of three pouchesnest inside each other • Vary levels ofdiiculty by how youfold, arrange or filleach pouch• Handy for travel• Easily ties onto crate• Available for small,medium & largecrates• Keeps dog in standfor grooming, clippingnails and cleaningears etc• Lies flat on the floor• Perfect for deliveringyour dog’s dry(kibble) dinner• Available in small &large sizes with deepor shallow pockets• Set of three pouchesnest inside each other • Vary levels ofdiiculty by how youfold, arrange or filleach pouch• Handy for travel• Easily ties onto crate• Available for small,medium & largecrates• Keeps dog in standfor grooming, clippingnails and cleaningears etc• Lies flat on the floor• Perfect for deliveringyour dog’s dry(kibble) dinner• Available in small &large sizes with deepor shallow pockets• Set of three pouchesnest inside each other • Vary levels ofdiiculty by how youfold, arrange or filleach pouch• Handy for travel• Easily ties onto crate• Available for small,medium & largecrates• Keeps dog in standfor grooming, clippingnails and cleaningears etc• Lies flat on the floor• Perfect for deliveringyour dog’s dry(kibble) dinner• Available in small &large sizes with deepor shallow pockets• Set of three pouchesnest inside each other • Vary levels ofdiiculty by how youfold, arrange or filleach pouch• Handy for travel• Easily ties onto crate• Available for small,medium & largecrates• Keeps dog in standfor grooming, clippingnails and cleaningears etc• Lies flat on the floor• Perfect for deliveringyour dog’s dry(kibble) dinner• Available in small &large sizes with deepor shallow pockets• Set of three pouchesnest inside each other • Vary levels ofdiiculty by how youfold, arrange or filleach pouch• Handy for travel

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12Animal Therapy Magazine | ISSUE 18THOSE with dogs in rehab, with chronic join issues or arthritis often nd themselves searching for an orthopaedic dog bed, but in reality, what does that actually mean? The bed must be supportive, easily accessed and exited, and allow the dog to stretch out fully. A bed that is too small for that basic sleeping position is equivalent to us sleeping in an armchair – comfy for a while, but stay there for any length of time and you end up cramped, sti and sore. In truth, there is no such thing as an orthopaedic dog bed as no research has been done to examine what type of bed construction gives a dog the optimal sleeping environment. There is a tendency to think that something soft and squishy is the right way to go. However, a bed that is very soft will be dicult for a dog with compromised mobility to move about on, making them reluctant to change position and increasing joint stiness through being immobile for excessive periods.Memory foam is often the go-to material and beds made with this are frequently described as ‘orthopaedic’ in retailers’ sales blurb. Memory foam is an excellent material in many ways, but there is nothing intrinsically orthopaedic about it. If it is thick enough to be supportive, it No such thing as an orthopaedic dog bedwill be too soft. Many larger, hairier dogs overheat on it, so it is not suitable for everyone. Memory foam crumb is a waste material that is most certainly not suitable for dogs with spinal, neurological or joint conditions.This very issue needed to be addressed soon after the foundation of the Big Dog Bed Company, when the owner’s GSD was diagnosed with both hip and spinal problems, requiring two surgical interventions. The Active RecoveryTM range is the result. Called orthopaedic for the sake of search engine visibility, the Active RecoveryTM Bed is actually a pressure relief bed whose construction is based on pressure relief surfaces used in human medicine, particularly for bariatric patients and those who are recumbent for extended periods. The castellated foam cells move in response to the direct loading received and are unaected by the surrounding foam surface. The result is an even distribution of load to the dog’s body which is held in a neutral position, removing tensions that have built up as a consequence of compensatory gait and pain management. The bed construction comprises 5cm base of high density foam for support topped by 5cm of castellated foam as the pressure relief surface. The AR Lite for smaller dogs comprises 3cm of high density foam and 5cm castellated pressure relief foam. The Active RecoveryTM range is available for use in veterinary kennels, as a surface for operating tables and as domestic dog beds. Some therapists use an Active RecoveryTM bed as a massage and acupuncture surface. Veterinary professionals can oer these beds for sale to their clients on a drop ship basis, eliminating any need to hold stock. Contact info@bigdogbedcompany.co.uk for information.The SafeRocker+ (SR+) delivers an easily controlled rocking action with no sudden movements or banging. If the dog is o-centre, the SafeRocker+ merely tilts slightly. It allows the therapist to focus on the exercise, rather than on controlling the equipment. SafeRocker+ combines well with the new Step SystemAnimal Therapy Magazine advert December 2019 SafeRocker+ combines well with the new Step System The SafeRocker+ (SR+) delivers an easily controlled rocking action with no sudden movements or banging. If the dog is off-centre, the SafeRocker+ merely tilts slightly. It allows the therapist to focus on the exercise, rather than on controlling the equipment. The Step System provides a method of presenting patients of all sizes with changes in height on a solid, stable surface. The whole system comprises six pieces, four 50 x 50cm and two 100 x 50cm blocks, all 7cm deep. They can be stacked to create a larger step up as appropriate to the dog size and condition. www.bdbco.vet The Step System provides a method of presenting patients of all sizes with changes in height on a solid, stable surface. The whole system comprises six pieces, four 50 x 50cm and two 100 x 50cm blocks, all 7cm deep. They can be stacked to create a larger step up as appropriate to the dog size and condition.www.bdbco.vet

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13 Animal Therapy Magazine | ISSUE 18Dynamic research has continued into 2000s to identify multiple cascades of biochemical reactions, originating in the mitochondria with photonic stimulation of cytochrome c oxidase which spreads throughout the entire cell aer light exposure. Global research of PBM is reaching it’s 50-year journey. Although further research is needed to rene our understanding, we now have a great level of understanding of key mechanisms, best wavelengths to use and dose parameters. PBM is one of the most active elds in photomedicine today. ere are thousands of published peer reviewed studies on humans and animals identifying molecular, cellular and tissue mechanisms which restores homeostasis, especially in cases where cell function may be compromised. Studied eects include:• Wound healing (benecial eects during all phases of wound healing eg. coagulation, inammation, proliferation and remodelling)• Reduction of inammation• Repair and regeneration of so tissue and musculoskeletal trauma• Stimulation of the immune system• Decreasing pain (due to anti-inammatory eects, neural blockade, stimulation of lymphatic activity, tissue repair and reduction of muscle spasms• Pre-conditioning – applied pre-surgery to decrease cell death and inammation • Rejuvenation of the skin (anti-aging) and hair regrowth and improving general wellness• Improving athletic performance and muscle recoveryBiphasic Dose ResponseAbiphasic dose responsehas been repeatedly observed, where low levels of light have a much better eect on stimulating and repairing tissues than high levels of light. e so-called Arndt-Schulz curve is frequently used to describe thisbiphasic dose response. (e comprehensive Biphasic Dose Response article referenced is ideal to refer to.)Penetration DepthSome degree of light penetration through tissue is an advantage but the argument that ‘higher power’ equates to deeper penetration, is simply not true and misleading. One of the best cited studies by Prof. Steve Jacques shows depth of penetration is best when using 808nm. e absorption of dierent photoreceptive constituents should also be taken into account. In many applications, choosing the wavelengths identied to be absorbed by Cytochrome C Oxidase is particularly relevant. Dierent tissue types have slightly dierent scattering and absorption characteristics and a popular paper by Kendric Smith in 1991 indicates that red and NIR light (630nm-1100nm) penetrates well.Literature shows the higher wavelengths (eg. above 900nm) are particularly absorbed by water. With ‘high power’ particularly Class 4, supercial absorbance of a 980nm laser will produce considerable heating.Choosing a erapeutic Laser/ LED phototherapy deviceby Ruth MilnerCompany Director with 23 year’s experience of Electrophysical Agents market. Member of International Light Associationcontinued overleafe purpose of this article is to provide a guide about current evidence and facts about Photobiomodulation and dierences between the technologies available to veterinary and animal therapy practice.Laser = Light Amplication by Stimulated Emission of Radiation (pinpoint/coherent beam)LED = Light Emitting Diode (spread out/incoherent beam)Discovery of PhotobiomodulationIt is possibly thanks to Hungarian pioneer of laser medicine, Prof. Endre Mester’s published discovery in 1967 which specically inuenced the development of red (visible) and near-infrared (invisible) therapeutic light devices. Mester observed that rodents exposed to his low power helium-neon ruby laser (633nm) healed the skin incisions much faster than the control group. In early 1980’s Prof. Tiina Karu, Head of the Laboratory of Laser Biology and Medicine in Moscow conducted the rst systematic investigation of the biostimulation phenomena with a wider range of wavelengths (300nm to 900nm) to help establish a detailed action spectra. TIINA KARUTiina nally isolated the key to the undeniable photobiological phenomena which she named Photobiomodulation (PBM) in 1995. This phenomenon lies in one of the nal stages in the mitochondrial respiratory chain driven by the photoreceptive enzyme, cytochrome c oxidase, and increases cellular energy, adenosine tri phosphate (ATP). 13 Animal Therapy Magazine | ISSUE 18

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14Animal Therapy Magazine | ISSUE 18Manufacturers choose their diodes based on best evidence and there are a range of wavelengths studied. General consensus from many studies show the visible red wavelengths (eg. 600-680nm) do not penetrate as deep as NIR so are usually best for skin and supercial conditions. NIR wavelengths have shown to penetrate to deeper levels into tissue (eg. 800-940nm). Wavelengths outside of these have also been studied and show there will be biostimulation.The Medicine and DosePBM is an ‘energy medicine’ and with any medicine, the ‘dose’ is also important to achieve an optimal/eective treatment outcome and how the light is applied will aect the dose level. Several factors should be considered to deliver the medicine and dose for treatment to be optimally eective. ere has been no conclusive agreement on the relatively large range of parameters studied which appear to elicit best or measurable results. Eectiveness also varies among individual cases and practitioners may need consider delivering personalised PBM treatment. PHOTOTHERAPYClass 3B v Class 4 Lasere maximum power of Class 3B lasers, permitting fastest speed of delivery of eective doses, is oen not utilised because that would already exceed the speed at which the cells can react (Biphasic Dose Response). So why a laser capable of even faster delivery would be preferable is so far unclear.As level of dose is an important factor for eectiveness, the recommended non-contact application techniques, which can hugely reduce energy delivered into the tissue, leaves open the question as to whether the energy delivered into tissue by Class 4 lasers is any greater than that delivered by Class 3B lasers.Studies show quicker does not equate to better and delivering energy too quickly negatively aects ecacy. Even if ‘super-pulsing’ is being used to deliver more energy to deep target cells more quickly, it cannot be assumed that such a dierent speed of delivery remains eective, let alone an improvement, without evidence.Authors and experienced specialists of the proven (non-thermal) PBM are voicing concerns about the emergence of the high power (photo-thermal) lasers being used for therapeutic purposes with claims of being superior. Apart from power, the only dierences between Class 3B and 4 lasers are the potential hazards and price.Practitioner insurance cover is likely to increase when using any laser device.Other Light Technologies for PBMere is still a misconception that devices need to be delivering laser light (coherent beam) and many still automatically refer to every device as ‘laser’ which is now technically incorrect. Many researchers, including Tiina Karu, observed that although light needs to be monochromatic, the coherence of laser light deteriorates quite quickly Factors to consider in calculating optimal dose• Wavelength (nm /nanometers)• Power (mW or W)• Energy density (from power density & time)• Irradiance (power density, W or mW/cm2)• Irradiation time (secs, mins)• Total energy delivered (joules)• Beam area (cm2)• Fluence (energy density)• Pulsed beam (if beam is pulsed, reported power should be average power)• Coherence (coherent light produced laser speckle)• Treatment Interval (hours, days, weeks)ere is in fact enough evidence showing PBM has quite a ‘wide window of dosing’ which has helped in the development of laser settings and simplied lower cost home use devices that will be eective.Terms to describe PBMAround 70 dierent terms have been used so far such as low-level laser therapy (LLLT), cold laser therapy, low intensity laser therapy, low level light therapy, so laser therapy, low uence diode laser irradiation, light-emitting diode phototherapy and even Class IV laser therapy. In 2015, the term Photobiomodulation became an ocial MeSH term and it has been agreed PBM or Photobiomodulation erapy (PBMT) should be adopted as the preferred terms going forward.Laser ClassicationVarious terms used such as ‘low-level’ were initially used to dierentiate the fact that devices being used for therapeutic biostimulation were not the high level ‘destructive’ lasers used for weaponry in the Cold War era of 1960s and 1970s. e ‘low-level’ terms also emphasise the dierence to surgical lasers which can cut, ablate and coagulate biological tissues due to a photothermal eect.It is important to note the majority of published laser papers from studies which refer to ‘low level’ laser, mean specic devices used for purposes of study are classied no higher than, and are actually Class 3B devices. MeSH Term for Photobiomodulation: Low-Level Light Therapy Treatment using irradiation with light of low power intensity so that the eects are a response to the light and not due to heat. A variety of light sources, especially low-power lasers are used.https://www.ncbi.nlm.nih.gov/mesh/?term=PhotobiomodulationBiostimulatory eects observed are photochemical, not from any photothermal property as per the denition in the currently agreed MeSH Term. “The international system of laser classication is concerned only with the risk for eye injury and, at higher powers, skin damage. Classication has nothing to do with suitability for laser treatment, nor does it mean a generational change nor ensure any improvement in ecacy.”How not to Promote Laser Therapy; Jan Tunér, DDS Lars Hode, DrSci (Swedish Laser Medical Society), Peter A Jenkins, MBA (Australian Medical Laser Association) http://www.laser.nu/lllt/pdf/Confounders.pdf14 Animal Therapy Magazine | ISSUE 18

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15 Animal Therapy Magazine | ISSUE 18at the surface of the skin. Over the last few decades increasing evidence has accumulated which suggest non-coherent light sources, such as Light Emitting Diodes (LEDs) can be highly eective. As long as the wavelength emitted is capable of being absorbed by the photo-acceptor molecules in the cells and the dose is within the recognised ‘therapeutic window’ and applied appropriately, there will be a biostimulatory eect into target tissue. Even halogen or incandescent lamps with coloured lters have also been shown to produce PBM eects.Evolution of LED light technology has improved signicantly since the late 1990s for all sorts of applications just as we see progression in many modern technologies. e early weak LEDs used for electronic indicators are a world away from the high-power LEDs that now exist today, although it is certainly not a case of ‘any LED will do’. WHICH DEVICE TO CHOOSE?Class 3B Low Level LaserDue the extensive body of research using Class 3B laser without a doubt, is likely to be the favoured choice in accordance with ‘evidence-based’ practice, to oer the most ‘optimal’ PBM treatment sessions for their patients. From around £3000 + VAT, manufacturers will oer a good choice of laser probes delivering a range of parameters observed in studies to provide the most optimal range of eects for numerous conditions. A good level of free introductory training is provided and optional reasonably priced more advanced training is oen available for more specic learning tailored on type of practice. Training will of course cover details about the risk, which is to only eyes. Laser goggles can be included with a ‘package deal’.Class 3B Laser manufacturers are also likely to include LED clusters in their probe options because they are relatively monochromatic, more economical priced than laser diodes and are a good ‘all-rounder’ probe for many conditions. Class 4 High Power LaserClass 4 lasers might be showing eectiveness for photobiomodulation compared to the safer, less expensive and proven Class 3B lasers, but assertions of superiority, especially with regards to ecacy are unsupported so far in literature.Due to the highest risk of Class IV, it goes without saying that all veterinary personnel operating Class IV laser should undergo advanced level training on, not only the principles and eects, but also, and more importantly, the risks of damage (eg. potential burn) to tissue. Even with what seems simple due to a multitude of ‘touch screen’ settings, Class 4 laser poses higher risk to operator and especially the patient. Be mindful of the patient’s reactions/tolerance to excessive thermal energy.LED DeviceWhilst a simple-to-use LED device oering one generic dose may not necessarily produce ‘optimal’ eects at the rst treatment session, devices https://www.gov.uk/government/publications/laser-radiation-safety-advice/laser-radiation-safety-adviceThe British Standard sets out 8 classes of laser products, these are:Class 1Class 1CClass 1MClass 2Class 2MClass 3R/3AClass 3B*Class 4*Power<0.5mW<1mW<5mW5-500mW>500mWRiskNo hazardHome use laser products can be harmful to the eye if repeated deliberate exposure of if beam is viewed using magnifying optical instruments.Only a small hazard potential for accidental exposure. The laser beams from these products exceed themaximum permissible exposure (MPE) for accidental viewing and can potentially cause eye injuries, but practically the risk of injury in most cases is relatively low for short and unintentional exposure.Devices intended for use by consumers should not be Class 3B or Class 4 laser products. Class 3B laser products may have sucient power to cause an eye injury, both from the direct beam and from reections. The higher the radiant power of the device the greater the risk of injury. Class 3B laser products are therefore considered hazardous to the eye. However, the extent and severity of any eye injury arising from an exposure to the laser beam of a Class 3B laser product will depend upon several factors including the radiant power entering the eye and the duration of the exposure.No upper restriction on output power. Class 4 laser products are capable of causing injury to both the eye and skin from direct exposure and reections also may be hazardous. Class 4 laser beams also present a re hazard. Lasers used for many laser displays, laser surgery and cutting metals may be Class 4 products.*Protective laser goggles should be wornBiostimulatory eectsNo evidencePhotochemical /Non-thermalPhotochemical/Non-thermalPhotochemical(Non-thermal)Photo-thermalcontinued overleaf15 Animal Therapy Magazine | ISSUE 18

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16Animal Therapy Magazine | ISSUE 18developed with high quality new generation LEDs will oer a viable eective entry level option for a practitioner to integrate into their practice. For less than £300, aordability, no risk to eyes with a basic user guide means an LED device can also be applied regularly at home to help maintain biostimulatory eects and possibly even reach more optimal results with regular application via the cumulative eects observed in studies. Home-use PBM is a sensible option when regular professional laser treatment is not possible due to nancial or logistical issues, if the patient has a long-term degenerative condition or when prescribed pain medication is restricted. In addition to small surface area devices, large ‘LED array’ devices are now also available for proactive general wellness, rejuvenation, helping to relieve chronic conditions or enhance sports performance. Many aware consumers will realise they won’t need to purchase a £5000+ medical laser to get pretty good health benets. More consumer devices are available in USA than Europe.A concern is the introduction of low quality or ‘underpowered’ LED devices may be available online. is unfortunate inevitable situation is already noticeable in both professional and consumer beauty market. Red light masks are widely available online and social media which sometimes cost less than £50-£100, making claims about the anti-aging and regenerative eects. Be very cautious if a full specication is not clearly showing at least the wavelengths, power output and energy density of the device and help your clients to make the right choice.High or low priceIf you are in the process of purchasing laser with limited knowledge of the market and dierence between technologies available, you may be vulnerable to exaggerated claims and be encouraged to invest in much higher priced equipment purely as a way of generating more income for the practice. High price indicating high quality and better treatment results is not necessarily as true as sales reps make out. ere is no ‘one size ts all’ laser system, they all have their limitations including new generation LED devices.e key is do your research, keep an open mind and have an idea on what level of treatments you want to oer with a PBM device whether laser or LED and don’t rely on sales information alone before investing.e fact remains that PBM is a wonderful tool, whether you wish to oer professional laser as stand-alone treatments or simply take advantage of the benets PBM oers to integrate in practice and help improve treatment outcome. PHOTOTHERAPYREFERENCESLow-Level Light Therapy: Photobiomodulation; Michael R. Hamblin, Cleber Ferraresi, Ying-Ying Huang, Lucas Freitas de Freitas, James D. CarrollLight Therapies (A Complete Guide to the Healing Power of Light); Anadi Martel (French Canadian Physicist & Researcher, President of International Light Association 2011-2018)Biphasic Dose Response in Low Level Light Therapy; Ying Ying Huang, Aaron C.-H. Chen, James D. Carroll, Michael R, HamblinHow not to Promote Laser Therapy; Jan Tunér, DDS Lars Hode, DrSci (Swedish Laser Medical Society), Peter A Jenkins, MBA (Australian Medical Laser Association) http://www.laser.nu/lllt/pdf/Confounders.pdf16 Animal Therapy Magazine | ISSUE 18

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18Animal Therapy Magazine | ISSUE 18HISTORICALLY, equine musculoskeletal practice has been centred around manual therapies. Mobilisation of soft tissue and joints, brings about a positive change in muscle balance and movement but how permanent is this change and is manual treatment enough? Posture and biomechanics Shortened, hypertonic muscles pull structures out of alignment causing poor posture and biomechanics. Pain points also lead to altered movement. The release of soft tissues will allow the underlying structures to realign and therefore oer a platform for better biomechanics and posture; however, this does not mean the latter is inevitable. Manual therapy does not address the lengthened, weakened and inactive muscles which contribute an equal amount to the problem. If these muscles are not activated and strengthened then the opposing shortened, overactive and dominant muscles will take up the slack and very quickly return to their pretreatment state. The only way to ensure the eect of manual treatment sticks, is to activate and strengthen the opposing muscles. Manual treatment ‘allows’ the structures to realign but it is the targeted exercise prescription that keeps them there. So in answer to the above question “is manual treatment enough?” the answer is no!Functionally correct movement To consider the importance of correct function let’s take an example from the eld of human exercise training. For many, the aim of going to the gym is to improve strength and muscle mass. But very often, the target exercises are of poor quality and function. A common example is using squats to strengthen weak gluteal muscles. Due to the fact that the gluteal muscles can not resist internal rotation of the femur - it would be dicult, if not impossible, to perform a functionally correct squat without valgus collapse of the knees. Valgus stress is a cause of collateral ligament and meniscal injury - repeating this movement is bad! Additionally, completing this poor exercise over and over again will only reinforce a functionally incorrect movement pattern and do nothing to activate the gluteal muscles. Not only does this reinforce a poor squat but also reinforces a poor gait. Exercises under the guidance of an exercise rehabilitation therapist, would encourage very small movements to activate muscles, only in the range of functionally correct movement. As soon as poor function creeps in, the exercise would be discontinued or changed. This approach encourages the right muscles to re and reinforces a correct movement pattern. Only when the gluteal muscles are strong and active enough to resist internal rotation of the femur and valgus stress on the knees, would a full squat be prescribed; and even then, the amount of repetitions would be determined by how functionally correct the movement was. If after three reps, function becomes poor, then three reps is enough. This example highlights the importance of exercise rehabilitation. Generally, exercise for horses during rehabilitation is focussed around a general progression towards tness. But we should be taking time to identify the biomechanical origin of the injury and prescribing very targeted exercises to correct these dysfunctions during the rehabilitation process. This principle can also be used in the prevention of injury. For example, a horse with weakness in his left gluteal muscle group will be suering from torque stresses to the thoracolumbar spine and lumbosacral joint. There will be a gait compensation and ultimately this could cause a performance limiting injury. Exercises to target the asymmetrical muscle mass would reduce these referred stresses, therefore reducing the chance of injury. Diploma in Equine Exercise Rehabilitation With our Diploma you will learn exercise techniques for the rehabilitation and prevention of spinal and limb conditions and how you can integrate exercise prescription into your current practice. By adding Equine Exercise Rehabilitation Therapist to your title, you can oer a more holistic treatment and shift the emphasis towards a longer term treatment for your patients. The Diploma comprises four units:• Foundation in Equine Exercise Rehabilitation• Equine Exercise Rehabilitation for limb conditions• Equine Exercise Rehabilitation for spinal and pelvic conditions• Clinical Practice in Equine Exercise RehabilitationThis provides learners with the opportunity to study the Diploma as a whole, or the unit certicates of interest individually. Study is exible and online for the most part with a nal clinical workshop which can be taken from anywhere in the world. www.justodevelopment.comEquine Exercise RehabilitationJUSTO DEVELOPMENT

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20Animal Therapy Magazine | ISSUE 18JOINT HEALTHThe benef its of Boswellia for joint care in petsMAINTAINING joint health for pets is important to ensure they lead a happy and healthy life with you. Their mobility can greatly impact their quality of life with even the smallest of tasks like getting into the car or bending down to their food bowl becoming a task.There are a number of reasons why your pet might need extra support with theirjoint health, which includes, old age, being overweight, as well as trauma or injury. Joint stiness tends to occur more often as you pet ages and some large breeds of dog in particular, are more prone to developing joint stiness.Signs your pet could need extra support for their joints could include:• Your pet may like resting more following exercise.• Your dog may lag behind on walks or not want to go out as much.• They may avoidperforming certain tasks, such as jumping into the car or onto a chair.• Your pet may seem irritable or sometimes aggressive.• Pets might seek out warm spots around the house, such as sunny spots, heat vents or near to radiators.Boswellia Extract for joint healthBoswellia trees are native to North Africa and India, the particular species Boswellia serrata only grows in mountainous forests of western and central India. Boswellia Extract plays an important role in maintaining healthy joint function, in dogs, cats and horses. It has been used for thousands of years and has over 400 independent clinical studies supporting its use. It has long been recognised for its fast-acting support to the natural systems that control inammation. According to early Ayurvedic texts, Boswellia was used in a number of areas such as: joint, respiratory and digestive support. More recent clinical studies have shown the ecacy of Boswellia for many more traditional uses.Boswellia Extract plays an important role in supporting smooth and comfortable joint movement. Unlike many unnatural ingredients, it does not cause damage to cartilage and its use has yielded impressive research results.The benets of Boswellia include:• It helps to maintain smooth and comfortable joint movement.• It will not cause damage to cartilage.• There are no reported side eects with long-term administration.• It does not cause glycosaminoglycan degradation, stomach irritation and joint degradation.• It can help to maintain the structural integrity of joint cartilage.Tips to support joint healthTo help maintain optimum joint health for your pet there are some positive things you can do, which include:Gentle exercise - it is important that your pet gets regular exercise to avoid stiness and muscle wastage. Think little and often to keep the joints mobile.Watch their weight - overweight dogs can be more prone to joint stiness and reduced mobility. Excess weight can add pressure to their joints. Comfort - provide a warm and comfy bed for your pet and be sure to give them plenty of bedding to pad around their joints. Visit your vet - regular vet visits ensure that your dog’s joints can be monitored. It is important to have regular health checks to ensure your pet is receiving the best possible care.Natural supplementsBoswellia Extract is the unique key ingredient innutraquin+, which is a fast-acting joint support product containing the necessary high strength ingredients that help maintain healthy joint function in dogs, cats and horses, whilst supporting the natural systems that control inammation.The benets of nutraquin+ are noticeable on average within one week due to its high strength formula and the inclusion of Boswellia Extract, which supports the natural systems that control inammation.For more information and to nd a nutraquin+ stockist visit www.nutravet.co.uk/nutraquin.

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22Animal Therapy Magazine | ISSUE 18An important diary date for early next year is Tuesday 28th January to Thursday 30th January when the UK’s only dedicated water leisure Exhibition, SPATEX 2020, returns to Coventry’s Ricoh Arena. With its three dedicated animal hydrotherapy seminars, it’s an important expo for all in the frontline of delivering treatment as well those involved in the maintenance of pools. When going green is good…SPATEX 2020 is the ideal hunting ground for new products and gives you access to the latest energy and time saving innovations for animal hydrotherapy pools. Conscious of climate change, the depletion of the world’s natural resources and the need to reduce the Industry’s dependency on plastic, SPATEX 2020 aims to promote an awareness of the environment. Talks and demonstrations in the Show’s free-to-attend, three-day double seminar and workshop programme will, amongst many other subjects, focus on how we can all play our part in becoming more eco-aware. With over a hundred international and domestic exhibitors, there will be lots of new products, including those that support a low energy, low carbon footprint. Update your skill setSo much more than just an Exhibition, SPATEX prides itself on providing a double seminar and workshop programme on all three days of the Show, packed full of free essential advice and training. Led by esteemed experts from Industry bodies such as the Institute of Swimming Pool Engineers (ISPE), the wide variety of topics include guidance on the latest methods of water treatment and testing, commercial pool operation, covers, heating and ventilation, health and safety etc. All the seminars and workshops are free to attend and attendees are awarded CPD points and a certicate of attendance. Visit www.spatex.co.uk to see SPATEX’s impressive list of exhibitors, details of the free double seminar and workshop programme and register for the Show’s regular e-newslines. SPATEX 2020 – Tuesday 28th January to Thursday 30th January. The Ericsson Exhibition Hall, Ricoh Arena, Coventry CV6 6GE is easy to get to - just 500 yards o the M6 and within two hours commuting time of 75 per cent of the population, it oers 2,000 free on-site car parking spaces. SPATEX 2020The Expo for hydrotherapists11.00 to 11.30 - Animal Hydrotherapy Pools – The Balancing Act - Howard Gosling FISPE, the renowned expert on water chemistry and former Chairman of the Pool Water Treatment Advisory Group (PWTAG), will focus on the Standards for non-human use pools. Water chemistry and balancing is not the easiest of topics and it is subject to continual innovation. This will be followed by a question and answer session. 12.30 to 13.15 - Using Research to Inform Evidence Based Practice - Dr Alison WillsPhD; BSc (Hons); PGCertLTHE, FHEA, Programme Manager BSc (Hons) Bioveterinary Science, Senior Lecturer in Animal Health, Hartpury University. Pet owners are increasingly taking their dogs for specialised hydrotherapy sessions following veterinary referral. Reasons for dogs to be referred to a hydrotherapy centre include to aid post-surgical rehabilitation, to manage chronic conditions and for general tness and conditioning. However, there is limited evidence examining how swimming or other forms of aquatic exercise (for example, walking on a water treadmill) benet dogs in terms of their locomotion. Uncertainty remains as to whether the limb movements induced by aquatic exercise are benecial for all dogs and the rehabilitation of all conditions. Further research is needed to appreciate the long-term benets of canine hydrotherapy and if clinically favourable biomechanical changes persist following cessation of therapy. 13.30 – 13.50 - Canine Hydrotherapy: Antimicrobial Management Practices - Aisling Carroll MSc, BSc (Hons), PGCE TLHE (Dist.), FHEA Programme Manager BSc (Hons) Applied Animal Science with Therapy & BSc (Hons) Animal Behaviour & Welfare, Lecturer in Animal Science & Animal Outreach Coordinator Hartpury University - Canine hydrotherapy within the UK can be delivered using swimming pools or via an underwater treadmill. The use of water in these treatment practices has been seen to improve range of motion for injury prevention and recovery purposes. Hydrotherapy centres promote warm, moist environments which provide favourable growing conditions for the proliferation of several waterborne pathogens. These can include Legionella bacteria, E.coli, Pseudomonas aeruginosa, Coliforms and Mycobacterium species which have the potential to impact the health of patients, owners and sta, especially those that may be elderly or immunocompromised. Although recommendations for the use of bromine or chlorine-based sanitisers within hydrotherapy environments exist, the susceptibility of the many dierent bacterial species is currently not yet clear. This leads to some important questions: What type of bacteria are present in this environment? What are the current management practices for the prevention of bacterial spread/infection? Moreover, what can be done to ensure the safety of patients, owners and sta? DEDICATED SEMINARSThere will be three dedicated seminars for animal hydrotherapists on Wednesday 29th January in Arena 2 to which all are welcome.

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24Animal Therapy Magazine | ISSUE 18The rst comprehensive book on Animal Osteopathyby Tony Nevin, BSc (Hons) Ost., DO. Zoo Ost LtdDESPITE the osteopathic profession being more than 130 years old, and although there are decades of clinical experience applying osteopathy to treat animals, there are currently only two published books and one self published book on equine osteopathy.If we look at chiropractic there are a few that cover the equine and canine patient. Physiotherapy has more than the other two professions combined.Why has the osteopathic profession been so slow at producing text suitable to teaching future generations? This is a question I have long asked myself.As clinical director on the Animal Osteopathy masters program run in conjunction with the McTimoney College I have found it frustrating to have little published text to oer our students. There is a vast body of knowledge from a clinical standpoint, with some published research, as well as lots that hasn’t been published.Due to this vacuum in osteopathic literature I set about putting together a team of the most suitable and respected osteopaths and veterinary surgeons in as many elds of animal work as I could reasonably t into a single textbook. It hadn’t escaped my attention that I was part of the problem, busy in clinical practice and teaching, yet having only produced a handful of research based papers over the space of 30 years.I had a publisher in mind, and once I had set out a framework for the book, with chapters covering specic types of animals and birds, I started negotiations with them.The sheer volume of work required to put this rst of a kind book together dictated the need to have a strong team of contributors from both professions. Due to the symbiotic working relationship that our two professions have I wanted to have at least one osteopath, and one vet contribute to each chapter.This not only provided the opportunity to get the best clinical minds to distil their knowledge onto paper but would also demonstrate why we should be working together.Once we had the publishers on board I set about designing a modular approach to each chapter. This was created to allow easy navigation between dierent chapters, and also great care and attention was placed in designing the book so that all could read it.To make the book as globally attractive as possible it was also decided that American English would be used, along with standard veterinary terminology so that all of the veterinary and para-professions could understand the text.A large glossary of terms has been included to further assist the student or practitioner.A total of 19 people have contributed to writing the book, with three of them also acting as editors, myself included. There were also two expert anatomical artists recruited to create the beautiful illustrations. They all form an international network and are highly respected within their professions. There are 10 chapters in total. The rst introduces animal osteopathy and some of the specic aspects of this section of the profession, as well as containing a useful table of known zoonotic diseases. The other nine chapters cover in detail applying osteopathy to the treatment of the dog, cat, small furries, the horse, livestock, reptiles, birds, small wildlife, and megafauna.The book has taken a while to compile and edit, partly due to the need to involve only those with the clinical knowledge, both in depth and scope, which meant involving colleagues who were already very busy. It is to their credit, and my eternal gratitude that they agreed to be involved. Without such a team this book would have been very much poorer.From the outset the book was designed to meet a teaching requirement to support students up to and including at least masters level (MSc), and to serve as a launch pad for those wishing to pursue a PhD.I think we have managed this. Certainly there is a vast content of knowledge not previously shared before that will be readily available to all who purchase a copy. It should also appeal to members of the other manual therapies who want to better understand what it is we do, why we do it, and how. It has not been designed to create a short cut to working with animals, but rather to create a more unied profession through international teaching.Within each chapter there is a section covering specic considerations, anatomy, orthopaedic problems, dierential diagnosis, osteopathic evaluation, osteopathic treatment, case studies, summary, and reference section. In certain chapters there are specic health and safety measures.Line drawings, as well as colour and black and white photographs, punctuate the text to clearly illustrate throughout each chapter. All this and a rather snazzy book cover have been a part of my life now for over 5 years of evenings, weekends, and holidays. Writing it was the easy part. Editing was much harder. As anyone will know, trying to get a bunch of osteopaths to agree on something and stick to a template is akin to herding cats. Add in a bunch of vets too and it has been pandemonium on occasions. However I would also add that it has been an amazing experience made all the richer by these fantastic people.The book should be available hot o the press whilst this edition of the magazine is still current. Published by Handspring Publishing, they can be found at www.handspringpublishing.comThe full title of the book is Animal Osteopathy, A comprehensive guide to the osteopathic treatment of animals and birds. Editors Tony Nevin, Chris Colles, Paolo Tozzi. ISBN 978-1-909141-30-8. There will also be an independent review of it in the magazine from one of the editors/contributors (other than myself of course) soon.

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25 Animal Therapy Magazine | ISSUE 18I’M in and out of professional sportsteams these days and get asked manyquestions about electrotherapy (orelectro physical agents (EPA's) as we’re now calling them). A lack of time to update oneself continuously on tissue repair and the evidence base is contributing to myths surrounding certain modalities. Some people just outright ‘believe’ that they do nothing, despite a huge volume of research to the contrary. Companies also do a good job of confusing us, ‘proving’ their device is the answer to all our prayers oering quick x solutions, when really it does not suit every injury or problem.Let’s be honest here, there isn’t much that’s completely brand new in electrotherapy. Companies do an excellent job of making it seem like a new product when in fact it’s a reinvention of something old. It just looks better and not like some of those dust covered scary looking devices I’ve seen lurking in dark corners of a hospital therapy unit! One of the main issues I come across on my visits is a lack of fully understanding the modality, when its best used and for what conditions. I am going to make a bold statement here; animal therapists do seem to have a better understanding than those therapists working with just humans (don’t shoot me!). In this article I am going to attempt a whirlwind tour through tissue healing with what to use and why. I am basing it on evidence, which comes from both the published resource and my own personal experience.In Fig. 1 it gives a complete overview of what is occurring when and the overlapping of the dierent activities. I think of it as an orchestra, it all starts o with just one group, the utes, slowly building tempo and sound, as other instruments join in. It builds to the crescendo of them all playing at once followed by a slowing down of tempo and instruments towards the end as they quietly go about their business.e diculty with trying to simplify anything is that there will always be Tissue healing and ElectrotherapyWhat, when, why?by Helen Walsh, BSc, MCSP, HCPC, Clinical Lead U.K. & IrelandFig.1. https://en.wikipedia.org/wiki/Wound_healing accessed October 2019.continued overleafoccasions when the injury is more severe and therefore spends more time in any of the above stages. As a therapist it’s up to us to determine a likelihood of where itsat. is is through taking a history of theinjury and in our assessment. Working with vets and having access to any diagnostic imaging of the case you are treating is very useful if not essential.Stage 1- BLEEDINGTime: up to 6 hours approximately Treatment: ICE 10 minutes on 10 minutes oFrom the table we can see that during those rst minutes the body is attempting to limit blood loss. Vasoconstriction and coagulation take precedence during the rst 10 minutes. Once there is enough coagulation to reduce bleeding the body triggers vasodilation. In that rst 6 hours the only intervention is ICE. However, this should not be le in place longer than 10 minutes. Time and again I’ve seen people strap it on and leave it during this period. e evidence has not changed regarding ice, it’s still only 10 minutes on and leave it o for at least 10 minutes. Stage 2- INFLAMMATIONTime: 6 hours- 3 days (this is ongoing for longer, as it starts crossing over with proliferation we treat dierently)Treatment: Non-thermal progressing to mild thermalInammation is NORMAL and NECESSARY. It’s got some serious bad press, we’ve been saying ‘anti-inammatory’ for a long time. ere is a point that it can become chronic and that’s the one we don’t want but in an acute injury we absolutely want it. For this reason, many including myself have been using the word ‘pro-inammatory’. Let’s try and speed it along its way but not fundamentally ‘change’ it. If you have the opportunity to treat at this point, the aim of treatment is to accelerate the normal process. As you move into this phase the intervention starts of with any of the non-thermal modalities depending on what it is that’s injured and how deep it is. Stage 3- PROLIFERATION Time: starts 24-48 hours after injury but peaks 2-3 weeks laterTreatment: Increase blood ow Fibroblasts start early on aer injury. ey play a role in angiogenesis (formation of new capillaries). It is an aerobic process and thus the increase in blood ow supports the delivery of oxygen to support it, especially in tissues that do not have a good blood supply. We can inuence this in several ways, mechanotransduction (aka exercise) can also support this process. Being selective at what exercise you start and ensuring that the healing isn’t completely disrupted by an excess of it. Other ways to inuence a greater inuence in blood ow can be through the use of EPA’s. e thermal inducing ones and the electric muscle stimulators. Stage 4 - REMODELINGTime: 1st week up to 1 yearTreatment: Heat, stretching, exercises, massageis is massively important to us therapists to achieve a well-organised scar that behaves as much like the tissue of the structure that it has repaired. You can have very positive inuences on this

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26Animal Therapy Magazine | ISSUE 18stage even months aer an injury. Never underestimate how long it can take something which has been damaged to fully repair and have the same strength it had before. Always be aware that the older a patient the longer things take! What modalities do we have at our disposal? We may only have one or two of the below. Some do more than others and you should always see if it ts with what you see week in week out! You denitely want something that can help with a majority and earns its place in your toolbox paying for itself in time! Disclaimer: I do keep abreast of current evidence I also talk to a lot of therapists which always helps when writing a guide. I do work for INDIBA which is an electromagnetic radiofrequency device. I have tried to be as unbiased in this as possible. I will always answer honestly about electro-physical agents. Pulsed shortwave therapy (PSWT) (also known as PEME; pulsedelectromagnetic energy, although thisis not the ideal name) has very goodevidence for wet/boggy tissue; muscle,hematomas, pain. e devices normallyoperate at 27.12MHz ere are now smaller devices that can be used at home for longer periods of time. ey are a good alternative to buying a huge device but you need to be aware of depth of penetration and dose (length of time) as they need to be le on for much longer to achieve a benecial eect. It’s a very useful little gadget for in between sessions especially if you can’t get backout to them and they don’t cost much tokeep a couple in your bag just in case.Pulsed and non-pulsed laser (LLLT & LILT, photobiomodulation): the main consideration of using any ‘light’ based therapy is that hair and skin are barriers. Its also been found that darker skin can block out even more of the energy by scattering and absorption. is has been found by hundreds of research papers. If it’s a wound on skin or in the rst 15mm with hair/skin colour not causing more of a barrier then laser is an excellent choice. e dierence between class 3b and 4 in simple terms; a class 4 can deliver more energy in less time. It does not go deeper, despite what the company say. ere is also no evidence yet showing that the mitochondria further down will take the energy deeper into the body. e issue has always been that laser works where it reaches brilliantly, it does nothing more than you just looking at it, anywhere it cannot reach. erefore hair, skin and what your trying to treat really matter with this type of energy delivery. It can be delivered in non-thermal and thermal doses, the heat can be a nice addition. Be wary of very expensive ones claiming they go deeper and do your homework if purchasing. Ask for a trial and look at what actual results you get in the outcome measures.Pulsed electromagnetic elds (PEMF) I’d throw it out there that this is one of the most highly confused areas of EPA’s. It is not surprising, the complexity of the interaction of electricity and magnetism can have us baed within minutes, especially when even the evidence has a multitude of parameters with quite a few not stating all the information needed. In so tissue injury, I’m not currently convinced (you may be and that’s ne!) that the best way is by wrapping the limb and having the magnetism around it. e evidence is patchy. I do think there is enough supporting pain relief though. However, one thing that does strike me is that sucient magnetic therapy needs to be delivered in order to achieve therapeutic results. Again, penetration depth of the therapy can quite oen be supercial even when le on for long periods, as in the study by Steyn 2000 where the measurement at 7mm from the wrap showed no dierence to the earth’s magnetic eld. Quiz the company on all the parameters and review the evidence for dosing.Ultrasound: I almost feel like it doesn’tneed to be in the list. I’d guess it’s themost well-known. Its cheap and easyto understand and there is a plethoraof evidence to support its use, thinkligaments and tendons. You can be verysupercial, and you can go a little bitdeeper. It’s considered a non-thermaltreatment because you will feel nothing.It doesn’t reach warm temperatures. Interms of fractures the evidence is very good. So much so you can get one on the NHS for delayed union (if your lucky, it is on NICE guidelines). Sports people use ultrasound to speed up fracture healing and do very well with it. Again, there are numerous companies selling devices so do your research and make sure it actually does do what it says on the tin.Radiofrequency electric currents (RFEC) In all honesty I have put this last because I clearly work for INDIBA which is a RFEC device. Confusion can arise with this technology from it being an electromagnetic current at a particular radiofrequency, INDIBA is 448KHz and currently the majority of evidence has been at RF 448KHz. e most ‘like’ it would be pulsed short wave, however there is a big dierence, the delivery is a direct electric current into the body which passes all the way through the body with some exiting via a neutral return plate. Recall above we mention magnetic with the coil on the outside, the magnetism here is accompanying the electric current through the tissues. e second part of confusion is that it can sit under the electrical stimulation title even though there is no muscle contraction, it can also deliver a thermal treatment to temperatures of 42 degrees and it can be non-thermal. is is the only one that I am aware of that goes very deep as it travels to wherever the neutral electrode is placed, and it is the only one that the evidence states will maintain an increase in tissue temperature for at least 45 minutes. All other modalities stop when the treatment stops. e limitation on this device is that the equine device is a bit heavy, it certainly will build your muscles. e small animal device for canine is super light. Again ask questions of the company and trial before you buy (I know you’d be convinced anyway like I was).at was a whirlwind tour through some modalities that can help in tissue healing. Apologies for not exploring everything!For anyone wanting more information there is a lot online, a quick Pubmed search will keep you busy for hours on the topic! Professor Tim Watson does have a new book coming out, (those of us who do not have hours to review the literature and critique it, he’s done it for you!) Amazon list it as March 2020 for release; Electro-physical agents: Evidence based practice, but you can pre-order now. In this there are plenty of updates on the last, as is the way with evidence, it keeps growing and hopefully informs our practice to achieve better outcomes. Professor Tim Watson will be presenting his popular talk this time on Pain in February 2020. Keep a look out for the date and tickets. If you follow us on Instagram (@indiba.animal.health.uk) follow INDIBAUK on facebook or sign up on our website (INDIBA.COM) on the animal health page you’ll be the rst to hear about any of our upcoming CPD events! TISSUE HEALING & ELECTROTHERAPY

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28Animal Therapy Magazine | ISSUE 18I RECENTLY watched a video online of someone struggling to get her ex racer into a contact. In the video the horse showed some head lobbing and a general resistance to any form of pressure on the rein and therefore the horse would be ‘running’ around the arena. e trainer was guiding the pupil of how to correct her position to get her ex racer to accept the contact. Her advice was; • To sit down into the horse• To keep her shoulder blades back and together• To lock her elbows to her side, with a rm grip on the rein and then push/drive the horse forward into the rein contact she has provided. As a retainer of ex racers I could see that this concept would, in time, possibly work; however, what I also know that in terms of longevity, progressing in training and most importantly, the soundenss, or comfort of the horse would not be maintained. Sometimes, the problem that we have isn't that the training or advice being given is incorrect advice, its advice which doesn't take into account the breed that is being trained. With any ex racer the weakest point in their conformation is their back. ey lack core strength and posture aer their let down period. eir neck is their h leg which they use to balance themselves. e breed itself isn't bred for us to ‘sit’ on them. ey are built for speed and endurance. With correct training both ridden and in hand we can develop the core muscles so they are strong enough to allow the rider to sit on them, but I cannot see how in the early stages of training by ‘forcing’ the riders seat into the horses back how that will help with the strengthening, correct training and development of the horse.A common misconception is that ex racers speed up because they ‘just want to go fast.’ e reason that your ex racer changes in rhythm when on the at is due to lack of balance. When the lose their balance or feel like their balance is being tested they speed up. Its like us humans in life. If we meet a problem, we try and get through it as fast as possible so its done and nished and gone. e one thing that most ex racers hate is the feeling that they cannot move forward, or that the ‘front door’ isn't open. Its nding a balance between you as a rider feeling like you can create a language and relationship with your horse so you can have control, but also so your horse doesn't feel conned, or ‘pinned down’ into a frame that they must sustain. e scales of training apply to any horse, any breed, any age and any level. e way in which you have to approach each scale may be dierent, and that is where your training comes in; however, it must not be lost, or even sacriced to obtain a desired picture.1. Rhythm 2. Supplness3. Contact4. Impulsion 5. Straightness (which leads to 6 which is collection)ey are meant to be achieved in this order, although there are occasion where one can be skipped in order to improve another. Until your horse is working in a rhythm he/she will not become supple. Until the horse is supple the contact will be inconsistent (degrees of suppleness vary according to the level of training) If the horse is not working through a supple back, forwards with impulsion to a consistent, elastic contact, he/she will not be straight. Collection could be referred to as balance, which we as retainers need to ask ourself at every level; where does the balance sit?We always have to remember and refer to; what do we have when we start? i.e. how has our racehorse been trained and allowed to go? And, where do we want to end up? It is dicult with social media these days to not get caught up in the hype, or seeing someone progressing quicker than you and you being tempted to try and keep up. As a retainer you have to remember that each horse has its own journey and there is no such thing as a ‘quick x,’ especially when it comes to the ex racehorse! Looking at the “Dubai Prince Change’ image you can see from the top photograph as a racehorse, that this is what we start with! A horse who is long in the frame, is allowed to travel (‘front door is open’ the hind limb reaching through, the croup higher than that of the front end and a giving rein to encourage the length of stride. Looking at the bottom right image of the same ‘moment in time’ in the canter phase as a retrained racehorse. e hind limb action is still reaching under his body; however, the croup is now lower than the wither as Dubai Prince has been given the time and training to become stronger over the back, which has allowed and encouraged the hindleg to take the weight. As a result the wither and shoulder have been able to li up, with the neck forward, out and not being used to balance. e ‘front door’ is still open and he can move freely forwards, but in a new balanced way compared to the top photograph. For the level of training that he was at in this photograph, the poll slightly dips down and away, and in an ideal world you would want to see the poll half an inch higher. However; for where he was From RaceHorse to Dressage HorseTHOROUGHBRED DRESSAGEby Louise RobsonAre we truly allowing our ex-racers to ‘go forwards’ ?

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29 Animal Therapy Magazine | ISSUE 18continued overleafin his training at this moment in time, he felt comfortable in that position and wanted to move freely forward. is is the sacrice you take for your horse as a retainer, and build on it over time rather than force the head to come up and the back and the neck to become sti. I see many an ex racer that has been taught to ‘put its head down’ and the rider then telling me that they're struggling in their dressage tests with; medium trot, transitions and general ride ability. I would almost be tempted to call this the ‘shut down’ stage. In the ‘shut down’ horse you will see;1. Resistance2. Contact issues3. Imbalance issuesIt is easy to get into the ‘shut down’ stage because it will feel like you have made your exracer quieter, slower and therefore in some peoples head ‘more rideable.’ In fact all you end up seeing is a horse who cannot truly move forward, swing across the back into a so contact and ultimately a harmonious pairing. We also have to bear in mind the comfort level of the ‘shut down’ horse. If all our ex racer is doing is ‘putting his head down’ then they will not be through the back and engaging their hind quarters. Much strain will be put in the back, under where the rider sits and the hindquarters. With these added strains you will get soreness through the back, which in a worst case scenario can lead to orthopaedic problems as the limbs are being over loaded to compensate for the sore back. e reality is is that all of the energy has to go somewhere! We have a big advantage in that our ex racers want to travel forwards, its just how dow we use that explosive energy, with their fast twitch bres ‘for good’ in a new way of going, rather than trying to force them to be slow and steady. Lots of gear changes, varying sized circles and transitions within and between each pace and also an allowing hand, with a so seat from the rider. In the early stages it is hard to ‘sit up’ on our ex racers. ey do slightly pull us forward from the hip, this s because them themselves are on the shoulder and struggling to maintain a throughness through the back and take us with them. Yes, we need to be able to sit up, but we need to be kind on ourselves and to see it as progression through the levels. Take it, if you will as a riders ‘scales of training’ alongside your horses. As their rhythm, contact, suppleness, straightness and impulsion become better so too do yours. if you can ride exercises that help with your horses straightness and balance, then you will be able to sit straight and in better balance. ere is no arguing that one of the hardest things for the ex racer to understand and be able to do is maintain and go forward into a contact. For your ex racer to be in a true contact, they need to be connected from back to front; however, how can we do this as in the early stages of retraining the back is a very weak point in the ex racer. e posture of the early ex racer is incorrect. ey lack core muscles and need time to develop these. Long reining, long reining over poles, lunge work in a pessoa, and hacking up and down hills will all help build them up. Spending less time on their backs will only help them in the long run. Once under saddle, we need to think of suppleness through the jaw to allow the release of the h leg (the neck) which in turn will release the back and then allow us to work from back to front. is is most true of Mission Impossible aka Silver who had 67 runs before he started his retraining as an 11 year old. He is described as a ‘war horse’ of the racing world, but also means he was rather set in his ways. e contact has been the hardest thing for him to understand and maintain, mainly because he is so dependant on his neck for his balance. As you can see from the top image (‘Silver change”) Silver has a rather large canter with a big hind limb action that pushes the balance almost up and over the top of him. When being asked to ‘sit and take the weight’ behind he would struggle to nd space under his body for that big hind limb movement to go. Lots of canter leg yields both from the quarter line to the track and on a circle helped place the shoulder on a dierent Dubai PrinceMission Impossiblecontinued overleaf

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30Animal Therapy Magazine | ISSUE 18line to that of the hindleg which allows it to come through and under his body. You can see from the photo abovethat the neck of Silver is very ‘out’ and could be a fraction rounder. e same with Dubai prince, for the level that he is at this is sucient until he becomes more comfortable and understanding in his balance and way of going. is canter keeps the forward movement without impinging on the canter quality. Its not just on the at that we can slightly ‘over control’ a situation. I thinks its very important for all horses to be seen free so we can see where their ‘natural’ way of going sits, o we as riders can asses, see what we can improve, but also, when we just need to leave them alone and let them go in a way that allows them to be happy athletes. Meet Lawrence aka Carole’s Lord. I knew from the moment that we lose jumped him that he would go onto be a superstar in the eventing world. You can see from the photo ‘baby Lawrence’ that this horse never had a problem with scope and tidiness over a fence, even in the early stages of retraining. Ironically he always struggled with maintaining a true three beat canter on the at, unless he was going a little ‘too quick’. Circles, transitions and lots of ‘square riding’ has helped him nd his balance and strength over his back. With most of the ex racers if you can position the shoulders on a slightly dierent track to the hidnlegs, it helps with the rhythm, balance, suppleness etc and their never truly straight so they cannot disconnect and fall onto their shoulders (Which is what most naturally want to do) With his wonderful rider Sarah Perry, they have worked hard on being able to maintain a three beat canter into a fence, without interfering too much with him, so when he jumps with a jockey on board (‘Lawrence jumping’) he is still able to jump the way he did on day one of his retraining. No matter what type of ex racer you have, there is always a ‘way forward’ and through your retraining problems. I think its very important to always assess as you go along the way and ask yourself; am I happy for the level that they're at. Always be willing to sacrice either your position, the ‘show frame’ or even a rosette for your horses happiness whether it be mentally and or physically. It will pay o in the long run!Mission ImpossibleBaby LawrenceTHOROUGHBRED DRESSAGE

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32Animal Therapy Magazine | ISSUE 18OSTEOARTHRITIS (OA) is a degenerative joint disease that causes pain and lameness in aected animals. e clinical presentation is caused by abnormal changes within the tissues of synovial joints, which includes loss of articular cartilage (Sanderson et al., 2009). As OA cannot be cured, it tends to be managed through a range of dierent approaches, which include, but are not limited to, analgesics, physical therapies and dietary management. It is important that owners understand that OA is a separate entity from the normal ageing process and that it has specic causes and clinical signs that require veterinary intervention (Rychel, 2010). e goal of treatment is to keep pets comfortable, mobile and pain-free for the rest of their life. Previous review articles have focussed quite extensively on pharmaceutical and nutraceutical management of canine OA (Aragon, Hofmeister and Budsberg, 2007), but increasing use of a range of therapies including hydrotherapy, manual therapies and electrotherapies suggests an additional need to evaluate the evidence in favour of these approaches. Pharmacological ManagementA common approach to the management of canine OA is to alleviate clinical signs through the administration of non-steroidal anti-inammatory drugs (NSAIDs) (Johnston, McLaughlin and Budsberg, 2008). Practices for prescribing NSAIDs for dogs with OA vary quite considerably with some clinicians recommending continuous therapy and others suggesting a more intermittent approach where drugs are only administered as needed (Innes, Clayton and Lascelles, 2010). ere are clear advantages and disadvantages to both approaches with constant therapy proposed to oer better pain control and improved joint use, and intermittent therapy mitigating adverse eects associated with long-term use of NSAIDs and issues with owner compliance (Innes, Clayton and Lascelles, 2010). Whilst NSAIDs can induce a range of side eects based on their mechanism of action, one of the most likely serious complications of long-term usage is gastrointestinal problems. However, there are a lack of controlled studies examining the adverse eects of long-term, compared to intermittent, use of NSAIDs in dogs. Research has indicated that aspirin is more likely to cause gastric bleeding than some of the more recently developed NSAID classes (Sennello and Leib, 2006). ere are many specic drugs that fall within the NSAID class that are used for the management of canine OA and some of these have been researched more extensively with regard to their clinical ecacy and how well they are tolerated. Meloxicam has been the subject of a number of veterinary clinical trials and has been demonstrated to be eective in reducing clinical signs of OA, with 12% or less of dogs experiencing mild gastrointestinal side eects (Doig et al., 2000; Nell et al., 2002; Moreau et al., 2003; Peterson and Keefe, 2004). Similar clinical studies have been performed for rocoxib, again demonstrating clinical Nutritional and therapeutic management of Canine Osteoarthritisby Dr. Alison Wills & Aisling Carrollbenet, but also indicating that adverse eects do occur in a small percentage of dogs studied (Hanson et al., 2006; Pollmeier et al., 2006; Ryan, Moldave and Carithers, 2006). Carprofen is the most studied of the newer NSAIDs, with a number of clinical studies attesting to the benet of the drug in alleviating the signs of OA (Johnston, McLaughlin and Budsberg, 2008) whilst only eliciting adverse eects in a small percentage of dogs studied (Mansa et al., 2007). Some dogs may be unsuitable for treatment with NSAIDs due to pre-existing renal, hepatic or gastrointestinal conditions. Gabapentin has been proposed as a suitable alternative in these animals, with low starting doses used to reduce sedative eects (Rychel, 2010). e opioid tramadol (sometimes considered an ‘atypical’ opioid) is also used in the management of canine OA. Tramadol may be used alone or alongside NSAIDs as part of multi-modal therapy in veterinary medicine to manage OA (Johnston, McLaughlin and Budsberg, 2008). However, despite this combination having been proven to be eective for people with OA (Wilder-Smith et al., 2001), there is a lack of clinical evidence in canine OA. However, combinations of tramadol and NSAIDs such as meloxicam or rocoxib have been investigated as a method of pain management for dogs undergoing surgical procedures (Davila et al., 2013; Teixeira et al., 2013). ese studies demonstrate the analgesic ecacy of these combinations but do not oer information on how well this pharmacological approach is tolerated when used for longer durations as is necessitated by chronic conditions. Animals undergoing other forms of therapy for management of OA such as hydrotherapy or physiotherapy may also be prescribed pharmacological treatment, which is paramount in ensuring the welfare of animals receiving therapeutic interventions.Hydro. Photo: Cotswold Dog SpaOSTEOARTHRITIS

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33 Animal Therapy Magazine | ISSUE 18continued overleafDietary ManagementWhen considering the treatment or prevention of OA, diet can play a signicant role; through supplementation or weight loss. Obesity is one of the most important management issues when considering OA in dogs. It is particularly common in small animals and is an important contributing risk factor in the development of the disease. As a dog ages, if obesity continues to be an issue, this can predispose the animal to a number of so tissue injuries such as cranial cruciate ligament rupture (CCLR) (Bokarewa et al., 2005). e additional weight can put signicant stress on aging joints, which can result in chronic inammation. is may ultimately lead to the animal becoming less active due to pain and lack of mobility and will adversely inuence joint health (Rychel, 2010). Previous studies have shown that a decrease in food intake leading to weight reduction will reduce clinical signs of OA and can improve the mobility of an animal (Budsberg and Bartges, 2006). Veterinary management of OA patients should equip owners with the necessary knowledge and guidance to continually assess and monitor weight and if necessary implement a weight loss programme. Joint Supplements and Nutraceuticalse evidence regarding the use of nutraceuticals and joint supplements to treat OA is varied and product dependent. Some studies have shown that the use of glucosamine with chondroitin can help reduce joint pain and these are typically the most common nutraceuticals recommended (Aragon, Hofmeister and Budsberg, 2007; Johnston, McLaughlin and Budsberg, 2008). ese have been observed to delay the onset of joint degeneration but the evidence of individual supplement ecacy is lacking due to dierences in product quality and bioavailability (Adebowale et al., 2002). Although there is limited evidence on the use of dietary supplements to treat or prevent OA in dogs, human studies may provide insight into the potential benets of this approach. Oil and fat extracts from avocado and soybean plants have been used to manage human OA (Altinel et al., 2007). Small studies focusing on equine, feline and canine OA patients have shown promising eects in improving mobility (Kawcak et al., 2007; Boileau et al., 2009). However, knowledge of the optimal ratios and doses of these components is still lacking. e benets of omega-3 fatty acids in treating and preventing inammation are well documented in humans and animals (Hansen et al. 2008). Omega-3 fatty acids are anti-inammatory and incorporate into synovial membranes and other joint-related structures. Other than their anti-inammatory properties, onega-3 fatty acids have a number of additional health benets such as improving renal and cardiac health, improving atopic disease and reducing neoplasia. Ideally, owners should be looking out for products that are high in eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA).HydrotherapyResearch has identied OA as the third most common reason for dogs to be presented to a canine hydrotherapy centre in the United Kingdom (Waining, Young and Williams, 2011). However, controlled studies of the eect of hydrotherapy on dogs with OA are lacking. e majority of experimental research into the use of canine hydrotherapy has focussed on dogs that have suered CCLR (Marsolais et al., 2003; Monk, Preston and McGowan, 2006). One study investigated the eect of a single session of swimming on the mobility of dogs with elbow dysplasia (Preston and Wills, 2018), but did not focus on dogs diagnosed with osteoarthritic changes. Research assessing the eect of swimming on OA biomarkers (substances that can be measured to indicate severity of the disease state) found signicant improvement in OA dogs that had undergone an eight-week swimming programme. Pain was also improved for the swimming group at week six (Nganvongpanit et al., 2014). Despite the lack of studies directly examining dogs with OA, theoretical consideration of the physical properties of water indicates that hydrotherapy is likely to benet osteoarthritic dogs (Cartlidge, 2015). In addition, given that hydrotherapy has been demonstrated to increase range of motion and stride length in dogs with other musculoskeletal pathologies, including predisposing causes of OA, it can be purported that hydrotherapy should also be benecial for osteoarthritic animals. PhysiotherapySimilarly to hydrotherapy, studies investigating the ecacy of physiotherapy tend to focus on dogs that have undergone specic surgeries (e.g. for CCLR) rather than the spectrum of pathological changes Physio. Photo: Cotswold Dog Spa

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34Animal Therapy Magazine | ISSUE 18characteristic of OA. A study of ten Labrador retrievers identied that daily passive stretching for 21 days resulted in a signicant increase in range of motion (Crook, McGowan and Pead, 2007). A programme of intensive physiotherapy and caloric restriction was shown to be eective in inducing weight loss and improving mobility and symmetry in dogs with OA (Mlacnik et al., 2006). Whilst these ndings appear to indicate the benet of physiotherapy, the improvement was seen in conjunction with weight loss, which in itself may have facilitated increased mobility. Furthermore, the intensive physiotherapy programme included the use of electrotherapy, which could have been responsible for the positive eect seen. ElectrotherapiesLaser therapy has been shown to be eective in controlling pain associated with inammation whilst avoiding the systemic side eects associated with long-term pharmacological management of pain (Di Domenica et al., 2005). An analgesic eect achieved via the use of red and near-infrared light would potentially allow the animal to display greater range of motion and may alleviate the symptoms of OA in the short-term (Saunders, 2008). Another alternative therapy is electrical stimulation. is type of therapy is used to increase strength and coordination in muscular structures, improve range of motion and decrease uid retention and pain (Johnston, McLaughlin and Budsberg, 2008). is can be particularly benecial for patients that are inactive as muscle atrophy can be avoided through electrical nerve stimulation (Saunders, 2008). Studies have shown that electrical stimulation set at 50 pulses for 175 microseconds causes a muscle to contract up to 50% of the normal isometric contraction. It was found that this neuromuscular stimulation can promote a faster return to function and can inuence the development of OA in dogs that may have suered an injury (Johnston, McLaughlin and Budsberg, 2008; Taylor, 1992). AcupunctureAcupuncture has also been considered as an eective and safe method for the management of OA, in particular pain. It is recommended that acupuncture be considered as part of a multimodal management plan (Fry et al., 2014). ere is growing evidence to support the use of acupuncture for the treatment of pain in veterinary medicine so much so that it is now accepted as a treatment method for pain in animals (Cassu et al., 2012; Groppetti, 2011).Conclusionere are a number of dierent therapeutic approaches for the management of the clinical signs of osteoarthritis in dogs. Whilst pharmaceutical intervention has been shown to be eective in pain management, there are potential concerns regarding side eects associated with long-term therapy. Alternative therapies including hydrotherapy, physiotherapy and laser therapy have been shown to reduce pain and inammation, in addition to increasing range of motion in animals with musculoskeletal pathologies. However, the long-term benet of these therapies in unclear and there may be cost and time implications of repeated treatments. Weight loss has been demonstrated to benet dogs with OA, whilst dietary supplements lack empirical evidence and are dependent on owner compliance. Combinations of therapies are commonly utilised as part of multi-modal treatment plans, these should be designed in collaboration with the veterinarian, paraprofessionals and owner to ensure optimal welfare and quality of life for the patient.e references for this article are available on request. Please email: hannah@animaltherapymedia.co.ukOSTEOARTHRITISAnimal and AgricultureHartpury UniversityHartpury, Gloucester GL19 3BEwww.hartpury.ac.ukHartpury is a specialist educational provider located in Gloucestershire with more than 3,600 college and university level students studying postgraduate and undergraduate degrees, A-levels and diplomas in the areas of sport, equine, animal, agriculture and veterinary nursing.Physio. Photo: Cotswold Dog Spa

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35 Animal Therapy Magazine | ISSUE 18NOW, fairly settled into my new home in Wiltshire, whilst clocking up the miles between teaching and clinics I’ve had time to reect on how the relocation has shaped my thinking on my sport and the way training and physiotherapy are so intertwined. Sitting and thinking about this topic during my motorway miles has actually been a nice change from subjecting my poor dogs to me screaming along to Adele songs. I’d say they are pretty relieved too!As a dressage rider and trainer I’d condently say that out of all the sports, dressage has to respect the correct mechanics of a horse. The dressage arena is like a microscope, you can’t get away with anything! This is mapped out for us with the scale of training pyramid which is my go to holy scripture to check the right education goes into the horse at the right time.What has been so fascinating about moving to Wavering Brooke’s farm and working alongside Equiperformance, is the daily input I’m receiving pre and post exercise.Admittedly I have limited technical understanding of the muscle groups and ways in which they work together, but where I am more at home is the mystical work in our industry, feel, gained from years of experience on many horses at varying stages in their career, diering conformations, ailments, personalities and histories.What the move has done is make me far more aware that on a daily basis there are more tweaks and adjustments I can make to accommodate weaknesses and imbalances. Not wanting to paint a picture of me being a robotic circus master but I’ll be honest and say that I am very pragmatic and have learnt from the majority of horses that struggling to achieve a particular movement or posture, does not instantly mean you have a physical problem. Of course it can but it can also just be that that horse isn’t ready for that stage of training and you just need to back for a bit and revisit at a more appropriate time for the horse, be that roundness, stride length, bend or strength. When my PT pushes me at the gym to be more equal in my body I understand why I am struggling with certain things, but by and large, over a period of time the struggle reduces as I train my body to be stronger and more symmetrical. Light bulb moment! Horses are no dierent.Working alongside physiotherapists on a daily basis has really opened my eyes more to another way of looking at why a horse isn’t performing to its full capability. Whilst they may say ‘no’ at one stage in their life, with correct development there is no reason why, in 3, 6, 9 months time they won’t happily say yes.Levi’s BlogUnder the microscope ...LEVI HUNTLevi regularly runs clinics up and down the country. If you would like an opportunity to experience his expertise, wit and charm rst hand you can contact him via his facebook page - Levi Hunt Equestrian or through his long suering PA - Nicky on 07771 610027Levi Hunt - Grand Prix International Rider for Great Britain, British Dressage Young Professional of the year 2016, Regional British Dressage Team Trainer, UKCC3 Coach

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36Animal Therapy Magazine | ISSUE 18CERVICAL SPONDYLOMYELOPATHYCervical vertebral malformation is a complex syndrome involving compressive lesions of the spinal cord. e condition aects both the dog and horse and the true etiology is poorly elucidated and is subsequently determined multifactorial.e pathogenesis of the disease has dierences between species and breeds, yet the clinical signs and resultant global physiological eects are the same. e prognosis is generally guarded and much controversy surrounds its treatment.In the second part of this series we discuss diagnosis and treatment.Diagnosise diagnosis of CSM is established viadiagnostic imaging. Denitive diagnosisof the dog is possible via magneticresonance imaging, as three dimensionalexamination across both a transverseand sagittal plane is possible, allowinggood visualisation of the spinal cordparenchyma, articular joint processes,nerve roots and intervertebral discs(Murthy et al 2014). Conversely in the horse it is reported to be conrmed by exclusion, following neurological examination and remedial two dimensional imaging techniques such as radiography and myelography, which has obvious limitations in terms of distinguishing pathogenesis. Rush (2009) discusses cytology of the cerebrospinal uid to rule out inammatory or infectious causes of neurological dysfunction to enable the clinicianto reduce disease dierentials, andsubjective assessment of the radiographsfor vertebral malformation and objectivedetermination of vertebral canaldiameter using sagittal ratio scoring(Janes et al 2014).Treatmentere is extreme controversy regarding the most appropriate treatment in both species with over 10 diering surgical techniques referred to within the literature (Steven 2013). ere is a poor prognosis associated with conservative management while surgical intervention is associated with increased mortality (Steven 2013).Canine CSM TreatmentConservative treatment has been historically considered ineective, but was implemented as a temporary measure to alleviate clinical signs. ere is a paucity of data to support this summation and in fact a growing base of evidence to support the ecacy of pharmaceutical and physiotherapeutic intervention in moderating the clinical signs associated with disease (Speciale and Fingeroth 2010; Platt and da Costa 2012). Da Costa et al (2008) reported either improvement (54%) or plateau (27%) in 81% of dogs managed medically, conversely Steven (2013) discusses reported success rates between 38%-45% with most dogs demonstrating adverse side eects from corticosteroid use, with most dogs being euthanised 6 months following diagnosis. e cornerstones of medical management are reported as corticosteroids and exercise restriction and appropriate restraints to prevent exacerbation of the dynamic disease component through high impact concussive activities (Platt and da Costa 2012). ere is no empirical data to support the ecacy of corticosteroid use, however Platt and da Costa (2012) explain the pharmacodynamics describing their action in decreasing vasogenic odema, protection from glutamate toxicity and reduction in apoptosis. Speciale and Fingeroth (2010) report some success with physiotherapy if there is good owner compliance but this paper examined a very small sample population of just 3 dogs. ere are in excess of 20 surgical treatment techniques reported within the literature and despite many authors reporting good successes, Steven (2013) states the large number of reported interventions reects the dicultly of treating CSM.ere are two basic types of surgery in the dog, either decompression or distraction-stabilisation procedures (Steven 2013). Direct decompression procedures reported include dorsal laminectomy, dorsal laminoplasty, ventral slot, inverted cone slot and hemilaminectomy (Platt and da Costa 2012). Distraction techniques are reported in abundance with varying arrays of media used to provide distraction of the vertebrae, ranging from bone gras through to thermoplastic polymers and titanium implants, all of which were combined with discectomies or ventral slots (Platt and da Costa 2012).Decompression via a ventral slot procedure is reported appropriate for single, static lesions but is described as challenging in the patient with DA-CSM because of the high probability of concurrent cervical vertebral malformation (Stevens 2013).Cervical Spondylomyelopathy PART IIby Danielle Pountain, RVN, Dip HE CVN, Dip AVN (SA)36 Animal Therapy Magazine | ISSUE 18

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37 Animal Therapy Magazine | ISSUE 18Vertebral distraction is reported to be indicated in the treatment of traction responsive lesions, dorsal spinal cord compression and nerve root impingement. ese procedures involve distract and implant xation (Steven 2013).Several surgical studies report good immediate post-operative success rates of between 70-80%, while long tem mortalities rates vary from 19-43%, with reports of 20-30% of cases demonstrating a re-emergence of clinical signs associated with neurological dysfunction (Steven 2013).Equine CSM Treatmentere is a paucity of evidence examining the outcome in horses with CSM following either medical or surgical treatment (Homan and Clark 2013).Conservative management of CSM isreportedly associated with a guardedprognosis with Rush (2009) suggestingfull recoveries are unlikely withoutintervention. Due to the link betweendevelopmental orthopaedic diseaseand nutrition, dietary modication is areported treatment technique in horsesunder 1 year old. e aim is to correctendocrine imbalances associated withhigh carbohydrate meals. Excessivecarbohydrate consumption increasesserum insulin and reduces serumthyroxine, which have been identiedas promoting factors in cartilageproliferation and retention withoutmaturation (Rush 2009). Clinical dietary modication involves the restriction of energy and protein, balanced vitamins and minerals with an abundance of vitamin A, E and Selenium (Hahn 2010). Reports indicate that box rest, glucocorticoids and Dimethyl sulfoxide (DMSO) have been demonstrated to oer transient resolution or improvement of clinical signs (Hahn 2012), while Homan and Clarke (2013) discovered 30% of 70 race horses treated medically went on to establish athletic careers. Rush (2009) suggests horses with neck pain may benet from intra-articularadministration of steroids andchondroprotective agents. Surgical intervention is the most widelyreported treatment method for equineCSM and is indicated to stop therepetitive trauma to the spinal cord.etiopathophysiology and consequently the treatment of the disease is still unclear. It is apparent that due to the availability and non-invasive nature of advanced diagnostic imaging techniques in the dog there is clearer delineation of the condition in this species. As it is not yet widely possible to perform three dimensional imaging of the horse, most cases are diagnosed on the basis of exclusion of other pathology. Due to the multifactorial nature of the disease with genetics, trauma, breed, age, husbandry and conrmation all reported to play a role in its development a multimodal approach to treatment is probably best advised, determining if surgical decompression or distraction is necessary based on the clinical signs and intended use of the horse or dog, owner compliance and nances, recruiting pharmaceutical and physiotherapeutic modalities where indicated. As there is poor correlation between the clinical sign and the extent of spinal cord compression and no established criterion for determining prognosis, this condition will remain a challenge to veterinary surgeons and pet owners alike. It is apparent that more research into this complex and devastating set of disease processes is necessary.In the horse we also see the reported division between appropriate intervention of distraction and decompression (Rush 2009). With Rush suggesting that horses with dynamic lesions undergo ventral stabilisation with the aected vertebrae fused in extension, while patients with static compressions should be considered as candidates for dorsal laminectomies involving removal of portions of the dorsal lamina, ligamentum avum and joint capsule at the site of compression. Horses that undergo cervical vertebral surgical intervention are reported to require a period of convalescence and rehabilitation of 6 – 12 months and gradual reintroduction to work with individualised exercise programmes that are based upon the neurological status and proposed use of the horse. Physiotherapy is advocated to help increase muscle strength and hasten return to work. Low intensity activities with greater duration are reported to be the most benecial (Rush 2009).ConclusionCSM is a complex and diverse multifactorial disease that aects man, horse and dog. ere is much that has not yet been elucidated and the 37 Animal Therapy Magazine | ISSUE 18

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38Animal Therapy Magazine | ISSUE 18Motivating and understanding the needs of RidersRIDER COACHINGBy Dianne Roberts BHSI/Stage 5 Performance Coach in Complete Horsemanship, BSc (Hons), UKCC 3 and BD CoachFROM a coaching point of view, I have seen many dierent types of rider over the years and have been guilty of wanting them to become better horsemen or horsewomen than they want for themselves as being passionate about learning, I thought that everybody else aspired to reach the same goals and push themselves as far as they could go rather than understand that they were as far as they wanted to go.For many years, I was based at a Midlands College and taught the equine management programmes across Further Education at Level One, Two and ree and was a course tutor for the National Certicate, Diploma and Extended Diploma courses for several years. ese courses at L3 are “A” level equivalent course and one of the modules is devoted to riding where the student must attain a certain level of riding and jumping, depending on the level of course being studied.Prior to the start date of the course, students are invited to attend an interview where their suitability for the course is looked at and the riding standard is assessed.Many of these riders had declared they had been riding for many years, some had declared 10 and 15 years where it would be assumed that a certain level or standard of riding would have been reached. Although true for some, unfortunately, in many cases, this was not so. Riders were unbalanced with a heavy “chair” seat and riding totally behind the movement of the horse which hinders the horse’s way of going and the rider is unable to inuence the horse in a positive way, being dependent on the reins for balance. Some were just very ineective in their riding and travelled as a “passenger” unable to inuence but also not being aware of what was going on underneath or around them.From a coaching point of view, to become an “expert” may take 100,000 repetitions of a skill or more, Arthur Kottas-Heldenberg in one of his demonstrations discussed that we need two lifetimes or more to really learn to ride. e learning process can be broken down and described as the following pieces of a jigsaw puzzle:Unconscious Incompetence – the rider is not aware of what is happening, and the riding position is dicult to maintain balanced.e learner may not be aware of the existence or relevance of the skill area and may not be aware that they have a deciency in the area concerned. e learner might deny the relevance or usefulness of the new skill. In order to progress, the learner must become aware or conscious of their incompetence in the skill area before any development of the new skill and learning can begin.e aim of the coach/trainer or teacher is to move the learner into the ‘conscious competence’ stage, possibly by demonstrating the skill or ability to the learner and discussing the benet that acquiring this skill will bring to the person’s eectiveness and competence as a rider. I have found the use of videoing the sessions and observational analysis useful as well as discussing the learner’s own goals and aspirations as a motivational tool or technique; but, be careful not to crush or demotivate at this stage. Try to document some positive points such as “what went well” during the session and get them to tell you or write down as a record “it would be even better if…..” is will enable the coach/trainer to decide if any progress was being made and if the learner was progressing towards the conscious incompetence stage.Conscious Incompetence – the rider is becoming more aware of how he/she would like to progress in the riding and is highlighting areas that need to be improved. ey are nding the riding position easier to maintain in walk and trot, canter is still dicult, and they may lack the security, depth and suppleness in their seat.However, the rider is becoming more aware of the existence and relevance of the skill required to enable them to improve their riding position and technique and are therefore, conscious of their deciency in this area, ideally by attempting or trying to use the skill on a daily basis on a range of horses, which will give the learner a dierent feel of each individuals horses paces and their way of going.e learner realises that by working towards improving their skill and ability, their eectiveness as a rider will improve.Ideally, the learner has a measure of the extent of their deciency in the relevant skill, and a measure of what level of skill is required for their own competence or goal. A very good way of highlighting this is to video the riding assessments at the beginning and then to video the sessions on an on-going basis to be able to allow the learner to analyse their own improvements and areas of deciency. Another way to monitor this may be to choose and ride through a dressage test and compare marks given on the way of going as well as looking at the collective scores, preferably with the same judge as used previously.e student must ideally make a commitment to learn and practice the new skill, and to move to the ‘conscious competence’ stage.C

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39 Animal Therapy Magazine | ISSUE 18Conscious Competence – the rider is now beginning to eectively inuence the horse’s way of going and has a balanced riding position with few positional faults.e learner achieves ‘conscious competence’ in a skill when they can perform it reliably at will. However, the learner will need to concentrate and think in order to perform the skill well and can do so without assistance. e learner may not be able to perform the skill reliably unless they are actively thinking about it – the skill is not yet ‘second nature’ or ‘automatic’ to them.e learner should be able to demonstrate the skill to another rider or learner but may not be able to teach it well to another person.e learner should ideally want to continue to practise the new skill and want to commit to becoming ‘unconsciously competent’ at it.Practise is the single most eective way to do this, which may take more than 10,000 repetitions of the exercise performed correctly each time.Unconscious Competence – which all riders/coaches/trainers aspire to – the “expert” level.e skill becomes so practised that it enters the unconscious parts of the brain – it becomes ‘second nature’. Listening and communicating are examples and it becomes possible to multi-task or perform certain skills whilst doing something else.is learner may be able to teach others in the skill concerned, although aer some time of being unconsciously competent the person might have diculty in explaining exactly how they do it – the skill has become largely instinctual.is may lead to the need for long-standing unconscious competence to be checked periodically against new standards that inevitably may arise in the industry concerned.Inuencing the position of the riderFrom this point of view, it is dicult to correct rider mistakes that are already deep seated and habitual. When you consciously learn a new muscular movement, a long and complicated process in the brain is required before the conscious eort develops into a pattern continued overleafthat becomes subconscious – a reex action. When a learned pattern needs to be changed, because it is incorrect, can be a long and frustrating journey for the learner. It takes time to establish a new pattern of movement that can easily revert back to the old habit just as you thought you had conquered it.You can never completely eliminate established nerve patterns, that is why it is very important to learn something correctly from the start.It can take a tennis player 100,000 repetitions to learn to serve, if this is incorrect, a further 2,000 correct repetitions to correct the habit and then a further 100,000 repetitions in the correct format for the behaviour to become a reex. When learning a new technique, the overall level of performance will deteriorate whilst the old habit is been broken and the new habit is being established over a period of time. Due to the diculty of this period, many learners prefer their own way of riding although wrong, it is comfortable, and they will start to question the trainer/coach. Making changes to a rider’s position causes frustration but it is important that they do not give up, even though it feels impossible.Some Common positional problems in the rideris pictures above are illustrating an unbalanced riding position, where the rider is sitting in a “chair seat” in picture 1, is tipping forward in picture 2 and is sitting crookedly in picture 3. ese illustrate the incorrect position but are also very common in those who are learning to ride.Picture 4 is demonstrating the rider leaning back behind the vertical with very tight hip and knee and picture 5 illustrates the rider drawing the lower leg too far back which can tip the rider forward as in picture 2 above.1 23 45

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40Animal Therapy Magazine | ISSUE 18Some ideas of how to work on the problemse use of the Franklin Balls - these are air- or water-lled plastic pilates balls (seen in the picture above) around 10cm in diameter and are used as part of the Franklin method of training, which was developed in 1994 by Eric Franklin. e use of the balls has become more popular as many coaches and trainers see the benet and improvement the balls make to the rider’s position in the saddle. Many riders have reported that by using the fascia roll under their seats, aer a few minutes of riding and on taking the fascia roll away, they feel they are sitting deeper and are more supple through the seat and have a greater awareness of what their body is doing. is can also help the rider to communicate the aids better to the horse. e rider has reported that they can feel the horse’s movements more clearly. Picture 6 is illustrating the positioning of the fascia roll and in picture 7 is showing it in action underneath the riders seat.e use of the so orange balls under the riders tight thigh helps to loosen the hip joint and help to alleviate tightness in the knee and thigh by gently holding the thigh away from the saddle (picture 8, 9 and 10). e balls help to release tension in the hip exors, which in turn allows the leg to drop down.e pictures above show the rider using the so orange balls underneath the arms which in turn help the rider to eliminate tension in the shoulder area and allow the rider to keep the arms closer to the body on removal. Using the balls in this way also makes the rider much more aware of the contact on the reins as the arms and hands are much stiller.The benets of working on the rider’s positionOver time - a more secure, balanced riding position with the rider aware of the eect he/she is having on the horse. e nal gures illustrate this.6RIDER COACHING78910

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41 Animal Therapy Magazine | ISSUE 18DEGENERATIVE joint disease (DJD) or osteoarthritis is one of the diseases most commonly encountered by equine practitioners. Results from the 2016 National Equine Health Survey (NEHS) revealed that more than 41% of lameness cases were caused by DJD. It is widely understood that early diagnosis and intervention is key, not only to prolonging the longevity of the aected animal, but more importantly, to provide immediate, eective pain relief. With this in mind, Equine Arthritis: Diagnostics and New Technology was conceived to bring together not only the treating veterinary surgeons, but also those front-line professionals most likely to have that vital rst encounter with patient and owner.In a mix of streamed veterinary and non-veterinary professionals presentations together with integrated sessions, the two-day programme will encourage an environment of collaborative learning focussing on key aspects of what we know about equine arthritis, where we are now in terms of diagnosis, treatment and management and, where we hope to be in the future. Keynote speakers include Dr Jane Nixon, Director of Equine Development, British Equestrian Federation who, along with farrier Dean Dibsdall and nutritionist Emma Short will show in their presentation ‘Getting it right from day one’, that even with the best breeding and conrmation in the world careful management and production from birth to four year old is vital to success. ACPAT physiotherapist Fiona Bloom stresses the importance of a multi-disciplinary approach to the arthritic horse. She takes an all-encompassing holistic look at the horse’s way of going, what it is expected to achieve in terms of work and performance and, how specic rider exercises can help achieve this. World renowned equine osteopath Gavin Scoeld discusses ‘Truly correct equine movement’. He looks at the scientic answer and its relevance to performance enhancement and, osteoarthritis prevention and management. He shows how this understanding can be taught and applied to help all aspects of the equine industry optimise equine posture and movement, aiding injury and osteoarthritis arthritis prevention and, performance enhancement.Streamed wet-lab sessions allow for an on site distal limb dissection, which will demonstrate the internal structures of the limb and how arthritic changes and outside inuences such as shoing and trimming impact the horse. The two days will be brought to a close with an afternoon of fully interactive panel sessions with representatives from across the equestrian professions. The rst will be centered around ‘When the drugs don’t work’, looking at holistic options available to keep the patient sound for as long as possible. This is followed by a case study work up with a lameness location diagnostic session headed by Dr.Ing. Thilo Pfau of the RVC and a panel discussion on treatment options.The event will enable therapists to gain a broad understanding of diagnosis, treatment and management and, how to work with the attending veterinary surgeon to achieve the best outcome and, to keep horses sound. www.pkwevents.co.ukEARLY BIRD PRICE £325 FOR BOTH DAYSEQUINEARTHRITISDiagnosis and New Technology20th – 21st MARCH 2020 Crockstead Farm Hotel Uckield East Sussex EQUINE ARTHRITIS CPD EVENTA global approach to equine arthritis15 hours of CPDA collaborative conference, bringing together irst contact front line professionals and equine vets, as the team supporting the arthritic horseA combination of practical and research-based presentations aimed at equine professionals looking to broaden their knowledge in equine arthritisStreamed wet-lab sessions include The inside story – a distal limb dissection and, practical joint injectionsTOP SPEAKERS INCLUDEAndy Crawford RVCS, Director, Sussex Equine HospitalGavin Scoield, Equine OsteopathFiona Bloom, ACPAT Equine PhysiotherapistDr Helen Warren, Equine NutritionDr Jane Nixon, Director of Equine Development, British Equestrian Federation To book your place now, visit www.pkwevents.co.ukEquine Arthritis HP Ad 190x135mm Animal Therapy.indd 1 17/10/2019 09:14A truly global approach to equine arthritisWhy does it take a team to keep a horse sound?

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42Animal Therapy Magazine | ISSUE 18Animal ﬁrst aid made easywww.animaltherapymedia.co.ukIn June, Animal Therapy Media launched our ﬁrst Podcast and since then we have recorded many more.You can follow us on Mixcloud under Animal Therapy Media to hear our existing and new releases hot off the press.Mary Bromiley by Sherry Scott I MISS my friend Mary, we pioneered the techniques foranimal physiotherapy together. We lectured on our ndingsand abilities to the veterinary profession and both took greatdelight in working together in a world that didn’t welcome uswith open arms. We had to prove ourselves and what we could dobefore anyone would accept us. e Late Stuart Hastie MRCVSwas perhaps our rst convert and he later became the presidentfor the animal only brigade.Mary was a human physiotherapist rst before including animalsin her work. We rst met when she was practicing in WimpoleStreet London and I had an apartment nearby in Baker street. Oneaernoon in Baker Street an Italian gentleman came to show usa new device “ A Laser “ . It was being presented to us as amazing and dramatically good!!! Mary asked about the safety aspects and we worried as the Italian decided to demonstrate how safe and easy it was to use by sticking the probe under his ngernail. We could smell the familiar smell of a farrier... Mary’s face was a picture when he started to bleed profusely. It seemed he was demonstrating the surgical laser by mistake. ...Mary decided that perhaps this was not for animals at the moment thus delaying the use of laser therapy for some time.Mary’s Downs House therapy yard was breaking new ground foranimals. She was aware that in the racing world the owners wouldpay for livery and treatment so she was able to do a good andthorough job there.We owe Mary so much, people working in the equine therapyindustry might take a moment to be grateful as so much of ourknowledge today is down to her tenacity . Mary was determinedbut kind, taking time to explain and educate the owners andstudents. Rabbit one of her daughters is studying with e collegeof Animal Physiotherapy at the moment so life has come fullcircle.Mary and I have one regret. When we were accepted I was animal only and Mary was a Chartered human therapist rst so there were two separate groups not one. I miss you Mary. Mary has a fantastic selection of books that are well worth adding to your library for reference. 'A way of life, Healing Animals', 'Equine Injury, erapy and Rehabilitation' and 'Massage techniques for Horse and Rider' are just a few to mention.

Issue 18

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