Issue 21 : simplebooklet.com

3 Animal Therapy Magazine | ISSUE 21GET IN TOUCH:Hannah Ashton – Editorhannah@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 21Issued 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: Canine Arthritis Management - see story on page 6.Welcome! Happy 21st Issue to Animal erapy Magazine.As COVID-19 remains the hot topic, we are pleased that most vets, therapists, trainers and other professionals have been able to get back to some kind of normality and continue doing what they do best. Unfortunately however, with so many restrictions still in place, we have seen most conferences have either moved online or cancelled completely putting all their focus in to 2021. Understandable of course, but it's such a shame as these events are not only fantastic for learning but also for getting together with like minded people, visiting the vast array of stands and learning about the new and exciting developments in the worlds of veterinary care, welfare and therapy.It has been amazing to see so many companies adapting to the change especially with webinars a plenty. Lock down certainly provided us with some fantastic learning opportunities.As always we thank all our contributors and writers who continue to support us, especially in these times of change, and hope that by next issue we can all start planning a bit more into the future without the fear of further lock downs and restrictions.We hope you enjoy this issue.Stay ealthy.Team Animal erapyWhat happens after graduation - Equine Massage Therapy ______________________ 4Canine Arthritis Management __________________ 6Cannabidiol or CBD __________________________ 8Levis Blog _________________________________ 11Moorcroft - The Ridden Horse Pain Ethogram ____ 12What is Myotherapy _________________________ 16District Veterinarary Nursing __________________ 18Dogs in Distress ____________________________ 20Tony Nevin - Clinical life with Covid-19 __________ 22Canine Massage Guild - Fleur __________________ 26Animal Chiropractic _________________________ 29Photizo - Treating Belle ______________________ 30Onlinepethealth - Education goes Wireless ______ 34CONTENTS

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4Animal Therapy Magazine | ISSUE 21In the second part of our series on what happens after graduation, Stephanie Bateman speaks to Equine Massage Training UK to discuss the options for massage therapistsEQUINE MASSAGEis thetherapeuticapplication ofmassage techniques to improve a horse’s health and wellbeing as well as increase performance.Equine Massage Training UK is an organisation dedicated to educating students to the highest level in equine massage. “We have many years’ experience as a trusted training provider,” says the company’s administrator Jaqui Supple. “We are an approved learning centre for Open Awards and our course is a level 3 diploma accredited by Ofqual. The Equine Massage Therapist Course is a weekend, part-time, exible and aordable course completed over six-months. It consists of practical, theory and module learning and is designed to provide students with basic knowledge and skills to begin in practice.” One of the course’s trainers, Andrea Pole, is qualied in both human and animal modalities which together with 25 years’ experience, oers students a broad knowledge base to draw upon. Sadly, not all massage courses are taught to such a high standard and graduates can nd themselves under-qualied and not usable.“With equine massage, there are no legalities around it – you can do half a day’s course and call yourself a massage therapist, so it’s really What happens after Graduation?GOVERNING BODIESimportant to ensure that the course you are studying is going to set you up with the relevant skills and experience to be acknowledged by the industry,” explains Jaqui. “We continue to support our members after graduation with CPD events and as a body to help them with any queries they have,” adds Jaqui. “We recommend that anyone working in the industry should be a member of at least one of the recognised bodies. I’d suggest looking out for registers that only accept therapist with a certain level of qualication to ensure high standards are maintained, as this will also help with insurances. You should also be oered CPD events and an annual AGM where you can discuss your concerns and have a say in what happens, and be able to go to them for advice.”

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5 Animal Therapy Magazine | ISSUE 21“I’m currently on two registers – RAMP and IAAT, but if I’m perfectly honest, registers do very little for their members,” she says. “I don’t think the registers do enough to market their members, in particular market them as people who have gone through proper channels and qualications. The main incentive to join an organisation is being told that if you don’t belong to this or that association, you won’t be able to practice and vets won’t use you. That is unfair and inaccurate and simply not a good enough reason.“It’s clear that massage therapy is regarded as a maintenance treatment rather than a veterinary treatment, but that doesn’t mean massage therapists should be undermined in any way. Correct massage is a skill and not working in conjunction with vets means in the wrong hands, it can be dangerous. “We’ve had to jump through so many hoops to get our course accredited, and taking those extra steps to do a recognised qualication has got to be benecial to these people and worth having. They want to be part of an organisation that promotes them and distinguishes them as people who have gone above and beyond and gone through a proper course and gained a proper qualication. “I understand and agree that registers should be there to police the standards of practitioners, and protect title, but they need to oer more than just a website with a list of names on it. It’s all good and well having these registers, but the general horse owning public aren’t aware of them enough. If I asked one of my clients which registers they look at to nd a practitioner, they don’t have a clue what I’m talking about. It wouldn’t make any dierence to my business whether I was on a register or not because I’ve been about so long people know my reputation and know how to nd me. I get clients through word of mouth, reputation and vet referrals. “It also still saddens me that some registers feel they are better than others which prevents there being one, unied register. Having one register would be so much easier for not only the practitioners, but for vets and clients as well – I’d like to get to a point where I can say to students this is where you need to register; they will represent you and look after you and support and promote you.“At the end of the day, these people are here because they want to help horses, so giving them a platform and regulating them is so important, but at the moment I don’t feel there is anyone that will really do that. If the registers want to be useful, they need to work harder for their members, put their egos aside and unify.”On completion of the course, successful graduates will receive a certicate of Equine Massage and this will entitle you to join IAAT and other relevant organisations. Talks are also currently underway with AHPR and IRVAP (see details below).nThe International Association of Animal Therapist (IAAT) IAAT is an inclusive organisation that values cooperation and collaboration. Membership of IAAT is open to all animal therapists, veterinary surgeons and nurses who hold an accredited qualication in the relevant animal therapies. www.iaat.org.uknAnimal Health Professions Register (AHPR) Membership of the AHPR is open to those who provide services for the treatment of animals under veterinary referral and for the maintenance of health. This includes chiropractic and manipulation, hydrotherapy, veterinary physiotherapy and sports therapy and massage. www.ahpr.org.uknThe Institute of Registered Veterinary and Animal Physiotherapists (IRVAP) IRVAP membership community includes veterinary surgeons, veterinary physiotherapists, animal musculoskeletal practitioners, veterinary nurses, canine hydrotherapists, animal massage therapists and TTouch practitioners who are holders of animal therapy qualications. www.irvap.org.ukPhotos show the Equine Massage course at Equine Massage Training UK“Registers need to do more”Human and Animal Therapist Andrea Pole, is qualied in physiotherapy, massage and spinal manipulation and has over 20 years’ experience. She trained alongside Ronnie Longford, (the rst McTimoney Chiropractor in the UK) for many years whilst establishing her own practice, and now works with some of the top equine yards and names in the UK. Here, she discusses her thoughts on the registers and how they could be doing more to support their members.

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6Animal Therapy Magazine | ISSUE 21THERE are many causes of arthritis in dogs, which is broadly either developmental, meaning the dog is genetically predisposed to have abnormally formed joints, or acquired, resulting from traumatic injury, infection or immune mediated disease.Arthritis is a household word that everyone has heard of and invariably knows someone that suers with it, even perhaps their own dog. It’s commonality oen leads us to forget that it is actually a very painful condition. is oversight is impart due to dogs experiencing pain not crying out but soldiering on because arthritis causes a specic form of pain, chronic pain. OSTEOARTHRITISIt’s JUST arthritis...Chronic pain implies its normal pain that persists for a long time, at least a couple of months, but is actually more complex than that. It is in fact a completely dierent physiological event which may lead to a suerer destined for chronic pain suering that kind of pain from day one. e dictionary term of arthritis is pain and inammation of the joint, but in reality, the pain of arthritis is a lot more complex and far-reaching than just the joints.Pain is typically classed as either being acute or chronic. is is an important distinction as while acute pain serves a useful biological purpose, chronic pain does not.Acute painPain has evolved to protect our bodies from harm. Acute pain in particular is an adaptive response to an injury that makes the individual experiencing the sensation of pain take action to protect them from reinjury and help the tissues heal. For example, acute pain will make you move your hand away from a hot pan to prevent a more severe burn or will make you avoid using a sprained wrist so the ligaments can heal more quickly.Acute pain usually only lasts as long as the injury itself.Chronic painChronic pain outlasts the initial trigger for the pain (a sore joint) and will persist for months or even years, no longer protecting the body from imminent danger. Sometimes referred to as maladaptive pain, the pain itself may be thought of as a disease in its own right.The eects of chronic pain go beyond the sensation of pain itself. It’s often associated with prolonged inammation which can actually stop tissues healing. It can have a serious eect on mental state. Somebody in chronic pain is aected physically, physiologically, cognitively and emotionally, an area that is far too complex for the scope of this article. Post-Traumatic-Stress-Disorder is linked in some cases to chronic pain, where there is no physical injury, but instead the fear of injury. We do not fully understand why chronic pain develops. Usually following injury, tissue heals, the peripheral sensation reduces and the heightened acute pain state resolves. However, in chronic pain, even if the injury has healed, the pain still persists and eventually becomes amplied.by Lynsey Tindall AVNDIPMED RVN

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7 Animal Therapy Magazine | ISSUE 21Inammatory PainInammation is characterised by pain, warmth, swelling and tenderness and is a natural response by the body to injury or disease. Usually, the body allows the area to heal and then settles back to normal. With diseases such as arthritis, the body’s attempt to return to homeostasis fails and more inammatory chemicals are released, attacking all of the joint structures, including the joint capsule and joint uid, irritating surrounding nerves and ligaments. This naturally waxes and wanes with arthritis, generally described as a “are” of the inammatory process, although this can commonly be triggered by inappropriate activity for the level of disease that is present. Non-Steroidal Anti-Inammatories are often prescribed for inammatory pain, and evidence tells us they are considered the backbone of treatment for arthritis in dogs. Compensatory PainOnce arthritis develops, the dog will begin to weight shift away from the aected joint, using the other limbs and muscles to compensate for the arthritic joint, This means the rest of the musculoskeletal system will be functioning in a way it was not designed to, leading to perhaps further injury, spasm and dysfunction, and with overloading of the repositioned weight on another joint. Such compensation is another source of pain for the dog, so whilst the initial pain came from the right hip for example, the dog is now also suering with pain in the left shoulder and in its neck. Neuropathic painNeuropathic, or nerve pain is now known to be a factor of arthritic pain. Usually caused by damaged or dysfunctional nerves, in arthritis it is produced possibly because of changes to pain pathways that are inherently seen with neuropathic pain. Humans describe it as tingling, burning, numbness or cold sensation, and sometimes as a small electric shock, stabbing or lightning bolt of pain. This may present in dogs with licking limbs, unusual reaction to being touched or stroked, or twitching of the skin amongst others. Central SensitisationUnmanaged, or mis-managed chronic pain leads to a state known as central sensitisation, or wind-up, and is a form of neuropathic pain. This is when the brain amplies the pain and discerns it to be even greater than the underlying pathology would usually be expected to produce. Initially, this might present as hyperalgesia, which is when something that may normally be slightly uncomfortable produces a heightened reaction from the dog. Others may show signs of allodynia, which is when a usually non-painful action, such as a stroke from a hand is perceived as painful by the dog. This type of pain is much harder to treat and get on top of.Emotional and Physical Impact of PainPain may start in the joints and the supporting tissues but it is perceived in the brain. As touched on earlier, pain is not only a physical but also an emotional experience and is perceived dierently by dierent individuals. So, it is not just about how it feels, but how it makes you feel. Humans describe living with chronic pain as exhausting and physically and mentally draining. There is a known close link with long-term pain and depression, and studies have shown that feeling anxious or depressed can increase your pain state. Some dogs with chronic pain will cope incredibly well physically, showing surprising agile movement and mobility despite underlying arthritic joints, but appear to be aected in a more emotional way. Dogs may show signs of what some may think of as depression, not wanting to interact socially, seeming anxious about noise or other dogs, and owners will often use the dog’s mental state as an indicator of pain. is is a very basic overview of pain, which is extremely complex and sometimes dicult to fully understand. However, hopefully this article has shown that arthritis is not all about what is happening with the dog’s joints. is demonstrates why a multimodal treatment plan is vital for the eective management of canine arthritis and why the dog should be managed holistically, or as a whole. Your vet may suggest dierent types of pain relief for your dog to be used in conjunction, in an attempt to combat the multiple pain pathways that are being aected. e pain needs to be controlled for the benet of the dog physically and emotionally, as well as then allowing a window of opportunity to introduce other aspects of a good management plan. Addressing bodyweight is vital, weight loss is proven to decrease the pain state. Giving consideration to lifestyle and environmental factors plays an equally important role , and in some cases a combination of these factors can even reduce the need for pharmaceutical pain relief. Further interventions, such as physiotherapy and hydrotherapy will encourage the rebuilding and maintenance of the dog’s muscular system, allowing decent structural support for the rest of the body. Much can be done for the arthritic dog, beyond just daily pain relief. Please see www.caninearthritis.co.uk for more in-depth information.

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8Animal Therapy Magazine | ISSUE 21CANNABIDIOL or CBD is extremely popular at the moment but what is it, what does it do and what is the UK legislation?Cannabidiol is a phytocannabinoid or a cannabinoid of plant origin. Cannabis Sativa or the Marijauana plant contains up to 80 phytocannabinoids including CBD and THC. THC which is illegal in the UK is the component of Marijuana that gives the high. It is psychotropic and may be associated with a number of unpleasant eects such as depression or suicidal thoughts. To understand what CBD does we need to understand the endocannabinoid system. All vertebrates are born with an endocannabinoid system which is the most ubiquitous receptor network in the body. Endocannabinoids have a homeostatic role in the body achieving balance in systems. They are involved in motor coordination, memory, pain modulation, appetite, neuroprotection and immunomodulation. Phytocannabinoids or plant origin cannabinoids have been found to have many potential modes of action some of which will modulate our own endocannabinoid system. CannabidiolThe Medicinal Cannabis products available in the UK include: Epidyolex a pure CBD product which has just received NICE approval for use on the NHS for two specic types of childhood epilepsy Sativex a combination of THC/CBD licensed for muscle spasticity in MS suerers Nabilone a synthetic THC product licensed for chemotherapy induced nausea However there is also a huge and largely unregulated market in human food supplements containing CBD. The current hype around CBD is largely consumer driven based on a belief that it has certain medicinal benets which have not yet been denitively proven scientically. A recent study showed that this market in the UK was worth £300 million which is more than the market for Vitamin C and Vitamin D put together. It’s predicted to grow rapidly and be worth just short of one billion pounds in 2025. Unfortunately products available on the high street are extremely variable in quality as the production is not regulated. As a result it’s impossible to know for sure if the product actually contains what is stated on the label or the certicate of analysis. The Centre for Medicinal Cannabis (CMC) recently conducted a test on CBD oils available on the high street which revealed that one product being retailed for £90 contained no cannabinoids at all; 11 contained less than 50% of the stated CBD content; 8 contained levels of solvents or heavy metals above that permitted in food stus and one contained 3.8% alcohol making it an alcoholic beverage. 45% of products contained levels of THC and another cannabinoid CBN which were illegal. Currently in the UK you can apply for a license to grow industrial hemp containing less than 0.2% THC. However the nal product being sold must contain less than 0.01% THC ie virtually zero. This legislation is often confused so that products may be sold which have higher than legal levels of THC. Read more: https://www.which.co.uk/news/ 2019/11/cbd-oil-why-its-hard-to-know-what-youregetting/ - Which? And another survey carried out by the BBC programme here: Trust me I’m a Doctor As a result of the hype, everywhere you look you see CBD oil for sale. It’s available online and on the high street, in health food shops, pharmacies, vape shops etc. What you should not see however is CBD for pets or CBD carrying medicinal claims for animals. by Dr Siobhan Menzies, BVM&S MRCVS GPCBDcontinued overleaf8 Animal Therapy Magazine | ISSUE 21

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10Animal Therapy Magazine | ISSUE 21The legislation for CBD use in animals is very dierent to that in people. In people CBD is regarded as a food supplement and is unregulated. In animals however CBD is classed as a veterinary medicine and as a result it is subject to regulation. In September 2018 the Veterinary Medicines Directorate issued the following statement on veterinary medicinal products containing cannabidiol:“Veterinary medicinal products containing cannabidiol We consider that veterinary products containing cannabidiol (CBD) are veterinary medicines and should be regulated as such. We have made this decision on the basis that products containing CBD full the following denition of a veterinary medicine in the Veterinary Medicines Regulations (VMR) by virtue of the eects they have: “any substance or combination of substances that may be used in, or administered to, animals with a view either to restoring, correcting or modifying physiological functions by exerting a pharmacological, immunological or metabolic action, or to making a medical diagnosis.” Marketing Authorisation requirement for CBD products CBD products for use in animals therefore now require a marketing authorisation before they can be sold or supplied in the UK. There are currently no CBD based products that have been granted a UK veterinary marketing authorisation. Using human CBD products to treat animals As there are currently no CBD products authorised in the UK for veterinary use, a veterinary surgeon may prescribe a legally obtained human CBD product under the provisions of the prescribing cascade. Administration of an unauthorised product containing CBD without a veterinary prescription is an oence under Regulation 8 of the VMR. Companies supplying CBD products for human use in line with the requirements of the Medicines and Healthcare products Regulatory Agency must not indicate or recommend their products for use on animals. Our next steps We will be writing to UK CBD suppliers and manufacturers to inform them of our decision and to ensure products containing CBD satisfy the requirements of the VMR. We will continue to provide regulatory guidance to any company wishing to apply for a marketing authorisation. “ The aim of this statement is to protect our animals as while early research is promising, medicinal benets in animals have yet to be denitively proven and long term eects and drug interactions have to be investigated. This guidance means that: 1. CBD cannot be sold in shops or online for use in animals. 2. Products must not carry any medicinal claims for animals. 3. CBD can only be prescribed for animals by a veterinary surgeon. 4. Vets must prescribe CBD strictly under the provisions of the prescribing cascade i.e. it can only be prescribed if the licensed treatments have been tried and aren’t sucient; if the licensed treatment isn’t tolerated by the animal or if there is no licensed treatment for that condition. 5. Theoretically under cascade vets should prescribe Epidyolex as it is the authorised human product. However Epidyolex is currently only available to specialist doctors in hospitals and is not available to vets. As a result vets can prescribe a legally obtained human cannabidiol product. It is up to the vet to ensure that the quality and safety of the product is adequate. In addition CBD can be prescribed by vets as an “extemporaneous product” by a manufacturer holding an authorisation that permits them to manufacture such products (commonly referred to as Specials Manufacturers (ManSA). 6. Medicinal claims must not be made. 7. Any product must be THC free. Ultimately vets prescribing cannabidiol should look for quality regulated manufacturing with growing of specic high-quality plants. The Cannabis Sativa plant is an accumulator which means it concentrates pesticides, heavy metals, solvents and other contaminants. Production of a cannabidiol containing product must ensure that these unwanted contaminants are removed. Every product should have a batch number traceable to a Certicate of Analysis (CoA) to conrm it contains 0% THC. The CoA is only as reliable as the producer and supply chain so ideally independent analysis should be made available. If the producer is unregulated how will you know if the nal product really contains what the CoA states? Self-certication is an obvious cause of concern. High quality products will be regulated by GMP (Good manufacturing practice) and GDP (Good distribution practice) guidelines. https://www.gov.uk/ guidance/good-manufacturing-practice-and-gooddistribution-practice. Another fact that vets should take into consideration when prescribing CBD is the potential for drug interactions. Cannabidiol may inuence the way some medications are metabolised within the body. It is essential to understand these processes in order to prescribe safely for a patient. If you think your pet might benet from CBD you should speak to your vet. They are best placed to investigate and treat the problem which your pet has and determine if CBD would be an appropriate medicine. Dr Siobhan Menzies BVM&S MRCVS GP CERT(WVA&CP) HolisticPet (NI) Ltd www.holisticpetni.com © Siobhan Menzies 2020CBD

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11 Animal Therapy Magazine | ISSUE 21I think we could all improve the quality and enjoyment whilst training for both us and our horses if we take a leaf out of the way we all we educated. “Bite size” revision, a variation of subjects learnt in one school day, chapters that if followed in the correct order build knowledge without overwhelming us in one go.Looking back, that’s what was being oered to me, if only I wasn’t so busy selling sweets out of my school bag on the black market whilst designing my perfect equestrian centre on page one of my Physics workbook!How many of us begin our ride and have a pre set goal with a plan which will help us achieve it? If you’re human like the rest of us, you’ve attempted the stretch.... changed the rein... pleaded for more impulsion so that your trainer doesn’t mention it in tomorrow’s lesson (yet again) and then nished with some randomly placed movements, from smaller circles to lateral work. If that sounds familiar now is the time to get planning. If it doesn’t ring a bell you must have your trainer present for every ride! Just like the nal page of every chapter in that text book guided your learning, so should your goal when riding. Try to make it an educated, realistic goal with the help of a trainer or that friend who is more advanced (or at least buys all the expensive tack and clothes, they’ll do!)For example, on a Monday morning I feel each horse and if I have a competition looming I aim to improve the quality of required movements or transitions by Friday, that keeps me on track for the working week, of course I don’t want to drill them to boredom so I mix my training with polework, road work and contrary to a Dressage Queen’s reputation,a canter in a eld (albeit 4mph).If for example I want to teach my horse a new movement or improve the standard of his way of going, I keep to the subject for that week, raising my expectations of the understanding and then quality as the days go on.With every horse, age, size, breed and level I may have a plan that sounds good to me but until I’m in the arena I haven’t clue where the session will take me. A soon as you are on board look and feel, nobody struggles to say what they don’t like when I ask them, so compartmentalise the way of going (which can seem overwhelming if looked at in one go) into bite size pieces. Too fast? Slow down. Lazy? Get excited and quicken up. Too left? Work right and visa versa. Before you know it your plan has evolved as you listen to your horse and incorporate how he feels. Lots of people tell me they get bored, or run out of things to do, I’ve spent thousands of hours in arenas now and I still haven’t run out of new discoveries.There is a world of information out there to help solve any issue and learn anything. YouTube, riding apps (RidelyUK being my favourite as yours truly has videos on there) books, online forums (if your dare) and advice from people in the industry combined is a wealth of knowledge you’ll never get to the end of. “The biggest marathons are just a series of individual steps”.... Why people run marathons is beyond me. Use a horse, way easier!Levi’s BlogI have a plan . . .LEVI HUNTLevi Hunt - Grand Prix International Rider for Great Britain, British Dressage Young Professional of the year 2016, Regional British Dressage Team Trainer, UKCC3 CoachLevi regularly runs clinics up and down the country. You can contact him via his facebook page - Levi Hunt Equestrian or through his PA - Nicky on 07771 61002711 Animal Therapy Magazine | ISSUE 21

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12Animal Therapy Magazine | ISSUE 21REHABILITATIONIt can be extremely dicult to recognise if a horse is in pain. Dr Sue Dyson, Chief Veterinary Adviser for the Moorcroft Equine Rehabilitation Centre, explains how the Ridden Horse Pain Ethogram can be used to identify discomfort and pain in horses. THE Ridden Horse Pain Ethogram (RHpE) was developed to enable all involved with ridden horses to better determine that a horse may be experiencing musculoskeletal pain. It has been obvious for many years that owners, trainers and even equine veterinarians are poor at recognising low-grade lameness that compromises or glazed expression, and riders become conditioned that these behaviours are normal for horses. Re-education of all involved with ridden horses is vitally important to improve horse welfare, horse performance and make horses more enjoyable and comfortable to ride. Horses are clever at masking low-grade lameness, especially when it involves more than one limb. ey adapt by reducing the range of motion of the thoracolumbosacral region, reducing step length and decreasing hindlimb impulsion. However, they try to communicate their discomfort by displaying abnormal behaviour.An ethogram is a catalogue of behaviours, each with strict denitions. e RHpE was developed by the comparison of non-lame and lame horses, starting with 117 behaviours and eventually reducing this to 24 behaviours, the majority of which were at least 10 times more likely to be seen in a lame horse compared with a non-lame horse. e display of eight or more of these behaviours is highly likely to reect the presence of musculoskeletal discomfort, although some lame horses score less than eight. Numerous studies have demonstrated that most pain-free horses score between zero and four behaviours. We have proven that there is a causal relationship between pain and these behaviours, because if we abolish lameness using nerve blocks, the horse’s behaviour immediately improves and the RHpE scores are signicantly reduced.e RHpE comprises facial expression, body markers and changes in gait. Observation of the horse working for approximately 10 minutes is usually sucient to make an accurate assessment. As with any clinical skill, training and practice are required for correct interpretation of the ethogram. performance and too oen the horse is blamed for being uncooperative or unwilling. Moreover, a large proportion of riders initially learn to ride at riding schools, where a high percentage of horses have low-grade lameness. ese horses show behaviours which are consistent with discomfort, for example ears back and an intense stare The Ridden Horse Pain Ethogram and identication of musculoskeletal painCTable 1 The 24 behaviours comprising the Ridden Horse Pain Ethogram. The display of 8 or more behaviours is likely to reect the presence of musculoskeletal pain.1. Repeated changes of head position (up/down), not in rhythm with the trot2. Head tilted or tilting repeatedly3. Head in front of vertical (>30°) for ≥10s4. Head behind vertical (>10°) for ≥10s5. Head position changes regularly, tossed or twisted from side to side, corrected constantly6. Ears rotated back behind vertical or at (both or one only) ≥5s; repeatedly lay at7. Eye lids closed or half closed for 2-5s; frequent blinking8. Sclera exposed repeatedly9. Intense stare (glazed expression, ‘zoned out’) for ≥5s10. Mouth opening ± shutting repeatedly with separation of teeth, for ≥10s11. Tongue exposed, protruding or hanging out, and/or moving in and out repeatedly12. Bit pulled through the mouth on one side (left or right), repeatedly13. Tail clamped tightly to middle or held to one side14. Tail swishing large movements: repeatedly up and down/side to side/ circular; repeatedly during transitions15. A rushed gait (frequency of trot steps > 40/15s); irregular rhythm in trot or canter; repeated changes of speed in trot or canter16. Gait too slow (frequency of trot steps <35/15s); passage-like trot17. Hindlimbs do not follow tracks of forelimbs but repeatedly deviated to left or right; on 3 tracks in trot or canter18. Canter repeated leg changes in front and / or behind; repeated strike o on wrong leg; disunited19. Spontaneous changes of gait (e.g., breaks from canter to trot, or trot to canter)20. Stumbles or trips more than once; repeated bilateral hindlimb toe drag21. Sudden change of direction, against rider’s direction; spooking22. Reluctance to move forwards (has to be kicked ± verbal encouragement), stops spontaneously23. Rearing (both forelimbs o the ground)24. Bucking or kicking backwards (one or both hindlimbs)1

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13 Animal Therapy Magazine | ISSUE 21Some horses are comfortable in trot but not in canter, so it is imperative that the horse is observed in all gaits. Ideally the work should include 10m diameter circles in rising trot, to the le and right, back to back as gures of eight. is manoeuvre is biomechanically more demanding than working trot around the periphery of an arena and may induce changes in both gait and behaviour. A dressage horse may be comfortable in working paces, but not in collection, or lateral movements resulting in more torque of the body, so the horse should be assessed performing its full repertoire of movements, including transitions. e RHpE behaviours are summarised in Table 1. It is important to recognise that some of the behaviours are timed, for example ears back for 5 seconds, so that momentary icking one or both ears back in response to a rider’s spur aid does not count. Other denitions use the word ‘repeated’. For correct interpretation of the ethogram it is important that the denitions are followed, and accurate timing is performed. Some preassessment of the horse and its tack is required in advance of application of the ethogram. Some horses have a small iris in one or both eyes, so the sclera (white of the eye) is visible at rest, and repeated exposure of the sclera cannot be used. If the bit is too wide, ‘bit pulled through to one side’ cannot be accurately interpreted. We have demonstrated that untrained assessors can dierentiate between non-lame and lame horses merely by using the RHpE, however training does improve their performance. A lame horse ridden by a skilled rider versus an unskilled rider may alter its behaviour and gait quality, but generally abnormal behaviour cannot be masked. An ill-tting saddle may contribute to pain causing abnormal behaviour. A rider overloading the back half of the saddle rather than in the middle of the saddle may also inuence behaviour, by contributing to discomfort.In conclusion the RHpE is a powerful tool for the recognition of musculoskeletal discomfort. It does not inform us of the source(s) of pain but tells us that further investigation is required. By identication of the causes of pain and appropriate treatment, performance may be dramatically improved. Top: Ears back, intense stare, head behind the verticalAbove: Horse in canter - tail swishing and behind the vertical line with nose, intense stare, lips separated (we cannot assess the teeth)Below: Horse in trot - eyes staring, tail swishing and ears back, front of head behind the verticalcontinued overleaf

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14Animal Therapy Magazine | ISSUE 21CASE STUDY Dr Dyson's Ethogram in actionMoses - a 9 year old ex-racehorse This lovely ex-racehorse showed signs of not going forward and being reluctant when ridden but when long-reined he was a much happier horse. He sometimes showed very subtle lameness; sometimes in front and sometimes behind, but never consistent and it was dicult to pinpoint where from.He showed many signs of discomfort, detailed in the Ethogram including:• Repeated change of head positions• Nose behind the vertical• Ears at back in all transitions• Gait too slowA great deal of help was sought at the Centre and he was eventually diagnosed with articular process (facet) joints pain in his thoracic and lumbar spine. This was conrmed rstly by an ultrasound scan to show the arthritic changes there, but also by blocking out this area and then riding him again to see what a dierence it made. This explained why he showed less signs of discomfort when he did not have a rider on his back but was working on the long-reins as the thoracic spine did not have to carry a weight.The area of the facet joints through the thoracic and lumbar spine were treated with anti-inammatories. Moses spent time working in long-reins, encouraging him to stretch, combining straight line work with turns. He built up much of the muscle that he had lost and developed more strength to carry the rider with ease and less discomfort. He also developed more condence in his movement as this can be lost if horses work for a time with pain and discomfort.When he returned to ridden work, he was a happier and much more comfortable horse. Lots of stretching was done by the rider to continue to strengthen the muscles and ligaments over the Facet joints. He really began to lift and swing through his back in a way that was not possible before. He did not lay his ears back in the transitions and he was not reluctant to go forward. In fact he went forward with ease and no discomfort. We were very happy indeed to help this horse and to make his life more comfortable.SUE DYSON VetMB PhD DEO DipECVSMR FRCVSRoyal College of Veterinary Surgeons Specialist in Equine OrthopaedicsEuropean Specialist in Veterinary Sports Medicine and Rehabilitation.Sue qualied from the University of Cambridge in 1980 and after an Internship at the University of Pennsylvania and a year in practice in the USA, spent 37 years at the Animal Health Trust, specialising in lameness and poor performance. Sue now works as a private consultant. Sue has also ridden to Advanced level eventing, Grade A Showjumping and Advanced Medium level dressage. She is currently Veterinary Advisor to Moorcroft Equine Rehabilitation Centre and to the Saddle Research Trust. www.moorcroftracehorse.org.ukREHABILITATION14 Animal Therapy Magazine | ISSUE 21

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16Animal Therapy Magazine | ISSUE 21Myotherapy – is a specialist, clinical form of targeted massage, applied in an appropriate series of techniques by a qualied practitioner to manage chronic muscular pain and inammation associated with many common musculoskeletal conditions. It is also utilised in rehabilitation programmes following trauma or surgery. Myotherapy can help to manage and support a wide range of mobility related issues, by identifying and treating areas of muscular injury, myofascial constriction and associated compensatory issues. It often forms part of integrative palliative care plans and is widely used as a pre and post event therapy for canine athletes and working dogs.Myotherapy is a whole body treatment involving the musculoskeletal system in its entirety including the highly complex fascial system. Targeted techniques are used alongside individual exercise plans and lifestyle management to support dogs with a complete package of complementary care as part of a multimodal treatment approach working on an integrative approach with other veterinary professionals. All cases are seen under veterinary referral or with veterinary consent.Injury or chronic disease processes, such as osteoarthritis, oen result in asymmetry of the whole body. is will subsequently result in development of compensatory issues, referred pain and associated lameness. Dysfunctional muscles and fascia will impede mobility and alter in integrity, aecting posture and resulting in an overall reduction in performance, and general wellbeing.With the application of myotherapy we encourage the development of healthy, functional muscle capable of supporting joints to enable and maintain eective mobility and promote recovery, alongside reducing levels of chronic pain and improving overall wellbeing. is is achieved through the identication of areas of muscular restriction; compromised fascia and myofascial trigger points which can result in the development of myofascial pain syndrome and immobility. When applied appropriately in a series of targeted clinical techniques, myotherapy can eect positive change within the musculoskeletal system by relaxing contracted muscles, improving blood, oxygen, and lymphatic circulation, increasing proprioception, neural stimulation and by stimulating the stretch reex in muscles.Myofascial Trigger Points and Myofascial Pain SyndromeFascia is a multifaceted form of connective tissue comprised of collagen bundles tightly packed and orientated in parallel to the direction of pull. Fascia forms a matrix of structural support, surrounding all body organs, structures and nerve bres; stabilizing, enclosing and separating muscles and other internal organs. Complex,sensorynerve endings are distributed thoughtthe fascia, sensing and communicating information about pressure, movement and direction. It also aids in the movement of nutrients, oxygen and uids and in the removal of toxins and waste via the lymphatic system - lymph nodesarelocated within thefascialmatrix. Fascia is not passive; it is responsible for transmitting a signicant force of a muscle contraction. Constricted fascia is known to aect central nervous system feedback from the spindle cells. Fascia is therefore a whole body communication system and vitally important in functional mobility. CANINE PHYSIO16 Animal Therapy Magazine | ISSUE 20What is Myotherapy?by Kirsty Cavill BSc (Hons) RVN MIAAT MVOA

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17 Animal Therapy Magazine | ISSUE 21 Fascia should be exible and almost gelatinous in nature allowing for the smooth movement of muscles within its boundaries, but can shorten, solidify and thicken in response to trauma, quickly resulting in the development of musculoskeletal compensatory issues and resultant pain.Myofascial trigger points (MFTPs) can form in muscle or fascial tissue and are characterised by areas of resistance on muscular palpation with associated pain or discomfort, which can be referred and autonomic in nature. It’s worth noting that MFTPs can be active or inactive and this will have a direct bearing on levels of pain or discomfort felt by the patient and subsequently determine which activities may become uncomfortable for them to do.Myotherapy Treatment Sessions Sessions are always conducted at the patient’s level (on the oor) and are always choice led, force free and based on trust. A thorough history is noted always referring to the full clinical history through the completion of pre-assessment questionnaires. Gait, stance, posture, muscular symmetry and weight loading distribution are assessed at every session alongside physical palpation of muscles, muscle bres, tendons and fascia to identify muscle quality and areas of functional abnormality. I also assess coat condition looking for the development of swirls which can indicate underlying areas so tissue compromise.Specialised targeted so tissue manipulations are applied at identied locations, in specic directions and velocity to stimulate the nervous system, allowing the so tissue to relax, resulting in subsequent realignment and an overall improvement in posture. is results in reduced muscular tension and levels of pain and discomfort within the entirety of musculoskeletal system. By treating the whole body and not just the apparent site of injury or compensation, symmetry and balance of that patient can be achieved. Each patient will respond dierently and therefore bespoke treatment sessions, including a progressive and targeted exercise programme, lifestyle and weight management plans are individually developed and constantly reviewed. Measureable change is recorded, full veterinary reports submitted and regular case reviews conducted. Kirsty Cavill BSc (Hons) RVN MIAAT MVOAKirsty qualied as a veterinary nurse in 1991 and graduated with an honours degree in Natural and Environmental Science in 2016. She is a diploma holder in Galen Myotherapy, a member of the International Association of Animal Therapists (IAAT) and accredited member of the Veterinary Osteoarthritis Alliance (VOA). During her career Kirsty has worked in small animal practice, has11 years’ experience working with exotic species and is currently Head Nurse for The Vet Connection. Kirsty also ownsand runs Paws Canine Myotherapy Care, specialising in mobility, musculoskeletal health and the management of senior and arthritic dogs. Kirsty is a volunteer vet nurse advisor with Canine Arthritis Management and a volunteer StreetNurse with the veterinary charity StreetVet. 17 Animal Therapy Magazine | ISSUE 21

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18Animal Therapy Magazine | ISSUE 21 District Veterinary NursingWe talk to Carla Finzel, RVNDistrict Veterinary Nursing makes veterinary nursing care accessible to Pet Owners and their beloved animal companions, helping Vets comply with the Equality Act 2010 and as such the Vets patients’ welfare is optimised and human-animal bonds are protected. Ale is Bryan’s lifeline and Bryan wishes to raise awareness of the crucial need there is in the veterinary industry and nursing profession for the district veterinary nursing role.Ale’s owner with disabilities sought help from Streetvet on the street in Brighton as he could not access the PDSA, though eligible. “For many pet owners with disabilities, non-visible and visible, normal veterinary practice settings can be challenging. Some communication skills and the ongoing support of their beloved animal companion needs, like Ale, is none existent and many pet owners lose their best friends and in some cases their only family because of this cli edge in the veterinary profession and the lack of inclusivity to them as service users.” Carla Finzel RVN, founder of the district veterinary nursing role says.“As Bryan was eligible for the PDSA, we were able to contact them but there was a huge roadblock, his disabilities, making access to PDSA veterinary care for Ale tricky. As I am a StreetVet nurse volunteer my boss vet Jade Statt, co-founder of charity StreetVet, knew all about the District Veterinary Nursing service I founded back in 2015 and referred Bryan and Ale to me aer Ale had been attacked by another dog and sustained a very bad bite wound to his already very arthritic shoulder.It was a very distressing time for Bryan, who struggled to communicate what had happened, so I acted as his agent and guardian of Ale so that the vets and nurses at the PDSA could assist them. Ale had an operation at the PDSA and was discharged in my care. I nursed him in his home so that Bryan who relies on Ale as his lifeline and Ale who adores Bryan could be together.” “Sometimes people who are desperate for support have the potential to fall through the cracks. StreetVet was created to provide those with pets of no xed abode with free veterinary care. Other charities exist to support those on low income and in receipt of benets, but what about the invisibly vulnerable? People like Ale’s owner Bryan, where mobility and communication are a concern, their needs are complex. This is where the role of a DVN is in my opinion invaluable, to help bridge the gap and make sure pets like Ale can access the care they deserve.” Jade Statt co-founder StreetVetere are many circumstances where pet owners face a very tough economical time, like the loss of a job as we are seeing a lot of due to Covid-19. Disability allowance is so low that even the cost of pet insurance is now something many cannot aord. If their pet becomes unwell we have to be able to get patients well far more quickly and aordably but in the same instance, we shouldn’t then leave them unattended once they leave the veterinary practice. We should not judge clients for not having pet insurance when we don’t know their personal circumstances. We have a moral responsibility and professional duty to support them.Roxy’s owner did not have pet insurance, which meant Roxy faced euthanasia due to veterinary treatment costs: “is time last week, I thought I was going to have to have my little cat, Roxy, put to sleep. She had been missing for 3 days but then reappeared with a nasty wound and terrible infection.” Carla and Ale at PDSACarla and RoxyDISTRICT VETERINARY NURSING

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19 Animal Therapy Magazine | ISSUE 21 So much has happened since September 2019 when we last interviewed Carla. She has managed in this time to secure and protect the title of District Veterinary Nurse. is means that only qualied and registered veterinary nurses can use this title. Carla has also created the Veterinary District Professionals Association (which she has co-funded with the member of the District Veterinary Nurse Development Group, a team of human health care professionals, vets and veterinary nurses). VDPA will hold the register of RVNs who have completed further training to become veterinary district nurses. “I am extremely honoured that so many RVNs have written in to apply to become DVNs. ese super talented, compassionate, and passionate veterinary nurses who want to protect human-animal bonds with their skill sets is just wonderful. Nothing compares to the feeling when you are that fundamental instrument in saving an animals life simply by administering the treatment plan the veterinary surgeon has prescribed but the pet owner, for whatever reason, is not able to carry out.” Roxy had an operation and came out of hospital the next day, however, the owner was told she would need her wound dressing changed every day at the vets and that she has a very long and expensive journey ahead. “I felt my only option was to have her put to sleep for her wellbeing and because I could not aord £45 a day in vet fees for I don’t know how long. I wasn’t eligible for help and she isn’t insured. When the day arrived I just couldn’t do it and asked my vet for any other options. “My vet referred me to Carla who phoned me that evening and reassured me that she would help me as much as humanly possible to get Roxy well again. Carla has shown me what to do and taken many pictures that we can use as daily comparisons to check her progress. Carla is happy to come in each day and help me as she could see I would not be able to do it on my own. Carla is so patient, friendly, caring and reassuring. I am so grateful to her and to my vets for doing everything to try and help me nd an aordable way to help Roxy. Nothing is ever too much trouble for Carla. I feel blessed to have her come into our lives. Roxy would have been put to sleep if it wasn’t for this service.” Veterinary nurses have trained for four long and arduous academic years, yet pet owners are expected to understand and implement some very challenging techniques in 15mins in a consult room and then implement at home.The Veterinary District Professionals Association has been approached by human health organisations as well as veterinary practices who want to become a part of the movement and provide each other with the right support to navigate daily life, for one health and one welfare.Therefore it is very important that as the Association where these Organisations, Pet Owners, Veterinary Practices and Veterinary District Nurses come together to ensure provision of animal welfare and human wellbeing via the Associations compassionate ethos, vision and ve aims:1. That all owners and patients are oered district veterinary nursing support as part of a prescribed treatment plan, when discharged from any veterinary premises.2. That all animals receive their veterinary treatment when the owner’s situation or the patient’s health may prevent this from being delivered by the owner.3. Without judgement and accessible to all, a District Registered Veterinary Nurse “should be a vision of the NOW” readily oered by vets no matter what the circumstances, to help support the veterinary profession in delivering the ve freedoms and One Health One Welfare.4. That District Registered Veterinary Nurses form part of social prescribing and contribute to the veterinary professions compliance with the Equality Act 2010.5. That Registered Veterinary Nurses have a clear route for career progression and an alternative career path in dierent aspects of the community, with the opportunity to develop and utilise additional transferable skills.For further info see the facebook public page District Veterinary Nurse Community.vetdistrictnurse@gmail.comCarla and RoxyRoxy progress

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20Animal Therapy Magazine | ISSUE 21DISTRESS in dogs caused by separation from their owners can result in problem behaviours including inappropriate elimination, excessive vocalisations and destructive behaviour (Landsberg et al. 2013). ese can be caused by changes in routine, for example a period in rehabilitation or changes in an owners work pattern where owners spend long periods of time at home and then suddenly spend time away at work (Ballantyne, 2018). Many of these behaviours are deemed undesirable by owners and can lead to a loss of bond between owner and dog resulting in relinquishment to shelters and in some cases euthanasia. Dog Appeasing Pheromone (DAP) is a synthetic version of a bitches appeasing pheromone used to reassure her puppies. e product is widely available commercially in pet stores and veterinary practices and is reported to promote calm behaviour in dogs in turn reducing distress. e product works by changing the dogs perception of the surroundings and its response to specic stimuli, providing the dog with a reassuring environment (Mills, 2012). Dispersed into the environment via a collar, diuser, spray or tablet format, the product helps reduce anxiety, and promotes an environment that helps facilitate behavioural modication (Mills, 2012). To date, research that has explored the ecacy of DAP has mainly focused on behavioural responses of dogs with physiological stress responses largely unreported. A recent study by Taylor et al. (2020) aimed to address this gap in research by determining whether a DAP diuser reduced behavioural and physiological stress responses in dogs when separated from their owners. e authors suggest that as DAP is widely used in veterinary practices, by animal therapists and in the home environment, the results are applicable to canine welfare. ey can be used to inform the veterinary industry as well as animal therapy practitioners and the general public in relation to the ecacy of synthetic pheromones in reducing stress behaviours of dogs. Methodse researchers studied 10 dogs in a laboratory environment at Suolk One Sixth Form College, Ipswich. e dogs visited the laboratory on two occasions and were exposed to both DAP and no DAP in the presence and absence of the owner. e procedure on each occasion involved owners placing the dog alone in the laboratory for 5 minutes, returning to the laboratory and staying with the dog for 5 minutes, leaving the dog alone again for 30 minutes with either DAP switched on or DAP switched o (depending on the condition) and then reuniting with the dog in the laboratory for 5 minutes. Behavioural responses including those indicative of stress were recorded in real time and also video recorded. Behaviours included barking, hyper salivation, panting, trembling, whining, orienting behaviour, lip licking, exploration and locomotion, amongst others. Physiological responses such as heart rate and heart rate variability were measured using a heart rate monitor and also eye and ear temperature using infrared thermography.ResultsWhen dogs were separated from their owner, orienting behaviour increased when dogs were exposed to DAP but orienting behaviour also increased when they were not exposed to the product. is suggests that arousal is due to owner absence rather than any eect of DAP. Core eye temperature also increased when the owner was absent and the DAP diuser was not switched but also increases in eye temperature were observed when owners were present aer the DAP HARTPURY UNIVERSITYe behavioural and physiological eects of dog appeasing pheromone on canine behaviour during separation from the ownerby Sienna Taylor MSc, BSc (Hons), FdSc; FHEADogs in DistressPhoto courtesy of Aisling Carroll

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21 Animal Therapy Magazine | ISSUE 21condition, again suggesting an aect from owner presence rather than DAP. No dierences in other behaviours or heart rate and ear temperature were recorded. Discussione ndings from the Taylor et al. (2020) study suggest that DAP does not have a marked inuence on the behaviour or physiology of dogs in a laboratory environment. e ndings support Hermiston et al. (2018), Broach and Dunham (2016) and Grigg and Piehler (2015), who also found DAP did not aect dog behaviour. It may be possible that the laboratory environment was too stressful for DAP to have a marked eect on behaviour. For example, owners were leaving their dogs throughout the study duration and the stress incurred may have been too great, especially if the product only produces mild eects (Hermiston et al. 2018). Eye temperature also increased when owners were absent. As dogs oen nd owner separation stressful (Prato-Previde et al. 2003), the increase in eye temperature was likely caused by owner absence as opposed to any eects of DAP. e authors state that the eld of infrared thermography is still developing and more research is required to explore its use when measuring stress responses in dogs. Heart rate and ear temperature were not aected by DAP, supporting others (e.g. Berger et al. 2013; de Paula et al. 2019). Although large individual variations were found by Berger et al. (2013) and de Paula et al. (2019) therefore future studies should focus on larger sample sizes, to reduce the eect of individual variation. e small sample size of 10 dogs may have contributed to the lack of eect, and the authors recommend further research repeating the study with a larger sample size.ConclusionsBased on the ndings of Taylor et al. (2020), DAP was ineective at reducing physiological and behavioural parameters during owner absence. Whilst the study ndings should be interpreted with some caution, the authors suggest that veterinary professionals should be cautious about recommending such products to clients until there is a stronger evidentiary basis supporting the use of DAP. e results from this study can also be used by animal therapy practitioners and the general public to assess whether DAPs are a worthwhile investment in reducing behavioural and physiological indicators of stress in dogs. Photo courtesy of Diane JonesCanineHartpury UniversityHartpury, Gloucesterwww.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.REFERENCESBallantyne, K.C. (2018) ‘Separation, Connement, or Noises: What Is Scaring That Dog?’, Veterinary Clinics: Small Animal Practice, 48(3), pp. 367-386.Berger, J.M., Spier, S.J., Davies, R., Gardner, I.A., Leutenegger, C.M. and Bain, M. (2013) ‘Behavioral and physiological responses of weaned foals treated with equine appeasing pheromone: A double-blinded, placebo-controlled, randomized trial’, Journal of Veterinary Behavior, 8(4), pp. 265-277.Broach, D. and Dunham, A.E. (2016) ‘Evaluation of a pheromone collar on canine behaviors during transition from foster homes to a training kennel in juvenile Military Working Dogs’, Journal of Veterinary Behavior, 14, pp. 41-51.de Paula, R.A., Aleixo, A.S.C., da Silva, L.P., Grandi, M.C., Tsunemi, M.H., Lourenço, M.L.G. and Chiacchio, S.B. (2019) ‘A test of the eects of the equine maternal pheromone on the clinical and ethological parameters of equines undergoing hoof trimming’, Journal of Veterinary Behavior, 31, pp. 28-35.Grigg, E.K. and Piehler, M. (2015) ‘Inuence of dog appeasing pheromone (DAP) on dogs housed in a long-term kennelling facility’, Veterinary Record Open, 2(1).Hermiston, C., Montrose, V.T. and Taylor, S. (2018) ‘The eects of dog-appeasing pheromone spray upon canine vocalizations and stress-related behaviors in a rescue shelter’, Journal of Veterinary Behavior, 26, pp. 11-16.Landsberg, G., Hunthausen, W. and Ackerman, L. (2013) Behavior Problems of the Dog and Cat-E-Book. London: Elsevier Health Sciences.Mills, D.S., Dube, M.B. and Zulch, H. (2012) Stress and pheromonatherapy in small animal clinical behaviour. Oxford: John Wiley & Sons.Prato-Previde, E., Spiezio, C., Sabatini, F. and Custance, D.M. (2003) ‘Is the dog-human relationship an attachment bond? An observational study using Ainsworth’s strange situation’, Behaviour, 140(2), pp. 225-254.Taylor, S., Webb, L., Montrose, V.T. and Williams, J. (2020) ‘The behavioral and physiological eects of dog appeasing pheromone upon canine behavior during separation from the owner’, Journal of Veterinary Behavior. In press.Photo courtesy of Lucy Bearman-Brown

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22Animal Therapy Magazine | ISSUE 21TONY NEVINLuckily we all have professional bodies we can turn to for advice, and that’s just what we did. From personal experience the advice we got was lacking in nite clarity and le as many questions unanswered, as to what we could and couldn’t do. From a practical viewpoint there were two main worries. Were we legally allowed to carry on treating patients, and if so what restrictions were we to work under?Financially how were we to survive if we were not allowed to treat patients?For most people these days there are not vast amounts of private savings and investments that can readily be Clinical life with Covid-19by Tony Nevin, BSc (Hons) Ost, DO, Zoo Ost LtdFOR most of us the year began with a hectic schedule and all looked bright and rosy. en like a bolt out of the blue we were hit with a completely dierent way of life. Apart from the threat of death or permanent disability, we were suddenly living in what amounted to a police state. Restrictions to our core values of freedom were imposed with a speed and alacrity that have sadly been missing from politicians for many decades. It takes a crisis to make these people step up to the mark it seems. From busy clinics treating all sorts of animals and birds, to discovering the delights of daytime television, we have had a very real shock to the system. liquidated. e advice has always been to try to keep a reserve sucient to allow you to survive a three month break without any income. Anyone with a young family and co-dependents will know this isn’t always possible.As an osteopath I was guided to the Institute of Osteopathy (iO) as they are our national professional association. For the rst few weeks of lockdown they seemed bewildered and confused by everything. Eventually, and probably due to a lot of member pressure, they contacted the various ministries and suddenly we were told we could see emergency cases at our own discretion, but that if we did anything that was later deemed unsafe, or inappropriate for the circumstances that Covid-19 had created, that we could be prosecuted at a later date! is was then reiterated by our governing body, the General Osteopathic Council (GOsC) via an e-mail.As I run clinics embedded within veterinary practices I had meetings with the principals of each, and we created protocols under which they were happy for me to see their patients. To be honest they were relieved as there were several post operative cases that desperately needed attention.Suddenly daytime TV had to wait (actually I found I didn’t watch any, as I suddenly had time and energy for more productive things) as I found these clinics busier than ever. e new working protocols meant that owners had to let us take their beloved pets into the building to examine and treat whilst they waited in the car park. Gloved, masked and sanitized we must have appeared like actors in a post apocalyptic movie scene for the worried owners. Yet that British

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23 Animal Therapy Magazine | ISSUE 21wartime mentality kicked in and suddenly we were a “can do” nation once more. We were all in it together. I should note that the majority of these patients I was seeing were dogs and cats at this point. As my equine clinics focus more on the chronic patient I wasn’t likely to be needed anytime soon.As I lead my rst canine patient into the building, through a separate entrance, and into my own treatment room situated at the far end of the building and away from the rest of the veterinary clinic, I wondered how the patient was going to react to being in a conned room with just me, and a masked me to boot?e dog didn’t appear to notice that my face was dierent, it merely responded to my voice and the usual silly nonsense I jabber on about when I’m alone with a non-human patient. When I knelt down to initiate the examination it wasn’t long before the mask got checked out. is brought a whole load of new worries. Not that this dog was at all nervous or aggressive, but what if one was?As the examination turned to treatment Ale the dog decided he would return the favour and tried grooming the disposable mask. It might protect against airborne particles but the manufacturers might like to know that it isn’t doggy proof! It lasted all of twenty seconds of his undivided attention. He loved it.Aer this episode I upgraded to fabric masks. ey still elicit a lot of attention, but are much more durable. I have had to invest in a large number to allow for washing, sterilizing, and seeing several patients a day.I do also possess a clear plastic face shield. Marvelous piece of kit, that is unless you are treating a small terrier. I’ve long since taken to removing my spectacles when treating these little characters as prior to this I’d had a couple of instances where patients had attacked their own reections in them.Some of the larger dogs have smacked their noses into it, which can be a little uncomfortable for the wearer too. So, on balance I tend not to wear this whilst actually treating small animals.Many owners have worried that their pet won’t relax enough for treatment to be eective. I must admit I was concerned about this too. So far, even the most boisterous animals have been easier to work with in the absence of their owners!On the equine front I have gradually returned to treating my chronic cases, with new protocols in place. Due to the size of these patients it is possible to keep one to two metres away from an owner whilst both are masked up. Again the horses don’t bat an eyelid. I think we are more bothered by it all.Some downsides to masks are that it is both harder to see an owner’s expression, and also to clearly hear what they are saying. Also the extra eort involved in both breathing and talking can result in a higher intake of CO2 throughout the day. is can lead to minor headaches and increased irritability, along with fatigue. For this reason I have taken to using the air conditioning at the clinics more than usual.is all leads to a slower treatment pace, although the workload is just as high. is is due to all of the sanitizing and strict control of patient and owner movements. Gone for now are the busy waiting areas and bustling receptions, with all of their chatter and good-hearted banter.Ironically there has been the least disruption to my wildlife work, as we already used to wear some protective equipment prior to all of this.Talking with owners prior and post consultation does allow for more focus during the treatment itself, as there aren’t the usual distractions, so on the whole there are as many positives as there are negatives from this new way of life.I haven’t touched on video and phone consultations here but may well in a future article, as they have created and presented a whole new way of oering help.It is a challenge, but one that we can tackle head on, and know that collectively we will prevail. As a footnote and a non-clinical one at that, whoever thought we could don a mask before entering a bank, and not get arrested? Above top: Fabric facemasks last longer.Below centre: Not just for weekends! Some of the PPE we use.Bottom: Sanitizer and a non-contact infrared thermometer.Opposite: A clear plastic screen. Tony Nevin, BSc (Hons) Ost, DO is Clinical Director on the MSc Animal Osteopathy programme, run through the McTimoney College of Chiropractic, Oxon. For more information contact Tony at +44 7831 759339. www.zooost.com www.horseost.co.uk www.coriniumradio.co.uk www.mixcloud.com/tonynevin23 Animal Therapy Magazine | ISSUE 21

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24Animal Therapy Magazine | ISSUE 21*Offer subject to an optional “low start” payment planCompanionAnimalHealth.com // 01646 603878TRADE-UPLASER THERAPYPROGRAMCONTACT USContact our UK office today at 01646 603878 or via email at georginam@litecure.com or fill out this form online https://info.companionanimalhealth.com/uk-trade-upfor your custom quotation, and take advantage of this exclusive offer.Veterinarians, Veterinary Physiotherapists and Rehab practitioners around the world are trading in their lower powered lasers of the past in preference of higher powered lasers for one simple reason—outcomes. Recent clinical evidence has revealed that the key to consistent, replicable outcomes is optimal energy delivered at depth, which requires more power at the surface of the skin than can be delivered by low powered lasers. The evidence also points to high irradiance for relief of pain in the recently published study on the treatment of degenerative myelopathy. Companion is now offering a combination trade-up and leasing program. You can transition to the latest laser technology for as little as £10 per month*, without any initial capital outlay!OFFER VALID THROUGH NOVEMBER 30, 2020CTX IQ 15 Watts12 Animal Therapy Magazine | ISSUE 21I run an osteopathic consultancy treating animals ranging from small pets, to horses, and also the more unusual such as injured wildlife and exotic megafauna which include elephant, rhino, big cats, and great apes.I have been using a Companion Animal class IV laser for about 18 months QRZDQGKDYHƓQDOO\IRXQGDWRROWRproperly complement the osteopathic work. It is like I have another string to the therapeutic bow. Both complement each RWKHUDQG,ƓQGE\XVLQJRVWHRSDWKLFtechniques followed by laser work that owners and zoo keepers comment on greater improvements when compared to using either or. I am careful to only XVHODVHUZKHUHLWFDQEHVWEHQHƓWWKHpatient, rather than as a panacea.One of the greatest aspects of the unit I have is its portability, and the fact that it has a very good battery life when mains power isn’t an option. I am also fond of the direct contact heads that are useful for some of the domestic animal ZRUN,ƓQGQRQFRQWDFWKHDGVZRUNbetter with my avian and wildlife work, so having the option is really useful.A notable case I saw where the laser was really useful was with a juvenile cheetah that had a mild metabolic SUREOHPDVDFXE'LHWVRUWHGWKHELRchemistry out, and a combination of osteopathic hands on work, followed by laser worked wonders on sorting out her forelimb valgus deformation that was affecting both carpi. Companion Laser TherapyTESTIMONIAL - Tony NevinThis case was followed by the BBC for their series Animal Park, and both the osteopathic and laser work were featured as part of this animal’s life story.Over all I can’t imagine running my clinics now without my laser with me. It has become an extension of me.For information on the Latest in Class IV Therapy Laser Technology, RNGCUGEQPVCEVQWT7-QHƂEGIGQTIKPCO"NKVGEWTGEQOI run an osteopathic consultancy treatinganimals ranging from small pets, tohorses, and also the more unusual suchas injured wildlife and exotic megafaunawhich include elephant, rhino, big cats,and great apes.I have been using a CompanionAnimal class IV laser for about 18 monthsQRZDQGKDYHƓQDOO\IRXQGDWRROWRproperly complement the osteopathicwork. It is like I have another string to thetherapeutic bow. Both complement eachRWKHUDQG,ƓQGE\XVLQJRVWHRSDWKLFtechniques followed by laser work thatowners and zoo keepers comment ongreater improvements when comparedto using either or. I am careful to onlyXVHODVHUZKHUHLWFDQEHVWEHQHƓWWKHpatient, rather than as a panacea.One of the greatest aspects of theunit I have is its portability, and the factthat it has a very good battery life whenmains power isn’t an option. I am alsofond of the direct contact heads that areuseful for some of the domestic animalZRUN,ƓQGQRQFRQWDFWKHDGVZRUNbetter with my avian and wildlife work, sohaving the option is really useful.A notable case I saw where thelaser was really useful was with a juvenilecheetah that had a mild metabolicSUREOHPDVDFXE'LHWVRUWHGWKHELRchemistry out, and a combination ofosteopathic hands on work, followed bylaser worked wonders on sorting out herforelimb valgus deformation that wasaffecting both carpi.Companion Laser TherapyTESTIMONIAL - Tony NevinThis case was followed by the BBC fortheir series Animal Park, and both theosteopathic and laser work were featuredas part of this animal’s life story.Over all I can’t imagine running my clinicsnow without my laser with me. It hasbecome an extension of me.For information on the Latest in Class IV Therapy Laser Technology, RNGCUGEQPVCEVQWT7-QHƂEGIGQTIKPCO"NKVGEWTGEQO

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25 Animal Therapy Magazine | ISSUE 21*Offer subject to an optional “low start” payment planCompanionAnimalHealth.com // 01646 603878TRADE-UPLASER THERAPYPROGRAMCONTACT USContact our UK office today at 01646 603878 or via email at georginam@litecure.com or fill out this form online https://info.companionanimalhealth.com/uk-trade-upfor your custom quotation, and take advantage of this exclusive offer.Veterinarians, Veterinary Physiotherapists and Rehab practitioners around the world are trading in their lower powered lasers of the past in preference of higher powered lasers for one simple reason—outcomes. Recent clinical evidence has revealed that the key to consistent, replicable outcomes is optimal energy delivered at depth, which requires more power at the surface of the skin than can be delivered by low powered lasers. The evidence also points to high irradiance for relief of pain in the recently published study on the treatment of degenerative myelopathy. Companion is now offering a combination trade-up and leasing program. You can transition to the latest laser technology for as little as £10 per month*, without any initial capital outlay!OFFER VALID THROUGH NOVEMBER 30, 2020CTX IQ 15 Watts

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26Animal Therapy Magazine | ISSUE 21FleurFrom track to treatmentby Lindsay Cope, Paw Vida Holistic erapies and Member of the Canine Massage GuildWHEN I rst treated Fleur, she was a 6-year-old rescue who had been living with her current owners for 3 and a half years. Because of a tattoo in her ear, and that she’d been handed into the rescue when found living in a shed in Ireland, it was assumed she was an ex- or failed racing dog. Fleur’s next stop was a rescue centre in Oxford, and then to a foster family in Doncaster before nding her forever home in Somerset with Becky and Pete, their son Owen, and their two cats. You could say she was well travelled! First StepsBecky soon noticed that Fleur presented with an intermittent right forelimb lameness, which seemed to be brought on and exacerbated by exercise. Sensibly, a visit to the vet revealed that she seemed to be in pain when her right elbow joint was fully extended whilst her right shoulder joint was exed, leading to a tentative veterinary diagnosis of a Bicep Brachii tendon pathology. CANINE MASSAGE GUILDClinical Canine Massage TherapyBefore embarking on long-term anti-inammatory medications, Becky decided to explore clinical canine massage, a complementary remedial therapy.Membership of the Canine Massage Guild requires a 2-year, rigorous training programme with the Canine Massage Therapy Centre Ltd, incorporating an integrated blend of 4 disciplines of massage: myofascial release, sports, deep tissue and Swedish in conjunction with the Lenton MethodÒ. A three-tiered approach, the Lenton Method combines advanced palpation skills, body-mapping, and an exclusive set of direct myofascial release protocols which has become so successful in the treatment of dogs that Winchester University are researching it as part of the worlds rst clinical trials into canine massage therapy. Combined with a deep understanding of canine anatomy and physiology, the application of these various techniques, strokes, stretches and releases, specically developed for the canine anatomy, aims to address myofascial pain, rehabilitate soft tissue injuries and manage chronic pain for dogs living with orthopaedic conditons, with results usually seen within 1 to 3 sessions.Just a little bit about Rescue Greyhounds Just as some breeds of dogs are more predisposed to certain orthopaedic conditions than others, as Canine Massage therapists we tend to nd similar patterns of musculoskeletal issues and injuries across canine athletes and sporting dogs, often specically dependent on their particular discipline, Greyhound racing, for example. A life on the racing track for Greyhounds is no picnic, often marred by injury, over-exertion, and pain. It’s no wonder when you consider their career starts at the tender age of 15 months and they reach speeds of up to 45mph. Looking at their anatomy and physiology, we can see why they make great racers, but also why they tend to suer with certain injuries. Greyhounds carry 55% of their body weight in muscle, which is 10% more than any other breed of dog, so it’s no surprise that muscular injuries are common. Whilst their forelimbs control their direction and act as shock absorbers, their hind limb muscles are much larger in order to produce the power and drive needed to create high speeds. Their specic anatomical conformation combined with a number of external risk factors for injury, e.g., always racing in an anticlockwise direction and on a camber, the varying structure and conditions of the racetracks themselves, and the multiple collisions they sustain with their competitors, we start to see a number of specic muscular and ligament sprains, and even orthopaedic fractures are quite common.Knowing Fleur’s likely background was useful. I was able to approach her treatment sessions knowing that in addition to the suspected Biceps Brachii tendon pathology, there would probably be other old or latent musculoskeletal issues and injuries that would also need addressing, and also where I was most likely to nd them. If you’ve had the pleasure of rehoming a rescue Greyhound, you may have noticed that they’re touch sensitive to specic areas of their body. This can be an indication that they are carrying an old injury from their racing days.

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27 Animal Therapy Magazine | ISSUE 2127 Animal Therapy Magazine | ISSUE 21Put 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! Initial AssessmentAs with any rst treatment session, we started with an in-depth consultation, discussing Fleur’s veterinary history (as far as was known), her diet and supplements, as well as her lifestyle and day-to-day activities including exercise levels and routine. We discussed Becky’s desired outcomes from the treatments so that they could be tailored accordingly. She hoped for improved mobility by resolving or reducing the frequency of the right forelimb lameness and in doing so, help Fleur’s pain management and avoid the need for anti-inammatories. As part of the initial assessment I took time to observe Fleur’s gait, watching her move around the house and in the garden. I noticed the right forelimb lameness, albeit very subtle at that time. Prior to starting treatment, I carried out a supercial palpation, feeling for any changes in temperature, texture, and tone, areas of tenderness, injury, scarring, spasm, knots and trigger points. As I began to palpate the muscles and soft tissue, it became evident that Fleur had a number of muscular issues, including:Strain – a painful tear to the muscle or the tendon which joins the muscle to the bone, as a result of overstretching or overloading. Fleur had acquired a Grade 2 supercial pectoral strain with associated scar tissue on her right forelimb.Myofascial Pain –Fascia is the 3D cobweb of connective tissue that envelopes every muscle, organ, and bone in the body and provides a surface for the muscles to slide and glide over one another during movement. However, when adhesions occur, fascia becomes restricted and dysfunctional, clamping down over the muscles and reducing or inhibiting this slide and glide action, causing stiness and reduced mobility, which is often associated wide radiating pain. Fleur had myofascial restrictions through her quadriceps and hamstring muscles as well as wide radiating myofascial pain over the thorax. Trigger Points - When restrictive adhesions build up between the muscle bres over time, usually as a result of repetitive strain and micro-trauma, they can form a trigger point. Hyperirritable bands within a muscle, trigger points can cause debilitating levels of pain and faux muscle fatigue. Fleur had palpable active trigger points on the rhomboid, teres major, and latissimus dorsi muscles bilaterally, and the tensor fascia lata muscle on the right. Hypertonicity - Persistent stress on a muscle can lead to hypertonicity, a state where there is too much resting tone in the muscle bres, decreasing their ability to lengthen and contract eciently and thus inhibiting normal movement. Fleur had several areas of hypertonicity but most notably over her Iliocostalis muscles through her lower back. Fleur relaxing into her treatmentcontinued overleaf

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28Animal Therapy Magazine | ISSUE 21CANINE MASSAGE GUILDMassage TreatmentsOwners are often concerned about whether their dog will stay still or be cooperative when having massage. We recognise that it’s a whole new experience for most dogs so its important to give the dog and empathy, after all, dogs experience pain just like us, it’s just they are better at hiding it. They don’t know what to expect or what is expected of them, so we prefer to give them as much choice as possible. Often, it’s just about giving them the time to understand the process and also discovering their preferred set-up. For her rst treatment, Fleur preferred to be treated in her bed on the oor. She responded well to massage and the next two sessions were on the couch where interestingly she relaxed much more quickly and deeply which her owner found fascinating and also reassuring. A Word about MuzzlesPeople who are ignorant about how muzzles can be helpful in our work may throw their hands up in horror when we say that we use them occasionally, for two main reasons. The rst, which surely must be simple to understand and appreciate, is that if a dog is touched somewhere tender they may react by snapping. That doesn’t mean it’s a bad or vicious dog. It’s easy enough for us humans to lash out if someone causes us therapeutic discomfort during a bodywork session, even when we know what is happening, which dogs of course do not. Owners with dogs that may tend to snap often ask us to muzzle their dogs – or bring a muzzle with them. Which owner wants their dog to nip someone? Especially someone trying to help them. It’s really important that owners are given credit for knowing their own dogs better than anyone and for professional therapists of any discipline to recognise this and respect an owners understanding.The second reason is that muzzles calm scared, fearful, shy or anxious dogs. As clicker-training guru Karen Pryor says on her website ‘But, muzzles are not just for aggression anymore. It’s high time to dispel those negative mental images. Rather than vilifying muzzles, it’s time to appreciate muzzles for all the good things they can do for dogs.’ Muzzles are a standardised part of risk assessments for professional and responsible canine health professionals and as a professional therapist I, along with all Canine Massage Guild Members, respect the safety guidelines established by the veterinary industry.In Fleur’s case, the occasional use of a muzzle had a calming aect when I reached areas that she found uncomfortable. The dierence was quite amazing. Whilst I used a wide range of massage techniques across the three sessions, the myofascial release techniques from the Lenton Method®, in particular helped break down adhesions that were causing her widespread pain. They also resulted in improved mobility and there was a signicant reduction in all restrictions across the three sessions. As part of the treatment, Becky and I also discussed aftercare advice and devised a customised care plan to help manage Fleur’s underlying issues and keep her moving and feeling younger for longer. The plan covered avoiding excessive jumping on and o of furniture and in and out of the car to reduce the impact on her joints; considering a joint care supplement to protect her joints as she aged; using various forms of thermotherapy including ice application to her recurrent strains when acute, and applying heat to areas of hypertonicity to help soften the muscle tissue, both of which I demonstrated to Becky during the course of the treatments. Results• Signicantly improved mobility• Less frequent episodes of right forelimb lameness• Spring in her step• Happier on walks• Improved pain management and no need for anti-inammatoriesFollowing Fleur’s treatments, Becky said, “After just three massage sessions, I’ve noticed that Fleur has a greater freedom of movement, a spring in her step, and generally seems happier on her walks! Its been amazing that this has happened so quickly, something we didn’t expect. Fleur has also experienced less frequent episodes of right forelimb lameness since the start of the massage sessions, seeing her suer in pain was hard so seeing such an improvement in both her mobility and demeanour has been astounding . She was also extremely relaxed and sleepy on the evenings after each treatment, not even stirring to ask for her dinner, which is most unlike her! We have been amazed at how this therapy has improved not just her quality of life but also her behaviour. I’d whole heartedly recommend this therapy to any dog owner, it’s quite simply life-chagning ”Fleur is now a very content 11-year-old enjoying the quiet life in her family’s beautiful new home in the countryside. With woods and elds to explore for miles, her new found mobility through clinical canine massage therapy allows her to experience life to the full. For more information on clinical canine massage therapy or to nd your local therapist please visit www.k9-massageguild.co.uk To contact Lindsay directly please visit www.pawvidatherapies.co.ukFor more information on Karen Pryor visit www.clickertraining.comAbove: Fleur can now enjoy the beach with her owner Becky. Below: Fleur is able to get on the sofa again

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29 Animal Therapy Magazine | ISSUE 21CHIROPRACTICA passion for helping others led me down the path of Wholistic wellness into a career that allows me to provide my patients with high quality healthcare. As a professional Chiropractor since 2006, I bring a holistic approach in order to nd comfortable and eective solutions for everyone. Qualied from Life West in 2006 and previously a veterinary nurse, I fell in love with the chiropractic profession! After obtaining my doctorate, I then specialised and became certied in Animal Chiropractic through the IVCA. I am an international teacher and lecturer also.As an experienced Chiropractor based in Champagne, France, I’m determined to help my patients understand their own health so they can be well informed when making important health decisions. This goes for my animal clients too. Chiropractic is one of the most popular and fastest growing healthcare modalities for animals right now.What is chiropractic?Quite simply Chiropractors work with the nervous system., this is the most important system in the body connecting the brain with the body but also providing the inter communication between the muscles, joints, cells and organs. With this master control system connected balanced and aligned the body is at its best. The chiropractic adjustment provides that connection. Using my hands and the natural biomechanics of the animal a quick adjustment releases the tension in that system. That body can then function at its best in alignment and in balance.Why do animals need to get adjusted?Like humans animals can experience a variety of challenges to their system. Chiropractors like to look at the whole picture. Imagine the very beginning of that animals life and the force of even the most natural birth on the body. Next tumbling and falling as a youngster, the natural traumas and aging process, various strains and stresses depending on the ‘job’ of that animal and nally the best part of chiropractic is that it works best as a PREVENTION.I run a mobile practice but many of my canine clients come to my oce. I have had outstanding results with racehorses and show jumpers and look upon these amazing animals as topathletes and they denitely deserve to be taken care of! I also see a lot of family pets including Dartagnan the bulldog who has been much more comfortable with his arthritis since starting care. Hanky and Panky the mini ponies are as naughty as their names suggest and love their sessions so much they think I’m part of their herd! I’ve had some unusual cases too including a mouse, a goat and an iguana with a damaged tail!I love to see families both in my human and animal practice and nothing makes me happier than when I get to see how well chiropractic works throughout the life of an individual. It’s not a ‘quick x’ but the results speak for themselves.What is the mission now?That every person AND animal has their own Chiropractor!Animal Chiropracticby Dr Charlotte Evans29 Animal Therapy Magazine | ISSUE 21

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30Animal Therapy Magazine | ISSUE 21Treating Belle with Photizo Vetcareby Anna Webb on behalf of Photizo VetcareBroadcaster, Author, Trainer has studied natural nutrition and therapies with the College of Integrated Veterinary erapies (CIVT)PHOTIZOWhen Jöelle Wéry’s Selle Francais, a mare named Belle, suered severe leg injuries, the week after Lockdown restrictions were enforced on March 29th, Photizo Vetcare jumped into action.The leg wounds were incurred after Belle and a gelding in the neighbouring paddock had a major disagreement. Belle tried to kick the gelding through the fence, but got her back legs caught leaving several deep lacerations.Jöelle consulted her vets who weren’t able to visit Belle due to Lockdown, but advised accordingly and she was given a ve-day course of antibiotics. Belle was moved to a dierent paddock away from the gelding in question to keep her as calm as possible. Jöelle also contacted Belle’s massage practitioner, Sophie Whymark of SLW Equine Sports & Rehabilitation Massage & Therapy, for support and advice. Sophie suggested borrowing her own Photizo Vetcare and to use it along side the course of antibiotics. Although being aware of Vetcare’s potential to speed up the wound healing process, Sophie had never used it in a situation like this, so she was eager to see for herself how the Vetcare would help with Belle’s wounds. Integrating Photizo’s red light therapy with her equine sports massage, Sophie is a fan of the Vetcare as a handy non-invasive treatment device.Sophie explained: I incorporate the Photizo into many of my sessions due to the wide range of benets that it provides. I treat a lot of dierent types of horses from retired ponies all the way up to professional competition horses. I nd that the Photizo is a great tool to use during post-event massages as it assists in repairing damaged cells, which could be in the form of a strained tendon/ ligament or a pulled muscle. On the other hand, I use the device on the older horse that is prone to swelling in the lower legs if stood for too long as it gives the circulatory and lymphatic system a boost.The Photizo Vetcare is a device that I would not be without, it is lightweight, easy to use and it boasts so many dierent benets. I believe that every yard should have one!”Belle

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31 Animal Therapy Magazine | ISSUE 21continued overleaf31 Animal Therapy Magazine | ISSUE 19On Day One Belle’s wounds were very raw. There were several small lacerations, which were dosed with the Vetcare twice daily. By the second day the wounds were looking much cleaner and starting to heal, and no sign of infection. Sophie explained: “Luckily we were able to apply Vetcare within the 4-6 hour window after the trauma, which helped reverses cell death, so the wounds had a high chance of an ecient recovery.”Delivering 30 x second pre-programmed doses of ‘evidence based’ red and near Infrared light using LED (light emitting diode) technology, Photizo promotes natural healing across a host of musculoskeletal conditions and speeds up wound healing. As the red light penetrates the mitochondria it creates a cascade of biological reactions and generates cellular energy at the point its being applied. For wounds it quickly reduces inammation and pain, increases the lymph ow to the aected area, reducing any risk of infection as the wound rapidly knits together. What’s more unlike when using a laser sourced red beam, there’s no need to wear eyewear with Photizo Vetcare, as LED light is not harmful to the eyes. Being lightweight and portable with a long battery life, paid dividends in Belle’s case treating her in the paddock. By Day Three the redness on Belle’s wounds were visibly reduced and still no sign of infection. Considering the lacerations were awkwardly position around the hock joint where there’s a lot of movement, the concern was that the wounds would be pulled and stretched as Belle walked. Fortunately this wasn’t the case and there was no bleeding or excess exudate leaking from the wounds either.Day OneDay ThreeDay OnePhotizo Application

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32Animal Therapy Magazine | ISSUE 21PHOTIZODay Four and recovery continued with no signs of inammation or swelling, which Belle is usually prone to after standing for too long, or when she is stabled for long periods. By Day Six the wounds were knitted together with clean healthy skin, no sign of any swelling or infection, but there was hair growth. Jöelle was worried that Belle’s hair might not grow back and she’d be left with scarring on her legs, but the hair was growing back and in her naturally deep brown colour.Day Seven and the scabs began to fall o leaving clean healthy rejuvenated skin underneath. Joelle continued to use the Vetcare twice daily morning and night even though the course of antibiotics had nished.Sophie added: “Belle seemed to enjoy her Photizo sessions showing lots of signs of relaxing during her treatment like licks and chews, yawns, and lowering her head, which are all signs of release”. Despite Belle being out 24/7 surprisingly there were no ies showing any interest in her legs or bothering her at all. The wounds were progressing well, with no infection and still looking clean. Another concern was that the wounds would attract ies that might infect or cause irritation and more damage to the injuries, but that wasn’t the case. On Day Ten the Vetcare treatments were reduced to one application per day. The wounds were clean, there was hair growing. Belle did not show any signs of lameness throughout, and was happy for the wounds to be touched.Sophie enthused: “I am delighted with Belle’s recovery, nothing less than fantastic! Belle’s owner, Joelle just wishes she’s known about the Vetcare sooner, considering it a must have for every equine’s rst aid box. I am so impressed that in 10 days, there was such a speedy recovery. I only wish I had been able to oer Belle a massage to give her lymphatic system an extra boost, but due to the restrictions due to COVID19 that wasn’t possible.” Ruth Milner, MD, Danetre Health Products, Photizo’s sole UK distributor explained: “We’ve received so many positive cases on Vetcare’s success at helping speed up wound healing as well as musculoskeletal injuries, so it’s wonderful to hear how well Belle’s injuries recovered so quickly. Photizo is the result of many years research with new generation LED technology and is setting a precedent as the healing eects of eective red & near-infrared light therapy, known as photobiomodulation, becomes more common with integrated animal health practice. “The recent COVID-19 lockdown meant animal owners had limited access to a professional practitioner at their homes/yards and there are occasions when an animal health professional cannot visit their patient regularly enough for optimum healing eects to be achieved with low-level laser. Belle’s case was a prime example of how eective and simple modern home-use photobiomodulation devices can sensibly be put into the hands of a client. Progress in this technology means devices like Photizo can be used eectively and safely to help continue the healing eects and help minimise scarring or post injury complications.”Day Four Day Ten

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34Animal Therapy Magazine | ISSUE 21 If there is one thing we have learnt through the rough ride that 2020 has presented so far, it is that we’re all closer together than we realise. A global community, connected by more than physical touch. In a world dominated by the internet, our professions adapt and evolve year after year. We need to strive continuously not only to keep up with developments in our profession, but to stay ahead of developments so that we can remain at, or reach, the top of our profession. This means constant, never-ending, continuing education and professional development. Onlinepethealth is here to make sure that Veterinary Rehabilitation Therapists achieve that in the easiest, most thorough way possible – through the internet. Here are some facts and stats on how online learning can benet both you as a professional and your company: (https://www.shiftelearning.com/blog/bid/301248/15-facts-and-stats-that-reveal-the-power-of-elearning)1. Learning through online platforms requires 40-60% less employee time than face-to-face learning. 2. Online learning increases retention rates by 25-60%. Retention rates in face-to-face learning environments are a mere 8-10%. 3. In the same amount of time, you can cover ve times more material online than in person. 4. Globally, 42% of companies report that online learning has led to an increase in revenue. 5. In total, 72% of companies say that online learning gives them an increased competitive edge, as their employees are easily able to stay ahead of changes in their industry. The statistics are great, and really leave us wondering why we did not adopt online learning as our primary vehicle for continuing education years ago! But do the stats hold true in the vetrehab profession? Can we really have happier employees, spend less Continuing Education goes Wirelesstime in CE training, learn more CE, learn it better, stay abreast of the eld, and increase our companies’ revenues through online learning? Allow me to share how we reach even better stats through online learning at Onlinepethealth: 1. All of our CE content is available in an easy-to-navigate members’ portal, accessible online at any time. 2. The members’ portal is lled to the brim with a library of lectures, research articles and business resources that enable you to search and solve the clinical problems we encounter daily in our practices. Ask and nd the answers to those challenging questions using our pool of the best and latest in research. 3. We use lecturers from all around the world, experts in their elds, to ensure that we’re constantly gathering knowledge from a wide range of credible sources and not just from one training facility. This means you stay abreast of the latest, all the time! 4. Our library grows every month as we broadcast live lectures directly to our members, allowing members to interact with and ask questions directly of the lecturers. 5. We provide monthly business training – a much overlooked aspect of most Vetrehabber training. Our business coaching geared specically to the world of Veterinary Rehabilitation helps you run your business as eciently and eectively as possible. With the right advice you can generate a higher income, take care of your sta, market your services appropriately, increase referrals, increase client retention … the list goes on! 6. More than anything else, Onlinepethealth is all about community. Our Facebook groups are supportive and interactive, and allow you to get the advice of thousands of Vetrehabbers from all around the world when you run into challenging cases that need more brains than one! 7. Our members have access to a voluntary, free mentorship programme that allows them to get one-on-one help from other Vetrehabbers, to ensure they’re growing and gaining condence on their professional journey. 8. We run an annual online conference to further connect our industry – the Vet Rehab Summit. 21 lectures, various discussion rooms, networking, prizes, and so much more. All freely available to our members on 14 November 2020. While our membership oers you phenomenal continuing education from global industry leaders in the comfort of your home, it may not be possible for everyone to become a member. If that is you, you don’t have to miss out! We have created a Free Members area where we share webinar, business advice and more. You are able to download your CE certicates in this free area, and we will update it and change the content out on a regular basis. The Veterinary Rehabilitation Podcast airs a new episode once a week. Here we interview Vetrehabbers about trends, techniques, books, training, business advice and much more. This is our way of making sure that every Vetrehabber benets from the advice and growth of our industry. If you don’t enjoy listening to podcasts, you might prefer following our weekly blog, where we touch on crucial topics to the development of our profession and the multi-disciplinary team. Some of our blogs are designed to be shared with pet owners to help educate them on your value and role in their animal’s life. Wherever you are in the world, and wherever you are on your journey of Veterinary Rehabilitation, Onlinepethealth is the place to connect, grow, develop, and push your boundaries for the ultimate benet of your patients and your business.www.onlinepethealth-info.comONLINEPETHEALTH34 Animal Therapy Magazine | ISSUE 21

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36Animal Therapy Magazine | ISSUE 21Animal 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 andreviews. • 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 informationM A G A Z I N ESUBSCRIBE NOW You can subscribe to read our online copy for just £10 per year.Further information can be found on our website animaltherapymedia.co.uk1 Animal Therapy Magazine | ISSUE 20Governing Bodies and RegistersWho do you go to?Coronavirus How Levi Hunt has adapted his training regimeTop tips from Dr. Jane Williams on bringing your horse back to into work after a breakRehoming dogs - top tips from an Animal BehaviouristRehabilitation From Brachial Plexus injury Thermal Imaging in practiceThe tale of the tailWhat does tail posture tell you about your horseCanine Arthritis Management What is arthritis and what can you do to manage it in your dogISSUE 20M A G A Z I N EAnimalerapyAnimalerapy