Issue 26 : simplebooklet.com

ANIMAL THERAPY MAGAZINE | ISSUE 26 3With the anticipation of sunnier daysaround the corner we are very muchlooking forward to working with andattending the vet festival in May.They have announced their speaker listand it looks fantastic. If you can’t attendwe will endeavour to bring you news duringand after the event so make sure you arefollowing us on one of our social media platforms.We are delighted to have editorial from Gillian Higgins in this issue.If you’ve not seen her live we highly recommend it. Her painting ofanatomical structures on horses really brings the workings under theskin to life. A brilliant way to learn.We also continue with our educational feature, helping those wanting a careerchange or deciding what subjects to take at GCSE level to help them towards theirdream job. In this issue we talk about Canine Massage, Canine Hydrotherapyand Animal Chiropractic.To subscribe for a printed copy to be delivered to your door, or for online access,please visit our website www.animaltherapymedia.co.uk and click on subscribe.Thank you and enjoy,Team Animal Therapy Magazinewelc omecontentsIssue 26May 2022Published QuarterlyHannah AshtonEditor hannah@animaltherapymedia.co.ukBeth LorraineSales Manager info@animaltherapymedia.co.ukTony NevinPodcasts and Research tony@animaltherapymedia.co.ukGET IN TOUCH:While every eﬀort 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: Marvin the Cane Corso courtesy of Battersea Dogs & Cats HomeTo subscribe with us or join our mailing lists please visit our website www.animaltherapymedia.co.uk4-5 Leucillin Antimicrobial Skincare6-8 Photizo Light Therapy10-11 One Medicine - bringing medicine full circle to beneﬁt both human and animal patients12-16 Canine Massage Guild Clinical Trials and Case Study17 Institute of Registered Veterinary Animal Physiotherapists (IRVAP)18-23 Considering Feeding Positions with Horses Inside Out24-25 Battersea welcomes new rehabilitation facilities for dogs and cats in need27 Levi Hunt - Inspect Your Gadget28-31 An Introduction to Equine Ulcers from Hartpury University32-34 Tony Nevin, an interesting case of the glass half full35 Are you thinking of a career as an animal therapist? Part 236-38 Becoming a Clinical Canine Massage Therapist40-41 Exploring a career in Canine Hydrotherapy42 Want to become an McTimoney Animal Chiropractor?44-45 VET Festival46 Subscribe to Animal Therapy magazine

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ANTISEPTIC SKINCARE5ANIMAL THERAPY MAGAZINE | ISSUE 26Antimicrobial Skincare Photosensitisation - A tangible solution for topical carePhotosensitization is a potentially serious skin condition characterized by sunburned, crusty, reddened and inamed skin, it is the body’s inability to react normally to sunlight and can often be incredibly stressful for both equine and owner.Initially early onset of skin damage may be diﬃcult to diﬀerentiate between sunburn and photosensitivity when encountered for the ﬁrst time, however Leucillin Skincare provides an eﬀective topical option for the symptoms of both, allowing for the ability to take instant action to provide relief, whilst assessing the situation and root cause. Historically Photosensitivity has been found in cattle, sheep, goats and horses who have been known to suﬀer from type 1 Photosensitivity, this is caused by exposure to plants containing photodynamic agents, such as common nemesis of the equestrian owner; Ragwort and St Johns Wort, which are often found in their pasture. More frequently now we are starting to see it in our companion animals too.Photosensitivity is not necessarily the plight of pink skinned animals but is almost always found in more exposed areas of skin such as ears, muzzles and eyelids. Redness develops rapidly and is soon followed by swelling and sensitivity. In addition to plants, Photosensitisation agents can also include bacteria and fungi, an onset of photosensitivity has been linked to liver disease and function.Photosensitivity treatment involves mostly soothing the symptoms, and whilst photosensitivity continues, animals should be shaded fully and consideration of predominantly only being allowed out during the hours of dusk or darkness. Behavioural signs of photosensitivity can include light evasion and shaking of the head. Secondary skin infections and ﬂuid discharge are treated with wound management techniques. Exposure to insects must also be prevented, as this could lead to secondary disease. The topical symptoms of secondary skin infections can include but are not limited to: inﬂammation of the skin, rashes, self-inﬂicted wounds in response to skin discomfort, scabbing, discharge from hives, redness, skin ulcers and damage to sensitive exposed tissue around eyes, muzzle and ears. Not only can Leucillin provide a soothing remedy to sunburn, it will also help control the secondary topical symptoms of photosensitivity cases, regardless of the cause, medical history or species of the animal.Symptoms of photosensitivity vary and Leucillin can safely be used on all, including broken and open tissue. The most important action if you suspect photosensitivity is to keep the animal in the shade. Leucillin can be applied to help soothe and manage the topical symptoms by generously spraying the solution on all minor wounds, hives and scabbing, and allowing to air dry. The active ingredient, Hypochlorous acid (HOCl) will have a instantly soothing eﬀect on the problem areas and will kill pathogens which will be taking advantage of broken skin. Leucillin’s skin pH neutral formula can safely be used in and around eyes, mouth and ears, simply liberally spray a cotton pad or clean gauze and wipe over the area or drip into the eye if needed. Leucillin cleverly mimics the immune function, rapidly and dramatically reducing pathogen load where applied, this has the eﬀect on the skin of soothing and reducing inﬂammation and redness. Leucillin creates the perfect environment for natural skin healing without causing detriment to the living tissue. Saturating the area will kill pathogens to the highest measurable amount keeping the area clean and allowing the body to concentrate on quick recovery. Leucillin is compatible with oral medications and is suitable and safe for any allergy prone skin so can be used alongside other therapies for photosensitive animals.Leucillin is available to purchase within the UK, Ireland, Europe, Iceland, Canada, South Africa, Singapore and Hong Kong.For more information and healthcare practitioner enquiries please contact:email: info@leucillin.comtel: 0345 548 9800web: www.leucillin.co.ukfb: www.facebook.com/leucillin insta: @leucillin_skincaren“A couple of years ago we bought a pony with a nasty skin condition all over his body, we thought we’d give him a chance, it was everywhere and it was so sore! We discovered Leucillin, bought from the tack store by accident, it worked!!!!! Thankyou, Annie & Mr FletcherReferences:https://www.msdvetmanual.com/dog-owners/skin-disorders-of-dogs/photosensitization-in-dogs

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ANIMAL THERAPY MAGAZINE | ISSUE 266PHOTIZOWhen Photizo shines its light on an integrated approach to rehabilitationHerefordshire based Sarah Darling had a 23-year career working as a remedial/sports massage therapist for people, combining a range of techniques, exercise, nutrition advice and an awareness of environmental factors for the best outcome for overall physical health.Five years ago, when Bella, her last family Golden Retriever passed,it marked a crossroads for Sarah. It was while she was chatting to an owner of a Border Terrier who’s gait was compromised from a recent cruciate surgery that Sarah only wished she could help.Later that evening, and after much research, Sarah couldn’t help but think how she could have perhaps helped Bella remain mobile for longer. And was driven by this emotion to create something positive: K9 Gait Massage Therapy. Enrolling to study as a Canine Merishia Massage Practitioner with Rose Holistic Therapies and Training in Buckinghamshire, Sarah admits learning to transfer her massage skills in people to animals wasn’t as easy as she’d ﬁrst imagined.Learning the complexity of a dogs biological and physiological structure, their biomechanics, common injuries, diseases, genetics, anomalies, as well as a whole new silent language, was not only mind blowing for Sarah, but a realisation that she could had done more for Bella, who remains her inspiration. Volunteering at the Hereford and Worcester Animal rescue charity, Sarah would provide massage, rehabilitation therapies and enrichment to help dogs in their care. Very often just providing the residents with a little maintenance massage, breaking up their day with one-to -one attention, made a big diﬀerence. Sarah explained: “I had spent so long working on people, and the transition to dogs was a bit intimidating at ﬁrst. At my local rescue, it was like a baptism of ﬁre. I met so many diﬀerent cases, old, young, conﬁdent, nervous, some had been badly mistreated, and many had lost the ability to trust, so it was challenging. By Anna Webb, broadcaster, author and columnist Broadcaster, author Anna Webb, has studied with the College of Veterinary Therapies, and is the host of A DOG’S LIFE podcast. She is owned by Prudence a Miniature Bull terrier, Mr Binks a re-homed Toy terrier, and Gremlin her rescued streetcat.

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ANIMAL THERAPY MAGAZINE | ISSUE 26 7PHOTIZOI immediately learnt that every dog is an individual, just as with people. Appreciating that many dogs are touch sensitive, it could take a lot of time and patience. Others were noise sensitive, others very wary of any movement. Every moment spent there enhanced my ability to understand their body language, and how through eye contact, their ear or tail carriage, their breathing, and how even just a little wag gave me the conﬁdence to proceed. It wasn’t long before I began fostering for the charity, and putting my multi-disciplinary approach into practice.”Sarah is passionate about educating all pet parents not only about on-going rehabilitation, but how to recognise pain and discomfort in their dogs and future preventative care. Sarah is also keen to inform on environmental factors that can have a negative impact on a dog’s physical, mental and emotional health such as obesity. Creating an awareness for the simple aspects that many pet parents simply are oblivious to like the eﬀects of slipping and sliding on laminate ﬂoors, or the repetitive strains of jumping on and oﬀ sofas, repeatedly leaping for balls, or the need to go for a long run every day. Oﬀering ‘environmental’ back up, Sarah will include an exercise and mental enrichment plan that’s appropriate through individual rehabilitation.Sarah enthused: “For me it’s very important to oﬀer consultation in the home. Apart from getting to meet the whole family, it’s beneﬁcial to see the layout of the house and the garden. It makes providing advice on simple adaptations such as adding non slip runners, stair gates, ramps to make navigating the home easier and safer. Plus, when forming a management plan, it is important that it is achievable and consistent. By working with the family, their commitments and environment, this only enhances their dogs’ recovery.I am a great fan of licki mats and brain teaser puzzles, especially for dogs going through crate rest and prolonged rehabilitation. I also suggest creating mini ‘agility’ circuits, for a fun way to re-build strength, such as simply stepping over some poles or moving in diﬀerent directions around objects to balance any compensations. But it’s the bond that grows between the parents and my clients that really motivates me too”.Sarah was introduced to Photizo’s Vetcare two years ago. Impressed by the Vetcare’s multifunctionality, not only at oﬀering cellular regeneration, pain relief and healing across a host of musculoskeletal conditions, but for wound healing and for helping calm dogs, by releasing dopamine, oxytocin, and lowering their heart rate. Since Photizo Vetcare launched in 2013 its popularity has soared amongst Animal Physiotherapists, Vet Nurses, Vets and complementary practitioners nationwide. The Vetcare’s success in practice has encouraged research in the ﬁeld of LED sourced red and near infrared Phototherapy.The bio-stimulatory eﬀects of the Vetcare allow Sarah to work more eﬃciently, spending less time manipulating, for example when working on trigger points, and more time creating positive results. Sarah explains: “Without doubt the Vetcare has been a game-changer! I love that with the Vetcare I can get so much more achieved in a session. It’s so simple to use, with no need for bulky eye goggles, and its pre-programmed doses make it easy to monitor the eﬀects. I see dogs relax so much faster, especially on a ﬁrst consultation. But it’s the way I can move deeper into areas with trigger points, and excessive tightness faster for better results. I oﬀer to either hire or sell units to the pet parent clients as a way of ensuring that in-between my sessions, they maintain the healing process”.

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ANIMAL THERAPY MAGAZINE | ISSUE 268PHOTIZOMany of Sarah’s cases display aspects of noise sensitivity and are nervous of the Vetcare’s signatory beep, marking the beginning of its 30 second dose of Red and NIR light. One Chihuahua named Chico really needed the beneﬁts of the Vetcare, but his sensitivity to sound and movement made it very diﬃcult to use the Vetcare. Sarah contacted Ruth Milner, MD of Photizo’s sole UK distributor, Danetre Health Products, asking if the device could be made noiseless for noise sensitive dogs like Chico. Bearing in mind that the RSPCA reckons that over 45% of dogs in the UK do suﬀer from some form of noise sensitivity, it made sense. Always adapting to help their customers, the Vetcare is now available in a noiseless version.Another of Sarah’s cases Daisy the 2 ½ year old Shih-Tzu was diagnosed with Intervertebral Disc Disease (IVDD). Sarah’s ﬁrst visit to assess Daisy was in December 2021, one week after her surgery to alleviate the pressure on her L1 and L2 discs. Daisy had been given a Grade 5 diagnosis, meaning complete paralysis of her hind legs. From the get go Sarah deployed Photizo’s Vetcare, recommending her parents purchased one so that Daisy could beneﬁt from Sarah’s suggested dosage twice daily. The start of Daisy’s rehabilitation was so hard for her parents, and Sarah’s advice helped every step of the way. Helping them learn how to express Daisy’s urine, carefully handle her every day, apply massage, range of motion techniques and Photizo Vetcare. Through Sarah’s recommendation, they also made some adaptations to their home environment, such as placing mats on slippy ﬂoors and a ramp to get on and oﬀ the furniture, which may have been a contributing factor in Daisy’s injury. And invested in various enrichment tools like licki mats, and interactive puzzle games.Sarah visited once a week for 15 weeks, but it was between week four and week 12 that some rehab exercises really kicked in. Day by day, Daisy changed from being very confused, and down to gradually becoming more cheerful and conﬁdent again. She explained: “At ﬁrst it was so heart breaking. Daisy’s head and neck hung low, she looked depressed, and couldn’t understand why she was unable to run around. Encouraging her core to ﬁre up, I’d support her movement with a sling as her massage encouraged her spinal nerves to repair, and muscles tighten. In the fourth week, there was a eureka moment as Daisy pushed up on her back legs on her own to reach an interactive toy! By week ﬁve, we noticed a tiny ﬂick of her tail which marked a landmark step-forwards that combined with Daisy’s posture improving!”At week six Daisy pushed up on her back legs without help, and held the stand for seven seconds! Sarah had added an electric toothbrush to provide extra stimulation to her paw-pads, with the aim of reviving some deep pain sensation. Meanwhile, twice daily use of Photizo’s Vetcare was proving to show results, as her back legs appeared to have more life. Also, daily dosing with Photizo on her neck and shoulders relieved stress and pressure as Daisy would crawl and scoot along the carpet. Beneﬁtting from the evidence-based doses of Red & NIR pulsed light, the Vetcare simply reduces pain, promotes blood ﬂow, oxygen release, and collagen formation, whilst restoring ATP into damaged cells. Daisy’s exercise program developed as she became stronger, and included daily outings in her pushchair for mental stimulation, range of leg motions, massage and sensory stimulation techniques. A gym workout including supported strength, balance and proprioception exercises, utilising equipment such as an exercise ball, textured matting and raised obstacles, all of which had to be achieved regularly throughout the week. At the time of writing, Daisy has continued to make a miraculous recovery. At week 18, she is now enjoying regular Hydrotherapy, and there is some sensation in her back legs. Daisy has also received her bespoke wheels, which let her enjoy the garden, and some independence. As Sarah always says: “Never say never, and with Daisy’s determination, her parents’ undeniable love, devotion and commitment and Sarah’s on-going support, maybe one day she will use her back legs again. n45% of dogs in the UK do suer from some form of noise sensitivity.....the Vetcare is now available in a noiseless version.

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ANIMAL THERAPY MAGAZINE | ISSUE 2610ONE MEDICINELately, as the days get longer and warmer, Henry (my dog) and I have been exploring and nding new circular dog walks. Following the signposts, seeing where the paths diverge and converge again and navigating obstacles en-route, such walks provide an opportunity for us to enjoy each other’s company and where I can share my problems with him before we come full circle and return home.I have come to view these walks as being a good metaphor for One Medicine, the paths of human and veterinary medicine have diverged, but by following a One Medicine roadmap there exists the potential for both disciplines to converge and there are a number of challenges that One Medicine needs to navigate. There is a powerful sense of being at one, when we return to the place we call home and when dealing with problems, as the saying goes “A problem shared is a problem halved”. It is also the case that some of the most comforting words we can hear when we encounter problems is when someone (be they human or animal) says “I care” either through words or actions.One Medicine is not a literal term about giving humans and animals the same medical therapeutics nor doctors treating animals and veterinarians treating people. Neither is it in competition with the more well-known, One Health. Instead, going back to my walking analogy, One Medicine is a compass by which the paths of human and veterinary medicine, which are currently so far apart, can re-converge, with the two disciplines walking in lockstep with each other, rather than veterinary medicine continually running to catch up as progress in human medicine marches ahead. It is about bridging the gap between the two disciplines, with professionals from both walking forward alongside each other, sharing information and knowledge, sharing the problems that their respective disciplines face and sharing each other’s company, rather than taking paths which become progressively narrower and narrower until a point is reached where you can’t see the wood for the trees.It is about changing the narrative on how we see the contribution that animals make to medicine, animals are not goods and we must reach a timepoint whereby there is a progressive reduction in laboratory animal testing and the value of an animal to medicine is considered in terms of what they can teach medicine in how they live, not how we learn at the expense of their lives. Personalised medicine, whereby medical interventions and treatments are tailored to the individual based on predictions of the individual’s risk and how they will react, is a goal shared by both disciplines. Data collected and collated from the study of animals with naturally occurring, spontaneous disease can be used to inform not only on the similarities that are shared with humans on a genetic and physiological basis, but also where diﬀerences occur as these can be just as informative. Likewise, if doctors had the opportunity to meet and talk with veterinarians more, knowledge on how human healthcare challenges are dealt with can provide invaluable information and inspiration to how similar healthcare challenges are dealt with in animal patients. The observational skills, skill sets and clinical language that both disciplines share illustrate that we must orientate the two disciplines to focus on their similarities and how their combined knowledge can beneﬁt each other rather than just focusing on what keeps them apart. There have been a number of initiatives by various organisations on bringing the two medical disciplines together and we need to ensure that this becomes commonplace with opportunities to bring them together One Medicine - bringing medicine full circle to beneﬁt both human and animal patientsBy Dr Tracey King MRSB, CSci. Research and Outreach Manager, Humanimal TrustWe must navigate away from doctors, veterinarians, nurses and allied health and scientic professionals working in silos, as well as One Medicine and One Health being siloed from each other. If we are to bring medicine full circle to benet both human and animal patients with equitable and sustainable medical progress then we must walk this journey forward together as one team.

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ANIMAL THERAPY MAGAZINE | ISSUE 26 11being routinely provided rather than they happen by some random chance.We must navigate away from doctors, veterinarians, nurses and allied health and scientiﬁc professionals working in silos, as well as One Medicine and One Health being siloed from each other. If we are to bring medicine full circle to beneﬁt both human and animal patients with equitable and sustainable medical progress then we must walk this journey forward together as one team. We must also not position One Medicine and One Health so that they are seen as being in direct competition with each other but rather they are synergistic and complementary to each other with the diﬀerence between the two being that One Medicine is simply broader in its scope with its focus on joined-up medical approaches. However, we must ensure that One Health follows our vision of One Medicine’s lead in that it promotes two-way exchanges and safeguards reciprocity. There are of course challenges and obstacles that both One Medicine and One Health face in areas such as governance and ensuring that the necessary frameworks e.g. regulatory, ethics etc., are robust and rigorous to protect both patients and practitioners, but such challenges are not insurmountable. To deal with such challenges, Humanimal Trust’s work focuses on ﬁve areas, which form the words “I care” – we stride with purpose towards our objectives of inﬂuencing others on the beneﬁts of a One Medicine approach, to promote collaboration and debate, to raise awareness, to fund research in One Medicine and to provide outreach on One Medicine by education.The paths that Henry and I have discovered are not new, they have existed for many years, waiting to be rediscovered, Henry and I share the journey together and eventually we come full circle. One Medicine, as a concept, has existed for many years, continually waiting to be rediscovered and there is much to gain, if we take joined-up approaches and travel this path together, then medicine too, shall come full circle to beneﬁt both human and animal patients. If you would like to join us on this One Medicine journey by becoming a member of our free to join Humanimal Hub (which is available as an app) or by becoming a volunteer, we’d love to hear from you and we very much look forward to walking alongside you on the road to One Medicine. nONE MEDICINEHumanimal Trust is a registered charity in England & Wales (no. 1156927) and in Scotland (no. SC048960).REFERENCES:King, T.A. (2021). The One Medicine concept: its emergence from history as a systematic approach to re-integrate human and veterinary medicine. Emerging Topics in Life Sciences. 5. 643-654. https://doi.org/10.1042/ETLS20200353 Morgan. M. (2022). Matt Morgan: Learning from all creatures great and small. BMJ 2022, 376:o723 http://dx.doi.org/10.1136/bmj.o723

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ANIMAL THERAPY MAGAZINE | ISSUE 26 13CANINE MASSAGECLINICAL TRIALS CANINE MASSAGE GUILD – LEADING THE WAYBy Lisa Stilwell - Clinical Trials Coordinator Canine Massage GuildEssex Rivers Clinical Canine Massage In clinical trials with Winchester University, 95% of dogs responded positively to clinical canine massage therapy!Rationale for Clinical TrialsEvidence- based research considers patient values, clinical expertise and other information which helps owners and Vets make more informed treatment decisions for dogs. Clinical canine massage is a powerful therapy for musculoskeletal pain management whether the patient is a top sporting dog or pet dog. Prior to 2021 we knew a wealth of anecdotal evidence existed on the eﬃcacy of the Lenton Method® but canine massage therapy had not been researched or tested academically.What is the Lenton Method®?The Canine Massage Guild formed by Natalie Lenton in 2012 has a mission to oﬀer aﬀordable, eﬀective, and ethical clinical canine massage therapy for dogs. Canine Massage Guild therapists are committed to the core values of animal welfare, consumer protection, clarity of the law and professional standards as well as delivering the best possible service to dogs, their owners, and veterinary practices. All Canine Massage Guild therapists are trained in the Lenton Method®, it is a 3-tiered approach to the evaluation, treatment and re-evaluation of the canine patient who presents with soft tissue or musculoskeletal injuries and / or degenerative diseases like canine osteoarthritis. The MethodologyThis research was approved by the Ethics Committee, University Centre Sparsholt UK (ref Riley: Canine Massage Project). With Veterinary consent, Canine Massage Guild practitioners across the UK, employed the Lenton Method® to treat muscular and myofascial conditions in dogs of all ages and across many breeds. The study looked at whether massage positively aﬀected the quality of life of dogs experiencing chronic pain, lameness, signs of aging, athletic performance and subclinical signs of pain as reported by owners.The practitioners were asked to complete a standardised report per dog prior to massage therapy and again after a course of three, hour-long massages. This documented life history variables (e.g. age, breed, sex), clinical diagnoses and known or deduced aetiologies, number - severity (score) and improvement status (improved/worsened/no change) of each of 5 principles of pain parameters (gait, posture, ADLs, behaviour, performance). Finally, in consultation with the subject’s owner, the practitioner considered post-treatment results and this data was submitted to the University of Winchester from across the UK, Ireland, and Spain.

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ANIMAL THERAPY MAGAZINE | ISSUE 2614CANINE MASSAGEThe ResultsInferential statistics have a traditional error rate in Biological Sciences of 5%, this equates to a 5% error rate that the results we have occurred by chance and 95% occurred because of the treatment given. As we had such a large sample of dogs we went for a conservative error rate of 0.1 %, this is equivalent to human clinical trials. Therefore, there is a 0.1% chance that the results of the study were due to random eﬀect.Out of 527 dogs, 492 dogs responded to treatment. The variables between cases such as age, breed and conditions were of a diverse enough range to ensure the type of dogs that therapists see in practice were represented. Whilst there are many reasons for whether or not a dog is responsive, this result evidenced that veterinary-diagnosed musculoskeletal conditions responded successfully after clinical canine massage therapy. Positive changes in the dogs’ mobility and behaviours were often observed after just one treatment, increasing with subsequent sessions.Owners and Vets can be assured that clinical canine massage has a rational, scientiﬁc basis and is justiﬁed and eﬀective when used for musculoskeletal pain and mobility issues. Further ResearchWe have been delighted with the ﬁndings of the clinical trials to date. Our plan to give certainty to the data through double blind trials in the summer of 2020 was unfortunately delayed, the global pandemic presented a unique set of challenges to the safe and eﬀective collection of data. This study attracted global interest; we are looking forward to progressing with the double blind trials in the future. The Canine Massage Guild celebrated its 10th Anniversary in March 2022 and is excited to continue leading the way in canine massage.The research paper ﬁrst published in the Vet Record 13 June 2021 titled Eﬀect of massage therapy on pain and quality of life in dogs: a cross sectional study can be accessed at https://bvajournals.onlinelibrary.wiley.com/doi/10.1002/vetr.586“Having the Lenton Method® selected by these prestigious universities for in-depth clinical trials will give us a scientically-proven approach owners can trust and we hope, will also raise the bar for the profession as a whole.” Natalie Lenton – founder of the Canine Massage Guild and Canine Massage Therapy Centre, and creator of the Lenton Method® “Working with the Canine Massage Guild has been such a positive experience. The knowledge and commitment of the practitioners, and their help and support with this study has been invaluable. I look forward to organising the forthcoming blind clinical trial with the Guild.” Dr Lisa Riley Senior Lecturer in Animal Welfare at University of Winchester.

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ANIMAL THERAPY MAGAZINE | ISSUE 26 15CANINE MASSAGE  CASE STUDYSaving Seren: the busy life of a Border CollieA Vets View of how Clinical Canine Massage Keeps Seren Exploring the Lakeland FellsBy Marcelle Cassar BVSc (Hons) CCRT MRCVSAnimal Rehabilitation Centre at Oakhill Vet Group, WindermereSeren, a 1-year-old female Border Collie, was living her best life working on a farm in mid-Wales until she and the farmers quad bike had an argument! She dislocated her left hip and fractured her pubic bone. After 2 surgical attempts to keep it in the socket, it did stay in place but the prospect of arthritis in the joint meant she was no longer considered a worthy sheepdog and was signed over to the vet practice for re-homing.As luck would have it the local vet Tina came to Seren’s rescue and adopted her. When Tina relocated to Cumbria in 2017, Seren swopped rural Wales for a life running on the Lakeland fells despite her dodgy hip. Fast forward a few years and Tina noticed Seren was slowing down and was looking uncomfortable especially after exercise, she even limped on her right hind leg which was her “good” leg.Vet DiagnosisRadiographs of her pelvis conﬁrmed she had osteoarthritis in the left hip now, but she also had lumbosacral disease. This is a condition of the lower back caused by degeneration of the intervertebral discs and adjacent tissues resulting in varying degrees of compression of the spinal cord and adjacent nerves. This causes pain, muscle weakness in the hind limbs and occasionally a reduction of sensation in the paws. A CT scan of her spine conﬁrmed the diagnosis and revealed the right side of her cord/L7 nerve root was compressed hence her right hind lameness.FindingsWhen I looked at Seren standing she was roaching her lumbar area, held her head lower than normal and her tail was held low.

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ANIMAL THERAPY MAGAZINE | ISSUE 2616CANINE MASSAGE  CASE STUDYAbout the Author: Marcelle Cassar is a veterinary surgeon with an interest in helping dogs with mobility issues using physical therapies alongside conventional medicine. Based at the Animal Rehabilitation Centre at Oakhill Vet Group in Windermere, clinical canine massage is an important part of her armoury in reducing the discomfort many dogs experience with muscular or fascial issues. Marcelle is also Veterinary Technical Advisor to the Canine Massage Guild.www.k9MassageGuild.co.uk https://oakhillvetgroup.co.uk/animal-rehabilitation/ When walking and trotting she had little forward drive through her hind legs.Seren was taking more weight through her forelimbs to decrease the pressure on her sore lower back. Consequently, her superﬁcial pectoral muscles held trigger points, her lower cervical muscles were hypertonic, and she experienced myofascial pain in the thoracic trapezius and rhomboid muscles. Also her thoracic epaxial muscles were reactive to palpation, sending spasms over her rib cage.The gluteal, quadriceps and hamstring muscle groups in her left leg were atrophied compared to the right hind and there was hypertonicity in the pectineus muscle.Seren had an epidural steroid injection at the time of the CT scan and her pain medication regime was adjusted to account for the neural pain she was experiencing.ResultsOne week later I started massage therapy with Seren aiming to alleviate her residual muscular compensatory discomfort. Using various massage techniques on Seren which included Swedish, Deep tissue, and Sports massage as well as Myofascial release, over the 3 weekly sessions she responded very well. She was far more comfortable both in her lower back and forequarters and her roached back straightened out. Her gait was more ﬂuid, she held her head in a more normal position and no longer limped on her right hind leg.Seren is now back on the fells, enjoying life to the full but perhaps not in top gear all the time! She has regular maintenance massages to help keep her comfortable and able to continue her exploration of the beautiful Cumbrian landscape.Marcelle says “EVERY case I treat is massaged without fail (unless contraindicated), so it is an integral part of the therapies on oﬀer at the Animal Rehabilitation Centre, Windermere.” nCLIENT TESTIMONIAL: Tina says “Seren really enjoyed her massage sessions, often falling asleep while Marcelle worked on her. I immediately saw an improvement in her mobility and exibility, especially evident after the second treatment. One most noticeable outward change was how she regained her sleek coat. Prior to the massages, areas over her upper back were rough. Marcelle explained how these hair icks are caused by fascial restrictions pulling the hair follicles into dierent positions, and once corrected, the hair can lie in its original orientation again. Now I look for coat changes to ensure Seren isn’t feeling any discomfort I’m not necessarily aware of.Overall Seren has really benetted from the massage therapy and will be having regular sessions to help keep her enjoying an active, outdoor life”

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ANIMAL THERAPY MAGAZINE | ISSUE 26 17IRVAPIRVAP is a professional body oering more than just membership to our members who often hold multi professional qualications and oer an integrated service to the animals in their care, leading to improved lives for animals and owners. IRVAP’s diversity is our community strength, represented by our dierent membership categories. https://www.irvap.org.uk/IRVAP Membership is divided into diﬀerent categories requiring speciﬁc evidence to join each one. You choose the category or subgroup that is your best ﬁt from the descriptions below and submit your evidence using our online system. We oﬀer a free second registration to all our members if they have the required evidence for more than one category or subgroup – Two Categories for the Price of one!Membership fees: Our annual membership runs from 31st March 2021 – 31st March 2022 with a fee of £90 for Veterinary Physiotherapists, Manual Therapists, Canine Hydrotherapists (ICH) and Equine Hydrotherapists (IEH) Members. Our Student Members annual fee is £10. Group Insurance Plan: All our practising members have the option to access our Group Insurance Plan at the same high limit of indemnity. This Professional Liability cover comprises Public Liability and Professional Indemnity with £5 million of cover each, as well as a Legal Expenses indemnity of £250,000. The policy wording covers a wide scope of practice that also speciﬁcally names veterinary physiotherapy, canine, and equine hydrotherapy.Institute of Registered Veterinary Animal Physiotherapists (IRVAP)What is IRVAP and who are their members?IRVAP CategoriesVeterinary physiotherapist member: MIRVAP (VP) - Cost £90 Holder of an accredited university qualiﬁcation at level 6 – 7. Evidenced by qualiﬁcation certiﬁcate, course transcripts, CV, CPD record and insurance certiﬁcation if not accessing the IRVAP group insurance scheme. Manual Therapist member: MIRVAP (MT) - Cost £90 (Animal Osteopath/Chiropractor/Masseur/Bodyworker) Holder of an accredited animal therapy qualiﬁcation level 3 – 6. Evidenced by qualiﬁcation certiﬁcate, course transcripts, CV, CPD record and insurance certiﬁcation if not accessing the IRVAP group insurance scheme. Free second listing in another IRVAP category / subgroup with appropriate evidence to meet its speciﬁc requirements and accreditation process. Institute of Canine Hydrotherapists: MIRVAP (ICH) - Cost £90 (Canine/Small Animal hydrotherapists)Holder of an Ofqual qualiﬁcation; level 3 certiﬁcate in canine hydrotherapy, as a minimum, with L4 -L7 holders required to map in their qualiﬁcation to the ICH day one canine hydrotherapy competencies. Evidence required includes qualiﬁcation certiﬁcate, course transcripts, CV, CPD record, ﬁrst aid certiﬁcate, water management requirements and insurance certiﬁcation if not accessing the IRVAP group insurance scheme. https://www.irvap.org.uk/institute-of-canine-hydrotherapists/ Institute of Equine Hydrotherapists: MIRVAP (IEH) - Cost £90The newest and industry ﬁrst equine hydrotherapy association for equine practitioners, Institute of Equine Hydrotherapists (IEH). Equine Hydrotherapists use water as therapy with various modalities - Equine Swimming pools, Equine Water Treadmills, Equine Water Walkers, Equine Spas and Equine Cryotherapy. Accredited courses have been developed and will be a huge advancement in the growth and progress of the Equine Hydrotherapy Industry. However, as we do not have a course as an entry requirement yet, we will be recognizing the multi routes of industry, training, and work experience. IEH Membership requirements: Curriculum Vitae outlining your equine industry experience, Equine Hydrotherapy industry experience/qualiﬁcations/training certiﬁcates - case studies/references from Veterinarians all great additions, Written evidence of daily water management procedures with each hydrotherapy modalities used, An Up to date Equine First Aid Certiﬁcate and Professional Indemnity and equine hydrotherapy speciﬁc Insurance certiﬁcate https://www.irvap.org.uk/institute-of-equine-hydrotherapists/

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ANIMAL THERAPY MAGAZINE | ISSUE 2618EQUINE FEEDINGConsidering FEEDING POSITIONSBy Gillian Higgins of HORSES INSIDE OUTAbout Gillian HigginsGillian is passionate about horses, anatomy and sharing her knowledge for the good of the horse. A British Horse Society Senior Coach, professional sports and remedial therapist and author. Well known for her anatomical paintings on live horses, Gillian specialises in assessing posture and movement, devising exercises for improving performance and educating horse owners. How we care for and manage the horsehas a huge impact on his health andwell-being. In an ideal world horseswould live out 24/7 in a herd as naturallyas possible, but modern-day practicesmean it’s not always possible forowners to keep their horses as natureintended. However, there is lots we can do to help the horse to mimic his naturalenvironment that promotes good posture including the position he is fed. To explain more, Gillian Higgins considers the pros and cons of dierent feeding positions and how they impact on the horse’s musculoskeletal health.

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ANIMAL THERAPY MAGAZINE | ISSUE 26 19EQUINE FEEDINGObserving Grazing PositionsWatching a horse grazing can reveal a lot about their musculoskeletal comfort and asymmetry. Here are a few things to look out for before deciding which feeding position is best for them.• The most comfortable, symmetrical horses graze and move around constantly, often not lifting their heads up as they move. They graze evenly to the left and right - spending approximately 50% of the time with their left leg forward and 50% with their right forward.• Uncomfortable horses ﬁnd a grazing position that’s comfortable, eat for a while, then lift their head up to move to the next spot.• Asymmetrical horses will split their forelimbs wide to graze and prefer one foreleg being forward most of the time. This asymmetry is usually reﬂected in the way they move, bend, and protract their forelimbs. This can cause mechanical lameness and asymmetrical hoof conformation.How the Head and Neck Position Aﬀects the BackTo understand the beneﬁts of diﬀerent feeding positions it’s important to understand the mechanics of the neck and back ligaments and their role in supporting back posture. This ligament continues as the supraspinous ligament linking the top of each spinous process from the withers to the end of the sacrum. The interspinous ligament ﬁlls in the spaces between the spinous processes stabilising the spine and the ventral longitudinal ligament runs beneath the spine linking all the vertebral bodies. These 4 ligaments ‘wrap’ the vertebral bodies in a cocoon of strong ligamental material which strengthens, stabilises and protects the spine. The nuchal ligament is one of the most important structures in the horse’s body. It has two parts. 1. The funicular (a chord like part) consists of two chords of strong ﬁbrous material that runs from the occipital bone to the withers. 2. The lamellar (sheet like part) descends from the funicular cord to the tops of the cervical vertebrae below.

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ANIMAL THERAPY MAGAZINE | ISSUE 2620EQUINE FEEDINGThis energy saving device reduces the amount of muscular eﬀort required to support, raise and lower the head, hold it in position and maintain correct alignment of the cervical vertebrae. When a horse is dozing his head is suspended by the nuchal ligament. Its high proportion of yellow ﬁbres makes it more elastic than other ligaments allowing it to stretch when the horse is ridden in an outline. The nuchal ligament restrains and stabilises the movement of the spinous processes at the highest point of the withers. This acts as a fulcrum which together with the supraspinous ligament supports the positioning of the back. The nuchal and supraspinous ligament has an important role to play in maintaining spinal posture. Nucal Ligament downWhen the head is down, the nuchal ligament is taught. This pulls on the supraspinous ligament, which attaches to the spinous processes of the thoracic vertebrae at the withers, prising them slightly apart, causing the back to rise and the ribcage to lift.Nucal Ligament upWhen the head is raised, the nuchal ligament slackens and the neck hollows. The resulting lack of tension in the supraspinous ligament causes the unsupported back to hollow. Horses that habitually go in a hollow outline are more prone to back problems.To learn more about this check out the recorded webinar: Understanding the Horse’s Neck www.horsesinsideout.com/webinar-neck

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ANIMAL THERAPY MAGAZINE | ISSUE 26 21Feeding From the FloorIn the wild horses will spend 16-18 hours a day grazing. Feeding hay and concentrates from ﬂoor level replicates this. Fortunately, there’s now many diﬀerent feeding options from hay cubes to spring-based feeders which enable hay to be fed from ground level whilst slowing intake and keeping hay tidy. PROS• Ensures the best alignment of the thoracic vertebrae, in terms of a ﬂexed vs extended position.• The nuchal and supraspinous ligaments are in positive traction - supporting the weight of the back and abdomen with minimum muscular eﬀort and reducing back muscle tension and shortening.• Helps maintain the correct alignment through the cervical vertebrae.• Opens and straightens the pharynx, trachea and oesophagus maximising function.• Stimulates the muscles and structures involved in supporting the back and carrying the weight of the rider. • Beneﬁcial for respiration – mucus, assisted by gravity, removes dust from the air passages through the nostrils.• Better for digestion and production of saliva.• Enables more eﬃcient use of the chewing mechanism.• Helps to correctly align the teeth so wear is more even. • When the head is in a lowered position, this relaxed posture stimulates the parasympathetic nervous system – rest and digest.CONS• Diﬃcult to control how quickly a horse eats his hay ration, important for horses that are on a diet. • A haynet tied too low can be dangerous as there’s a risk the horse may get their foot caught in it. • For horses that box walk or make a mess of their bed mixing hay into their bedding is wasteful and costly. EQUINE FEEDINGFeeding from the oor is good for the back and neck, and the respiratory and digestive systems

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ANIMAL THERAPY MAGAZINE | ISSUE 2622PROS• Dust and small particles fall from the hay, so they are less likely to be ingested or inhaled.• It’s easier to keep the stable tidy as you can easily sweep underneath.• Horses tend to stand square in front when eating from chest height and above because they don’t need to spread their front feet to reach the ground. A horse with a marked asymmetry within their fore hoof conformation and a consistently asymmetrical grazing stance will beneﬁt from being fed from a slightly higher position. CONS• Consider how long the horse is standing in poor posture with his head high and back hollowed whilst eating. In this position the spaces between the spinous processes are smaller putting pressure on the interspinous ligament and strain on the muscular skeletal system.• A high head position stimulates the sympathetic nervous system that’s associated with anxiety, tension and the ﬂight response. • When a horse pulls hay from a haynet with a jerking type movement, the back muscles will contract. When this is repeated for hours every day, it’s strengthening the back muscles to create back extension – not something riders want for their horses. • The higher the haynet the more likely the horse is to pull the hay out to one side with a twisting motion of the head. All horses have a preference to one side or the other, if the haynet is always tied to one side of the stable door, for example always on the right, it’s likely that the horse will pull hay out to the left – towards to view. This develops asymmetry, so also consider where the haynet is tied the stable.EQUINE FEEDINGThe Teeth and TMJAs well as allowing opening and closing and side to side movement, the TMJ allows the lower jaw to move relative to the upper jaw in a rostral – caudal direction. Feeding from a high position causes the lower jaw to slide back altering the alignment of the teeth, chewing patterns and increase the risk of ramps and hooks developing. Grazing allows the lower jaw to move downwards promoting correct alignment and therefore a more even wear of the teeth.Feeding in this position is bad for the back and causes uneven wear patterns in the teethFeeding HighFeeding from high haynets and hay racks is usually seen as a bad thing for the musculoskeletal system, back and for tension. However, there are times when feeding from this position (including chest height) is beneﬁcial. To learn more about the anatomy, function of the TMJ and exercises to promote health, check out our Head Anatomy recorded webinar: www.horsesinsideout.com/webinar-head

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ANIMAL THERAPY MAGAZINE | ISSUE 26 23EQUINE FEEDINGOther Head Positions to ConsiderFeeding isn’t the only time we should avoid high head positions, it’s important to consider every aspect of a horse’s management. For example, the height of stable doors and tie rings. These can be too high for small ponies causing them to adopt an unnaturally high head carriage, aﬀecting their posture and comfort.Travelling horses is another example. This can be stressful for horses - anything that can be done to alleviate stress and muscle tension, is a good thing. Lorries with high tack lockers aren’t ideal as they don’t provide enough room for the horse to lower his head, travelling for long distances with a high head carriage puts strain on the back. Food for ThoughtWe owe our horses the best possible environment in which to thrive. Whether in the ﬁeld, stable, travelling or being ridden it’s up to us to ensure their comfort, welfare and safety. Studying each horse’s characteristic asymmetries and posture can help us decide which is the best feeding position for each horse. Remember variety is important so having multiple feeding stations can be beneﬁcial.Gillian’s BooksGillian has written 10 books all of which are of interest to equine therapists. This article includes in part extracts from Gillian’s book, How Your Horse Moves and Horse Anatomy for Performance. If you would like to learn more visit www.horsesinsideout.com/shop The Horses Inside Out AcademyThe Horses Inside Out Academy is our online learning hub. It’s free to join and once a member you can access the free tutorial video channel. You can purchase, pick and mix style, lifetime access to the recorded webinars, online lecture demonstrations, and more. The Academy provides educational opportunities in applied equine anatomy and biomechanics accessible to everyone everywhere in the world. www.horsesinsideout.com/academy

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ANIMAL THERAPY MAGAZINE | ISSUE 2624REHABILITATIONAt Battersea we oer our love and dedicated care to dogs and cats who need us by rescuing, rehabilitating and rehoming animals at our centres, and by sharing our knowledge and resources with rescue organisations around the world. As a leading animal welfare charity, Battersea has cared for more than 3.1 million dogs and cats in need of our help since 1860.welcomes new rehabilitation facilities for dogs and cats in needTo help us care for the animals that come into us, Battersea is home to a state-of-the-art veterinary clinic and has a large clinical team of veterinary surgeons, nurses, care assistants, hydrotherapists and a physiotherapist. Every animal that passes through our doors will meet the clinic team. Whilst some animals are lucky enough to only require routine procedures, all too often, we ﬁnd our new arrivals are suﬀering with chronic conditions that require extensive treatment and rehabilitation. To support some of our animals, we opened a new rehabilitation centre in Summer 2021. This includes an underwater treadmill and a 6x3 metre pool. Without being able to oﬀer eﬀective rehabilitation, we would be limited with the care and surgical options we can provide for our animals in need. Our team really are crucial in enabling us to successfully rehabilitate our patients. For those more complicated cases, we can refer to veterinary specialists and continue post-op rehabilitation back at Battersea. Providing our patients with eﬀective rehabilitation enables us to reduce their recovery times, provide vital enrichment during their recovery period and ﬁnd their forever homes as quickly as possible. An example of a patient beneﬁting from our new facilities is Charley, an 18-month-old Border Collie. He presented lame on arrival to Battersea and underwent radiographs which diagnosed a left subluxated hip. Following diagnosis, Charley underwent a left sided femoral head and neck osteotomy (FHNO) and promptly started a rehabilitation plan. A combination of physiotherapy and hydrotherapy along with his love of tennis balls, ensured he thoroughly enjoyed every session. Charley spent his recovery in a foster home and inevitably, after supporting Charley through such an intensive rehabilitation programme, we’re pleased to say that the foster carer fell in love and adopted him. By Megan Goldring, Veterinary Physiotherapist and Hydrotherapist and Rachel Abd’ee, Hydrotherapist at Battersea

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ANIMAL THERAPY MAGAZINE | ISSUE 26 25REHABILITATIONThe rehabilitation centre is ideal for our post-operative cases like Charley, but also for animals requiring conservative management, such as, Marvin. Marvin is a 5-month-old Cane Corso puppy that came into us with a history of living in extremely poor conditions and had been conﬁned to a small cage for all his upbringing. As a result, Marvin has severe bilateral carpal hyper extension. Shortly after Marvin arrived at our centre, we started him on a physiotherapy and hydrotherapy plan. Swimming allows Marvin to exercise against resistance, helping to strengthen his carpal ligaments without needing to bear weight. Marvin’s rehabilitation is currently ongoing, but he is making excellent progress and we hope to soon ﬁnd him the loving home that he deserves. In addition to physiotherapy and hydrotherapy, we also have a range of complementary equipment, including class IV laser therapy which beneﬁts dogs like Athena, a 3-month-old Husky puppy. Athena recently presented non-weight bearing on her right hind limb with localised swelling around her hock. Radiographs conﬁrmed a fracture to her distal tibia and ﬁbula. She was referred for surgery to repair the fracture and returned to us the following day to continue her rehabilitation.Athena receives laser therapy twice weekly to help reduce the inﬂammation around her wound, promote tissue healing and assist with pain relief as part of a multi-modal treatment approach. She has also started gentle physiotherapy exercises and we will continue to progress the intensity of her sessions over the following weeks. Later into her recovery, we will look to include active hydrotherapy. Until such time, we will incorporate desensitisation training inside the centre and make use of passive treadmill sessions until she is ready to start exercising. External servicesNot only are we treating Battersea animals, we have also opened our doors to external clients. This allows us to extend our reach to many other dogs in need ensuring hydrotherapy can continue to be a viable treatment option for Battersea animals that aren’t yet lucky enough to have a committed owner. Our external patients are referred for a variety of conditions, some of which are very rare. Barney, a 10-year-old Lhasa Apso had acute onset, progressive, non-ambulatory tetrapareisis and was diagnosed with polyradiculoneuritisOn choosing Battersea as their hydrotherapy centre, Barney’s owner said:“We got our other dog, Fred, from Battersea. The fact that I’ve been there before, met loads of the staﬀ and seen ﬁrst-hand how much everything they do is for the beneﬁt of the dogs, there was no doubt in my mind that was where Barney would be doing his hydro.”Barney’s treatment plan initially consisted of pool sessions. This helped to maintain his joint range of movement (ROM) and muscle mass, reduce hypertonicity and provide sensory input during his early stages of recovery. Further into his rehabilitation, we also incorporated the underwater treadmill to increase proprioception and help to re-educate his gait pattern. As this was our ﬁrst case of treating polyradiculoneuritis, it was important that we were all able to use our skills and clinical reasoning to form his treatment plan. In our profession, personal development and continued learning is crucial to treatment success. Barney made a remarkable recovery and this is something we can continue to remember and learn from. Following the popularity of our hydrotherapy centre, we have recently launched physiotherapy for our external clients. We are delighted to have increased our scope of service and look forward to further expanding our clinical team in the near future. You can take a 3D tour and ﬁnd out more about Battersea’s hydrotherapy centre by visiting: https://www.battersea.org.uk/about-us/what-we-do/hydrotherapy-battersea nBeforeAfter

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ANIMAL THERAPY MAGAZINE | ISSUE 26 27LEVI HUNTLevi’s BlogInspect YOUR Gadgetby Levi HuntThere are certain subjects in the Equestrian training world that you don’t bring up unless you’re ready for some serious debate... it’s a bit like bringing up Brexit at the dinner party. Some call them “gadgets”, others call them “additional training devices”. Whatever device I’m thinking of, from draw reins to side reins, elastic bum bands to EquiAmi, there are a series of questions I ask myself before using them.Have I tried the au naturel / vegan route of just using my own physical aides to no or little avail?Will introducing an artiﬁcial device beneﬁt what I am trying to work on, without forcing the position?The third question leads me to my ﬁnal one. Will the aid I am considering using work whilst allowing elasticity Whatever I am trying to achieve with a horse, elasticity within the frame is of upmost priority. So when you are using a training aid, really analyse with your eye and feel, is it allowing your horse to move within the posture to promote suppleness. We are training for ﬂowing movement, not a still picture. And just for the record, I’m a remainer! nABOUT LEVI Levi Hunt is a Grand Prix International Rider for Great Britain. He is a regional British Dressage team trainer, UKCC3 Coach and in 2016 he was awarded British Dressage Young Professional of the year.Now set up in a beautiful yard near USK, Levi holds regular private coaching sessions on site, (with overnight accommodation if needed) as well as travels to Stratford-Upon-Avon, Kidderminster, Romsley and Broadway to teach. For more information or to book, please contact Nicky on 07771 610027.

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28 ANIMAL THERAPY MAGAZINE | ISSUE 26EQUINE ULCERSEQUINE ULCERSAN INTRODUCTION TO equine ulcers Dr Jane WilliamsHartpury University, Gloucester, GL19 3BE, UKIntroduction Equine Gastric Ulcer Syndrome (EGUS) describes the ulcer-forming diseases of the horse’s stomach that cause pain, impair the welfare of horses and require treatment to reduce the severity of the syndrome (Andrews et al., 1999). EGUS is a common, welfare- and performance-limiting disease aﬀecting up to 100% of racehorses and 60% of sport and leisure horses. EGUS includes both squamous (upper stomach) and glandular (lower stomach) ulcers. The European College of Internal Medicine (ECEIM) consensus deﬁnes EGUS as Equine Gastric Disease (EGD), which is as an over-arching term encompassing both Equine Squamous Gastric Disease (ESGD) and Equine Glandular Gastric Disease (EGGD); these terms speciﬁcally describe the aﬀected anatomical area where ulceration is present (Sykes et al., 2015). However colloquially EGD remains commonly referred to by horse owners, veterinarians and the equestrian media as EGUS and this term will be used for this article. EGUS was recognized as two distinct diseases in 2015: Equine Squamous Gastric Disease (ESGD) and Equine Glandular Gastric Disease (EGGD) (Bowen, 2018). The aetiopathogenesis of ESGD is generally determined from mucosal acid injury however, as EGGD has no determined aetiopathogenesis, it is classiﬁed by the anatomical region aﬀected (cardia, fundus, antrum or pylorus) and the description of the gross appearance of lesions (Sykes et al., 2015). ESGD is characterized by ulceration and erosion of the squamous mucosa in the horse’s stomach. EGGD in contrast is found in multiple areas of the stomach, is associated with non-ulcerative lesions which appear to have a range of aetiopathogeneses (Sykes et al., 2015). Prevalence rates vary with the type ofEGUS, with between 47-65% prevalence of EGGD reported in Thoroughbred racehorses and ESGD prevalence at up to 93% of TB racehorses (Sykes et al., 2015; Hepburn, 2011). Both types of ulcers frequently aﬀect all types of ridden horses and are considered painful, and can negatively impact ridden performance, handling and reduce equine quality of life. What is EGUS?Horses are non-ruminant herbivores, with one, relatively small stomach (holding approximately 12 litres or 10% of the GI tract) and a digestive tract that have adapted to a high forage diet. This requires the horse to spend a signiﬁcant proportion of their daily time budget consuming forage to ensure a constant ﬂow of saliva to buﬀer stomach acid and maintain gastric pH at >4. The horse’s stomach has two regions separated by the margo plicatus: the non-glandular squamous region where the oesophagus enters and the glandular region below, further subdivided into cardiac, fundic, and pyloric gland regions, deﬁned according to the presence of diﬀerent types of gland in the mucous membrane. The gastric contents exit the stomach via the pyloric sphincter. Feral horses are reported to graze for approximately 16 hours per day, however modern equine management often necessitates stabled periods with no or limited turnout, which may not facilitate ad libitum access to forage. For example, racehorse management often includes longer periods of stabling and diets fed are typically high-grain and low forage diets (Nadeau et al., 2003). When feed is provided intermittently in restricted diets, the gastric pH of the horse’s stomach can fall below four exposing the squamous mucosa to an acidic environment and potential damage (Andrews et al., 2005). The squamous region is particularly at risk due to the lack of protective mucosal barriers, necessitating pH ≥6 to prevent acid erosion (Nadeau et al., 2003). Less is understood about the aetiology of EGGD; the glandular mucosa is considered stable at pH between 1 and 3, due to the more consistent exposure to the acidic environment of the ventral section of the stomach and a breakdown in the defence mechanism, which has been associated with NSAID administration and bacterial challenge, and is believed to result in damage (Sykes et al., 2015). Periods of intense exercise, common in racehorses and sport horses, can also result in increased movement of the stomach contents and combined with reduced forage diets, this can circulate the acidic chyme increasing the risk of damage, ultimately resulting in ESGD and EGGD (Nadeau et al., 2003). Grazing or the provision of forage ad libitum facilitates a continuous ﬂow of saliva and therefore has a protective function in the stomach raising the pH, and is recommended to reduce the risk of developing EGUS (Nadeau et al., 2003). Equine Gastric Ulcer Syndrome is a common, welfare and performancelimiting disease

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29ANIMAL THERAPY MAGAZINE | ISSUE 26EQUINE ULCERSClinical signs and risk factors of EGUSDespite the high incidence of EGUS within horses, no general consensus exists on what the conclusive clinical signs of either EGSD or EGGD are, or which risk factors can predict the presence of gastric disease. EGUS is characterised by intestinal discomﬁt but the eﬀects on individual horses’ health and welfare can vary from mild to severe. For ESGD, clinical symptoms are associated with signs of intestinal pain including inappetence, management and training regimes, poor body condition, colic, diet, stereotypical behaviour, temperament changes and poor ridden performance (Sykes et al., 2015; 2019) (Figure 1). Horses with EGGD also often present with a reduced appetite, unexplained weight loss, changes in temperament especially when ridden often focused on a reluctance to move forward freely and cutaneous sensitivity leading to resentment when mounting, and when leg aids or girths are applied, are fed high starch diets and are engaged in high intensity training regimes (Rendle et al., 2018; Sykes et al., 2019). A reduction in performance, characterised by reduced competitive or race performance, or an increase in conﬂict behaviours or reluctance when ridden can often be the ﬁrst clues a horse could be suﬀering from EGUS. Unfortunately, many of the potential clinical signs of EGUS can be present in other clinical diseases, could be related to the stage of training or behavioural issues in the horse, and not all horses subject to intensive management and training regimes will develop ulcers. A survey of horse owners (Marlin et al. 2019) also identiﬁed owners can fail to recognize the signs that may indicate a horse is aﬀected by EGUS, which could lead to them undertaking ineﬀective or harmful treatments or failing to obtain appropriate and timely veterinary support, ultimately comprising equine welfare. Therefore, deﬁnitive diagnosis of EGUS requires a full clinical examination, evaluation of the horse’s history and management, and a gastroscopy (endoscopy of the stomach). Risk factors for development EGUSAccess to good quality pasture and increased turnout (if required with access to additional forage) and ideally with con-speciﬁcs, is considered a protective factor for EGUS (Lester et al., 2007) (Figure 2). High-grain diets high-intensity exercise, feeding straw as the only forage in the diet, increased periods between forage meals (>6hrs), fasting or periods of starvation, and increased starch in diet, intermittent or reduced access to water, entering intense management regimes and training after period of turnout have all been recorded to increase the incidence of ESGD (Luthersson et al., 2009; Vatistas et al., 1999). Yet despite these risk factors being widely discussed as relevant risk factors for the development of ulcers, evidence is still ambiguous and more research needed to elucidate the degree nutritional and management factors contribute to the aetiology of both ESGD and especially EGGD, where little is still known. Prevention, treatment and management As the clinical signs of EGUS are non-speciﬁc and variable, diagnosis requires sedation and passage of an endoscope into the stomach to identify the presence and type of gastric ulcer disease present to guide subsequent treatment selection. The presence of food can impair visibility of the gastroscope, therefore fasting is undertaken to ensure the stomach is empty prior to examination; in racehorses this can usually occur within 6-8hrs (Sykes and Jokisalo, 2015a) whereas horses fed on an ad libitum forage-based diet, fasting overnight is required (Sykes and Jokisalo, 2015b). Currently, blood tests and biomechanical markers are not considered reliable diagnostic indicators of either ESGD or EGGD (Sykes et al., 2015). A sucrose permeability test is available and while this has shown some promise in horses with moderate to severe gastric ulceration, the ECEIM state that gastroscopy remains the preferred method of diagnosis (Sykes et al., 2015). Once the presence of ulcers is conﬁrmed by gastroscopy, the number and severity of EGSD ulcers present will be assessed and graded by the mucosal appearance

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30 ANIMAL THERAPY MAGAZINE | ISSUE 26EQUINE ULCERSof lesions (Sykes et al., 2015). Various grading systems have been used however the ECEIM recommendation is to use the 0-4 EGUS Council grading system (Sykes et al., 2015). Consensus on grading glandular ulcers has not been agreed to date, therefore for EGGD, it is recommended that lesions are described by their presence/absence, anatomical location, distribution, and appearance (Sykes et al., 2015). See table 1.The number and severity of ulcers is often thought to correlate with the severity of presentation of EGUS in horses, however caution should be applied to taking this approach. Individual presentation of EGUS can vary between horses, and some horses with ulcers will not present with explicit clinical signs. Sykes and colleagues (2015) recommend that the assessment of clinical relevance should not be made on endoscopic appearance alone, suggesting the clinician should assess the relevance of an individual’s lesions in light of the horse’s recent usage, its history and presenting clinical signs. The ECEIM suggest a similar approach to that used in humans with ulcers, taking the approach that ‘no acid, no ulcer’ is the cornerstone of any therapeutic approach, should be applied in horse, therefore appropriate acid suppressor treatment is indicated in the management of both ESGD, where eﬃcacy is well documented, and EGGD, despite understanding this condition less (Sykes et al., 2015). Proton pump inhibitors such as omeprazole have been most eﬀective in reducing the severity of disease however duration of treatment also needs to be considered; omeprazole (administered at 4.0 mg/kg orally) has been reported to result in a EGSD lesion healing rate of 78% within 28-35 days but this reduces to only 25% for EGGD lesions (Sykes et al., 2015). Follow up or control gastroscopes are therefore essential to monitor the eﬃcacy of treatment in aﬀected horses. Suggested treatment protocols are provided in Tables 2 and 3.Continued pharmacologic treatment at lower doses (2mg/kg per day) has also been suggested as a preventative strategy for ESGD (Sykes et al., 2015; Mason et al., 2019). Alongside treatment, although diet has not been unequivocally shown to be a risk factor for ulcers, nutritional management strategies such as reduced grain feeds, increased forage, access to pasture turn-out and ad lib forage sources are recommended to avoid recurrence of gastric ulcers. Sykes et al (2015) recommend horse owners should engage in the following good practice nutritional strategies to prevent ulcer:• Continuous access to good quality grass pasture as ideal; alternatively, Table 1: Grading of EGSD stomach ulcers adapted from 1999 EGUS Council (Sykes et al., 2015)Grade 0 The epithelium is intact and there is no appearance of hyperkeratosisGrade 1 The mucosa is intact, but there are areas of hyperkeratosisGrade 2 Small, single or multifocal lesionsGrade 3 Large single or extensive superﬁcial lesionsGrade 4 Extensive lesions with areas of apparent deep ulceration

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31ANIMAL THERAPY MAGAZINE | ISSUE 26EQUINE ULCERSReferences Andrews, F.M. and NADEAU, J.A., 1999. Clinical syndromes of gastric ulceration in foals and mature horses. Equine Veterinary Journal, 31(S29), pp.30-33.Andrews, F.M., Buchanan, B.R., Elliot, S.B., Clariday, N.A. and Edwards, L.H., 2005. Gastric ulcers in horses. Journal of Animal Science, 83(suppl_13), pp.E18-E21.Bowen, M., 2018. Equine glandular gastric disease recommendations. Equine Health, 2018(40), pp.29-33.Hepburn, R., 2011. Gastric ulceration in horses. In Practice, 33(3), pp.116-124.Lester, G.D., Robertson, I.D. and Secombe, C., 2007. Risk factors for gastric ulceration in Thoroughbred racehorses. Risk factors for gastric ulceration in Thoroughbred racehorses.Luthersson, N., Nielsen, K.H., Harris, P. and Parkin, T.D.H., 2009. Risk factors associated with equine gastric ulceration syndrome (EGUS) in 201 horses in Denmark. Equine veterinary journal, 41(7), pp.625-630.Marlin, D., Williams, J., Pickles, K. and Sykes, B., 2019. Horse owner understanding of equine gastric ulcer syndrome (EGUS). Journal of Equine Veterinary Science, 76, p.55.Mason, L.V., Moroney, J.R. and Mason, R.J., 2019. Prophylactic therapy with omeprazole for prevention of equine gastric ulcer syndrome (EGUS) in horses in active training: a meta-analysis. Equine veterinary journal, 51(1), pp.11-19.Nadeau, J.A., Andrews, F.M., Patton, C.S., Argenzio, R.A., Mathew, A.G. and Saxton, A.M., 2003. Eects of hydrochloric, acetic, butyric, and propionic acids on pathogenesis of ulcers in the non-glandular portion of the stomach of horses. American journal of veterinary research, 64(4), pp.404-412.Rendle, D., Bowen, M., Brazil, T., Conwell, R., Hallowell, G., Hepburn, R., Hewetson, M. and Sykes, B., 2018. Recommendations for the management of equine glandular gastric disease. UK-Vet Equine, 2(Sup1), pp.2-11.Sykes, B.W. and Jokisalo, J.M., 2014a. Rethinking equine gastric ulcer syndrome: Part 1–Terminology, clinical signs and diagnosis. Equine Veterinary Education, 26(10), pp.543-547.Sykes, B.W., Hewetson, M., Hepburn, R.J., Luthersson, N. and Tamzali, Y., 2015. European College of Equine Internal Medicine Consensus Statement—equine gastric ulcer syndrome in adult horses. Journal of Veterinary Internal Medicine, 29(5), p.1288.Sykes, B.W. and Jokisalo, J.M., 2015a. Rethinking equine gastric ulcer syndrome: Part 2–Equine squamous gastric ulcer syndrome (ESGUS). Equine Veterinary Education, 27(5), pp.264-268.Sykes, B. and Jokisalo, J.M., 2015b. Rethinking equine gastric ulcer syndrome: Part 3–Equine glandular gastric ulcer syndrome (EGGUS). Equine Veterinary Education, 27(7), pp.372-375.Sykes, B.W., 2019. Courses for horses: Rethinking the use of proton pump inhibitors in the treatment of equine gastric ulcer syndrome. Equine Veterinary Education, 31(8), pp.441-446.Vatistas, N.J., Sierman, R.L., Holste, J., Cox, J.L., Pinalto, G. and Schultz, K.T., 1999. Induction and maintenance of gastric ulceration in horses in simulated race training. Equine Veterinary Journal, 31(S29), pp.40-44.free choice, or at least frequent feedings (4–6 meals/day), of hay can be a suitable replacement if pasture is not available;• Forage (hay) to be fed at a minimum of 1.5 kg (DM)/100 kg bodyweight per day; for obese horses and ponies the minimum level of forage should be fed but utilise mature and low energy content forages for this;• Straw should not be the only forage provided but can be safely included in the ration at <0.25 kg (DM)/100 kg bodyweight; • Horses should be fed grain and concentrates sparingly; diets should not exceed 2 g/kg bodyweight of starch intake per day or more than 1 g/kg bodyweight of starch per meal; and;• Concentrate meals should not be fed less than 6 hours apart. ConclusionTo date, research in EGUS has often centred on ESGD and perceived high-risk populations such as racehorses, reducing application to the wider equestrian sector. Risk factors for EGSD are proposed but further work needs to occur to fully understand these and limited knowledge of risk factors for EGGD exists. Clinical signs are also varied and may be overlooked initially by owners. Responsible owners should be aware of the warning signs of EGUS to enable them to seek veterinary advice as warranted and adopting good management practice including increased social turnout, high forage-low grain diets and ad libitum or an increased frequency of forage feeds should support gastric health and enhance equine welfare. nTable 2. Treatment recommendations for Equine Squamous Glandular Disease (EGSD) suggested by Sykes et al. (2015)Table 3. Treatment recommendations for Equine Glandular Gastric Disease (EGGD) suggested by Sykes et al. (2015)

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ANIMAL THERAPY MAGAZINE | ISSUE 2632ORTHOTICSAn interesting case of the glass half fullBy Tony Nevin, BSc (Hons) Ost, DO, Zoo OstReferences:1 https://www.thedonkeysanctuary.org.uk2 https://www.donkeyrescue.co.uk3 https://www.thebrooke.orgI have always tried to live my life by the mantra of this title. My approach to unusual clinical cases is no dierent. Despite being present in every Christmas nativity play, the humble donkey has featured less in 21st century life.Research and understanding of the needs and health issues of horses and ponies has accelerated in recent times yet little thought is given to this traditional beast of burden.There are some incredible charities doing sterling work such as the Donkey Sanctuary1, Island Farm Sanctuary2, and Brooke Horse and Donkey Charity3. Aside from these charities there are countless individuals who look after and rescue donkeys.Enter Tommy the Wonky Donkey. His salvation was via a kind-hearted couple who rescued several ponies and two donkeys including himself. When Tommy arrived he already had a deformity to the distal part of his front right leg. Although he received veterinary care the deformity around his carpus steadily got worse. The farrier did as much as he could and the owners tried in vain to help him as well.Tommy was referred to a specialist equine hospital for thorough examination and a diagnosis of his problem. From the radiographs taken it was clear that there was too much bony deformity for the

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ANIMAL THERAPY MAGAZINE | ISSUE 26 33ORTHOTICSleg to function properly and as surgically remodelling or removing part of the limb was not an option he was sent for a second opinion to Dr Chris Colles, an equine orthopaedic surgical specialist. Dr Colles explained to the owner that surgically removing the end of the limb and ﬁtting a prosthesis was not an option because of the problems with the vascular supply to that region, and it was at this stage that he asked for me to become involved to see if I could work with a specialist orthotic company to create a brace that would allow Tommy to more evenly spread his weight through all four limbs and therefore improve his locomotor function such that he could lead as normal a life as possible.The company in question make prosthetic limbs for human amputees and have immense knowledge dealing with Para-Olympians, however this was their ﬁrst attempt at making a prosthesis to help a donkey.As a team we met several times to look at the biomechanics of the donkey and it was here that Warwickshire College helped us by providing the skeleton of the front limb of a donkey so that the prosthesis company could see better what was going to be needed. I brought in the bio-mechanics of how the limb should work and the loading that was expected through each of the joints, and of the limb in total along with range of motion. Also taken into account were the changes that would have to be accommodated within the rest of Tommy’s musculoskeletal system (MSK).Taking a cast of the front limb was challenging and involved the use of a mechanical hoist with padded sling in order to take the weight from the front limbs and allow enough time for a plaster of paris cast to be taken so that a prototype prosthetic support could be designed and built. The idea that we worked with was to provide a carbon ﬁbre shell to go around the distal part of the limb and then have a load bearing metal alloy extension connecting this to a strong nylon and rubber foot. Built into the prototype were several areas that we could adjust and the carbon ﬁbre casing itself was hinged with strong fabric and Velcro fasteners and encapsulated the entire distal part of the limb up to just distal to the elbow. The metal alloy leg, extending from where the carpus should have been, was built into the carbon ﬁbre and had an adjustable socket that allowed us to workout Tommy’s weight bearing and limb orientation such that we could adjust it easily and then lock it in place once we had worked out the exact ﬁne tuning. This was necessary due to the extent of Tommy’s compensatory pattern.The initial prototype needed modifying and within a matter of a few weeks we had designed and produced a bespoke limb support for Tommy. What amazed us was once the prosthesis was ﬁtted he immediately started to weight bear on the deformed limb. Over the next three weeks we ﬁtted the limb prosthesis initially for an hour a day, building up until it was on all day, only taken oﬀ in the evening when he was ready to lay down and go to sleep. It soon became apparent that Tommy had become very attached to his new brace and the owners sometimes had diﬃculty getting him to let them take it oﬀ. He would generally tell them when he was ready! We monitored closely the aﬀected limb to ensure that there were no pressure sores or microbial problems either. We were lucky that he is a very fastidiously clean donkey and like most of his kin he doesn’t like getting wet and so the moment weather conditions turned he would make his way to his barn where he would be joined by his best friend who was the other donkey that was rescued with him.It wasn’t long before the media heard about Tommy’s new found mobility and it also coincided with Christmas, and so Tommy became probably the most famous donkey in the UK and has continued to enjoy notoriety both here at home and around the world. He is being closely monitored and also receives regular osteopathic support as he develops better movement and better muscling now that he is much more mobile. The company in question make prosthetic limbs for human amputees and have immense knowledge dealing with Para-Olympians, however this was their rst attempt at making a prosthesis to help a donkey.

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ANIMAL THERAPY MAGAZINE | ISSUE 2634ORTHOTICSWhen I originally met Tommy, he had a scoliotic posture and also lacked muscling around both shoulders, neck, and part of his top line. He also put most of his front-end weight through his left forelimb. There were mechanical changes here where he was medially rotating the entire left limb in order to place the foot into the midline. Not only did I have to work on his entire MSK but we also had to persuade him to change his posture and the way he moved. This is no small task with a donkey!We combined osteopathy with class 4 laser, and also brought in the services of an extremely good animal communicator, as it was clear to anyone watching that Tommy seemed to associate me with discomfort even though I was the one helping him to get better. What was lovely was the that he really liked seeing Matt from Dorset Orthopaedic when he would visit to check on the brace. Whenever the animal communicator was there with me Tommy would be much easier to work with, and after several months he does seem to like me now.Although the orthotic brace has given Tommy a new lease of life, and the freedom to enjoy the vast outdoor space he and his companions have, his movement will never be the same as a donkey should be, and he is likely to need maintenance treatments for the rest of his life. However, to watch him move around now is incredible because he has really got his vitality and energy back.During the media interest in Tommy we did receive criticism regarding ﬁtting a prosthetic brace to the deformed limb, with some people seeing it as cruel and a welfare issue. Anyone who meets Tommy would see that he is living life to the full, and he’s back to bossing his best friend around. All of his other bodily functions have been ﬁne. It is incredible to see how he has taken to being able to move around again and interact with his other equine friends.From a clinical point of view my biggest concerns throughout were that the prosthetic brace would cause pressure sores and vascular issues to the aﬀected limb, and I was also worried about the scapulothoracic articulation, and glenohumeral joint integrity due to the carpus being unable to ﬂex and extend. For Dorset Orthopaedic to make a prosthetic brace that would work we had to create one with a ﬁxed joint. Because Tommy’s condition was of a chronic longstanding nature I was also concerned if the rest of his MSK would adapt to the changes we were making or whether he would end up in even more of a debilitated state than he had been. By not creating a glass ceiling for ourselves and because we were working very much as a team, in this speciﬁc case we have been able to give Tommy back his independence and improve his mental wellbeing. Sometimes it is easier to see a situation like this as irreversible, and therefore as practitioners we are more likely to walk away rather than look at bringing other professions on board and brainstorming to create a solution. Obviously every case is unique, and every case is likely to have a diﬀerent outcome, but if Tommy has taught me one thing it is that I might need a bigger glass! nReferences:1 https://www.thedonkeysanctuary.org.uk2 https://www.donkeyrescue.co.uk3 https://www.thebrooke.org

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ANIMAL THERAPY MAGAZINE | ISSUE 2636CANINE MASSAGE THERAPISTBECOMING A Clinical Canine Massage erapistCanine complementary therapies are a relatively new consideration as a career option and oer a dierent avenue to help our canine friends.There are several canine massage courses available in the UK with diﬀering course content, but my key, and most important, piece of advice is to ﬁnd one that teaches the practical element in person. Whilst theory can be completed via distance learning, you will not achieve your full potential if all learning is on-line. You may choose your course based on content, the location or even price, but if you want this as a career, then consider the level of training you will receive as this will determine your future success. Ask yourself, can you learn everything you need to know on a 1-day course to eﬀectively help a dog’s injuries/condition? And more importantly would you want your dog treated by a person who had never had hands on supervision and only done a short course. Its questions like this that your potential future clients will ask too. The Canine Massage Guild (Guild) is a professional association for Clinical Canine Massage Therapists, aiming to raise the industry standards. All members have trained with the Canine Massage Therapy Centre Ltd, (CMTC) on the Clinical Canine Massage Practitioner Programme (Practitioner Programme) which has been running for 10 years. Entry to the Canine Massage Guild depends upon a successful pass of the CMTC Clinical Canine Massage Practitioner Programme.By Natalie Lenton, Director, Canine Massage Therapy Centre

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ANIMAL THERAPY MAGAZINE | ISSUE 26 37CANINE MASSAGE THERAPISTIs this career right for you?Whilst it is not possible to job shadow a Canine Massage Therapist, you can experience canine massage for yourself, and it is recommended that you do so prior to enrolling on the course. You can do this in 1 or ideally a combination of the following 3 ways:1. Take your dog to see a therapist – please note they will not teach you, but it allows you to see what is involved, the modalities we use and importantly the results that are achieved in a relatively short time frame2. Attend a 1 day workshop with your own dog through the Canine Massage Therapy Centre, they have a team of Workshop Instructors aacross the country which can be found on their website3. Watch the DVD ‘Canine Massage in 3 Easy Steps’ available to stream from Vimeo or to purchase as a hard copy, and learn a few basics at home to see if you enjoy the therapy with the your own dogEntry Requirements for the Clinical Canine Massage Practitioner Programme delivered by Canine Massage Therapy Centre and externally accredited by LANTRAIt is desirable to have one of the following:1. A degree or qualiﬁcation in a relevant ﬁeld eg. medical / bodywork /complementary therapies OR2. You are an established Myofascial Release therapist for humans or Massage Therapist with training at or above Level 3 OR3. A high level of relevant experience OR4. You have attended a 1-day workshop / or watched the DVD AND Have completed the written formal qualifying questions with evidence based research AND have 8 GCSE’s (or equivalent) and 3 A Levels (or equivalent)You must have experience of living with and owning a dog no matter which option is relevant to you.Access onto the Programme depends upon:• One of the above entry requirements• Submission of the self-assessment form• A written paper• A telephone interviewLearning MethodThe Clinical Canine Massage Practitioner Programme is studied over a 2 year period. It comprises of anatomy and physiology theory in module format undertaken as home study, which must be completed within 14 months and prior to attending in-person practical sessions to ensure the learner has achieved recognition of prior learning. You will then put this into practice through case studies. As a guide, the notional learning hours breakdown is as follows:• Home Study Modules – 600 hours• Practical Training – 14 Days 120 hours in person with online lectures and further practical sessions• Externship – 200 hours• Revision and Practice – 200 can be more depending on individual learner and broken down over 12 months• Total: Approx 1200 hours – Over a period of 2 yearsEverything you need to learn is contained within the course or set as further research. In fact, even those with a background in anatomy still have to complete the same full course to ensure everyone has the same knowledge & can work to the set standard. There is no fast-track option and in person attendance at practicals is mandatory. 4 Disciplines of massage and the Lenton Method™ are taught on the course • Swedish Massage• Sports Massage• Deep Tissue• Myofascial Release; both the direct and indirect approach.• Exclusive to the course is the Lenton Method™, a 3-tiered system of canine massage therapy developed and pioneered by the Director of CMTC, Natalie Lenton.‘The Lenton Method’ involves:• Advanced palpation• Bodymapping• The 7 series of myofascial release protocols• The Lenton Method is the only methodology of canine massage therapy to have clinical trials and research behind itIn clinical trials with Winchester University, it was found across a large scale study of 527 dogs, that 95% of dogs with musculoskeletal issues respond positively to canine massage therapy with the Lenton Method approach. The Vet Record, published by the British Veterinary Association, has recently published the clinical trials results for the Lenton Method exlusively taught by CMTC, and can be viewed and downloaded here:https://bvajournals.onlinelibrary.wiley.com/doi/10.1002/vetr.586

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ANIMAL THERAPY MAGAZINE | ISSUE 2638CANINE MASSAGE THERAPISTCollectively across the disciplines the student will learn approximately 60 techniques along with adapations and variations to suit the presenting canine client to respect that there is not a singular approach which suits all dogs. Routines are not taught as with remedial therapy it is important that after consultation with full medical history, gait and posture analysis and full body palpation that the therapist is able to clinically justify a discernible treatment plan for the individual dog to suit their requirements, needs and presenting pathology as well as their personality.Who Is The Course For?• Adults wanting a career change working with dogs (minimum age 21)• Veterinary Nurses and Vets• Animal and Human Physiotherapists• McTimoney Animal Manipulators• Hydrotherapists• Groomers• Human Massage Therapists thinking of combining their practice to dual species• People wanting to work with dogs who are determined, committed and not afraid of hard workPersonal CharacteristicsYou should be someone who:• Likes to study and complete assignments – this course is aimed at 1st/2nd year degree level• Is interested in anatomy – this course contains medical terminology and Latin names and is functional. We seek to improve the status of canine clients with musculoskeletal and neurological pathologies along with dogs with anxiety issues and those who may have experienced physical and/or emotional trauma.• Is self-motivated to study at home and undertake further research• Can commit to 2 years of training - this can be done whilst working, but the course it is to be completed in a set timeframe not at your own leisure, it is not a roll on/roll oﬀ course• Likes people – this is still a person-orientated job and you client is most often sat with you during treatment of their dog• Likes and understands dogs – you need to be able to read and understand them, we of course teach you how to do this on the course as our approach is diﬀerent to other modalities where quite often a technique is ‘just applied’. In this course you are taught how to listen to the dog and to do that we also coach you in how to listen to a diﬀerent aspect of yourself too. With this therapy we ask, “how can we help and work with the dog” rather than “this is something im going to do to a dog”. The intention yields diﬀerent results.• Is a self-starter. To make this work as a career, like anyone who is self-employed, running a business takes a lot of time and dedication.ConsiderationsIt can be important to recognise that Canine Massage is physically demanding work. It can also be emotionally draining at times so the applicant should consider:• Are your hands up to it? A good degree of manual dexterity is required• Are your back/hips/ankles/knees up to it? You will spend prolonged periods sat working on the ﬂoor or standing at a table.• If you can deal with the emotional side of some cases• You can contact Canine Massage Therapy to discuss the occupational hazards or elements of physical stress that are associated with being a Clinical Canine Massage Therapist before you start the course as they take the approach that you come ﬁrst in this, after all, you have to, or else you are unable to help these wonderful dogs in turn.Additional InfoCMTC teaches anatomy from the ground up however, it is very beneﬁcial to have some grounding in the subject before you commence the course. Although this is not mandatory we ﬁnd that a lot of students want to do something in between applying to enrolment to prepare for the course.CMTC recommend a short online dog anatomy course with the Open College to those applicants who have no experience of anatomy and physiology, to help prepare them for the course. If you state that you are applying to study with Canine Massage Therapy Centre then you will be eligible for a discount.https://www.opencollege.info/product/dog-anatomy-course/ (quote the CMTC special discount code K9AT01)You can read the full course content and download the prospectus for the Canine Massage Practitioner Programme at:https://www.k9-massage.co.uk/courses/clinical-canine-massage-practitioner-programme/ n

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ANIMAL THERAPY MAGAZINE | ISSUE 26 39NARCH maintains the list of Registered Canine Hydrotherapists, striving for professionalism and the highest standards of care and treatment for dogs in a hydrotherapy setting.Why refer to a NARCH Registered Canine Hydrotherapist (RCH)?• All centres are fully insured and monitored to ensure education and qualication standards. Underwater treadmill services require advanced qualications.• Animal welfare is the rst consideration and all animals are treated with the utmost care to ensure best treatment.• We can assure owners, veterinary professionals, physiotherapists and pet insurance providers of the high standards of education, training and integrity of all our members.If you want to nd out more about referring a pet or joining as a member, please visit: www.narch.org.uk or enquiries@narch.org.ukIf you would like to contribute to plese contact:Hannah Ashton, Editor hannah@animaltherapymedia.co.ukBeth Lorraine, Sales Manager info@animaltherapymedia.co.uk

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ANIMAL THERAPY MAGAZINE | ISSUE 2640CANINE HYDROTHERAPYExploring a career in Canine HydrotherapyBy Barbara Houlding, GradDipPhys, MScVetPhys, MCSP, FIRVAP, ACPAT Chartered Physiotherapist and Veterinary Physiotherapist. K9HS Courses Principal, IRVAP ChairCanine hydrotherapy has signicantly evolved over the past 20 years and oers an exciting and fullling career. The market demand for high quality services continues to exceed the provision in many parts of the UK, which is reected by the continued growth of this speciality within the private canine veterinary sector. Outpatient and inpatient hydrotherapy services are delivered by independent private centres or within veterinary hospitals and clinics. This training overview is from my perspective as an accredited training provider in canine hydrotherapy and as a canine veterinary physiotherapist and hydrotherapy clinical specialist for over 20 years. School leavers, those seeking a career change, or professionals wishing to add a qualiﬁcation to their portfolio, can ﬁnd it a challenge when researching the various current training routes available. There are now a number of qualiﬁcation awarding bodies delivering a range of canine hydrotherapy courses. These are delivered by their respective recognised training providers, which include independent centres delivering services to the public, as well as college based courses.The minimum requirement adopted by the UK industry is to successfully achieve an Ofqual level 3 Certiﬁcate in Canine Hydrotherapy or equivalent. Qualiﬁcation guides are available online to explore the diﬀerent course curriculums. Booking a call with the training provider to chat through all your course queries is essential to ensure the course is the right ﬁt for you. Level 6 Veterinary Physiotherapy courses may cover Level 3 unit topics within their curriculum and veterinary physiotherapists can apply for recognised prior learning (RPL). The L3 certiﬁcate is just the start as it represents the foundation for safe and eﬀective practice for the routine case. There is now a progression route available to advance practice. Alongside a qualiﬁcation comes the obligation of being a canine professional, achieved by joining one or more of the professional and trade associations.

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ANIMAL THERAPY MAGAZINE | ISSUE 26 41CANINE HYDROTHERAPYThe Institute of Canine Hydrotherapists is a sub group of the Institute of Registered Veterinary and Animal Physiotherapists (IRVAP) which oﬀers student membership whilst training. The others are the Canine Hydrotherapy Association (CHA) and the National Association of Registered Canine Hydrotherapists (NARCH). Selecting your professional organisation will align with your practice ethos and the support, beneﬁts and mentoring services they provide. As an unregulated profession there are two voluntary regulatory bodies, RAMP and the AHPR, which have a diﬀerent role to the professional bodies and work closely with Defra and the RCVS. All qualiﬁed Hydrotherapists must hold appropriate insurance to practice and be committed to regular Continuing Professional Development (CPD) to keep practice and skills up to date. As a hands on profession, training includes an important practical component which is supported by the four key pillars of practice below: 1. Development of appropriate interpersonal skills2. Eﬀective communication skills with professionals, owners and dogs3. Professionalism in all aspects of practice4. Expanding your “therapeutic toolbox” of clinically reasoned assessment and treatment techniques, supported by underpinning scientiﬁc knowledge. Utilising your transferable skills linked to a passion for working with dogs and a willingness for active learning along the career journey are fundamental for success. The physical demands of working as a canine hydrotherapist to achieve great results for each dog in your professional care, leads to fantastic job satisfaction. n“There is always something new to learn.”

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ANIMAL THERAPY MAGAZINE | ISSUE 2642The name McTimoney is synonymous with gentle and eective chiropractic care within the animal industry. From his initial inception of the specic techniques used as a human treatment in the 1950’s, John McTimoney developed the highly successful human adjustments to treat animals and today the technique is used widely across the UK and in various areas across the world, in horses, dogs, other domestics and farm animals…. even the occasional zoo animal as well. All McTimoney Animal practitioners are qualiﬁed to the highest level and this can only be achieved by completing the MSc in Animal Manipulation (Chiropractic) at the McTimoney College in Abingdon. Other routes are available. We suggest you check out www.rampregister.org and www.ahpr.org.uk to ﬁnd a recognised course. Applicants to the two year part-time course must already hold a relevant degree, for example as a human physiotherapist, osteopath or chiropractor, or through studying a BSc (Hons) in Veterinary Science, Veterinary Physiotherapy, Equine Rehabilitation, Animal Sciences or a similar topic. Applicants should have a broad experience of working with or owning animals and have often observed treatment on their own animals before commencing on the course. In order to enter degree level Higher Education, you must complete either A- levels or a relevant Level 3 Diploma so if you are still at school, then investigate the degree you are most interested in doing on the UCAS website and check what their entry requirements are when choosing your next step at 16 years old. Typically, universities are looking for three grade B or above in A Levels with biology being a required subject.The McTimoney College is based in Abingdon, Oxfordshire with courses available in both human and animal chiropractic treatment. Human training can also be undertaken at the College’s Manchester base. Student loans are available for both courses and current or past Olympians are also able to apply for sponsorship to the human training programme through the International Federation for Sport Chiropractic (FICS) Olympian Scholarship Programme.If you would like to know more about how to train as a McTimoney Animal Practitioner, please visit the McTimoney College of Chiropractic at www.mctimoney-college.ac.uk nWant to become an McTimoney Animal Chiropractor? We spoke to the McTimoney College to nd out how.ANIMAL CHIROPRACTIC

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ANIMAL THERAPY MAGAZINE | ISSUE 2644A feast of inspiration, learning, fun and relaxation is promised at this year’s VET Festival as the nal speaker programme and amenities for delegates are announced.A packed clinical programme will update delegates on the latest thinking across a wide range of veterinary practice. Ophthalmologist Dr Renata Stavinohova; European and RCVS Specialist in Small Animal Surgery (soft tissue) Dr Jon Bray; RVN and BVNA Council Member Jack Pye, and RCVS Specialist in Feline Medicine Dr Nicki Reed are just some of the internationally-recognised speakers joining VET Festival this year. The Wellness and Practice Development programme includes Rachel Morris MBE, a British Paralympic sportswoman with gold medals in both cycling and rowing, who will address the important topic of resilience, while Brian Faulkner, co-founder of Colourful CPD, will discuss how to address self-doubt and develop self-conﬁdence. The event’s headline partner MWI Animal Health will be helping practices in their quest to become more sustainable, oﬀering advice and guidance – in addition to the opportunity to ‘make your own’ fruit smoothie, using their smoothie bikes. The company is working to electrify its ﬂeet and will be demonstrating its ﬁrst electric van at VET Festival. It will also be running its ever-popular pub quiz on the Friday evening.VET FESTIVALFinal Plans for VET Festival 2022 Announced20-21 May, Loseley Park, Guildford, Surrey

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ANIMAL THERAPY MAGAZINE | ISSUE 26 45VET FESTIVALNew sponsor ManyPets (formerly Bought By Many Pet Insurance) is supporting a range of activities, including massages, drinks, party make up and a free photo and print to take home, in VET Festival’s unique Relax and Recharge Hub. It is also sponsoring the Nursing Stream. Medivet is supporting the Delegate Food Village. A recent study into veterinary well-being carried out by VET Festival, highlighted the importance of taking time out for lunch and a clearly-deﬁned lunch break to allow for relaxation and social time is a key element of the conference programme. The event caterer, Eventist Group, is taking part in the onefeedstwo initiative, which means that every meal served at VET Festival will fund a school meal for a child in poverty.VET Festival’s signature Wellness Hub is being run in partnership with MWI Animal Health and featuring VetYogi this year. The VetYogi team will run yoga and meditation sessions throughout the event, tailored speciﬁcally for veterinary professionals and suitable for all levels of experience.Finally, VET Festival will, once again, welcome a wide range of exhibitors from across the veterinary industry in a diverse exhibitor village surrounding the lecture tents. They include charities, such as Battersea Dogs & Cats Home, together with pharmaceutical and equipment companies including Boehringer Ingelheim Animal Health, Kong (KVP), Lintbells Veterinary and Woodley Equipment Company Ltd.All delegates receive free admission to the ever-popular VETFest™ Live Party Night, which is 70’s- themed this year and will doubtless, once again, prove a highlight of the event. Nicole Cooper, Managing Director, said: “Now that Spring is in the air and with the weeks counting down, VET Festival is nearly upon us. The support we have received from speakers, partners and exhibitors as we have built this year’s event has exceeded our expectations and we thank them all. The response from delegates has also been fantastic. “We’re looking forward to giving delegates the opportunity to learn from leaders in the veterinary and wellness ﬁelds, as well as giving them a chance to relax and let their hair down as they take advantage of the wide range of well-being activities on oﬀer. It’s shaping up to be a brilliant and unforgettable couple of days and we’re so excited to be back.” nTickets for VET Festival can be purchased here: https://www.vetfestival.co.uk“We’re looking forward to giving delegates the opportunity to learn from leaders in the veterinary and wellness elds, as well as giving them a chance to relax and let their hair down as they take advantage of the wide range of well-being activities on oer.”

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Animal Therapy Magazine was created by professionals working in the ﬁeld of animal therapy. There was a general feeling that the industry lacked an open publication where professionals and owners could learn, companies could share their research and development and associations could keep everyone abreast of progress.You have two subscription options:Full Subscription£39.95 p/year• Printed copy of our magazine - delivered to you quarterly (UK Only)PLUS: • Full access to all online content from your phone, tablet and computer• Access to special oﬀers from industry suppliers• Automatic yearly renewalOnline-Only Subscription£29.95 p/year• Full access to all online content from your phone, tablet and computer• Access to special oﬀers from industry suppliers• Automatic yearly renewalSubscribe with us and receive new issues hot o the press.Subscribe at: www.animaltherapymedia.co.ukAnimal Therapy Magazine is published quarterly and distributed directly to professional associations, therapy clinics, colleges and universities, conferences, events and our extensive list of subscribers.

Issue 26

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