Issue 23 : simplebooklet.com

2Animal Therapy Magazine | ISSUE 23Supply and Service of Medical Devicestrimbio offers a vast range of products all at very competitive pricesAnimal Therapy Products Vetkin-Tape® Kinesiology Tape A robust tape with good ventilation. Vetkin-Tape® has 25% increased adhesiveness to other tapes. It is 20% larger than Human tapes and gives maximum results for animals.Anatomical ChartsEquine and Canine Skeleton or Muscular charts with German, English and Latin text. 50cm x 70cm printed on 200gsm art paper, with attachable plastic rods for hanging.£6.25 +VAT£13.95 +VATExtra Large Wobble CushionThis large wobble cushion (55cm dia.) is ideal for animals as £36.95 +VATNEW Digital Vet H-WaveThe new Vet H-Wave has been upgraded with xed and adjustable frequencies, a backlit screen and a lighter battery. The Vet H-wave uses a signal £1750.00 +VATMobile 2 Ultrasound with Battery & Carry Bag This unit is ideal for animal therapy where the unit can be powered by battery whilst in its carry bag, and be protected from the elements. Call for latest pricing offerHand Held LaserA hand held system that does not require protective glasses and runs off standard AA batteries. The unit is extremely hard wearing, portable and effective within supercial and soft tissue injuries.Laser PackageThese packages are ideal for all Animal Therapy Practicians as we can mix and match the probes & clusters to suit the required eld of treatment.Neurotrac Sports Muscle StimA dual channel muscle stim unit which has 15 preset programmes and the option to store 3 of your own custom programmes.£73.95 +VATBiomag 2 Base UnitThe Biomag 2 unit has a range of frequencies offering a range of treatment options from soft tissue injuries, fracture repair enhancement and pain relief.Prices start from £495.00 +VATthat is natural to the body. It emulates the H wave form found in nerve signals and therefore enables greater and deeper penetration of a low frequency current, whilst using signicantly less power than other machines.£295.00 +VAT2 limbs can be easily placed on the cushion, for balance and proprioception work.01403 597597 www.trimbio.co.uk sales@trimbio.co.ukCall for latest pricing offeranimal therapy ad 01 21 artwork.indd 1 02/02/2021 09:20

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3 Animal Therapy Magazine | ISSUE 23GET 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.ukWelcome! After the announcement from the UK Prime Minister Boris Johnson on Monday 22nd February, we are all starting to feel more positive for the remaining of 2021. Obviously it all needs to go to plan but ngers crossed we can all see friends and family in person rather than on a screen, and our much loved conferences and events can take place in the second half of the year.Lock down has been a challenging time for so many but it has also given us time that many of us usually don't have. A huge thank you to all those people who have used that spare time to write up case studies, dissertation summaries and research for us to share with all our readers.A big thank you as always to all our contributors to this issue, we really hope you enjoy it and as always, if you have a story to share please get in touch with us hannah@animaltherapymedia.co.ukTake careTeam Animal TherapyCONTENTSM A G A Z I N EAnimalerapyAnimal Skincarewww.leucillin.co.ukLeucillin is a safe, effective and versatile skincare solution mimicking the body’s own immune system, it isspecially formulated to match the natural pH of your pets skin.Leucillin is non-toxic, will not sting and is safe for all skin types including ears, eyes and sensitive skin.Leucillin quickly relieves, soothes and calms for good skin and coat condition.Available from all good pet shops, Pets At Home and Just For Pets storesTHE NATURAL WAYTO CARE FOR YOURPETS SKINFast acting formula soothing and calming to: effective allergy managementskinfold care for brachycephalic breeds itchy skinsore pawscuts, grazes & post surgical sitesweepy eyesirritated ears dry, flakey or smelly skin 100% safe on all skin typesFor all mammals, birds & reptilesYour Pet Safe Antiseptic SprayTough on Pathogens includingMRSA, E.coli & SARS-C0V-2Yet skin pH NeutralGentle to SkinSafe for All The Family FP_JULY20.qxp_Layout 1 03/09/2020 16:18 Page 1Four steps to consider before you change animal careers________________________________4Canicrossing - a veterinary physiotherapist perspective __________________________________ 6CAM4Animals -celebrating their 3rd anniversary ___12Photizo - treating Jenson ______________________14Tony Nevin - When NOT to treat ________________18 Acute Idiopathic Polyradiculoneuritis in dogs _____20Intervertebral Disc Disease (IVDD) _______________22Dog wheelchairs _____________________________24From t to fat to t ___________________________28Hartpury University - head and neck positions in the reidden horse ____________________________32Canine Massage Guild - Case Study - Teddy _______36Head shy horses _____________________________40Levis Blog __________________________________45CAM - Supplementss for arthritis management ____46www.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: Jura, owned by Frankie. See full story on page 6. Photo: @barkerandhound (Barker & Hound). ISSUE 23Issued Quarterly

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4Animal Therapy Magazine | ISSUE 23 Four steps to consider before you change animal careersWhat has made you consider a career change in Animal Care? Perhaps COVID has changed your circumstances and you are now in a position where you are reviewing what you want? Are you nally realising your true passions for Animal Welfare? Or perhaps it’s your current employer that has provided a training opportunity for you to explore new things?Careers in Animal Care have always been popular, but roles in the industry are more regulated than ever. There are also many routes to think about, multiple options for training and many personal and lifestyle factors you may want to consider. So, before you embark headrst into a particular animal job or business, we wanted to give you some guidance. Animal Courses Direct has been developing qualications for animal professionals since 2005, and therefore we thought it would be helpful to provide you with important considerations for a career change into this vast sector.Step 1: Know your regulationsThe Animal Activity Licensing Regulations (2018) states that any individual whose work involves boarding for cats or dogs, selling animals as pets, hiring out horses, breeding dogs or keeping or training animals for exhibition, must have clear evidence of knowledge and experience or a minimum of anOfqual regulated Level 2 qualicationin a relevant subject. This is also relevant If you are considering launching your own animal business, so please make sure you have the correct regulated qualications before you launch any animal products or services.To meet the Higher Standard, a member of sta with a relevantOfqual regulated Level 3 qualicationmust be present during the working day. Therefore, consider existing qualications, you have and check if they are relevant for the new sector you want to explore. ANIMAL COURSES DIRECTStep 3. Discover alternative animal careersDespite COVID harming many industries and people’s livelihood, it has provided many opportunities for people to start afresh. We have seen a variety of applications from people who want to train in animal care, these range from Pilots who want to become Animal Hydrotherapists to Teachers who want to start their own Dog Grooming Business.Sometimes the best roles are the lesser-known ones, so we have made a list of alternative animal care careers:Animal Licensing Inspector/ OcerAnimal Licensing Inspectors are employed by Local Authorities to monitor and license animal businesses. They are employed by charities and Local Authorities to assist with animals in need, prevent animal cruelty, enforce legislation, and advise the public on responsible pet ownership.Relevant training: Level 3 Diploma Animal Welfare OcerAnimal Assisted Intervention TherapistAnimal Assisted Intervention (AAI) is a type of therapy for people that involves animals as a form of treatment. The goal of AAI is to improve a patient’s social, emotional, or cognitive functioning. Trained animals are selected to provide therapeutic visits to hospitals, nursing homes, hospices, special needs schools and prisons.Relevant training: Level 3 Diploma in Animal Assisted Intervention.Animal HydrotherapistsSmall Animal Hydrotherapists use hydrotherapy rehabilitation techniques to assist animals with pain management, mobility issues and exercise. This is an active job that can require treatment and training for animals both in and out of the water. This is a career route for those who want to set up their own Hydrotherapy business or as part of an existing hydrotherapy franchise.Relevant training: Level 3 Diploma in Small Animal Hydrotherapy.by Animal Courses Direct4 Animal Therapy Magazine | ISSUE 23Step 2: Explore funding optionsMany organisations have training funds for their employees, so it is worth checking if your current employer has a pot of money to support development and training. Another consideration is through redundancies, if you have been made redundant there may be scope for negotiating a training fund with HR for your next career step.The Ministry of Defence Enhanced Learning Credits Scheme (ELC) is an initiative to encourage lifelong learning for members of the Armed Forces. Its scheme provides nancial support (using an up-front payment) for higher level Ofqual regulated qualications (Level 3 and above). Service Leavers are also able to use their Individual Resettlement Training Costs (IRTC) funding and Resettlement Grant (RG) funding for our training courses.Alternatively, you can consider paying for training with monthly payment plans like Klarna. At Animal Courses Direct we oer monthly instalments across all our Ofqual regulated qualications and accredited courses, so you can spread out the cost over a period of time.

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5 Animal Therapy Magazine | ISSUE 23 Animal Therapy Magazine | ISSUE 23 5 Assistance Dog TrainerAn Assistance Dog trainer trains dogs to enable people with physical diculties or illnesses, to lead independent lives. Dogs can be trained in a variety of supportive roles including Guide Dogs, Hearing Dogs, Disability Dogs, Cancer Detection dogs, Diabetes Hypo-alert dogs, Seizure alert dogs, and more.Relevant training: Level 3 Diploma in Assistance Dog Training.Step 4: Consider what you want in the long termWith so much uncertainty, it is a challenge to plan out your career this year. Therefore, take a moment to consider that things may be quite dierent by the time you have completed your animal training.We suggest that not only should you research the training and regulated qualication required, but also what the role entails and what you will be doing physically and practically on a day-to-day basis.You may want to establish whether the role requires a driving license, or perhaps it requires you to be physically t and healthy to be able to lift heavy animals. Consider the expected hours and what days you may have to work, for example, many animal jobs require individuals to work weekends and be on call.Our qualications have been set up so that you can complete all your theory training online, before completing any practical training. This has proven to be helpful in lockdown, and you can dedicate this time to studying and completing assignments. Our practical training will commence this year when is safe to do so, and we will make sure you are notied with the latest updates.All of the qualications mentioned in this article are available to study via our website: animalcoursesdirect.co.uk If you have any further questions about training and development in the animal care industry, please call 01202 006 040 to speak to one of our friendly student support team.

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6Animal Therapy Magazine | ISSUE 23CANICROSSINGCANICROSSING is the art of human and dog running together. The sport has grown exponentially in popularity throughout the UK. Whilst there is literature to support other dog sports (Marcellin-Little, Levine & Taylor, 2005); there is little in the way of peer-reviewed research about canicrossing in order for veterinary professionals to condently advise owners. Running is the most natural thing for a dog to do. From a musculoskeletal point of view, if done responsibly and with the right support from the veterinary team, canicross can improve body Conf ident conversations about CanicrossingA veterinary physiotherapy perspectiveby Charlotte Swarbrick, BSc (Hons) PGDip ClinDem MIRVAP(VP). Managing Director of Cochrane Physiotherapy. Veterinary Physiotherapist at University of Glasgow Small Animal Hospital & Riverside Veterinary Practice, West Lothian. condition, cardiovascular health and proprioception, while improving the bond between the dog and their human. But, with limited veterinary professional advice and training available to owners, embarking on such an activity increases the risk of injury or illness for the dog. A study by Lafuente and Whyle (2018) suggested almost 22% of dogs are injured whilst taking part in canicross - that’s 1 in 5! This article aims to give a brief, evidence-based overview of available literature regarding nutrition, harnesses and injury prevention, to support therapists when advising owners. Consideration 1NUTRITION & HYDRATIONA dog taking part in a new sport or increasing the intensity or frequency of a sport, must be properly nourished and hydrated (Hill, 1998). A Vet and physiotherapist can advise on whether a dog is currently over or under weight and how this may aect performance, risk of injury and also healing (Guo & Dipietro, 2010). Dierent nutrition plans should be developed for a normal or rest day, and for running or increased exercise days, with regard to nutritional components, feeding amount, A harness should allow full range of movement of all limbs, at all paces …… and avoid any bony landmarks.6 Animal Therapy Magazine | ISSUE 23

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7 Animal Therapy Magazine | ISSUE 23A harness should have its components regularly checked for parts which may rub, be fraying or break …… and it should not aect the dog’s behaviour upon seeing, being tted with or running in the harness.A harness should not slip and move as the dog turns or changes gait …… or apply pressure to areas like the spine, as the dog moves in the harness.frequency, and time left between meals and exercise. A literature review by Payne (2011) discusses why applying human-type principles on this topic, such as adding supplements like electrolytes, can be harmful to dogs. He recommends water being made available at all times should be sucient for a dog to adequately hydrate itself before, during and after the most rigorous of exercise. Hydration also involves many factors such as temperature and humidity (Carter & Hall, 2017). Only a veterinary professional is qualied to make recommendations on your dog’s specic nutritional requirements. This will be based on their body condition, age, breed, behaviour and musculoskeletal health. Consideration 2THE HARNESSA well tted harness will cause the minimum restriction to a dog’s natural movement (Blake, Williams & Ferro de Godoy, 2019) and involves many factors in much the same way that dierent runners will need dierent running shoes to have a comfortable experience. The kinematics of a dog is an underplayed component of harness tting, and veterinary physiotherapists are uniquely trained to understand dog biomechanics, locomotion and how this couples with the mechanisms of injury. They can observe, palpate and analyse for pre-existing issues which may aect the harness choice whilst discussing the importance of this with an owner. The key to harness tting is not how it looks on the dog, but how they move in it, with no two dogs moving identically. A physiotherapist can appropriately assess if a harness avoids crucial musculoskeletal structures, enables full range of motion and does not cause restriction to functional movement. They can also advise whether a dog can run in harness at all before they have reached full skeletal maturity (1 -2 years old depending on breed and other factors) as harness-running dogs before full development can lead to deformities and long-term complications (Lewis, 2019). continued overleaf7 Animal Therapy Magazine | ISSUE 23

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8Animal Therapy Magazine | ISSUE 23CANICROSSING8 Animal Therapy Magazine | ISSUE 23Consideration 3THE RUNNING PART!The nal piece of the responsible canicrosser puzzle is ensuring the dog follows a training programme to build up distance and speed slowly. On average, a human will train twice as much as a dog (Perez, Garcia & Barlow, 2016), yet the dog is expected to perform equally. Additionally, dogs should follow a conditioning programme, developed by a therapist, in order for them build up their musculoskeletal integrity to further prevent injury and achieve optimal athletic ability. Recent research from Pardey et al. (2018) conrmed the extreme forces placed through canine joints when jumping out of the boot of a car, so this should be avoided at all costs when arriving at a run site, with the dog lifted or a ramp used. Prior to any harness (or free) run, a dog should undergo a 10-minute warm up regime (Cullen et al. 2013). This is an opportunity to identify any issues with the dog before running. Prior to racing and high intensity runs, basic massage is also benecial and can be applied to the main muscle groups if the dog is immobile for a time. This allows the blood to circulate and joints to lubricate. Whilst running, close attention should be paid to the dog in motion. Owners should be given advice on how to look for lameness or changes in posture or gait. If a dog ever refuses to run, alters their performance or shows signs of injury, the owner should stop running immediately and seek veterinary advice, even if the dog wants to keep running. At the end of a run, the dog should follow a cool down regime for a minimum of 10 minutes (Cullen et al, 2013). Then, it can be passively stretched, as instructed by a physiotherapist. Depending on the dog and post-run circumstances, a coat or eece might also be benecial. Finally, it is important to give dogs rest days from canicrossing for their mental and physical wellbeing. Overtraining, or expecting the dog to do too much too soon is the most common cause of injury and, like humans, they must be given time to relax, replenish and recuperate between runs.A dog should be fully assessed statically and dynamically by someone who has been properly trained to understand canine kinematics and biomechanics, in all gaits …… and have a complete musculoskeletal check and nutritional evaluation by a veterinary professional before commencing a canicross training programme.A harness should not restrict cardiovascular or respiratory function in the neck and chest.

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9 Animal Therapy Magazine | ISSUE 23 9 Animal Therapy Magazine | ISSUE 23REFERENCES Blake, S., Williams, R. and Ferro de Godoy, R., 2019. A Systematic Review of the Biomechanical Eects of Harness and Head-Collar use in Dogs. Available from: https://www.biorxiv.org/content/10.1101/759258v1 Carter, A.J. and Hall, E.J., 2018. Investigating factors aecting the body temperature of dogs competing in cross country (canicross) races in the UK. Journal of Thermal Biology. 72, pp.33-38. Available from: https://www.sciencedirect.com/science/article/pii/S0306456517304102Cullen, K.L.,Dickey, J.P., Bent,L.R.,Thomason, J.J. and Moëns, N.M., 2013. Survey-based analysis of risk factors for injury among dogs participating in agility training and competition events. Journal of the American Veterinary Medical Association. 243(7), pp.1019-1024. Available from: https://avmajournals.avma.org/doi/abs/10.2460/javma.243.7.1019 Guo, S. and Dipietro, L.A., 2010. Factors aecting wound healing. Journal of Dental Research. 89(3), pp.219-29. Available from: https://pubmed.ncbi.nlm.nih.gov/20139336/ Hill, R.C., 1998. The Nutritional Requirements of Exercising Dogs. The Journal of Nutrition. 128(12), pp.2686S–2690S. Available from:https://doi.org/10.1093/jn/128.12.2686SLafuente, P. and Whyle, C., 2018. A Retrospective Survey of Injuries Occurring in Dogs and Handlers Participating in Canicross. Vet Comp Orthop Traumatol. 31(05), pp.332-338. Available from: https://www.thieme-connect.com/products/ejournals/abstract/10.1055/s-0038-1661390 Lewis, G., 2019. Musculoskeletal Development of the Puppy: Birth to Twelve Months. Animal Therapy Magazine. 15, pp.41-44. Available from: https://www.researchgate.net/publication/333118590_Musculoskeletal_Development_of_the_Puppy_Birth_to_Twelve_Months Marcellin-Little, D. J., Levine, D., and Taylor, R., 2005. Rehabilitation and Conditioning of Sporting Dogs. Veterinary Clinics of North America: Small Animal Practice. 35(6), pp.1427–1439. Available from: https://doi.org/10.1016/J.CVSM.2005.08.002https://www.academia.edu/21602751/Rehabilitation_and_conditioning_of_sporting_dogsPardey, D., Tabor, G., Oxley, J.A. and Wills, A.P., 2018. Peak forelimb ground reaction forces experienced by dogs jumping from a simulated car boot. Vet Record. 182(25), pp.716. Available from: https://pubmed.ncbi.nlm.nih.gov/29622683/ Payne, R., 2011. A Short Review of Racing Greyhound Electrolyte Physiology. In: GBGB Welfare. Greyhound Board of Great Britain. Available on request.Pérez, O.P., García, L.M. and Barlow, K.J. 2016. Canicross and Mushing Training. Sport and Physical Education - National Seminar of Medicine, Nursing, Physiotherapy, Nutrition and Physical Exercise. University of Vigo. Available from: https://mpsp.webs.uvigo.es/comunica/Pontevedra16-2a.pdf ABOUT THE AUTHORCharlotte SwarbrickBSc (Hons) PGDip ClinDem MIRVAP(VP)Having originally trained and worked in the human medicine eld, Charlotte went on to qualify as a veterinary physiotherapist from the University of Nottingham. She runs her own business, Cochrane Physiotherapy (www.cochranephysiotherapy.co.uk), with her human physiotherapist partner which focusses on digital physiotherapy services across the UK. She also works as a veterinary physiotherapist at University of Glasgow Small Animal Hospital and Riverside Veterinary Practice and is a clinical placement provider for the University of Nottingham vet physio course. Charlotte has a passion for continued professional development regularly lecturing and speaking at events, owner education and improving clinical pathways within the veterinary eld. She advocates increased awareness and understanding of veterinary physiotherapy acrossScotland. In her free time, you will nd Charlottehiking and trail running with her dogs in the Scottish countryside.Canicrossing is a fantastic sport for dogs of all shapes, temperaments and sizes to take part in. From a physiotherapy perspective, it is a great way for a dog and their owner to exercise in a controlled way with a lower incidence of injury than other dog sports like agility (Cullen et al. 2013). The biggest recommendation of all is an owner committing their dog to regular maintenance check-ups with a physiotherapist. Prevention is always better than cure.Canicross should not cause the dog to change the way it moves naturally when out of harness …… and must be stopped if there is any concern about the dog’s welfare, health or wellbeing.Photo: @barkerandhound

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10Animal Therapy Magazine | ISSUE 23HORSE & GROOMEPSOM SALT• CALMS NERVOUSNESS AND ANXIETY• CONDITIONS HAIR AND FUR • RELIEVES ACHES AND PAINS• SOOTHES ATOPIC DERMATITIS AND OTHER SKIN CONDITIONS®A5 DOG LEAFLET.indd 1 15/12/2020 12:14www.horseandgroomepsomsalt.co.ukOUR FURRY FAMILY MEMBERS DESERVE THE BESTHorse & Groom® Epsom salt is the rst of its kind with a special focus on supporting the health and wellbeing of your beloved canine companions. Enjoyed by people for over 400 years, the benets of Epsom salt are numerous but less well known are the applications to our canine friends.Accredited by the Pet Industry Federation, we understand how important your four legged companions are and we’re passionate about providing the best for them. Our unique product is of the highest quality and free from any anti-caking agents, articial colours or additives; the perfect natural addition to your dog’s grooming regime. Simply dissolve our salts in warm water and use as a soak, spray, exfoliator or rinse to keep your dog looking and feeling their best. • Dissolve in warm water for a therapeutic soak to ease arthritis,aches and pains • Add to a spritz bottle with warm water for a gentle treatment toease atopic dermatitis • Mix with your dog shampoo for a deep cleanse – great for removingstubborn dirt• Soak your dog in a warm bath with our salts for a relaxing treatment tocalm hyperactivityEPSOM SALT• CALMS NERVOUSNESS AND ANXIETY• CONDITIONS HAIR AND FUR • RELIEVES ACHES AND PAINS• SOOTHES ATOPIC DERMATITIS AND OTHER SKIN CONDITIONS®A5 DOG LEAFLET.indd 1 15/12/2020 12:14www.horseandgroomepsomsalt.co.ukOUR FURRY FAMILY MEMBERS DESERVE THE BESTHorse & Groom® Epsom salt is the rst of its kind with a special focus on supporting the health and wellbeing of your beloved canine companions. Enjoyed by people for over 400 years, the benets of Epsom salt are numerous but less well known are the applications to our canine friends.Accredited by the Pet Industry Federation, we understand how important your four legged companions are and we’re passionate about providing the best for them. Our unique product is of the highest quality and free from any anti-caking agents, articial colours or additives; the perfect natural addition to your dog’s grooming regime. Simply dissolve our salts in warm water and use as a soak, spray, exfoliator or rinse to keep your dog looking and feeling their best. • Dissolve in warm water for a therapeutic soak to ease arthritis,aches and pains • Add to a spritz bottle with warm water for a gentle treatment toease atopic dermatitis • Mix with your dog shampoo for a deep cleanse – great for removingstubborn dirt• Soak your dog in a warm bath with our salts for a relaxing treatment tocalm hyperactivitywww.horseandgroomepsomsalt.co.ukA5 DOG LEAFLET.indd 2 15/12/2020 12:14

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11 Animal Therapy Magazine | ISSUE 23Our furry family members deserve the very bestHORSE & GROOMThe benets of Horse & Groom® Epsom Salt include:• Calms nervousness and anxiety Epsom salts are known for their calming impact in humans but the same is also true for animals. Adding Epsom salts to your dog’s bath water or shampoo acts as a natural way to ease anxiety and stress for them.• Conditions all types of coat Each dog has a dierent type of coat – rough haired, smooth haired, thick fur, short fur and so on. The wonderful thing with Horse & Groom® Epsom salt is they’re suitable for all types of coat. You’ll notice the coat appears more glossy and healthy after using our Epsom salt. • Relieves aches and pains Whether a strenuous exercise session at the park, or a long walk in tough conditions our dogs can also feel the strain on their muscles, joints, paws, pads and skin. Our Epsom salt provides a natural way to recover from nicks, grazes, aching limbs and paws.• Soothes arthritis Arthritis is particularly prominent in older dogs, but even some as young as puppies can suer from this painful condition. A natural way to soothe away the discomfort of arthritis is to soak the dog’s body in Epsom salt water. The magnesium in the salts provides a welcome relief to canines experiencing pain and discomfort from arthritis.• Improves itchy skin conditions (atopic dermatitis) Much like humans, dogs can develop allergies and intolerances too which have an uncomfortable impact on their skin. This can be very distressing for the dog and owner alike. It is a condition which aects many dogs and it is important that the treatment is quick and eective but also gentle on the already sensitive and agitated areas. Bring natural relief to an itching dog by adding Epsom salt to their shampoo or using as a spray to relieve and comfort dermatitis and itchy skin conditions. Don’t just take our word for itWe truly believe in the restorative healing properties of Epsom salts to enrich and improve the lives of our most loved pets. Here’s what one of our rst customers had to say about their experience:“I gave my dusty boxer dog (she loves to roll around in the mud) a bath with your salts and she has come out incredibly shiny. The one thing we have noticed is that she is much less itchy. She suers terribly from allergies in the summer, her skin gets very dry and irritated from bugs in the long grass and the heat, but since she has had a luxury bath she has barely itched and is much less irritated by it.”Gemma MartinAt Horse & Groom® we believe every bath time should be a soothing and restorative treat for all dogs. We oer only the nest quality Epsom salt, just as mother nature intended, for all dogs to benet. Horse & Groom® delivers exceptional quality Epsom salt so our beloved canine companions can benet from them every day. Epsom salt has been enjoyed by people for over 400 years, so we felt it was about time our four-legged friends got to enjoy these healing benets too. And we’re sure your customers will be coming back for more once they’ve tried them.Natural and versatileOur Epsom salt is only ever the highest quality and completely free from all anti-caking agents, articial colours and additives. Making them the perfect natural addition to a dog’s grooming regime. They’re really easy to use, simply dissolve the salts in warm water and use as a soak, spray, exfoliator or rinse to keep our canine companions looking and feeling their best – they can even be added to dog shampoo!Safe and Accredited We’re accredited by the Pet Industry Federation to give you condence and trust in our product. We’ll only ever provide the best for dogs because we understand just how important they are to their families and your customers but also because we genuinely feel all dogs deserve nothing but the best. Availability As well as oering 2.5 kg bags for resale in veterinary surgeries and dog grooming salons, we can oer 10 kg bags for use in dog grooming salons and 25 kg bags for canine hydrotherapy centres. Please contact us via our website: www.horseandgroomepsomsalt.co.uk to discuss POS materials, to nd out more about our natural high quality Epsom salts and how they can deliver an entirely new income stream to your business.

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12Animal Therapy Magazine | ISSUE 23CAM4animals celebrate their third anniversary this month, so they tell us their story CAM4ANIMALSIntegration and collaborationIt’s important to us to encourage full integration between our conventional vets and the referral CAM professionals. We are open-minded and collaborative in order to optimise the health and wellbeing of our supporters’ animals. Even wildlife can benet from holistic healthcare! We consider that every animal is a unique case and deserves a care plan that’s appropriate to them whether that involves conventional medicine, diagnostics and surgery, complementary or alternative treatment options. Future plansPlans for our fourth year are to establish partners and associates in order to:• Continue to collaborate with vets and other practitioners working in holistic veterinary care or who are supportive of it.• Expand website and newsletter resources for animal owners and professionals.• Encourage new vets and practitioners to take up CAM.How you can help?Adding to our resources: Can you contribute articles and case studies both to our website CAM4animals.co.uk and a fortnightly newsletter. This will also showcase your expertise and business. Please do sign up to the newsletter! Social media is crucial to spreading the word and enabling more people to nd out about and access CAM treatments. Simply following us and liking and sharing our posts is invaluable and we regularly retweet and share posts from followers like you too. You can also join our closed Facebook group and share your events there for our supporters to see.Join our team: We have a small team of people whose dedication is essential to the continuation of CAM4animals. Their input is subject to the vagaries of life perhaps even more than if we were in paid positions. Please let us know if you would like to join us - could you help us run our Facebook page or Pinterest account for example? Funding support: We may be volunteer run, but we do have funding needs to cover such things as running the website, design and printing of yers, software packages, postage and stationery, expenses for meetings and visits to shows. Consequently, we rely on donations and also special oers on professional consultations and courses or products – a discount for CAM4animals supporters and a donation to us also results in plenty of publicity for you. If you can help, we’d love to hear from you. What started as a campaign to protect Complementary and Alternative Veterinary Medicines (CAM) transformed into a thriving group of pro-CAM supporters promoting its appropriate use as part of true integrated veterinary care in the UK. We are a 100% volunteer-run, consumer-driven organisation and our website and social media platforms oer a wide variety of resources for animal owners, vets and practitioners alike. Examples of the breadth of information we cover can be seen in our pictured social media slides below.Comprising holistic vets, CAM practitioners, animal owners and guardians we came together as a result of the Royal College of Veterinary Surgeon’s position statement on CAM in November 2017. Deeply concerned that our right to choose CAM for our animals would be lost, we attended a meeting with the RCVS where we presented our points very clearly. We highlighted the RCVS’s lack of consultation with stakeholders as well as their failure to give full consideration to the evidence demonstrating the benets of CAM. This was backed up by a petition signed by over 21,000 UK animal owners, guardians, farmers, vets and a range of CAM practitioners. CAM is popular!We quickly realised that far from there being a subsequent knock back to the use of CAM treatments for animals, the reality was an increase in demand for holistic vets and practitioners and a need to access them. We also realised that there was a lack of comprehensive and credible information available in one place about the wide range of modalities available and how to nd a suitable practitioner. With this in mind and with growing support, CAM4animals was ocially formed to ll this gap in March 2018. CAM4animals12 Animal Therapy Magazine | ISSUE 23

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13 Animal Therapy Magazine | ISSUE 23Julie-Anne Thorne, Naturally Cats:CAM4animals have given me faith that CAM options for animals is becoming mainstream. I applaud the wealth of knowledge and information they have for animal guardians. I constantly direct people to their website when they are looking for holistic treatment modalities. I’ve been a rm supporter of this amazing organisation for the past 12 months and will continue to provide my support to them as they support giving animal guardians a choice in animal care. Truly amazing organisation run by dedicated and compassionate people. Thank you for all you do.Team member Lolie Borgars: I have followed CAM4animals since the start and then joined as a volunteer. As a raw feeder, with dogs who regularly visit for hydro, physio and acupuncture CAM4animals is so important to me. We must be able to make our own informed choices. The CAM4animals website and Facebook group are my ‘go-to’ for recommendations and signposts to nd CAM professionals. Being a part of CAM4animals means so much to me.Whole Health Agriculture: Holistic farmers have been supportive of CAM4animals since the outset, recognising the contribution they make to safeguarding freedom and choice in animal healthcare. Farmers are under pressure to reduce antibiotics and synthetic/toxic inputs, and many are successfully using CAM approaches to achieve this, so any organisation supporting them is invaluable. We value our association with CAM4animals who have championed our farmers and raised awareness for the need to protect CAM in farming.Vet nurse, Morag Sutherland RVN DMS, Cert SAN:I am so very grateful to have the fabulous CAM4animals website to direct clients to. So many are wanting to “do more” for their pets and yet nd it hard to know where to turn. This website (and the awesome team who work so hard to make it so useful) has lled a conspicuous gap. Sue Armstrong MA VetMB VetMFHom CertIAVH MRCVS RsHom, Founder of The True Animal Plan:"We are pleased to have CAM4animals as one of our aliates helping to empower animal guardians to make well-informed decisions for the health and well being of the animals in their care."Team member Val Brown: I use a homeopathic vet and McTimoney Chiropractor for my elderly rescue dog. Being part of the CAM4animals is invaluable, losing our homeopath vets and knowing that new ones are discouraged from training just doesn’t bear thinking about. CAM4animals provides information on every aspect of CAM for animal owners. This support can only be positive for the future health of our animals.Yaz, Yorkshire Pooches Therapies: CAM4animals has provided a platform to share my work as an animal paraprofessional, for which I am truly grateful! Complementary therapies are vital and have so much to oer. However, they can sometimes be misunderstood, CAM4animals provides comprehensive case studies for many dierent therapies to help bridge the gap from conventional medicine to alternative medicine and complementary therapies. Here’s what some of our supporters have to say: 13 Animal Therapy Magazine | ISSUE 23❝❞

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14Animal Therapy Magazine | ISSUE 23Treating Jensonwith Photizo Vetcareby Anna Webb on behalf of Photizo VetcareBroadcaster, Author, Trainer has studied natural nutrition and therapies with the College of Integrated Veterinary Therapies (CIVT)PHOTIZOJenny Sims, the owner of Jenson, a 16-year old Irish Sports Horse and BE all-rounder noticed he was tapping the odd pole during the show jumping phase at the Frickley ODE in July 2016. Immediately concerned Jenny’s trainer, Abbie Coulson, concluded that something wasn’t quite right. Lizzie Allen of Darrowby Vets was called in for a poor performance diagnosis and a hoof imbalance was identied. Jenson’s Farrier of 11 years, Mark Connole, helped remedy this to some extent. Despite Jenson not displaying any lameness as such at that time, Vet Lizzie Allen referred him to Newmarket Vets for further diagnostics and work up in Aug 2016. Diagnosis by Vet, Sue Dyson, revealed as proximal suspensory desmitis (PSD) high suspensory disease and associated sacroiliac (SI) dysfunction.Jenny has owned Jenson for 11 years and together enjoyed pleasure rides to dressage, and show jumping to Eventing. Notably at Shelford Manor in May 2016, where they were placed 7th – their rst and what could have potentially been their last BE placing.Feeling that this was potentially the end of Jenson’s career, it was around this time therapist Eleanor Frost began treating Jenson with sports and remedial massage to support his on-going care. Jenny Sims explained: “He is the most lovable honesthorse, who is a true gent and henever fails to put a smile on my face.He loves to lay down in his stable, to see how many shavings he can get on his rug! As Jenson was not a candidate for an operation, I needed to nd out about alternative therapies”.As a reection of the issues in Jenson’s body Eleanor found a multitude of tight areas requiring therapeutic work. The routine of therapy was maintained bi-monthly for Jenson in addition to light ridden and ground work and varied training. It was 2017 when Eleanor became involved with Photizo when searching for something extra to add to the therapy 'toolkit'. Not a fan of gadgets and fads, she took her time to research and trial the Vetcare. Spending a day with Ruth Milner MD at Danetre Health Products, the UK Photizo HQ, Eleanor gleaned information regarding the research behind the technology, its biological eects and its correct usage and dosage. Over the past four years Eleanor has combined the Vetcare both in her professional practice and personally on herself, friends, family members and animals. She enthused: “The results were exceptional with accelerated healing from all manner of conditions from a wound or cut, to sore throats, toothache, headaches, even acne/skin complaints. I have numerous case studies now, such as Jenny's, which have enhanced my appreciation of the device, in its own right, and as a supplementary tool used with massage.”continued overleaf

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16Animal Therapy Magazine | ISSUE 23With condence in the unit Eleanor began to oer it on a trial period to clients to also see and feel the benets it had to oer. Jenny eagerly trialled the unit for a fortnight specically to the aected hind limb and sacroiliac regions.Eleanor explained: “Jenny was so taken with Photizo. She purchased her own for daily usage on Jenson. This worked well between my visits as following a treatment, I could go on to advise hot spots or target areas for Jenny to focus on.I was genuinely astounded at the dierence in Jenson’s body and how it felt. Making the comparisons between my visits and Jenny using the Photizo unit. It was quite phenomenal. It only highlighted further the benets that red light has to oer." Vetcare was integrated on Jenson in combination with sports and remedial massage techniques. Incorporating eeurage, petrissage and tapotement massage methods as required. Plus some trigger point and myofasical release work, along with some elements of cranio-sacral therapy. Jenson initially required Photizo therapy in his lumbar, sacroiliac region, gluteals, right biceps femoris and right distal hind limb. Eleanor also recommended he needed Photizo support to the right brachiocephalic and his cranial thoracic regions.Jenson’s progress was credited to Jenny’s diligence and determination to make him well spending several hours a week dedicated to Jenson’s Photizo sessions.Jenny's patience was repaid ten-fold when, one year on from the initial diagnosis, the vet, Lizzie Allen, returned to scan Jenson. With a great deal of trepidation and a lot riding on this outcome, everyone involved was thrilled to discover that there was accelerated healing with the suspensory ligament. Plus a vast improvement with only a tiny degree of remaining scar tissue, and no sacroiliac dysfunction was identied either.Incredibly Vet Lizzie Allen suggested that far from Jenson ‘hanging up his shoes’ for the quieter life, the realms of competing at low level and going cross country again, was a possibility!The general consensus was all round surprise at the improvement and overall rate of healing within the year as often times such injuries can continue considerably.Jenson is now 16 years old and still enjoys being worked up to four times a week doing a variety of hacking, schooling and attending clinics. Eleanor continues to treat him every other month and Jenny maintains in between visits with the Photizo.Ruth Milner MD of Danetre Health Products commented: “It’s been brilliant observing Eleanor’s on-going success with Photizo. It’s proof that our handy device combining the latest LED technology to deliver highly eective doses of phototherapy works. It’s such an accessible tool, especially when focussing on a holistic approach to promote natural healing.” Jenny added: “I’m really impressed with the Photizo unit, as it is such a simple bit of kit, which has been of huge benet to Jenson’s situation. It is so easy to use, and I am still using it on him ona regular basis (and even on myself from time to time!).I’m so grateful to Eleanor for mentioning about the Vetcare, as the improvements in Jenson’s scansare amazing. People really need to know about this product, and the amount of benets it has! Jenson is now able to jump again, and if he continues to go from strength to strength, then who knows what the future will hold for us both!”PHOTIZO

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18Animal Therapy Magazine | ISSUE 23TONY NEVINWhen NOT to treatby Tony Nevin, BSc (Hons) Ost, DO, Zoo Ost LtdMost of the time we focus on nding out how to treat, when, and how often to treat for each, and every condition we are faced with. Building up experience and expertise as our careers progress is essential if we are to succeed. It is also vital that our professions grow and continuously improve their knowledge bases and advance the way they deliver their services.By sharing knowledge and skill sets between professions can accelerate this process. e cross pollination of learning can be intoxicating, as well as addictive. I know because I nd it so.Although this is fantastic from a progressive point of view, I do think we need to ask ourselves when we should NOT treat, or when we should call it a day during a treatment programme.If we are practising within a veterinary clinic this is not usually a common factor as the pet’s vet will be involved in the treatment plan. Where the boundaries can become less dened is when treatment takes place outside of a clinical environment. is places more responsibility and professional judgement on the individual practitioner. In most cases this will not present any problems and treatment plans will be identical to those within a clinical environment.What can challenge professional judgement?A desire to achieve a positive outcome can easily cloud judgement, especially if the patient is very cute (this refers to animals only!). e more time we spend trying to help, the more invested we can become. Owners will oen fuel this, by wishing to see improvements from each session. ey spend all their time with them, whereas we get snapshots. Video footage can help ll in the gaps, and since it has become readily available, these situations have been much easier to manage. Drawing a line between helping and allowing any suering can be dicult to measure. Yet we have an absolute duty to ensure we never allow suering to be prolonged due to anything we do or say.there is oen much less data to draw on regarding treatment protocols, and expected recovery rates (especially with wildlife casualties). In certain situations the patient may be from a critically endangered species and therefore every possible chance is given to help them. Having said that, no patient can ever be allowed to suer no matter how rare it is.roughout my career I have been faced with all the above, and sometimes several times a week. We are programmed to be empathetic, and to want to strive to improve our skills, and to do so we must be allowed to learn, and trial possible new techniques or combinations of treatment. Looking at a family pet or a treasured horse, and knowing that it just cannot be helped anymore is not easy, but it is something we must embrace as part of the career we have chosen.I am so glad I elected early on in my career to work as an integrated member of any veterinary team, and this is especially so when it comes to any wild or exotic species. Each team member has their part to play, and we all get to contribute to the protocols for each individual patient. at really helps to remove any personal issues Certain conditions can improve up to a point and then plateau. At what point do we stop?Some of these conditions will require maintenance sessions, but at what frequency?Treating a patient every week or two indenitely is not exhibiting good judgement, and what is more will bring just criticism to our professions. If there is one thing that the veterinary profession hates more than taxes, it is any hint of someone using an animal as a means of making money un-necessarily, or dare I say, unethically?Measuring what we do is sometimes somewhat subjective; therefore we must make doubly sure we do not do anything to diminish our professionalism.is whole area is a mine eld. Separating owner prejudice to terminating treatment, or of them accepting that as much as possible has been done, is not always easy. Many pets are an owner’s sole source of company, so to suggest the time is drawing close to an end is not something to be taken lightly.ere are grey areas too. One of these is when working with wildlife and captive exotic species. In this sector 18 Animal Therapy Magazine | ISSUE 23

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19 Animal Therapy Magazine | ISSUE 23any of us might have regarding a patient. Let’s face it, we all develop favourites. By integrating into a team we get to acknowledge any favourites, and still the rest of the team will deliver the correct outcome, whether it is more treatment, or calling it a day.By utilising other sta members to monitor progress, possible pain, and whether the patient is coping or not, we can remove a lot of the self-judgement we place ourselves under. We can concentrate on what we do best.When I’m teaching post graduate students, they will often hear me talk about my basic protocols for applying any osteopathic treatment:• Find the problem• Feel the problem• Fix the problem• Forget the problem- Finding the problem, relates to being able to accurately assessing the patient to ascertain the causation of the problem and its physical origin.- Feeling the problem means just that, palpating the structures to conrm your ndings.- Fixing the problem, means applying whatever tools are in your skill toolbox to address the issues and allow the patient to return to, or as close to, normal function as is possible.- Forgetting the problem means once it’s xed leave it alone. I know we love feeling structures and getting all hands on, but we must make sure we don’t overcook any condition. This section also applies to recognising when you’ve done as much as you can, or that the patient isn’t coping with your ministrations.These four F’s have served me well for the past three decades.If we stay true to our professional standards and do not allow ourselves to be persuaded to do otherwise, we should have no real issues. Some days can be tough but that is just the nature of what we have chosen to do. Hey, if it were easy, everybody would want to do what we do.19 Animal Therapy Magazine | ISSUE 23Tony 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/tonynevin

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20Animal Therapy Magazine | ISSUE 23ACUTE IDIOPATHIC POLYRADICULONEURITIS is a very uncommon neurological condition which can be seen in small animals, which can result in tetraparesis resulting in their mobility temporarily diminished.What Is Acute Idiopathic Polyradiculoneuritis?Acute idiopathic polyradiculoneuritis (AIPRN) or “coonhound paralysis” is the most frequently identied acute generalised peripheral neuropathy in dogs worldwide. It is characterised by the acute onset of paresis or paralysis of lower motor neurons (LMN) which develops within 24 to 72 hours (Martinez-Anton, 2018). It is a disease that aects the axon and myelin sheath of the ventral nerve roots, spinal nerves, cranial nerves, and peripheral nerves in dogs. The majority of dogs who have suered from AIPRN in the United States have developed the condition after coming in contact with a raccoon 7–14 days before developing clinical signs. Thus the commonly used term ‘‘coonhound paralysis” (Holt et al., 2011). It is thought that the condition is caused by the bite or a scratch of a racoon, especially during hunting season.However, in other countries where racoons do not exist, the cause of the condition is unknown but is known to involve immune-mediated mechanisms (Kraljevic, et al., 2021).Clinical SignsThe initial clinical signs typically develop in the pelvic limbs that progress within 1–2 days to accid tetra-paresis or tetraplegia and, in some cases, aected cranial nerves. Death from respiratory paralysis can occur in severe cases. Spinal cord reexes are weak to absent, and severe muscle Acute Idiopathic Polyradiculoneuritis in Dogsby Ryan Wharton BSc(Hons) Vet Phys MNAVPatrophy is evident within 10–14 days (Stanciu et al., 2014). It is an immune-mediated disorder aecting the ventral spinal nerve roots more severely, with minimal dorsal nerve root involvement (Martinez-Anton et al., 2018).Other clinical signs include:• Weakness in all four limbs• Non-ambulatory paresis (support needed when walking)• Symmetrical weakness (ambulatory paresis)• Paralysis• Muscle atrophy which can be seen in all limbs• Reduced or diminished postural and neurological reexes• Loss of bark (dysphonia, aphonia)• Loss of bladder function• Weak head and/or neck functionTreatment For Acute Idiopathic PolyradiculoneuritisMost patients with this disease begin to show signs of improvement after week 3, with complete recovery after two to six months (Stanciu et al., 2014). Intensive physical therapy is very eective in the treatment of this disease, primarily to reduce neurogenic muscle atrophy and maintain joint mobility.Following diagnosis, owners are informed of home-care treatment which may include, ensuring the patient is being turned every 2-4 hours to help with the removal of uid from the lungs and stimulate lymphatic drainage. They may also be advised to provide soft thick bedding for the patient, to reduce the likelihood of pressure sores. Owners are advised to seek help and assistance from a trained veterinary physiotherapist and hydrotherapist to enhance recovery.Treatment for AIPRN is heavily reliant on intense physiotherapy typical sessions may include:• The use of various stimulatory exercises to excite sensory nerves and proprioceptive pathways. These include gentle eeurage, vibration (hand or handheld device), brushing to the limbs and toes (toothbrush or hairbrush) and toe pinches to improve the limb withdrawal reex.• PROM exercises, to help prevent muscle contracture, joint brosis, prevent cartilage atrophy and encourage the replenishment of synovial uid.• Assisting the patient from lateral to sternal recumbency, progressing from sternal to sit, then sit to a stand, reducing the need for support over time.• Peanut ball assisted standing and craniocaudal weight shifting to encourage weightbearing.• Maintaining soft tissue extensibility is also addressed through massage and stretching.• Electrical muscle stimulation (EMS) to address muscle atrophy.• Pulsed Magnetic Field Therapy and Laser TherapyFollowing physiotherapy and/or hydrotherapy, most aected patients will show signs of complete recovery by 2–6 months. Patients with severe signs and marked muscle atrophy may never recover completely (Stanciu et al., 2014). No medication is proven eective for reversing this disorder, however, appropriate and eective pain relief can be administered when needed (Hunter and Downing, 2021).IDIOPATHIC POLYRADICULONEURITIS20 Animal Therapy Magazine | ISSUE 23

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21 Animal Therapy Magazine | ISSUE 23GLOSSARYIDIOPATHIC - A disease with an unknown cause.NEURITIS - Inammation of nerves or general inammation of peripheral nervesAPHONIA - Inability to speak through disease of or damage to the larynx or mouth.DYSPHONIA - Diculty in speaking due to a physical disorder of the mouth, tongue, throat, or vocal cordsREFERENCESHolt, N., Murray, M., Cuddon, P.A. and Lappin, M.R., (2011). Seroprevalence of various infectious agents in dogs with suspected acute canine polyradiculoneuritis. Journal of veterinary internal medicine, 25(2), pp.261-266.Hunter, T. and Downing, R., (2021). Coonhound Paralysis. [online] VCA Animal Hospital. Available at: <https://vcahospitals.com/know-your-pet/coonhound-paralysis> [Accessed 8 January 2021].Kraljević, A., Kajin, F., Kiš, I., Brkljača Bottegarro, N., Pirkić, B., Bureš, T. and Vrbanac, Z., (2021). Rehabilitation of dogs from Acute Idiopathic Polyradiculoneuritis-a case report. Veterinarska stanica, 52(2), pp.245-253.MartinezAnton, L., Marenda, M., Firestone, S.M., Bushell, R.N., Child, G., Hamilton, A.I., Long, S.N. and Le Chevoir, M.A.R., (2018). Investigation of the role of Campylobacter infection in suspected acute polyradiculoneuritis in dogs. Journal of veterinary internal medicine, 32(1),pp.352-360.Stanciu, G.D., Musteata, M., Armasu, M., Saftencu, P.M. And Solcan, G., (2014).Electrophysiological Aspects in Idiopathic Acute Canine Polyradiculoneuritis. Bulletin of University of Agricultural Sciences and Veterinary Medicine Cluj-Napoca. Veterinary Medicine, 71(2), Pp.292-297.ABOUT THE AUTHORRyan Wharton BSc(Hons) Vet Phys MNAVPBusiness: RawPhysio - Veterinary Physiotherapy. A business based in Shropshire, focusing on small animal rehabilitation.Association: Member of National Association of Veterinary Physiotherapists (NAVP)Interest area: I have a real interest in neurological cases and the impact we can have as therapists, on the outcome of each neurologically impaired patient, which I nd very rewarding. I also have a great interest in canine hydrotherapy and how physiotherapy and hydrotherapy work very well in unison. I have recently enrolled in a Small Animal Hydrotherapy course at Hawksmoor Hydrotherapy which I hope to have completed this year, which will enable me to oer both services to patients.CASE STUDYA 13 year old male Labrador Retriever, owners reported onset tetraplegia and were referred to a specialist referral centre where the patient was diagnosed with AIPRN which was conrmed by a cerebrospinal uid analysis which showed elevated levels of total protein. An MRI scan was also carried out to help determine the diagnosis. The patient had 2 days of in-house physiotherapy andwas discharged after 7 days following diagnosis.The patient was seen for home-based physiotherapy on day 16 following diagnosis. The patient was non-ambulatory and was being turned every 2-4hours with PROM and stimulatory exercises (toe pinches) being carried out 4-5 times per day. Neurological reexes such as limb withdrawal were mildly responsive, patella reex and cutaneous sensation responses were not present. These were carried out each session to track progression.Initially from weeks 1-4, treatment sessions were carried out 3 times per week, consisting of light massage, stretches, PROM, joint compressions, toe pinches, and vibration to the limbs to excite sensory nerves. PEMFT and laser therapy was also carried out in session. The patient was tted with a Help ‘em Up Harness for mobility and was also prescribed craniocaudal weight shifting with the support of a peanut ball to encourage weight-bearing. The owners were also taught how to encourage the patient from a lateral to sternal recumbency.From weeks 4-8, the patient showed signs of improvement, limb withdrawal reexes were more responsive and a mild patella reex response was present. Owners were prescribed EMS to help prevent further atrophy and help rebuild musculature. Exercises remained the same, however, the progression from sternal to sit transitions were carried out.A few months following diagnosis, reexes have become more responsive, the patient is now able to ambulate with minimal support, displaying mild signs of ataxia. Muscle mass has increased and the need for EMS, no longer. The patient is now carrying out cavaletti poles for proprioceptive awareness and sit 2 stand exercises alongside daily 5-10 minute walks.SUMMARYThe prognosis and time for recovery dier from each case, most cases will recovery within 6 months, however intense physiotherapy and hydrotherapy can help shorten the recovery period for each patient suering from this disease.21 Animal Therapy Magazine | ISSUE 23

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22Animal Therapy Magazine | ISSUE 23CANINE IVDDCanine Intervertebral Disc Disease (IVDD)INTERVERTEBRAL DISC DISEASE (IVDD) is the most common neurological disorder in canines to date, aecting two percent of the domestic dog population. Unfortunately, it is thought that some breeds are predisposed to the condition, including Dachshund, Basset hound, Shih tzu and German Shephard, however many breeds are reported to have suered the condition. IVDD is a condition that occurs when the cushioning discs between each vertebrae of the spinal column either budge or burst into the space of the spinal cord. e discs then press on the nerves of the spinal cord, causing pain, nerve damage, loss of balance and coordination and even paralysis. e structure of a normal interverbal disc is made up of the disc outer part (annulus brousus) and the gel like formation called the nucleus pulposus forming the inner part of the disc. On a cross section of the vertebrae the disc shows to sit closely below the spinal cord, therefore any damage done to the disc will easily impact on the spinal cord.ere are two types of IVDD.Hanson’s Type 1 – Type 1 IVDD is when the nucleus pulposus or inner part of the disc hardens or calcies. is causes the annulus brousus (outer structure of the disc) to tear, allowing this to enter the space of the spinal cord and placing tension on the nerves. is can occur because of a sudden movement or trauma, such as a forceful impact from jumping and landing in the incorrect way. Hanson’s Type 2 – Type 2 IVDD is when the nucleus pulposus protrudes from the outer brous proportion of the disc more gradually through slow degeneration. is too results in pressure on the nerves of the spinal cord. Treatment OptionsTreatment for canine IVDD depends on the severity of the disorder. • Conservative Care – is is used in the circumstances when the dog has minimal symptoms, usually alongside medication. Conservative care oen includes strict rest, therefore conning the dog to a create or small area. is in all cases needs to be carried out for several weeks to give to dog time to rest and symptoms to decrease. Following this exercise is slowly introduced in a controlled manor. A dog that has suered any grade of IVDD is at higher risk of further disc herniation and therefore jumping and stair use are strongly advised against. • Medication – Medications are always used in the treatment of IVDD. is should only ever be advised by a vet, to ensure the correct medication and dosage is given. • Steroids – there are a variety of opinions within veterinary medicine if steroids should be used during the care for IVDD, however some vets will proscribe them as a strong anti-inammatory. • NSAIDS – Nonsteroidal anti-inammatories will decrease inammation during the conservative care and post-surgery.• Pain Medication – this is oen prescribed to block the pain receptors pre- and post-operatively. It is important to restrict the dog’s movement correctly when prescribed these due to them not feeling pain and therefore very easily doing too much and causing further damage. • Muscle relaxants – Occasionally these are used when the muscles around the spinal area go into shock and spasm. by Emma Green, E Green Animal Physiotherapy22 Animal Therapy Magazine | ISSUE 23Symptoms Symptoms of IVDD can include: • Pain or weakness to the rear legs (Lameness).• Anxious behaviour.• Muscle spasms/ soreness over the neck and back.• Unnormal unwillingness to jump or use stairs.• Arching of the back.• Loss of bladder/ bowel control.• Lowered head stance.• Back pain or stiness.• Yelping unexpectedly when being touched or with movement.• Dragging one or more leg. • Lack of coordination and balance.• Abnormal reexes.• Bulging of the spine.• Paralysis.If any of these symptoms are apparent, in the case of IVDD time is of the essence. The dog must be seen by a vet as quickly as possible. The vet will use a grading system to clarify the severity of the case and treat accordingly. Grades of IVDDGrade 1 – Pain only. A dog that can walk (move normally buy is showing signs of pain and muscle tension or spasms). There will also be a reluctance to be active. Grade 2 – Ambulatory paralysis. These patients can walk but are weak and their balance and coordination will be compromised. They will show signs of leg crossing when walking and knuckling. Grade 3 – Non- Ambulatory paralysis. The patient is not able to hold its own body weight but will still have motor function of legs and tail.Grade 4 – Paraplegia. These patients have no voluntary movement often in the hind legs. Grade 5 – Paraplegia with no deep pain sensation. These patients have no voluntary movement and cannot feel their limbs or tail.

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23 Animal Therapy Magazine | ISSUE 23CASE STUDY  ALFFEYOn 2nd March Aley a nine-year-old Cocker Spaniel suered IVDD, grade ve. This was not caused by a signicant trauma that the owners were aware of and Aley had been active all day. After a walk and approximately an hour rest Aley started to show signs of loss of balance and coordination. He was taken to the vets immediately and then referred to an orthoepic specialist practice where he was diagnosed. Aley’s owners were advised the prognosis was poor due to him not having any deep pain sensation. He had lost control of is bladder and bowls and was increasingly showing signs of paralysis symptoms. The owners requested the opportunity to give Aley every chance and therefore opted for surgery. Aley came through the surgery successfully and was advised rest.Physiotherapy started on 28th March - My plan with Aley was to start passive movements and try and create and nerve stimulus to hopefully create some reaction even if only small. The stimulus worked and he started to gain feeling through his paw pads. Aley received physiotherapy treatment with me twice a week for an hour each session. The sessions included massage and passive movement along with electrotherapy. Electrotherapy was used to heal the surgical incision and to aid the anti-inammatory responses. On 4th April we started to stand Aley aided. Placing his feet but with no weight bearing through his limb, ensuring minimal pressure to his back. Using equipment such as physiotherapy • Surgery – More commonly used when the dog has limited movement or has become paralysed due to IVDD. ere are two types of surgical procedures that would be chosen. • Fenestration – is surgery is used for small spinal cord compressions. When the nuclei pulposus is removed through the brous ring of the disc. e disc material in the vertebral column is not removed, therefore there has limited risk.• Hemilaminectomy – this is a decompressive technique, therefore requires specialist equipment and veterinary skills. Protruding disc material is removed from the vertebral canal aer a specic hole is drilled to remove it. In the dog’s back this is done on both sides of the vertebrae, in the dog’s neck it is done from the underside of the bone. Recovery times highly dier depending on the surgical outcome and the patients healing process.Rehabilitation Rehabilitation of all grades of IVDD should include therapy from a qualied physiotherapist. A physiotherapist will provide rehabilitation exercises for owners to begin during the resting period and will assess for any progress and add further exercises throughout the healing process.Be aware that grade four and ve patients can have limited to no success of walking unaided post operatively and as a consequence, accessories such as canine wheelchairs are used to aid the dogs movement for the rest of its life. Only y percent of grade ve cases learn to walk unaided again and of those a further seventeen and a half percent suer further complications that oen result in euthanasia. peanut made this process easier and the equipment should be left with the owners to ensure this exercise is continuing daily. Electrotherapy was used to stimulate nerve activity throughout the body. By 11th May Aley was attempting to stand unaided. His tail movement had increased, and muscle mass was beginning to improve. When the vet allowed it, walks were started using harness equipment. First aiding front and back legs and then reducing to back leg harnesses. Using active games that increased Aley’s adrenaline levels were useful. Excitement over shadows and butteries in the garden encouraged Aley to stand more often and for longer periods.As the standing increased I introduced the use of a wobble board, however with all of this work and progress it took another year before Aley was able to walk unaided. He continued to improve and walked successfully unaided to go on walks, increasing hill work to help strengthen him. Although Aley regained his movement, he has never regained his bladder or bowl control and his bladder must be expressed manually. This has led to several urinary tract infections along the course of the rehabilitation. Aley’s rehabilitation and the enormous eort of his owners, resulted in an incredibly happy able-bodied dog, however it is important as a practitioner to manage owners’ expectation and never promise results like these as so many complications can arise along the way.

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24Animal Therapy Magazine | ISSUE 23PHYSICAL REHABILITATION helps pets to heal, regain their strength, and return to normal function. Patients unable to bear their own weight contend with a longer and more dicult recuperation time. Incorporating mobility assistance into post-operative patient protocol helps to speed up recovery and get dogs back on their feet sooner. Dog wheelchairs are life-changing tools that enable pets to exercise, play, and regain their independence. The fully adjustable Walkin’ Wheels wheelchair is preferred by veterinary professionals, rehab specialists, and pet parents worldwide. The Walkin’ Wheels provides long-term support for patients suering from degenerative mobility conditions or for short-term rehabilitative use.Incorporating a cart into your post-op patient protocol allows a patient to stand upright instead of laying in lateral recumbency, and can improve recovery times by getting patients back on their feet faster. Walking exercises improve a pet’s range of motion, increase their strength, as well as improve blood Dog Wheelchairs Enhancing Patient Mobility & RecoveryWALKIN’ PETScirculation. Additionally, adding ve to ten-minute cart walks into a patient’s treatment plan several times daily, can improve a dog’s mental health as well as save a technician’s back.Benets of Using a Hind Limb Cart in Your Rehab Treatment PlanPatient selection is always the most important thing to successfully using carts in your rehab treatment plan. Pets that are recovering from surgeries such as: TPLO’s, TTA’s, Total Hip Replacements, FHO’s and many others, may benet from cart assistance early in their recovery. Improving patient comfort level, encouraging weight bearing, improving range of motion, and increasing muscle mass, are key components to a patient’s recovery.Providing assistance with a hind limb cart early on, may promote healing as well as prevent falling or slipping, which can be harmful to surgery sites or implants as they are healing. Using a wheelchair as part of a rehab plan for the rst 2-4 weeks after surgery, may help to prevent injury to the non-aected hind limb by giving extra support versus increasing the amount of weight placed and possibly creating new injuries. For patients needing the full support of a quad wheelchair, the Walkin’ Wheels oers a front attachment to easily convert any rear wheelchair into a four-wheel cart.Integrating Dog Wheelchairs into Your Hospital’s Rehabilitation Protocols• Wheelchair Assisted Walking ExercisesA wheelchair can be used to enhance a patient’s structured exercise and encourage their continued mobility during Rehab sessions. In most rehabilitative cases, the patient has likely been inactive for an extended period of time, causing them to fatigue quickly. The cart provides additional support to relieve joint stress and make it easier to bear weight in the injured area. During early sessions, begin with short-timed walks and slowly increase the duration over time as the dog builds strength and increases their stamina. Cart time should be between 6-10 minutes in length. Complete exercise 3-4 times daily based on the patient’s condition and need.• Assisted Walking with Proprioception Training During RehabFor patients with hind limb proprioceptive decits, place the patient into their Walkin’ Wheels and try placing a No-Knuckling Training Sock on the aected limb or limbs and begin walking. This exercise will encourage proprioception training while the patient is fully and independently supported. Walk for 5-10 minutes, this can be repeated 3-4 times daily, based on the patient. Session length may be increased at therapist’s discretion. If needed both the wheelchair and the No-Knuckling Training Sock can be utilized during hydrotherapy sessions.• Assisted Walking with Strength TrainingOnce the patient has gotten stronger, but still may need moderate support for workouts, you can add leg weights to any limb that needs increased strength. It may be best to only apply one leg weight at a time, but it’s up to the therapist’s discretion how much weight and how long is appropriate, based on the patient.• Rear Support Wheelchair with TherabandsResistance Therabands may be used on the hind limbs to target specic muscle groups and attached to the struts of a patient’s Walkin’ Wheels wheelchair to add strength training to your patient’s cart walks. Place for 5-10 minutes at a time during a walk. Doing this twice daily is recommended, but times may vary based on each patient. Therabands can vary in resistance levels, so starting out with a low level and increasing based on patient needs is advised.With over 20-years of experience, Walkin’ Pets oers a complete line of proven products, designed by pet mobility experts working in the eld, purpose-built to meet the needs of pet professionals and the patients in their care. For further information on the Walkin’ Wheels wheelchair or other mobility products, email PetProfessionals@WalkinPets.com or visit www.vet.handicappedpets.com24 Animal Therapy Magazine | ISSUE 23

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26Animal Therapy Magazine | ISSUE 23Why Walker & Drake’s Cold Pressed Food is great for senior dogs as well as a general conditioning diet26 Animal Therapy Magazine | ISSUE 23WALKER AND DRAKEAs we move from the winter into the spring months, it is important to look at the condition of your dog. It goes without saying that every dog should be fed a good diet and as the old adage says, what you put in you get out. By feeding high quality ingredients and a good meat content you will ultimately end up with a dog with good teeth, healthy skin, a shiny coat and the right body weight that is appropriate to the breed. Starting a good diet early at the puppy stage will also result hopefully in longevity, healthy joints, teeth, skin, coat and immune system.As dogs get older and slower it is also important to watch their diet to make sure that rstly they do not become obese, and secondly, that the food you are feeding them provides them with the correct level or protein according to their activity level. The correct diet should also contain a balance of vitamins, minerals, essential fatty and amino acids. Senior dogs naturally require a higher-bre diet to improve gastrointestinal health.Walker and Drake is an exciting new range of Cold Pressed food for dogs that is made from the highest quality ingredients to keep those senior doggy tails wagging. The meat and the majority of vegetables are sourced from British farms and quality producers, and the sh is sourced from traceable sheries.A healthy microbiome is crucial for a dog’s overall health, from nutrient absorption to mental health. When bacteria become out of balance, disorders such as inammatory bowel disease (IBD), digestive issues, immune system reactions, diabetes, and even depression can result. It is therefore important that you feed a dog a balanced diet that contains all the nutrients your dog needs for health and wellbeing and avoid any ingredients that are likely to cause an allergy or intolerance such as llers, articial colourings and preservatives. Walker and Drake recipes are easily digestible, grain and gluten free, promote good gut health, hypoallergenic, are great for joint, skin and coat care and the immune system. They contain no nasties and are made in the UK.The Cold Pressed manufacturing technique is the best way of producing a dog food that preserves the nutritional integrity of all the ingredients.The blended ingredients are pressed at a lower temperature of 40 - 44°C compared to standard extruded dry dog food which is extruded under pressure at a temperature of approximately 140°C and above. The Cold Pressed end result is a naturally softer, denser, complete nutrition dog food which breaks down easier in the stomach. It is gentler on tummies too, as opposed to standard extruded food which can absorb liquid, stay in the stomach longer and lead to bloating and discomfort. The lower temperatures of Cold Pressed manufacture are also the key to locking in natural enzymes and vitamins, as well as retaining bre and molecular structures. This gives much more scope to include vegetables and botanicals that might normally lose their nutritional benets in a standard extruded kibble process.Walker & Drake is available in three tasty recipes, Duck, Ocean Fish and Chicken. The attractive 2 kg and 10 kg bags made from 100% recyclable PE/PE. Feed according to the size, weight, age and activity level of dog as per the instructions on the website. For further information visit: www.walkeranddrake.com and for trade and breeder enquires contact Tim Matthews our Sales Director email:tim@walkeranddrake.com

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28Animal Therapy Magazine | ISSUE 23THE t of a saddle to a horse’s back has an enormous impact on their physiology, locomotion, and welfare. A well-tting saddle is designed to evenly distribute the weight of a rider and optimise their position in the seat, allowing the horse to perform without restriction. However, horse’s bodies can change shape dramatically, greatly inuencing the way a saddle ts, and it is a fact universally acknowledged by any rider, owner, or groom that a summer out at grass will leave even the most formidable of hunters resembling a mare in foal. Due to the interconnectivity of a horse’s physiology, it is unlikely that any problems with saddle-t will remain localised: a saddle that creates discomfort will lead to inhibitory movements, compensatory strain, and subsequent injuries. e primary objective of this study was to monitor the physical changes of the backs of ve working hunters in the months between their working seasons, From Fit, to Fat, to FitMonitoring horses’ back dimensions as they alter through post-season to pre-season training and assessing the relationship these changes have with the t of the horses’ saddles.the epaxial muscles and those ligaments which are aected directly by or are physically in contact with the saddle, which also relates with the vertebral column, skin, nerves, and fascia. Any negative inuence between anatomy and saddle will create broader problems. For instance, if a rider is thrown o balance by an unstable saddle they will compensate and sit crookedly, leading to the horse having to compensate for the imbalance themselves. Should the saddle extend further than the eighteenth thoracic vertebra, the more vulnerable transverse processes of the lumbar spine will be exposed to excess pressure, resulting in discomfort. Another example is the saddle tree: too wide and the pommel will be too low, restricting the movement of the scapulae and impacting on the withers and Nuchal ligament. Tension will ensue through the Rhomboideus, Trapezius, Triceps Brachii, Serratus muscles, Pectorals and even the muscles of the foreleg. If a saddle persistently comes into contact with the withers the Nuchal laminae can become inamed, leading to issues in the neck as well as the back. If a tree is too narrow the saddle can pinch the withers, causing pain and irritation; it will also result in the pommel being too high, tipping the rider backwards and creating extra pressure on the back. Any pressure points ensuing from a poorly tting saddle will cause inammation which can spread far from the original site of injury aecting muscles, fascia, skin, and nerves. Saddle sores, galls and abrasions may also occur, which can lead to infection. Muscle atrophy can develop where the pressure from a saddle interrupts circulation, or where the horse attempts SADDLE FITTINGby Jess Eyres Dip. A. Phys. MIAAT. 28 Animal Therapy Magazine | ISSUE 23 and how these changes interacted with the way their saddles tted. Hunters are expected to experience the greatest body-mass changes between active seasons, and by focussing on the horses’ ‘down-time’ and assessing them more frequently, I hoped to expand on previous research (Greve et al. 2015). A control/start measurement was obtained in the week following the closing meet, and over the ‘letting-down’ period two of the horses remained in light work, while the others were each away at grass from between 2 – 11 weeks. All of the horses were back in work for the ‘ttening-up’ period between weeks 11 - 26. THE IMPORTANCE OF A WELLFITTING SADDLEe area beneath a rider might appear fairly straightforward, but in fact a saddle interacts with a complex structure comprising composite parts working in reciprocal relationships. For the purposes of this study, I focused on

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29 Animal Therapy Magazine | ISSUE 23At each assessment, I evaluated the t of each horse’s saddle using a guide obtained from the Master Saddler Association (this can be accessed at www.mastersaddlers.com/points), to appraise the relationship between horse and saddle throughout the study. RESULTS e data collected supports the idea that back shape and saddle-t inuence one another, and also shows that changes in back dimensions happen more frequently than may previously have been expected. One horse shared a saddle tted to another, which had a conspicuously negative impact on the way their back developed, while another showed compensatory changes in their back dimensions in response to an unstable saddle. e horses were not assessed by a Master Saddler until week 20 or later and they may have benetted from earlier intervention, as from week 18 onwards all ve horses experienced consistent decreases in mass in response to more intense workloads as part of their tness and conditioning programmes. Two of the horses exhibited extreme negative behaviour when being saddled and even when being assessed for this study. ose horses most frequently assessed by a professional saddle-tter had consistently better saddle-t scores, and subsequently better relationships with their saddles: even with continuing changes in their back dimensions, the saddles were more ‘sympathetic’ to these horses’ shapes. One horse performed regular advanced schooling sessions with a professional dressage rider throughout the study and they displayed the most even body-mass development. I believe this improved their results over the other case studies and was not mere coincidence: hunting is by its very nature is unfettered and involves linear movements, with long periods favouring one leg by the horse and one diagonal by the rider. e next step in this research would be to monitor back dimensions and saddle-t in a sample of working hunters and compare results between those who undertake regular advanced schooling and those who do not. CONCLUSION is study corroborates the collegial relationship existing between a horse’s back and their saddle. Overall, it supports the assertion that saddles should be checked more frequently to reduce the potential for issues and injuries caused by ill-tting saddles. 29 Animal Therapy Magazine | ISSUE 23 Photos from top: Annie, Cobe, Maisie, Tom and Yeats.to avoid constant pressure by contracting the necessary muscles and altering their movement. Behavioural problems resulting from poorly-tting saddles can include:• Rearing• Bucking• Head tossing• Refusal to jump• Refusal to make upwards transitions• Dicult to mount – “Cold-backed”• Resistant to being saddledMEASURING THE HORSESSkeletal conformation was used to ensure that measurements were taken at the same points consistently. e proximal (‘A’) marker was placed four ngers’ widths behind the easily palpable scapula cartilage.e caudal (‘D’) marker was placed at the point of the eighteenth oracic vertebrae, located by palpating the caudal-most rib. Markers ‘B’ and ‘C’ were placed equidistant between these, making the surface area of measurements accurate and unique for each horse.A Flexicurve© was placed on the markers, and it’s centre aligned with the centre of the spine. It was pressed ush to the horse before being removed onto an A2 layout pad, where I traced the line made and marked each of the 5cm increments. Each drawing could be placed upon another to measure the dierence between the markers and so the development of each line as the study progressed.

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31 Animal Therapy Magazine | ISSUE 23Learning theory is not only understanding how an animal perceivesand understands its surroundings, our actions and its interaction withus and others, but also how our behaviour around the animalinfluences their behaviour. To understand this, it is important tounderstand how learning takes place in the animal’s brain andanalyse why they respond and behave the way they do in specificsituations. We may think the animal is doing something with an aimin mind, but in reality, it is likely that their aim is completely different.This is because they perceive the world very differently to us and thisis where Learning Theory comes in. If we are to communicate with ourhorses, we need adjust our human behaviour to make it easier for theanimal to understand us too. Why is understanding Learning Theory important? As a practitionerwe work with animals to improve their health, function, and welfare.This requires us to understand the animal and implement treatmentin a safe and effective (but also therapeutic, stress-free) manner thatthe animal can enjoy. Understanding learning theory allows us toimprove not only treatment and rehabilitation efficacy, but also ownerrelationships, helping them to work in harmony with their animal. Thismeans that they can undertake any exercises that are set betweensessions in a safer and more effective way. This causes the animalmuch less stress and confusion,What is learning Theory?Want to learn more? Canine Learning Theory Equine Learning Theory Go to animalosteopathyinternational.comStudy withus online.

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32Animal Therapy Magazine | ISSUE 23THE dispute about which head and neck position (HNP) in ridden horses should be considered ‘correct’ can be traced back to the renaissance period and persists today. HNPs do not only dier in their aesthetics but some can negatively aect horse welfare. As a matter of fact, scientic evidence indicating compromised welfare of horses ridden in HNPs with their noseline BTV is mounting.[e.g.,1,2] For instance, based on ndings of a meta-analysis on the eect of HNP on welfare and other physiological parameters such as kinematics [3] the researchers concluded that only one out of 55 scholarly articles focusing on HNP indicated positive eects of hyperexion (i.e., extremely overbending a horse’s head on neck to Head and Neck Positions in the ridden horseAre we deviating from what is considered ‘incorrect’ or behind the vertical?such an extent that the nose almost touches the chest) on horses. When given the choice, horses preferred a HNP in front of the vertical to one behind the vertical[1]. Since horses cannot simply use words to tell us how they feel, they instead express discomfort or pain through so-called ‘conict behaviours’ such as tail swishing, abnormal oral behaviour, ears xed back, attempted bucks, fearfulness[1], and those behaviours were frequently observed among horses ridden in an overbent BTV HNP. So far, evidence suggests avoiding riding or training horses in BTV HNPs. Let us take a closer look at what ocial training manuals and guidelines tell us about BTV HNPs:The gradual exion of the poll and by Tanja Bornmann (MSc Equine Science; qualied equestrian coach), Academic Equitation, Canada.and Dr Jane Williams, Hartpury University, Gloucester, UK, GL19 3BEHARTPURY UNIVERSITYarching of the neck through taking contact with the horse mouth via bit and reins is achieved through systematic training and conditioning of the horse [4,5]. At any training stage the horse’s noseline should not come behind an imaginary vertical line to the ground as this is described as ‘faulty’ in ocial dressage rulebooks[5] and riding manuals[4]. Unfortunately, in contrast to this guidance, horses working with BTV HNP are frequently observed across a range of equestrian disciplines, particularly where it is a requirement to work horses in a exed HNP, such as in dressage. Although ocially not approved in the competition ring, the practice of overbending horses’ heads to dierent degrees during warm-up or cool-down remains permitted at FEI-sanctioned shows[6] and presents a serious welfare concern[7]. According to FEI rules, warming-up horses in BTV HNP is a permitted practice, if no force is applied when asking the horse to obtain this HNP. Surprisingly, there is no reliable measure of judging whether a horse is ‘forced’ to obtain a certain HNP. We know that horses may express discomfort quietly through, for instance, certain facial expressions or conict behaviours, and some equestrians may misinterpret those ‘unwanted’ or ‘bad’ behaviours as disobedience, ‘naughtiness’, or unwillingness to perform, even though they can be indicators of pain or distress. Interesting although BTV HNP is associated with compromised horse welfare and described as ‘faulty’ in ocial rulebooks, a large proportion of horse vendors still advertise horses in this ‘incorrect’ HNP. Researchers Horse ridden with his noseline slightly behind the vertical. The lightly opened mouth (ash noseband probably prevents the horse from further opening his mouth) can be an indicator of the rider applying pressure to ‘hold’ the horse head in this exed position – in equestrian jargon referred to as ‘on-the-bit’. Photo: K. Stroud.

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33 Animal Therapy Magazine | ISSUE 23determined that some equestrians incorrectly consider BTV HNP in sales advertisements as an indicator of advanced training[8]. Consequently, BTV HNP might epitomise a misperception among equestrians of horses working in a correct outline, referred to as on-the-bit, and attract more buyers. ‘Forcing’ the horse to obtain a hyperexed or BTV HNP by applying strong rein pressure, contrary to the principles of self-carriage, may falsely suggest talent for dressage to potential buyers and misleadingly present a horse as well-schooled. It appears that BTV HNPs are still seen as aesthetic, and perhaps correct in terms of training, by a larger number of equestrians. Previous studies examining HNPs in horse advertisements in Australia[9] and the UK [8] reported that 68% and 70% of sampled horses, respectively, were depicted in the BTV HNP. In contrast, another team of researchers explored human preferences for certain HNPs and reported that only 7% of the participants in their study cohort preferred the BTV HNP[10]. One study published in 2020[11] analysed a total of 570 photographs of ridden horses advertised in a popular Australian horse sales magazine by comparing HNPs depicted in the advertised photographs using issues from 2005 versus 2018. 47% of all horse vendors, based on combined data from the 2005 and 2018 issues, selected photographs that showed their horses ridden in a BTV HNP, suggesting that this HNP remains prominent amongst vendors. However, when comparing BTV frequencies between the years, the researchers recorded a signicant reduction in BTV HNP prevalence by 13.7% from 53.4% in 2005 to 39.7% in 2018. This may not sound like a lot but, overall, the decrease of BTV HNP in 2005 versus 2018 may be carefully interpreted as a positive development in terms of horse welfare. However, a large proportion of horses ridden with BTV HNPs were advertised in magazine categories in which working a horse in a exed HNP was common. BTV was observed as the main HNP (57.84%, 2005 and 2018 observations combined) in the magazine categories warmbloods, eventers, show, and performance horses (WESP). In 2018, the prevalence of BTV HNP reduced by 36.4% in WESP categories. This observation could possibly indicate that vendors’ and, consequently, equestrians’ awareness of ‘correct’ HNP may have increased from 2005 to 2018 but may also be linked to the decreased number of horses listed in the WESP categories in 2018. Horses listed in the WESP categories were also more frequently advertised as competed/shown. One might assume that equestrians’ awareness of ‘correct’ HNP might increase with Horse ridden with his noseline in front of the vertical (vertical line to the ground) and the poll (atlanto-occipital joint area) presenting the highest point. NoA refers to the noseline angle (in front of or behind the vertical). Photo: Author’s Archive.continued overleaf

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34Animal Therapy Magazine | ISSUE 23show experience since BTV HNP is not advocated in, for instance, dressage tests. Surprisingly, this was not the case and training and competition experience of sales horses did not impact the prevalence of BTV HNP, i.e., frequency of BTV HNP did not reduce with increased training or show experience of the horse. Paradoxically, competing at advanced levels was linked to a higher prevalence of BTV HNP in another study[10], and was not penalised by judges despite being contrary to FEI recommendations. Therefore, BTV HNP in horse sales advertisements may be misinterpreted by both, vendor, and potential buyer, as an indicator of a horse working in self-carriage at advanced level[8] and willingly taking contact with the rider’s hands, perhaps promising talent for the discipline of dressage, which may increase the vendor’s chances of sale and attract more buyers. The high prevalence of BTV HNP in horses advertised in dressage saddles when compared to any other saddle type may present another misperception among vendors and buyers of horses showing talent for dressage and working at advanced training levels[8] since working horses in a exed HNP is required in dressage tests. Yet, we must acknowledge that vendors’ advertised horse photographs only provide a snapshot of a horse/rider combination and the reasons behind selecting a BTV HNP could be purely based on personal aesthetics[9]. The 2020 study[11] also recorded that horses ridden without a noseband were less often depicted with their noseline BTV. Nosebands are mandatory in some competitive equestrian disciplines, such as dressage, and there is scientic evidence that noseband t and tightness can impact HNP. Tight nosebands can prevent horses from opening their mouth. Consequently, they cannot avoid strong bit pressure exerted by the rider’s hands via the reins. In competitive dressage, open horse mouths are considered a sign of resistance and judges may assign lower test scores to those horse-rider pairs.[5] Therefore, some vendors may opt to use tight nosebands to mask incorrect training techniques, perhaps aiming to gain a better sales prices. REFERENCES:[1] König von Borstel UU, Duncan IJ, Shoveller AK, Merkies K, Keeling LJ, Millman ST. Impact of riding in a coercively obtained Rollkur posture on welfare and fear of performance horses. Appl Anim Behav Sci 2009; 116(2-4): 228-236. [2] Smiet E, van Dierendonck MC, Sleutjens J, Menheere PPCA, van Breda E, de Boer D, Back W, Wijnberg ID, van der Kolk JH. Eect of dierent head and neck positions on behaviour, heart rate variability and cortisol levels in lunged Royal Dutch Sport horses. Vet J 2014; 202 (1): 26-32. [3] König v. Borstel U, Kienapfel K, McLean A, Wilkins C, Evans D, McGreevy P. Hyperexing horses’ necks – meta-analysis and cost-benet evaluation. In: Heleski C, Merkies K, editors. Proceedings 11th International Equitation Science Conference; 2015 August 5-8 Vancouver, Canada, p. 20. [4] Print P, editor. The BHS complete manual of equitation. 2nd ed. Shrewsbury: Kenilworth Press; 2011.[5] Federation Equestre Internationale (FEI). Dressage Rules 2020 [internet]. Lausanne: FEI; 2020. Available from: https://inside.fei.org/sites/default/les/FEI_Dressage_Rules_2020_Clean_Version.pdf[6] Federation Equestre Internationale (FEI). FEI Manual for Dressage Stewards 2009 [internet]. Lausanne: FEI; 2009. Available from: https://inside.fei.org/sites/default/les/Dressage%20Stewards%20Manual%202019_clean_0.pdf [7] International Society for Equitation Science (ISES). Position statement on alterations of the horse’s head and neck posture in equitation (2015) [internet]. Available from: https://equitationscience.com/equitation/position-statement-on-alterations-of-the-horses-head-and-neck-posture-in-equitation[8] Hutchings K, Randle H. Is horse head position used as an indicator of training in advertisements?Proceedings 9th International Equitation Science Conference; 2013 July 17-20Newark, PA p.79.[9] McGreevy PD, Harman A, McLean A, Hawson L. Over-exing the horse’s neck: a modern equestrian obsession? J Vet Behav 2010; 5(4): 180-186.[10] Caspar GL, Dhand NK, McGreevy PD. Human Preferences for Conformation Attributes and Head-And-Neck Positions in Horses. PLoS one 2015; 10(6): e0131880.[11] Bornmann T, Williams J, Richardson, K.Comparison of the Head and Neck Positions in Ridden Horses Advertised in an Australian Horse Sales Magazine: 2005 Versus 2018. J Equ Vet Sci 2020; 95: 103280.[12] Thompson K. Perceptions of Equitation Science revealed in an online forum: Improving equine health and welfare by communicating science to equestrians and equestrian to scientists. J Vet Behav 2018; 25: 1-8.Although research-based information is highly valued by a proportion of the equestrian community[12], practically applying research ndings in daily training is often inhibited by resistance and resilience to change, traditions, and, perhaps, economic disadvantages. This might be one reason why the practice of schooling horses with their noseline BTV remains a common sight in equitation, particularly at disciplines where exing the horse head and neck is required in competition. Another explanation could be that equestrians are informed about what incorrect HNP constitutes but are unable to apply this knowledge in a practical training context. Besides the need for further education about incorrect HNP and its impact on horse welfare, research into human mindset change suggests that the involvement of leading organisations and gures within the equestrian industry may help facilitate change. We can all make a change by educating ourselves and others about incorrect HNP and training practices compromising horse welfare, or, as Ghandi puts it: “We need not wait to see what others do.” Happy riding! HARTPURY UNIVERSITYEquineHartpury 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.

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36Animal Therapy Magazine | ISSUE 23CASE STUDY  TEDDYWhy building trust is essential for eective therapyby Karen Young of Safe Hands Clinical Canine Massagecontinued overleafCANINE MASSAGELet’s Meet TeddyTeddy is a 12-year-old Polish Lowland Sheepdog who, in her younger years, loved nothing more than long, cross-country runs around the beautiful Hertfordshire countryside … until disaster struck. One day, in 2016, poor Teddy woke up in agony and unable to stand. An emergency X-ray at the Royal Veterinary College (RVC) revealed a ‘slipped disc’ in her thoracic spine. Surgery was followed by physiotherapy and then hydrotherapy but the only thing that seemed to help was lots of rest and restricted exercise. To make matters worse, further disc bulges were found in Teddy’s lumbar spine. Choosing to avoid further surgery, the degenerative condition was managed for the next four years with relatively high doses of pain meds.But Teddy’s health challenges didn’t end there. As the pandemic struck in 2020, she not only developed Cushings disease (a tumour on her adrenal gland) but also signicant arthritic changes in both her wrists, conrmed by Fitzpatrick Referrals. An op to remove the tumour led to pancreatitis and then aspiration pneumonia! When – and how - would this poor dog recover?Building TrustSince her original back injury, Teddy had shown no interest in exercise or exploring her world. Seemingly clutching at straws, her owner, Jo Culhane, decided to try massage therapy, although she wasn’t hopeful. By the time Karen Horne (VetMB MA MRCVS), from Alistair J Poole Veterinary surgery referred her to me as an urgent case her condition had deteriorated, and she had barely left her bed in a week. By now it was late December 2020 and, with Covid cases rising, I could only treat urgent cases without the owner present. Given her previous extensive tests and investigations, Teddy was understandably anxious, so allowing 90 minutes for the rst session was instrumental in the trust gaining exercise. I vividly remember her rst session. Without her mum’s support, Teddy was extremely frightened and hid under the massage table for half an hour, so I just pretended I didn’t know she was there! I kept quite still, didn’t look at her, and simply read out loud in a calm voice. Finally, Teddy started to relax. I threw some treats away from us both so that she had to leave the table to get them but didn’t need to come near me. After eating the treats, Teddy settled where they had fallen. Although she still refused to engage with me, I did manage to touch her, gently, slowly and just the supercial tissue layers, but progress had been made. Teddy had begun to trust me. By session four we were a team! Teddy was even presenting areas that she wanted me to work on, despite the work obviously causing some therapeutic discomfort.Initial Assessment for Canine Massage TherapyDespite Teddy’s trust issues at the beginning, I was still able to identify the eect that the lack of exercise was having in her tissue. All the muscles in her torso were hypotonic - except for her Iliocostalis bilaterally which were hypertonic and painful to touch.Hypotonicity in dogs is relatively uncommon and I hadn’t encountered a case as extreme as Teddy’s. The tissue felt more like blancmange. The Teddy waiting patiently for her fourth massage36 Animal Therapy Magazine | ISSUE 23Karen Young

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37 Animal Therapy Magazine | ISSUE 23Coat changes / icking up / dry in areal l lKyphosis (roaching) / Lordosis (swayback)l l lTwitching, or ‘shivery’ skinl l lInexplicable tremorsl l lTail carriage e.g., swimmers taill l lNeck / back / shoulder issuesl l lUneven nail wearl l lHip or stie rotation (dog stands / sits with knee pointing out)l l lDown on the wristl l lReluctance to be petted /groomed / examinedl l lDisinterested in life /isolating themselves /depressed l l lSelf mutilation e.g., nibbling their hind areal l lLick granuloma, e.g., excessive licking of wristl l lSnapping when touched or towel driedl l lSnapping at other dogs as a pre-warning for them to stay awayl l lAnxietyl l lFrequent rolling on backl l lLame / limping /carrying a leg or pawl l lReduced range of movementl l lStiff when movingl l lSlowing down on walks l l lAbduction or adduction (throwing a leg)l l lSingle trackingl l lPacing l l lHopping/skippingl l lLack of reach or drivel l lCrabbing l l lStruggling to get up on or down from sofa, stairs, carl l lNot settling, pacing at night timel l lWeakness in back legsl l lGeneral signs of ageingl l lStruggling / slowing down on walksl l lDifculty rising from lying downl l lSlipping / unbalanced on ooringl l lLying down to eatl l l Agility dogs – pole knocking, weave and /or contact issues, lack of drive, measuring,l l lGun dogs – early onset fatigue, retrieval issuesl l lCanicross – early onset fatigue, reluctance to wear harness, not pullingl l lObedience - change in work positions e.g., down stay / sendaway l l lFlyball -Turning wide on box, missing/avoiding jumps l l lAll disciplines: any deviation from natural performance l l lIf you have noticed, or have concerns about, your dog’s mobility and /or behaviour, you can easily classify your observations with the 5 Principles of Pain, a useful aid for identifying symptoms of musculoskeletal conditions that could be helped by clinical canine massage. The signs of muscular pain listed can be mistaken by some owners as simply signs of ageing or ‘just something they do’. The reality is, however, that muscular pain can be caused by anything from normal activities of daily living to chronic, arthritic conditions. Just tick the severity of each of the conditions that apply to your dog and turn over.      l Sometimesl Oftenl AlwaysWhat’s your dog trying to tell you?A guide to help you assess your dog for the viability of clinical canine massage therapyDiseased joints rely on the extra muscular support which, in itself, is likely to mean increased secondary pain. For truly effective management of chronic pain, all areas of associated muscular dysfunction must be addressed.Please tick the relevant boxes... Osteoarthritis Hip dysplasia Cruciate ligament Elbow dysplasia Spondylosis Luxating patella OCD Previous break / fracture Other My dog is pre-surgery My dog is post-surgerywww.k9-massageguild.co.uk

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38Animal Therapy Magazine | ISSUE 23resulting slower, shorter muscle bre contraction meant that, for Teddy, it would take a lot more eort to use her muscles than it would for a healthy dog. She would tire faster and runs the risk of joint damage and deterioration. In addition, Teddy’s prolonged immobility had also reduced the eectiveness of nerve impulses to her skeletal muscles, reducing her ne motor skills and aecting her balance and coordination. This manifested as low body awareness, low condence in her movement and a clumsy and uncoordinated appearance.By contrast, the Iliocostalis muscles bilaterally were so hypertonic that they felt like bone, were painful, and ran a high risk of straining. Further issues identied• Tight, restrictive, and painful dorsal aspect of neck • Hind limbs atrophied and hypotonic Severe muscle wastage in back legs• Restricted range of movement in forelimbs • Demeanour and posture: head held exceptionally low; shuing Teddy Turns a CornerA key Canine Massage Guild therapy principle is ‘results in 1-3 sessions’. Given everything that Teddy had endured over the years, would we be able to live by that tenet? Well, extraordinarily, the answer is a resounding ‘YES’! After just three sessions, Teddy had started to stretch – and even lie on her back – something she hadn’t done for the past year. And then, after thefourthsession, just look! Teddy is actually rolling joyfully in the snow, demonstrating massively improved spinal mobility, comfort, and freedom of movement. This dear, sweet dog is nally able to enjoy life once again. Teddy’s owner Jo Culhane said:“With Karen’s therapy and advice, Teddy has become more alert, motivated, and stimulated. We can’t believe the dierence that canine massage therapy has made to Teddy, and in such a short space of time! This therapy has really helped to turn Teddy around.”I wonder now whether we would have made the same degree of progress if Jo had been able to come into the clinic. We will never know; but I have noticed that some of my clients are quicker to settle and more responsive to massage when their owners are not in the clinic with them. This is particularly true if the owners get stressed when their dog shows signs of discomfort. I hope that this helps reassure other owners who are considering canine massage therapy for their dog . Before Covid I didn’t treat dogs without their owner present. At least there is a positive to be taken from this strange year. Massage therapy can be as eective (and possibly more so in some cases) when the owner is unable to attend a session. We are in strange times, but by being exible, and adaptable, and by taking more time to build trust I am still able to help my clients to lead happier, healthier lives.Jo said, “Other dog owners should know that with canine massage therapy there is hope when it comes to help for their older dog. Teddy was struggling. She was having diculty standing, didn’t want to play or go for a walk, and was sleeping all day. We let her rest, thinking that was the right thing to do, but Karen has taught us that with the right therapy Teddy can, and wants to do, a lot more. After her treatments Teddy is now actually enjoying short walks, she’s become more sociable, joining in and wanting to be with the family and has regained her ‘doggy mannerisms’ We are delighted with the complete turnaround from how Teddy was before to how she is now and cannot recommend Karen, or Clinical Canine Massage Therapy, enough.”CANINE MASSAGE38 Animal Therapy Magazine | ISSUE 23Top: After four years of pain and bed rest and bed rest, canine massage therapy nally gave Teddy her life back. Above: Owner Jo Culhane with Teddy. Below: Teddy relaxing in Karen's massage clinicFor more information on Clinical Canine Massage therapy or to nd your local therapist please visit www.k9-massageguild.co.uk

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39 Animal Therapy Magazine | ISSUE 23Animal Therapy Magazine was born in 2015 and created by professional animal therapists working in the eld day to day.Whilst there are internal membership publications we felt there wasn’t really a publication dedicated to treating animals with therapeutic techniques that was available to professionals and owners at all levels. Our content aims to provide education to anyone working with animals whether that be vets, therapists, trainers, behaviourists, competitors and of course the dedicated pet owner who wants to do everything they can to keep their beloved friend as happy, healthy and comfortable as possible.In June 2019, Animal Therapy Media launched their rst Podcast and since then we have recorded many more. You can follow us on Mixcloud under Animal Therapy Media to hear our existing and new releases hot o the press.We release issues 4 times a year. Our content comes from people working in the eld giving us fantastic, current case studies as well as covering topics and solutions that crop up in their day to day working. We keep a breadth of new and emerging products including nutrition and techniques as well as evolving research from existing products. The animal therapy industry is constantly growing and continuous education is paramount. As such we have partnered with some fantastic associations, CPD events, conferences and webinars to help guide people to top quality speakers and research.We invite anyone working within animal therapy to get in touch if they have content they would like to share, however, the therapies must be recognised by the Royal College of Veterinary Surgeons, have full and accredited training. Practitioners must work alongside vets / under veterinary referral and they must hold professional insurance.We pride ourselves in being neutral across recognised therapies and supportive to those people who have great information to share but not yet the condence in their ability to communicate it.For any content requests please contact Hannah at: Hannah@animaltherapymedia.co.ukFor all advertising enquiries please contact Beth at: info@animaltherapymedia.co.ukwww. animaltherapymedia.co.ukSUBSCRIBE NOW You can subscribe to read our online copy for just £10 per year.Further information can be found on our website animaltherapymedia.co.ukM A G A Z I N EAnimalerapy

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40Animal Therapy Magazine | ISSUE 23Head shyness is a condition whereby a horse fears being touched on or near its face or head. Behaviours associated with head shyness can range from lifting their head to avoid touch or contact to extreme anxiety when approached. This can make performing simple tasks such as grooming the face, or putting on a head collar or bridle dicult for handlers and stressful and scary for the horse. HEAD SHYNESS can have a number of causes including, but not limited to; the memory of a traumatic event, fear of pain or discomfort or current physical pain. Smith – omas (2019) suggests that horses are not born head-shy; but that it is a self-preservation response to protect from pain or further pain. Pehkonen et al. (2019) discovered that head shy behaviours could also be associated with dental infections and that they signicantly reduced when the infected teeth were removed. erefore, for the physiotherapist attending a head shy horse, it is wise to check the dental history and recommend dental intervention if there have been previous issues or if the horse has not received recent dental treatment, particularly if the head shy behaviours have worsened or altered recently. e head of the horse, including the intricate arrangement of the poll and the connections between skull and spine is a remarkable anatomical design and is subject to a range of pressures, from both daily activities as well as pressures from bridles during riding. Bridle design can contribute to poll pressure and therefore head shyness. A study by Murray et al. (2015) adjusted bridle design to limit pressure points, and found a subsequent increase in stride length as well as carpal and tarsal exion. ey attributed this to increased comfort, as due to the conformation and level of intricacy of the structures of the poll, any pain or restrictions here can hugely aect gait and stride as well as soundness. Most bits exert some amount of poll pressure (Benoist & Cross, 2018) which can result in residual tension or pain at the poll. Bit t should be discussed during treatment, particularly for horses ridden frequently. If the mouth can be examined then lip folds and tongue edges should be checked for signs of soreness or damage which could contribute to head shyness, and referral to a trained bit tter should be advised if there is reason for concern. ere are many small muscles in the poll, which work in concert together to help support the vertebrae here and ex the head relative to the neck. Wilson, J. (2015) describes the energy dissipation from hindlimb to head as a wave and tightness at the poll could interrupt the wave. us tightness in the poll can have a more global eect on the action of the hindleg and everything in between. Poll tightness may compromise how a horse is able to use the muscles of the back and may result in a shortened stride length in the hindquarters because they are unable to step up under themselves easily and freely. is in part is due to the connectivity between muscles in the form of fascial connections and muscle chains. Higgins, G. (2012) describes Head Shy HorsesWhat can the physiotherapist do?by Sophie Pickard (BSc. Hons) Veterinary Nursing. Dip. Animal Physio. EEBW. RAMP member. EQUINE PHYSIOTHERAPYLeft: The rectus capitis dorsalis muscles play a crucial role in head movement and respond well to gentle massage, particularly in head shy horses. Right: Addressing the muscles of the poll of an anxious rescue horse using massage techniques. Photo courtesy of Jacqueline Sheedy.

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41 Animal Therapy Magazine | ISSUE 23the atlas (C1) as an important anchor point for many muscles, which span across multiple muscle chains such as the splenius in the extensor chain and the brachiocephalic in the exor chain as well as the rectus capitis muscles located at the poll. A study by Alvarez et al (2006) reinforces this concept by examining the eects of head and neck position on thoracolumbar kinematics and found that varying head and neck position has a signicant inuence on back kinematics. Elevated head and neck positions induced extension in the thoracic region and exion in the lumbar region, whilst a lower head carriage had the opposite eect. And a REFERENCES Alvarez, C., Rhodin, M., Bobbert, M., Meyer, M., Weishaupt, A. Johnston, C., Van Weeren, P. (2006). The eect of head and neck position on the thoracolumbar kinematics in the unridden horse. Equine Veterinary Journal. Vol. 38. Issue. S38. Pp.445-451.Benoist, C., Cross, G. (2018). A Photographic Methodology for Analysing Bit Position Under Rein Tension. Journal of equine veterinary science. Vol. 67. Pp. 102-111.Higgins, G. (2012). Horse Anatomy for Performance. David and Charles. Exeter. Murray, R., Guire, R., Fisher, M., Fairfax, V. (2015) A Bridle Designed to Avoid Peak Pressure Locations Under the Headpiece and Noseband Is Associated With More Uniform Pressure and Increased Carpal and Tarsal Flexion, Compared With the Horse’s Usual Bridle. Journal of Equine Veterinary Science. Vol. 35, Issues 11–12. Pages 947-955.Pehkonen, J., Karma, L., Raekallio, M. (2019). Behavioural signs associated with equine periapical infection in cheek teeth. Journal of Equine Veterinary Science. Pp. 144-150.Smith-Thomas, H. (2019). Dealing with Head shy horses. (Online). Available at: - https://equimed.com/health-centers/behavior/articles/dealing-with-head-shy-or-ear-shy-horses Accessed on 20/3/2020. Wilson, J. (2015). Preventing and Relieving Tightness in Your Horse’s Poll. [Online} available at:- https://practicalhorsemanmag.com/health-archive/preventing-and-relieving-tightness-in-horses-poll-30187. Accessed on 17/3/2020.very high position of the head and neck seems to disturb normal kinematics completely. e implications of this are huge and demonstrate the need for a holistic approach for the therapist, even when movement changes seem localised.Ultimately the physiotherapist can contribute a great deal to the physical and emotional well-being of the head shy horse. With a considerate and holistic approach, the source of pain can be addressed and resolved, particularly with responsible referral where necessary. e approach for comprehensive treatment of the condition is multifactorial; Checking local factors such as dental health, bit and bridle t, may provide a relatively simple solution; Treating the sources of pain using a multimodal approach with massage, mobilisations or electrotherapies as required, to resolve the current issues as well as educating owners on the eect of certain management techniques and approaches on the delicate structures of the head and poll, and correct movement principles including provision of exercises to encourage and enable the horse to utilise its body in a healthy way to enhance performance and prevent tension and tightness developing at the poll.

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42Animal Therapy Magazine | ISSUE 23AFTER stie joint surgery, cryo-compressive splints can help with early functional recovery. These devices combine two simultaneous actions which are particularly indicated in the postoperative period: cold and compression. These are already widely used in humans to improve analgesia and postoperative recovery, and they are now available and adapted for the canine stie joint.Clinical benets of compressive cryotherapyThe therapeutic eects of cold have long been known and widely accepted in the management of musculoskeletal injuries, whether traumatic or post-surgery. Indeed, in the aphorisms of Hippocrates (460-370 BC), the use of ice or snow was already recommended to reduce swelling and pain(1).Cryotherapy has analgesic, anti-inammatory, anti-edematous and muscle relaxant eects. When cold is applied locally, a decrease in skin temperature (but no decrease in core temperature), intramuscular and intra-articular temperature is observed. This local hypothermia leads to a Compressive CryotherapyA prime choice for stie joint surgery in dogs ?by Thibaut Cachon DMV, Dipl ECVS, PhD, Surgery Department, Lyon Veterinary Campus, VetAgro-SupVETLIGdecrease in the metabolic activity of the surrounding tissues associated with venous and arterial vasoconstriction. This results in a lower inammatory reaction, linked to the reduction of enzyme activity, production of chemical mediators and cellular metabolism. This anti-inammatory eect promotes cell survival, reduces secondary hypoxic lesions and decreases vascular permeability. This decrease in vascular permeability and the cold-induced vasoconstriction limit the formation of post-traumatic edemas. Finally, the analgesic eect of cryotherapy, partly related to the reduction of edemas, is also due to the reduced excitability of nociceptors and to nerve conduction velocity. This analgesia seems to appear when the skin temperature reaches approximately 10 to 15°C and stays so 15 to 30 minutes after application(2-5).During local compression, a decrease in blood ow and edema is also observed. These eects work synergistically with cryotherapy. Indeed, the combined actions of compression and cold accelerate, accentuate and favour the penetration of the local temperature decrease while encouraging lymphatic drainage. Compression also improves the conformation of the splint around the anatomical area of interest, thus ensuring a better distribution of cold and a better maintenance of the splint(3,5).The place of compressive cryotherapyIndications for compressive cryotherapy are mainly acute post-traumatic injuries: sprain, muscle straining, dislocation, fracture, hematoma, ecchymosis, edema, as well as immediate post-operative care. In humans, the use of compressive cryotherapy still remains rather empirical. However, many studies show that its use following musculoskeletal trauma or in postoperative care signicantly improves functional recovery and seems more eective than the simple application of an ice bladder. These eects are particularly signicant after knee surgery, such as cranial cruciate ligament repair or total knee prosthesis.A decrease in postoperative pain, in the use of analgesics and an improved range of motion are widely noted. In some studies, these benets were observed up to one month postoperatively(2,3,5-7).The optimal parameters for the use of compressive therapy are still controversial. However, it is clearly accepted that immediate application, i.e. as close as possible to the trauma, is preferable and that it should be limited to the inammatory phase, i.e. the rst 3 to 5 days.The contraindications of cryotherapy are rare and scarcely reported in veterinary medicine. In humans, we are aware of the following: skin sensitivity disorders, allergies to the cold, Raynaud syndrome, cryoglobulinemia, diabetes and metabolic diseases (risk of skin lesions on fragile skin).WWW.VETLIG.COMMechanism of actionCRYOTHERAPYCOMPRESSION-Reduce metabolic activity Inhibition enzymatic reaction -Reduce release of histaminVascoconstrictionReduce nerve conduction velocityLimit tissue damageReduce oedemaAnalgesiaA recent meta-analysis showed that Cold Compression Therapy is superior to cryotherapy alone in the acute rehab-ilitation stages in people undergoing knee surgery.These improvements are thought to be due to more intensive contact of the cooling aggregate with the skin and the direct effects of compression.Dr. T. Cachon, L’essential Vet Magazine 2020.22.5oc18.8oc CRYOTHERAPY BRACEcontinued overleafCONTACT USPhone: 07891 468999Mail: karen@vetlig.comWeb: www.vetlig.com CRYOTHERAPY BRACEProduct Information Size Orientation Ref. CharacteristicsSMLRIGHTLEFTRIGHTLEFTRIGHTLEFTRAC-GDS01AC-GGS01AC-GDM01AC-GGM01AC-GDL01AC-GGL0115-25KgLength : 26 cmCircumference : 31 cm15-35KgLength : 28 cmCircumference : 35 cm35-50KgLength : 30 cmCircumference : 38 cmVETLIG LTD offers a full range of synthetic for veterinary use, our products are minimally invasive and mimic the original native ligament or tendon we are replacing or reinforcing. Vetlig products aim to regain quicker post operative mobility and quality of life compared to conventional repairs. We only use human medical grade UHMWPE facilities. VETLIGSOFT TISSUE INTERNAL FIXATIONVETLIGWWW.VETLIG.COMCRANIAL CRUCIATE LIGAMENT REPAIRARTIFICIAL LIGAMENTS FOR VE TERINAR Y USE•N von Freeden et al. 2017 Comparrison of two cold compression therapy protocols after TPLO in dogs. Tierarztliche praxis kleintiere 4/2017.int surgery in dogs? L’essentiel veterinary magazine, No 577, 8-14th October 2020.•L Bietrix, The expert think, a review of cryotherapy for dogs. Abstract vet review, 71 page 9. 2020.Compressive cryotherapy mechanism of action

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43 Animal Therapy Magazine | ISSUE 23WWW.VETLIG.COMThe cold compression brace reduces inammation, oedema and pain : it is enhanced by compression.BENEFITSCRYOTHERAPYBRACEwith compressionINDICATIONSPre and post-operative care for Cranial Cruciate Ligament repair - Arthroscopy - Physiotherapy.Acute musculoskeletal disorders (sprains, tendonitis, dislocation).COLD COMPRESSION THERAPY PROVIDES ANALGESIA AND A FASTER RECOVERYSTABILITY VERSATILITY RECOVERYSTABILITY VERSATILITY RECOVERYCONTACT USPhone: 07891 468999Mail: karen@vetlig.comWeb: www.vetlig.comCONTACT USPhone: 07891 468999Mail: karen@vetlig.comWeb: www.vetlig.com CRYOTHERAPY BRACEProduct Information Size Orientation Ref. CharacteristicsSMLRIGHTLEFTRIGHTLEFTRIGHTLEFTRAC-GDS01AC-GGS01AC-GDM01AC-GGM01AC-GDL01AC-GGL0115-25KgLength : 26 cmCircumference : 31 cm15-35KgLength : 28 cmCircumference : 35 cm35-50KgLength : 30 cmCircumference : 38 cmVETLIG LTD offers a full range of synthetic for veterinary use, our products are minimally invasive and mimic the original native ligament or tendon we are replacing or reinforcing. Vetlig products aim to regain quicker post operative mobility and quality of life compared to conventional repairs. We only use human medical grade UHMWPE facilities. VETLIGSOFT TISSUE INTERNAL FIXATIONVETLIGWWW.VETLIG.COMCRANIAL CRUCIATE LIGAMENT REPAIRARTIFICIAL LIGAMENTS FOR VE TERINAR Y USE•N von Freeden et al. 2017 Comparrison of two cold compression therapy protocols after TPLO in dogs. Tierarztliche praxis kleintiere 4/2017.int surgery in dogs? L’essentiel veterinary magazine, No 577, 8-14th October 2020.•L Bietrix, The expert think, a review of cryotherapy for dogs. Abstract vet review, 71 page 9. 2020.❝❞

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44Animal Therapy Magazine | ISSUE 23VETLIGREFERENCES1. Meeusen DR, Handelberg DF, Framhout L, Daems S. Inuence de la cryothérapie (Cryotron®) sur la douleur et l’inammation après arthroscopie de l’épaule. :15.2. Sadoghi P, Hasenhütl S, Gruber G, Leitner L, Leithner A, Rumpold-Seitlinger G, et al. Impact of a new cryotherapy device on early rehabilitation after primary total knee arthroplasty (TKA): a prospective randomised controlled trial. Int Orthop. 2018;42(6):1265–73.3. Murgier J, Cassard X. Cryothérapie avec compression dynamique intermittente pour analgésie après reconstruction du ligament croisé antérieur : une étude préliminaire. Revue de Chirurgie Orthopédique et Traumatologique. 2014 May 1;100(3):233–6.4. Malanga GA, Yan N, Stark J. Mechanisms and ecacy of heat and cold therapies for musculoskeletal injury. Postgrad Med. 2015 Jan;127(1):57–65.5. Block JE. Cold and compression in the management of musculoskeletal injuries and orthopedic operative procedures: a narrative review. Open Access J Sports Med. 2010 Jul 7;1: 105–13.6. Chughtai M, Sodhi N, Jawad M, Newman JM, Khlopas A, Bhave A, et al. Cryotherapy Treatment After Unicompartmental and Total Knee Arthroplasty: A Review. J Arthroplasty. 2017;32(12):3822–32.7. Gatewood CT, Tran AA, Dragoo JL. The ecacy of post-operative devices following knee arthroscopic surgery: a systematic review. Knee Surg Sports Traumatol Arthrosc. 2017 Feb;25(2):501-1Practical use of compressive cryotherapy in veterinary medicineWhile compressive cryotherapy is interesting for the management of all musculoskeletal traumas, it is particularly indicated in the immediate post-operative period. The splint which is currently available in veterinary medicine is perfectly adapted to the conformation of the canine stie joint and is therefore ideally used in the post-operative stabilization of a ruptured cranial cruciate ligament. It consists of a cryopack and can be inated using a pressure bulb (Figure 1). The splint is currently available in three sizes, either left-sided or right-sided. It is therefore possible to treat all patients between 15 and 50kg. Other sizes are to come, to complete the existing range.To be as eective as possible, the splint should be applied immediately after the procedure is completed, before the animal wakes up (Figure 2). It should be used during the rst 4 to 5 days postoperatively, at a rate of 3 to 4 daily CONTACT USPhone: 07891 468999Mail: karen@vetlig.comWeb: www.vetlig.com CRYOTHERAPY BRACEProduct InformationSize Orientation Ref. CharacteristicsSMLRIGHTLEFTRIGHTLEFTRIGHTLEFTRAC-GDS01AC-GGS01AC-GDM01AC-GGM01AC-GDL01AC-GGL0115-25KgLength : 26 cmCircumference : 31 cm15-35KgLength : 28 cmCircumference : 35 cm35-50KgLength : 30 cmCircumference : 38 cmVETLIG LTD offers a full range of synthetic for veterinary use, our products are minimally invasive and mimic the original native ligament or tendon we are replacing or reinforcing. Vetlig products aim to regain quicker post operative mobility and quality of life compared to conventional repairs. We only use human medical grade UHMWPE facilities. VETLIGSOFT TISSUE INTERNAL FIXAT IONVETLIGWWW.VETLIG.COMCRANIAL CRUCIATE LIGAMENT REPAIRARTIFICIAL LIGAMENTS FOR VE TERINAR Y USE•N von Freeden et al. 2017 Comparrison of two cold compression therapy protocols after TPLO in dogs. Tierarztliche praxis kleintiere 4/2017.int surgery in dogs? L’essentiel veterinary magazine, No 577, 8-14th October 2020.•L Bietrix, The expert think, a review of cryotherapy for dogs. Abstract vet review, 71 page 9. 2020.Figure 3: Thermal imaging of a canine stie joint before (A) and after ten minutes (B) of cryo-compressive splint application. Local skin temperature dropped from 36.8°C to 16.3°C.Figure 1: Cryo-compressive splint specic to the canine stie joint. It consists of a cryopack and can be inated using a pressure bulb. The table (above) shows chracteristics of splints available.Figure 2: Placement of a cryo-compressive splint in the immediate post-operative period of stie joint surgery.sessions of about 20 minutes each. The tolerance and eectiveness of the device seem to be satisfactory (Figure 3). The main risk of cryotherapy is the appearance of skin lesions from overly prolonged or unprotected application. Direct skin-to-cryogen contact should therefore be avoided and application should be limited to approximately 20 minutes, while monitoring the area.Compressive cryotherapy is very interesting in postoperative pain management. The development of a specic canine splint should make it easier to use and thus improve the post-operative management of our animals.For supply in the UK please contact VETLIG Ltd: wwwvetlig.com

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45 Animal Therapy Magazine | ISSUE 23No season is the same when it comes to owning and caring for our horses and each season comes with their own unique challenges. Spring supplies endless energy with the fresh rich grass supply that has to be monitored and managed. Summer brings issues with seasonal ies that battle with us for time with our horses. The winter months however can be the most challenging and many of the environmental forces can have a negative aect on the wellbeing of our horses. A combination of dark, wet and cold months can often mean restricted grazing for many which results in less movement for our horses and this typically causes a general stiening throughout their bodies. Having looked back on 4 years worth of diary entries (Yes I have more time than usual due to lockdown, don’t judge me!) I can see a trend of more frequent well-being treatments through the Nov-March months. I tend to book physiotherapy, chiropractic and massage therapists by eye and feel. This tells me that I feel and see the need to help supple my horses bodies much more through the months where turnout is restricted due to wet, muddy or frozen ground. Other steps I take to help them along through the darker months is extra stretching before and after work. Massage pads, periods under solariums/ heat lamps, hot water bottles on loins and adequate rugging during warmup and cool down when exercising are all things that help. When the weather is far from ideal I notice clients warmup time reduce as riders subconsciously like to “get going” to keep warm. Sometimes this is essential, horses can be much fresher when storm “beast from the east” is blowing up their behind! If my horses can’t be turned out and arenas or walkers are frozen then inhand walking is a must. Hours are spent trudging around the yard or arena with my horses on the end of rope endlessly trying to nip me, if only they knew the good it was doing them! Throughout winter months the rst thing we loose is minutes of mobility a day, even if your horse has all year turnout, they won’t be walking for grass as often as there typically isn’t any to forage! Replace as much natural movement with planned exercise or free time where possible. Use the support network of professionals that are on hand to help treat your horse and do what you can to help keep them moving! Spring always ends up coming back around!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 610027Levi’s BlogChanging needs in changing seasons45 Animal Therapy Magazine | ISSUE 23

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46Animal Therapy Magazine | ISSUE 23Supplements for arthritis management Therapist role in directing clients to evidence based decisions by Robyn Lowe RVNOSTEOARTHRITIS is the progressive, permanent degeneration of cartilage surrounding joints1. It can be debilitating for the patient, worrying for the owner and can cause both emotional and nancial stress on a client/owner. Animal therapists know that a multi-modal approach to management of arthritis is benecial to the patient. As part of this management, owners are often reaching for supplements believing them to be natural, side eect free options. Therapists are often asked their opinion during a therapy session. Of course it is absolutely imperative that patients are not experiencing pain or discomfort while undergoing therapy, so ensuring analgesia (pain relief and anti-inammatory for example) medication is optimal is the rst port of call alongside working harmoniously with the clients veterinary practice to provide excellent, holistic and well rounded care to arthritis management.Advising on supplementation can be tricky so providing choices that have the best evidence base is essential. So much money can be wasted, money that could be directed towards more evidence based interventions that gives the patient the best care possible.What is there to consider when considering how eective supplements are?There are many anecdotal success stories on forums, the internet, and chat groups. Before we precede any further I would like to highlight caregiver placebo. Caregiver placebo is a phenomenon where a client/owner or ‘caregiver’ believes they are seeing a marked improvement of health and welfare due to the fact they are giving OSTEOARTHRITISa treatment, when in fact there is no marked change in the health of the animal. This means that the animal is no better, but the owner believes they are. This could seriously impact the animal’s welfare and delay the use of treatments that will actually benet the dog’s health and welfare. We already know that caregiver placebo is extremely prevalent amongst our clients (and veterinary professionals). In one study a caregiver placebo eect was seen at 39.7% of the time for owners evaluating their dog's lameness2. This highlights the need to warn clients of this issue and educate them to allow them to assess their dog from an independent and objective view point. It also highlights that owners need to be aware that not everything you hear or read is as it seems. There may be other factors going on that have inuenced the positive outcome that people are reporting.What are the available supplements?There are currently huge arrays of supplements on the market that claim to help or aid arthritis management in some way. Due to marketing regulations, supplement companies have to be particularly careful in how they advertise and word health and medical claims. I rmly believe that if a company is making outlandish claims, for instance ‘miracle cure’ they are not only are they overstepping the mark but are also too good to be true! As upsetting as it is, there is no ‘cure’ for arthritis, it is a progressive and degenerative disease and anyone claiming 100% eciency is not a trustworthy source. Nothing is 100% when it comes to management, every single dog is an individual. What are Omega-3s?Omega-3 and omega-6 are both essential fatty acids. It is believed that the ratio of omega-3 and omega-6 is important to consider when supplementing however a study in 2006 stated that the dose and source is more important3. Omega-6s are pro-inammatory, whereas omega-3 is not. In one study the dogs were fed a test food containing a 31-fold increase in total omega-3 fatty acid content and a 34-fold decrease in omega-6-omega-3 ratio, compared with the control food. This study concluded that ingestion of the test food raised blood concentrations of omega-3

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47 Animal Therapy Magazine | ISSUE 23uid. The ndings of the studies support the conclusion that dietary supplementation with GLM may be of particular benet in the management of dogs with arthritic signs’10.GlucosamineThis is an extremely popular and well known arthritis supplement for both humans and animals. It has been shown to potentially help repair joints as it is a building block of articular cartilage. However, there is still much debate as to what concentration will actually reach the joint and therefore if it will be any use.Is there any evidence for the use of glucosamine?There is a GAIT study in 2006 that suggested glucosamine alone or with chondroitin sulphate did not perform better than placebo. This has been a 2 year study and has concluded ‘over 2 years no treatment achieved a clinically important dierence in the WOMAC scale of pain or function as compared with placebo’ 11. However the Mayo Clinic suggests that ‘oral use of glucosamine sulfate might provide some pain relief for people with osteoarthritis of the knee, hip or spine’12. The NHS will no longer prescribe it following a study that looked at evidence in a number of clinical trials13. In a recent review on glucosamine and chondroitin given together, it was concluded that ‘although glucosamine and chondroitin have benign adverse eect proles*, the clinical benet of using these agents remains questionable. The available evidence is dicult to interpret due to the use of dierent manufacturers, salt forms, compositions, sources, strengths, regimens, therapy durations, and combinations of active ingredients.14’ * meaning no harmful eects.This review, based on the available literature, discussed the potential benets of glucosamine and chondroitin use in osteoarthritic canines, and concluded it can neither be conrmed nor denied. It is concluded that further clinical studies using improved methodology is required. The review believed that clinical trials conducted to date have yielded mixed results and this could have been down to shortcomings in the clinical trials.continued overleafAre there any other products that may contain Omega-3 Fatty acids?There are other products that contain Omega-3s such as Flax seed products. As far as I am aware we are still not sure how well these are metabolised by dogs8. The study stated ‘In the FLX group, it was especially noteworthy that PL-docosahexaenoic acid [DHA] was unchanged during the entire period, indicating some resistance for plasma levels to accumulate’. Another common source of Omega-3 is Green Lipped mussel (GLM). GLM contains both glycosaminoglycans which are structural within cartilage, and have high levels of omega-3s. It is clear from initial studies that the way the extract is produced is critical for its eectiveness. There is evidence of it having a mild to moderately positive eect on mobility and pain in dogs with osteoarthritis, but the number of suitable trials are still considered limited, although growing all the time. For instance one review concluded that a GLM-enriched diet modied gait in dogs with arthritis in that the PVF signicantly increased over a 60 day period when GLM was introduced into a standardized control diet. They suggested that this showed the ecacy of a GLM-enriched diet. The study concluded that such diets should be proposed as an adjunctive treatment to conventional medication9.This is supported by a conclusion to a review stating ‘It is possible that the nutrients present in whole freeze-dried GLM powder may act to reduce inammation and pain, to limit further cartilage degeneration and, potentially, to support the regeneration of damaged joint cartilage and synovial fatty acids and appeared to improve the arthritic condition in pet dogs with osteoarthritis4.What is the theory behind them?The theory is that by supplementing with omega-3 encourages the replacement of omega-6 in cell walls. Thus there are less omega-6 fatty acids available for creating increased inammation in and around the joint. The omega-3 fatty acids found to be eective in this role are eicosapentaenoic acid EPA and docosahexaenoic acid (DHA) which are from marine-based sources such as sh oil.What is the evidence behind Omega Threes?There is substantial scientic evidence to support their use and recent studies have shown statistically signicant mild improvement in owner perception of comfort and mobility.A few examples are discussed below;In a six month study of 127 dogs with osteoarthritis, those fed on a high omega three diet had improved ability to rise from a resting position and play compared to dogs fed on a control diet5. It important to highlight the length of this study and that the action of many supplements do not occur quickly or instantly. For this reason they are not an appropriate substitute for medication if your dog is experiencing pain. Secondly a further study on dogs fed a diet containing 3.5% Omega three fatty acids for 90 days showed they had improved peak vertical force values (PVF) and subjective improvement in lameness and weight-bearing when compared with dogs on a control diet6. This could suggest that supplementing an arthritic dogs diet with Omega threes, or feeding a high omega three diet could be an appropriate intervention for an arthritic dog. Furthermore a clinical trial was performed where dogs with stable chronic arthritis who were already treated with Carprofen where fed a diet supplemented with omega-3. This found that they could take a signicantly decreased dosage of Carprofen7.

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48Animal Therapy Magazine | ISSUE 23OSTEOARTHRITISWRITER BIORobyn Lowe RVNI am a Registered Veterinary Nurse who qualied with a degree from Myerscough School of Veterinary Nursing in 2016 and have started my RCVS Diploma in Advanced Veterinary Nursing in 2018. I have worked on a volunteer basis with animals since I was four and my passion for this profession has only grown since then. I enjoy osteoarthritis clinics and using multi-modal approaches to managing the condition, it can be extremely rewarding seeing both owners and patients travel this extremely dicult journey together to improve quality of life.FOOD FOR THOUGHT!For further reading please visit www.caninearthritis.co.uk where there is a wealth of articles available.Above you mention Chondroitin Sulphate, what is this?Chondroitin sulphate is extracted from mammalian cartilage. In a similar way to glucosamine it is believed to provide structural components for helping to repair the articular cartilage.So what is the evidence base for Chondrotin?There appears to be only weak evidence of its eectiveness both structurally and in improving the clinical condition of arthritis in dogs. It is often paired with Glucosamine and or GLM as suggested above. One review stated that a few In vitro studies15 have shown benecial eects and support the chondroprotective eect. They stated that some in-vivo evidence exists that diets supplemented with glucosamine hydrochloride and chondroitin sulphate together improves mobility in cats with joint disease. Furthermore it states that bioavailablity and pharmacokinetic data is limited but suggests that when combined, the compounds are absorbed in dogs and that there is accumulation after multiple dosing, suggesting a possible residual eect. This statement is consistent with in vitro studies and therefore the two compounds may be more benecial when used together. However as most evidence is in-vitro despite the initial suggestions of their benet, after looking at the data, they concluded ‘the benets of using a combination of glucosamine hydrochloride and chondroitin sulfate nutraceuticals to improve symptoms associated with canine and feline joint disease has yet to be determined’16.Tumeric Turmeric has been used throughout history as a natural anti-inammatory. There have been in vitro studies on this claim and these studies suggest antioxidant, anti-inammatory, and anti-cancer activity for curcumin and other constituents of turmeric. It must be highlighted that in vitro studies don’t always equate to a clinical benet for patients17. A lot of focus is on one of its active ingredients called curcumin, however, there are other ingredients and there is some evidence that these possess anti-inammatory properties. The most studied in terms of medical applications are the curcuminoids. In humans it has been suggested that there is little reliable evidence to support the use of turmeric for any health condition because so few clinical trials have beenconducted18. Many of the studies that have been done in humans have focused on curcumin and have found that it is poorly absorbed when taken orally19. One controlled study in dogs found no objective dierence but there was improvement in subjective indicators20. Boswelia Boswelia is extracted from the bark and resin of the Indian Boswelia tree. Interestingly Boswelia resin has been evaluated in 24 dogs in an open multi-center study. Improvement in clinical signs, lameness, and pain was found in 17 of 24 dogs21. This suggests that more research is necessary in order to conrm that Boswelia would be a truly benical addition to a regime.What are your concerns with the use of supplements?I completely understand that in cases of osteoarthritis owners (myself included) want to do everything possible for their pets. Supplements are just so easily accessible, there are adverts everywhere for them, they are in pet shops, online, on forums. The main concern I have is that very often people seem to have a misconception that they are an appropriate replacement for conventional analgesic medication. I feel that many do not have enough evidence to support that idea. Some supplements or combinations of supplements may certainly be benecial as one part of the multimodal approach to arthritis management, however I feel that we should be aware that they may not, from the evidence we have, provide anywhere near enough pain relief to improve our animal’s quality of life. Although some owners seem to have developed a fear of traditional medication, especially when considering it on a long term basis, I think it’s important to remember that life should be measured by quality and not quantity. So many NSAIDs and other medications have been proven very safe for long term use, even if individual animals are not suited to it. Furthermore buying multiple supplements at whatever cost, over and over again, despite little evidence for their use, will be nancially draining and achieving very little. Owners would be better focusing on more evidence based therapies, management tools or medications. This could be as simple as buying a £3.99 carpet runner from your local bargain shop, rather than allowing your dog to slip, slide and crash through your hallway when the postman comes knocking ...

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49 Animal Therapy Magazine | ISSUE 23REFERENCES1. Sanderson RO, Beata C, Flipo R-M, Genevois J-P, Macias C, Tacke S, Vezzoni A and Innes JF (2009). Systematic review of the management of canine osteoarthritis, Veterinary Record 164(14): 418-4242. https://www.ncbi.nlm.nih.gov/pubmed/231135233. Hall JA, Picton RA, Skinner MM, Jewell DE, Wander RC. The (n-3) fatty acid dose, independent of the (n-6) to (n-3) fatty acid ratio, aect the plasma fatty acid prole of normal dogs. J Nutr. 2006;136:2338–2344. [PubMed] [Google Scholar]4. https://www.ncbi.nlm.nih.gov/m/pubmed/20043800/?fbclid=IwAR2ZkZODWeQ7tdIU8JcJu1lQVpgy61oqJoNiLZCOKpM7i9MI3vzZsEm84Ng5. Roush JK, Dodd CE, Fritsch DA, et al. Multicenter veterinary practice assessment of the eects of omega-3 fatty acids on osteoarthritis in dogs. J Am Vet Med Assoc 2010;236:59-66.6. Roush JK, Cross AR, Renberg WC, et al. Evaluation of the eects of dietary supplementation with sh oil omega-3 fatty acids on weight bearing in dogs with osteoarthritis. J Am Vet Med Assoc 2010;236:67-73.7. Fritsch DA, Allen TA, Dodd CE, et al. A multicenter study of the eect of dietary supplementation with sh oil omega-3 fatty acids on carprofen dosage in dogs with osteoarthritis. J Am Vet Med Assoc 2010;236:535-539.8. https://academic.oup.com/jn/article/128/12/2641S/47243079. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3525174/10. https://academic.oup.com/jn/article/132/6/1634S/468786411. https://www.ncbi.nlm.nih.gov/pubmed/2052584012. https://www.mayoclinic.org/drugs-supplements-glucosamine/art-2036287413. https://caninearthritis.co.uk/managing-arthritis/diet-and-nutrition/available-supplements/14. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5356289/15. The term in vitro, in contrast to in vivo, refers to a medical study or experiment which is done in the laboratory within the connes of a test tube or laboratory dish. https://www.verywellhealth.com/what-does-in-vivo-and-in-vitro-mean-224911816. https://www.baneld.com/Baneld/media/PDF/Downloads/CriticallyAppraisedTopics/2010_Winter_CAT_Evaluation-of-Nutraceuticals.pdf17. http://skeptvet.com/Blog/2013/09/turmeric-for-pets/18. https://nccih.nih.gov/health/turmeric/ataglance.htm19. http://www.cancer.org/treatment/treatments-and-side-eects/complementary-and-alternative-medicine/more-cam-info.html20. https://www.ncbi.nlm.nih.gov/pubmed/1272362821. Reichling J, Schmokel H, Fitzi J, et al. Dietary support with Boswellia resin in canine in ammatory joint and spinal disease. Schweiz Arch Tierheilkd 2004;146:71-79.Non-ProtThe Institute of Registered Veterinary &Animal Physiotherapists IRVAP is a dynamiccommunity of qualied professionals workingin animal therapy. Our shared belief is everyanimal deserves the best available treatmentand their owners are supported and informed.Membership CategoriesMIRVAP(VP) - Veterinary PhysiotherapistsMIRVAP(MT) - Manual TherapistsMIRVAP(ICH) - Institute of Canine HydrotherapistsMIRVAP(IEH) - Institute of Equine Hydrotherapistswww.irvap.org.uk614_HR_IRVAP_HPH.indd 1 19/11/2020 14:35

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