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ISSUE 29 - Published November 2023Elevating education in animal health & welfare Screening for Gastrointestinal Tract Conditions SHINING A LIGHT ON PHOTOBIOMODULATION plus£4.95Equine Arthritis: Take control with TurmericChristmas PromotionsChristmas PromotionsJeffTHE BEARDED DRAGON THE BEARDED DRAGON

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ANIMAL THERAPY MAGAZINE ISSUE 29 3Contents 5 EQUINE HYDROTHERAPY Evolving for the future 8 SUCCEED Screening for Gastrointestinal Tract Conditions 12 MACHINE LEARNING IN VETERINARY How to safely impliment AI in your practice 14 INVESTIGATING THE PERCEPTIONS of Veterinary Physiotherapy Treatment in the Management of Equine Osteoarthritis 17 ELECTROLYTES and the Performance Horse 20 CASE STUDY The Moores Orthopaedic Clinic 24 CHRISTMAS PROMOTIONS 26 RED LIGHT THERAPY Shining a light on Photobiomodulation 29 KISSING SPINES? Too Common 32 CANINE COGNITIVE DYSFUNCTION and its relation to osteoarthritis 36 AN OSTEOPATHIC CASE STUDY Treating two Red River Hogs 39 EQUITATION SCIENCE using evidence to empower equine therapists 39321443 LEVI HUNT Keep your eyes open to listen to your horse 44 IRVAP 47 IMPORTANCE OF EFFECTIVE WATER MANAGEMENT in Canine Hydrotherapy 50 CASE STUDY: JEFF The Bearded Dragon 52 EQUINE ARTHRITIS Take control with Turmeric

ANIMAL THERAPY MAGAZINE ISSUE 29 4PAGE CONTENT TITLEGET INTOUCH Hannah Ashton Editor hannah@animaltherapymedia.co.uk Georgina Bashforth Graphics Editor georgina@animaltherapymedia.co.uk Beth Lorraine Sales Manager info@animaltherapymedia.co.uk Tony Nevin Podcasts & Research tony@animaltherapymedia.co.uk Operations Team Ruth Milner ruth@animaltherapymedia.co.uk Sophie Milner sophie@animaltherapymedia.co.uk Nicola Ravensford nicola@animaltherapymedia.co.uk To subscribe with us or join our mailing list please visit our website www.animaltherapymedia.co.ukSo this issue we have .... Kentucky research into the daily use of electrolytes Levi hunt talks about - open your eyes to listen to your horse. The value in just stopping and looking at their posture, expression, demeanour Some fab case studies including Jeff the Bearded Dragon with a crocked tail, conservative management of a horse with kissing spine, treatment of two red river hogs with osteoarthritis and the treatment and management of Milly, the labradoodle with a Humeral Intracondylar Fissurele Canine Cognitive dysfunction and its relation to osteoarthritis. Exploring clinical signs and management both pharmaceutical and therapeutic Hartpury have written about Equitation science, using evidence to empower therapists. Deep diving into behaviour and why they may respond as they do. The Institute of Equine Hydrotherapists and how they are building a course for their members so clients can be confident that their therapist puts welfare and therapeutic handling is at the forefront of their techniques. And lots more.... Tea m AT M ISSUE 30 will be out 1st March 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 upon the information contained in this publication or website. The publishers or authors do not give any warrenty for the completeness or accuracy for this publication’s content, explanation or opinion. No part of this publication and/ or website maybe reproduced, stored in a retrieval system or transmitted in any form withour 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: Lowerfield Farm, Wiltshire Pet Turkey in the Christmas Trees Curtesy of: Harry Stokes

ANIMAL THERAPY MAGAZINE ISSUE 29 5HYDROTHERAPYEquine Hydrotherapy: Evolving for the futuren a therapeutic world where some technologies come and go and some techniques are briefly fashionable, equine hydrotherapy has been around for a long time and is becoming even more popular since the underwater treadmill has been developed. Whilst practice is mainly focused on underwater treadmills, there is still an interest in pools and a growing interest in salt water spas and oxygen therapy. However, there is also growing concern for the number of horses that are either further injured or worked incorrectly as a result of the minimal training available. As the Co-Chair of the Institute of Equine Hydrotherapists (IEH) and VetHed company Director, we have been looking at what can be done to help safeguard and evolve the industry. Whilst most equipment is acquired with in-house training, this is not always the case and not every member of staff will be suitably trained. IFirstly, hydrotherapy provides a low-impact form of exercise, reducing stress on joints and minimising the risk of further injury. The buoyancy of water supports the horse's weight, allowing for controlled movement and muscle strengthening without excessive strain. This is especially advantageous when we consider conditions such as arthritis and orthopaedic injuries. Secondly, hydrotherapy enhances cardiovascular fitness and circulation. The hydrostatic pressure exerted by water stimulates blood flow, aiding in the removal of metabolic waste products and promoting tissue healing. This increased circulation also helps to reduce inflammation and swelling, accelerating the recovery process. So whether the horse is in training or rehabilitation the increased blood flow will be hugely favourable. Furthermore, hydrotherapy can improve range of motion and flexibility. The resistance provided by water during exercise encourages horses to engage their core, leading to improved joint mobility and muscle tone. This is particularly beneficial for horses recovering from musculoskeletal injuries or surgeries. But before we look further in to the industry, why has it become so popular? Well, research is telling us a lot. 123author Grace Nattrass PGCert, FHEA, AdvCertVPhys, BSc (Hons), MIRVAP

ANIMAL THERAPY MAGAZINE ISSUE 29 6HYDROTHERAPYrisks considerationsWhile equine hydrotherapy offers numerous benefits, it is essential to acknowledge the potential risks and considerations associated with this treatment modality. Firstly, the temperature of the water used in hydrotherapy must be carefully regulated to avoid thermal stress on the horse. Water that is too cold or too hot can cause discomfort and muscle spasms. Maintaining an optimal water temperature, specific to the equipment (spa, pool or treadmill) is crucial to ensure the horse's safety and well-being. Additionally, the duration and intensity of hydrotherapy sessions must be tailored to each horse's individual needs. Overexertion or excessive exercise in water can lead to fatigue, muscle strain, or even exacerbation of existing injuries. Therefore, it is vital to have professionals overseeing the hydrotherapy sessions and designing appropriate exercise programs for each horse. &The effectiveness of equine hydrotherapy is supported by scientific principles rooted in biomechanics, physiology, and hydrodynamics. Biomechanically, water provides resistance that challenges the horse's muscles, leading to increased strength and endurance. The viscosity of water creates a controlled environment for exercise, allowing for targeted muscle engagement and improved proprioception. Physiologically, hydrotherapy stimulates the cardiovascular system, enhancing blood circulation and oxygen delivery to tissues. This increased blood flow aids in the removal of waste products, such as lactic acid, reducing muscle soreness and promoting tissue repair. The hydrostatic pressure exerted by water also assists in reducing oedema and swelling, facilitating the healing process.

ANIMAL THERAPY MAGAZINE ISSUE 29 7HYDROTHERAPYHydrodynamics plays a crucial role in equine hydrotherapy. The buoyancy of water reduces the gravitational forces acting on the horse's body, relieving stress on joints and supporting weight-bearing structures. This allows for pain-free movement and exercise, particularly beneficial for horses with orthopaedic conditions or post-surgical rehabilitation.HydrodynamicsAfter a brief look at the science, it is easy to understand that equine hydrotherapy, like all animal physiotherapy, osteopathy etc. is an art and a science, and that requires training and practice. Currently, the role of the equine hydrotherapist is unregulated. However, there is training at level two focused at those wanting to be an assistant and in spring next year there will also be at Diploma in Equine Hydrotherapy at QLS Level 6, launched by VetHed. This aims to prepare anyone wanting to run or work in an equine hydrotherapy centre and would also futureproof their role should the industry become regulated in the near future. If we can not only mirror, but exceed the canine hydrotherapy training framework, we will offer higher standards of welfare to the horses rehabilitating or improving their sporting performance. We can welcome regulation; to encourage all yards to employ trained and qualified, members of professional bodies and regulatory bodies. Over the next few years, the equine hydrotherapy industry can transform into an informed, highly skilled and trusted industry. I hope you’ll be a part of it in support, research or practice. The Institute of Equine Hydrotherapists is a sub group of IRVAP and the only professional body for equine hydrotherapists in the UK. Their progressive outlook and drive to raise industry standards is led by Co-Chairs Gaby Kerfoot and Grace Nattrass, and supported by industry experts. www.irvap.org.uk/institute-of-equine-hydrotherapists

ANIMAL THERAPY MAGAZINE ISSUE 29 8DIGESTIVE HEALTHScreening for Gastrointestinal Tract ConditionsThe work of the para professional is crucial in maintaining the ongoing health of the horse, ensuring that all systems are working correctly and in balance. While physiotherapists, osteopaths and chiropractors are typically focused on muscular/skeletal issues, the digestive health of the horse is worth their consideration, given the potential impact of the latter on the former. Emma Hardy, PhD

ANIMAL THERAPY MAGAZINE ISSUE 29 9DIGESTIVE HEALTHIt is an unfortunate dilemma that the lifestyle required for performance can be a significant departure from how the horse has evolved to live. The often-unavoidable management routines, dietary needs and stress of training and competition leaves the horse at a significant risk of gastrointestinal disease. Disturbances to the health of the gastrointestinal tract can elicit a range of symptoms and signs. Some are easily recognised, such as weight loss, diarrhoea, and poor condition, but others may masquerade as something very different. Increasingly, signs such as hind limb lameness, changes in gait quality and back pain are being identified as originating from gastrointestinal discomfort. These particular issues may lead the horse owners to consulting the paraprofessional. As a result, physiotherapists, osteopaths and chiropractors should include an assessment of a horse’s GI health as part of their overall evaluation. The proficiency at which chiropractors, osteopaths and physiotherapists can investigate, evaluate and arrive at a carefully considered diagnosis is in no doubt, but when it comes to the gastrointestinal tract, making a differential diagnosis can be more difficult. Ruling in or out a gastrointestinal tract issue can be a vital step in establishing what is wrong with the horse, and how best to formulate an effective recovery plan. However, even the very best para professional can be limited in his or her licensed capacity to investigate an internal problem, which is where veterinary advice and involvement may become necessary. Current methods of detection are not bad, but not good It has been well established that gastric ulcers are nearly ubiquitous in horses used for competition. Digestive disorders beyond the stomach also bear significant consideration for the horse and demand attention from owners and professionals alike. It has become apparent that large colon pathology is more significant and widespread than previously thought. Whilst these is still much be learnt, it can be agreed that for effective resolution, accurate and reliable methods of initial detection are key. This focuses treatment and limits the possibility of longer term effects, which is of course crucial in achieving a full recovery. Gastrointestinal Tract health problems aren’t always easy to spot“”

ANIMAL THERAPY MAGAZINE ISSUE 29 10DIGESTIVE HEALTHShould a gastrointestinal tract condition be suspected, a quick and easy way to investigate this further is by screening the horse with the SUCCEED® Equine Fecal Blood Test™ (FBT). The FBT is a lateral flow assay which detects albumin and haemoglobin within a fresh faecal sample. The blood components serve as markers of inflammation and bleeding which can facilitate diagnosis of many gastrointestinal tract disorders, from suspected ulceration, colitis, IBD, protein losing enteropathy, or colic, to investigating the causes of more generalised loss of weight/condition/performance and changes in temperament. Furthermore, due to the nature of degradation of albumin within the tract, the FBT can help to locate the point of source, being gastric or at a point thereafter. Despite its simplicity of use, the FBT is available through veterinary practices only due to the range of gastrointestinal tract disorders that may be reflected in the results. Evaluation of these test results, combined with other diagnostic tests and the vet’s expertise, facilitates a differential diagnosis, which is vital in devising a targeted and effective plan for resolution. The FBT is the only test which enables the vet to perform an initial screening for gastrointestinal tract conditions, being affordable, completely non-invasive and returning results within 15 minutes, stable-side. Initial Gastrointestinal Tract screening using the SUCCEED® Equine Fecal Blood Test™The FBT can help narrow down options for further testing and therapyThe initial information gained about the gastrointestinal tract from using the FBT equips the vet to consider or negate further diagnostic techniques or medication options. For example, a positive result for gastric bleeding may warrant subsequent gastroscopy to visualise and score gastric ulceration, whilst a positive result for inflammation beyond the stomach may rule out this procedure and initiate a hindgut-directed drug therapy or a gastrointestinal nutritive supplement course. The test can also be carried out over the duration of recovery to assess treatment efficacy, as well as to simply monitor ongoing gastrointestinal tract health as part of a wellness program. The FBT gives all those involved in the health and welfare of the horse a window into the gastrointestinal tract. By knowing what is going on inside the horse, perhaps even before symptoms become overtly apparent additional diagnostics, treatment strategies and preventative measures can be rapidly implemented, securing a fast and long-term resolution. window into the gastrointestinal tract

SUCCEED® is a registered trademark, and Equine Fecal Blood Test™ is a trademark of Freedom Health LLC. © 2023. All Rights Reserved. U.S. Patent Nos. 7,629,180 and 8,168,446. Canadian Patent No. 2,601,368.SUCCEED® is a registered trademark, and Digestive Conditioning Program™ is a trademark of Freedom Health LLC. © 2023. All Rights Reserved. U.S. Patent Nos. 7,658,964; 7,824,706; 7,988,989 and 8,197,842. www.succeedFBT.co.uk www.succeed-equine.co.ukOptimal equine GI health requires accurate IDENTIFICATION if a condition is suspected.The ultimate SOLUTION for equine digestive health.Performance, appearance, temperament and overall health are all significantly influenced by the condition of the GI tract. SUCCEED® Digestive Conditioning Program™ is a daily functional feed which helps optimise the structure and functioning of the entire tract. Ideal for horses facing the rigours of training, performance and related lifestyle factors, it can both aid recovery and help offset the challenges the GI tract can face when under these conditions. It’s supported with clinical trials, published research and multiple patents worldwide.In the U.K. call or email Dr. Emma Hardy at 01522 309946 / ehardy@freedomhealthllc.com In Ireland call or email Sandra Hughes at +353 87 3781739 / shughes@freedomhealthllc.comContact Succeed to enquire about your suitability for a free trial The SUCCEED® Equine Fecal Blood Test™ (FBT) allows for the detection of bleeding and inflammation originating from the GI tract, using just a fresh faecal sample. This simple, rapid and affordable, stable side test can be invaluable if you suspect a GI tract condition, or as part of a routine wellness program. The horse’s digestive system is the key to overall health, which is why you should have your vet test your horse regularly with the Succeed FBT to ensure targeted treatment, resolution and optimal prevention.

ANIMAL THERAPY MAGAZINE ISSUE 29 12TECHNOLOGIESMachine Learning in Veterinary: How to Safely Implement AI in Your PracticeGiven the ever-growing number of households, globally with multiple pets, no matter how much you may wish you could, you simply can not ignore AI. What’s for sure is the increasing number of pet owners out there certainly are not! In fact, Forbes recently reported that pet owners as a demographic are extremely early adopters of AI and other tech tools. The reason being the humanisation of their pets and the parental desire to gain more access to insights around their four-legged, family member’s health care needs. Interestingly, despite this thirst for more knowledge, pet parents, on average, are still not surfacing most of their queries. With a whopping 92% of a pet’s health issues still not being presented to their vet. It is here that unarguably AI (under the guidance of qualified veterinary teams) is more relevant and valuable than ever before. This is because it can remove the unnecessary complexities of activities such as ‘Telephone Tennis’ and ‘Answer Phone Tag’ with great ease. Adding AI into a clinic not only opens opportunities to implement more efficient workflow solutions, but by doing so it can also elevate the standard of pet care a clinic or practice can offer. Look for ‘AI assisted’ features rather than ‘AI led’ to increase your capabilities without sacrificing control. It is also good to note that regardless of the style of AI tools you use, when incorporating AI within any clinic it is essential that you make sure the AI assisted services you layer in are respectful. That is, they understand or can accommodate the nuances of the profession, do not risk data privacy breaches at any level, and do so while still helping you maintain a personal, well engaged relationship with your clients. As a veterinary team it is essential you enroll in technologies that empower you. Look for hybrid AI features that are proven to augment existing patient advocacy efforts. As it is this level of service that will ensure you maintain your place at the heart of every one of your patient’s pet care journeys. Are Pet Owners Ready for AI?Are Pet Owners Ready for AI?It is more than likely that at varying points this year (whether you’ve wanted to or not), you have given some thought to AI (artificial intelligence that is not artificial insemination) and its place within veterinary medicine. Regardless of whether your anticipation has been riddled with fear or excitement, the wait is now over. AI is well and truly here!author Will Monk

ANIMAL THERAPY MAGAZINE ISSUE 29 13TECHNOLOGIESCould AI Undermine the Integrity of Veterinary Professionals?Could AI Undermine the Integrity of Veterinary Professionals?In my experience the best way to ensure the integrity of any tech you utilise is to make sure that it has been developed by the community it was meant for. My teams will often place the tools and features we create in the hands of the professionals it affects. Doing so allows that community to be the judge of how best to mediate its functionality and reliability. For vets this will include best practices for using it as part of their pet owner engagements. I encourage you to take new AI tools and try to break them to tailor them to your specific needs and enhance them. Don’t bury your head in the sand and try to ignore them, be a part of what grows them into the essential extension of our services we very much need them to be. Don’t fear them! A recent white paper published by VetCT (in collaboration with AI), concluded that overall, the use of AI tools in radiology (for example) had proven to significantly improve the diagnostic process, when used in conjunction with human expertise. The human involvement being the key to using these new technologies to enhance (not replace) our capabilities. Responsibly generated AI is developed under robust regulations, with open dialogue to ensure that all elements prioritise the well-being and safety of the pets and people it serves. Because let’s be honest, as amazing a leap as AI is, it does have its limitations which is why it’s important that any veterinary AI functionality is overseen and monitored by veterinary professionals. AI generated chats for example are a great way to clear through the daily avalanche of basic pet queries that do not need to come into the clinic, but collectively take up a lot of time to filter through, monitor and reply to. Automatic AI generated answers that can understand the whole context of the chat in question and suggest the best next reply by the veterinary team, means you’re only reviewing and sending, rather than thinking up, typing and then proofreading any given answer. This kind of AI functionality can appropriately support a veterinary team, allowing them to simply oversee and sign off before a reply is made whilst also clawing back hours of previously lost time from their working week. Time that can be better allocated to patients that need to be seen and assessed in person. Ultimately you want to use AI to help you help more pets, without sacrificing more of your time. AI is not going to replace vets, but vet professionals augmented with AI will likely displace vet professionals that just close their eyes to it and let the opportunities pass them by. When there is tech out there that can augment and enhance our existing patient advocacy efforts, we should engage with it. This is an exciting time now to see just how many more pets we as a community can each serve more easily and with greater ease.

ANIMAL THERAPY MAGAZINE ISSUE 29 14OSTEOARTHRITISInvestigating the Perceptions OF VETERINARY PHYSIOTHERAPY TREATMENT IN THE MANAGEMENT OF EQUINE OSTEOARTHRITIS Ellie Robinson’m sure it is unsurprising to most of us that osteoarthritis is one of the most commonly seen musculoskeletal conditions in equine practice, contributing to an estimated 60% of all lameness cases seen by vets. Although unfortunately it is incurable, there are numerous treatment options now available to help manage the symptoms of the condition and maintain the horse’s quality of life. 60%Various studies have investigated the use of intra-articular corticosteroids as a treatment option, but there is little evidence to support the use of veterinary physiotherapy as an additional management technique. Furthermore, the current evidence lacks an understanding of horse owner perception, which we all know has a huge influence on the outcome of the horse following treatment. I

ANIMAL THERAPY MAGAZINE ISSUE 29 15OSTEOARTHRITISThis gap in current knowledge led me to carry out my undergraduate dissertation in this subject, so I distributed two online questionnaires, one targeted at horse owners and one at Veterinary Physiotherapists. My results reassuringly showed that 90% of horse owners employed a Veterinary Physiotherapist to treat their horse on a regular basis, and of these owners, 98% believed that the main benefit of treatment was to maintain the soundness, comfort, or performance level of their horse. The most common treatment techniques and modalities implemented were massage therapy, passive stretching and LASER, as reported by both horse owners and practitioners, and the most popular treatment frequency was every 6-12 weeks. Following statistical analysis, a significant association was found between the use of dynamic mobilisation exercises and owner opinion on the benefit of treatment, indicating that horse owners were more likely to have a higher opinion on the treatment if dynamic mobilisation exercises were used. It also was found that 70% of practitioners made management recommendations to clients, indicating the importance of a holistic approach to veterinary physiotherapy treatment when managing a chronic condition such as osteoarthritis. ANALYSIS98%

ANIMAL THERAPY MAGAZINE ISSUE 29 17ELECTROLYTES &In the exercising horse, sodium, potassium, chloride, and magnesium are lost in sweat and urine. Owners need to have some idea of the magnitude of loss of electrolytes during exercise before a feeding program can be developed to replace these losses. Since most of the electrolyte loss in the horse occurs through sweating, one method of calculating electrolyte requirements can be based on amounts of sweat loss. Body weight loss during exercise is a good way to estimate the amount of fluid lost, where 1 kg (2.2 lb) of body weight loss equals 1 liter of fluid. FACTORSThe amount of fluid loss will depend on a number of factors such as duration and intensity of exercise, temperature, and humidity. Therefore, the best way to determine this loss is to weigh the horse before and after exercise. This after-exercise weight should be taken before the horse is allowed to drink. During a routine workout, sweat loss in a racehorse amounts to between 5 and 10 liters. Losses of 25 liters might occur during a normal endurance ride, and 40 liters of fluid loss would probably only be seen in an exhausted, dehydrated endurance horse in serious danger of dying.Electrolytes are substances that play an important role in maintaining osmotic pressure, fluid balance, and nerve and muscle activity. These substances are important because without the proper electrolyte levels, performance horses are slowed by fatigue and muscle weakness.

ANIMAL THERAPY MAGAZINE ISSUE 29 18ELECTROLYTES FORAGEA major source of potassium for horses is forage. Hays typically contain from 10 to 20 grams of potassium per kg. When fed in adequate amounts, hay provides a great deal of a performance horse’s potassium requirement. Besides providing large quantities of potassium, forage helps maintain water balance in exercised horses. German research has shown that horses fed adequate forage maintained water and potassium balance better during exercise than horses fed a high-concentrate diet. Unfortunately, forage is very low in sodium and marginal in chloride. Therefore, supplemental sodium and chloride are required by the performance horse. A portion of the sodium and chloride required by the performance horse can be provided by a salt lick. Research at Cornell University has shown that horses at rest will voluntarily consume about 50 grams per day from a salt block. When researchers from the University of Tennessee and University of Georgia measured weight loss, water loss, and electrolyte balance in horses competing in a three-day event in New Jersey, they found that the 48 horses measured in this study lost an average of 18.4 liters of body water during the cross country phase of the three-day event. This occurred even though the environmental conditions during this event were fairly mild.FUFILLAlthough it is theoretically possible to fulfill an exercising horse’s electrolyte needs with plenty of good-quality forage and free-choice salt licks, many equine practitioners have reported that supplemental electrolytes are important and beneficial for maximum performance. Besides aiding in the prevention of tying-up, electrolytes help horses rebound from hard work sooner, return to feed quicker, and begin the necessary rebuilding phase that occurs after exertion.

ANIMAL THERAPY MAGAZINE ISSUE 29 19ELECTROLYTES Save time & streamline your businessExciting new plans coming!Due for release early 2024YOUR EQUINE &YOUR EQUINE &CANINE EXERCISECANINE EXERCISEPRESCRIPTION APPPRESCRIPTION APPPRO MONTHLYEQUINE, CANINEOR BOTHENDS 31/12/2023Create home exerciseprogrammes your clients will love!Over 250 videos andgrowing@EQUICANTISEQUICANTIS.COMATMAG5050% off for 2 months!FORMULATEDWhile electrolytes are essential to the performance horse, electrolyte preparations must be properly formulated to meet the horse’s needs. Equine electrolyte replacements should not be largely sugar, but instead should be formulated to replace what is actually lost from the horse during exercise. In summary, electrolytes are essential nutrients for the performance horse. Because horses lose large quantities of electrolytes in sweat, requirements increase with exercise intensity and sweat loss.Adequate intakes of good quality forage and a free-choice salt lick will help meet much of the electrolyte requirements of the performance horse. In addition, a commercial electrolyte supplement can help prevent electrolyte depletion. Kentucky Equine Research recommends the use of Restore SR (Restore in Australia), which contains the latest technology in electrolyte therapy, a proprietary slow-release mechanism that allows sodium to be released gradually into the gastrointestinal tract for sustained absorption. Reprinted courtesy of Kentucky Equine Research. Kentucky Equine Research is an international equine nutrition, research, and consultation company serving horse owners and the feed industry. Our goals are to advance the industry's knowledge of equine nutrition and exercise physiology, apply that knowledge to produce healthier, more athletic horses, and support the nutritional care of all horses throughout their lives. Learn more at https://ker.com.

ANIMAL THERAPY MAGAZINE ISSUE 29 20CASE STUDYby Andy Moores, BVSc, CertSAS, DSAS(Orth), DipECVS, FRCVS & Anna Lindley, RVN, Dip.A.Physio, IAATTilly, a 4 year-old Labradoodle, presented to The Moores Orthopaedic Clinic in Hampshire due to recurrent left forelimb lameness. She had been diagnosed with a Humeral Intracondylar Fissure (HIF) five months earlier. HIF, which used to be called incomplete ossification of the humeral condyle, is a stress fracture of the humeral condyle and is most often seen, but not exclusively, in spaniel breeds. HIF is typically treated by placing a screw across the humeral condyle to strengthen the condyle, reduce stress on the distal humerus and reduce the risk of complete condylar fracture. An advanced practitioner surgeon at Tilly's GP practice performed surgery to place a 3.5mm cortical screw across the left humeral condyle. She initially improved but became lame again four months after surgery and was referred to Andy Moores, a specialist surgeon and an internationally-recognised expert on HIF, at The Moores Orthopaedic Clinic. Here, Tilly presented 5/10 lame with discomfort in the left elbow. A CT scan with iMAR (iterative metal artifact reduction) processing showed that the original 3.5mm screw was placed too proximal, was impinging on the joint surface and was broken. The screw would need to be replaced with the challenge that Tilly's humeral condyle is relatively small and the original drill hole for the 3.5mm screw would need to be avoided. With the help of Bill Oxley at Vet3D the CT scan was used to plan the ideal screw trajectory and patient-specific 3D-printed guides (PSGs) were created to allow a new screw to be placed in exactly the right position. The broken screw was removed and a stronger HIF-specific screw (N2) was placed. Case Study

ANIMAL THERAPY MAGAZINE ISSUE 29 21CASE STUDYTilly improved immediately after surgery and was discharged with instructions for rest and rehabilitation. She returned to The Moores Orthopaedic Clinic four weeks after surgery at which point she was sound with full elbow range of motion and no elbow discomfort. Her owner commented that she was the happiest she had been since before the first surgery.HIF can be a challenging condition to treat. The fissure in the centre of the humeral condyle may not heal after surgery meaning that in some patients the transcondylar implant will be subjected to long-term stresses. These stresses can result in fatigue failure of the implant, if the implant is undersized. Placing a suitably-sized implant in the relatively small humeral condyle requires great care to avoid inadvertent placement of the screw into the joint. The 3.5mm cortical screw has a core size of 2.4mm and the N2 HIF screw has a core size of 3.1mm. Since the core size is proportional to the bending strength of the implant to the power of 4, small differences in core size can make a huge difference to screw strength. Although not used routinely, the use of 3D-printed PSGs in this case facilitated accurate placement of a more suitably-sized screw. Tilly's case demonstrates the value of a specialist referral for even relatively straight-forward surgical conditions. Andy Moores, BVSc, CertSAS, DSAS(Orth), DipECVS, FRCVSa new screw placed in exactly the right positionthe original 3.5mm screw was placed too proximal

ANIMAL THERAPY MAGAZINE ISSUE 29 22CASE STUDYPhysiotherapyPhysiotherapy was recommended by Moores Orthopaedic Clinic following discharge from hospital. Her owner commented that physiotherapy wasn't recommended after her last procedure and she wished it was.On initial assessment (2 weeks post op), Tilly presented a happy and active dog but her owner expressed concern she was getting depressed from not going out. She has another dog so leaving her on her own whilst exercising her friend was heartbreaking. She admitted she had been taking her out for 30 minutes on lead. I explained the importance of not doing too much too soon, allowing the bone and tissue to heal. On gait assessment, Tilly was placing the left forelimb well but was walking with 2/10ths lameness. As soon as she was coming to a stand, she weight shifted off the left forelimb. She was also stiff in her lumbar spine, the left hindlimb lacked flexion in the hip and stifle, and she would circumduct it. She also had a shortened swing phase. When asked to sit, she sat square but leaned over to the right and abducted the LFL. On palpation, Tilly was a little hypertonic in the muscles of the neck and bilateral cranial scapulars. She gave normal and comfortable passive range of motion in the affected limb. On measuring her muscle mass circumference she had a 3cm deficit on the left forelimb compared to the right forelimb. I suspect was not a recent issue and could be from not having rehabilitation after the first operation. She also had some palpable heat and trigger points in the epaxial muscles of the thoracolumbar spine bilaterally. She gave a slight pain reaction when palpating this region (sat down and turned her head). On palpation of the hindlimbs, Tilly was reluctant to extend the left hip, and had a 4cm deficit compared to the right hind. The hamstrings and medial muscles in the right hind limb were hypertonic. I treated Tilly with some laser therapy, a massage with some passive stretches (her left hip was within normal limits and comfortable after the treatment), and some Pulsed Electromagnetic Field Therapy (PEMF). two weeks post opI then went through some targeted exercises aimed at increasing the flexibility in her neck and spine as well as increasing strength and function in her left side. These included: • Biscuits to hips, a great one for spinal stretching and introducing weight bearing in a low impact way. • Give paw at different heights and distance from her body) for forelimb flexion, extension as well as abduction and adduction of the shoulder. Also weight bearing and confidence building of the affected limb. • Step ups on a yoga block aimed at encouraging weight bearing on the forelimb and further increase some weight through the hindlimbs (ensuring the hindlimbs are lined up and square with forelimbs). • The treatment home plan also included damp heat and cold therapy.

ANIMAL THERAPY MAGAZINE ISSUE 29 23CASE STUDYAddressing the home environment is an essential part of rehabilitation. I assessed the flooring and advised rugs where they were slippery, raising her food and water bowls and adjusting her exercise to balance out her physical and mental health (5 mins x 4 times daily). I advised weekly sessions for an initial period of 4-6 weeks depending on how she responded. three weeks post opAt week 2 (3 weeks post op), Tilly's owner was really pleased with how she was progressing (although reported she would not do the therapeutic exercises I had prescribed-she apparently played up and refused!) On assessment, she was comfortable and had good range of movement in both the left forelimb and left hip. After carrying out a treatment, (laser, massage with stretches and PEMF), Tilly did the therapeutic exercises with me and her owner. Her owner was concerned that she wouldn't do them if I wasn't there as so I advised on some alternatives that could be done in the garden or while out on a short walk which should be easier. This included • Walking through long grass and over tree roots. This will help with joint flexion. • Weight bearing and figure of eights. Great for spinal flexion and weight bearing. five weeks post opAt my 3rd session (5 weeks post op), Tilly had been back to Moores Orthopaedic clinic for a post op check and x-ray which showed that the bone was healing well. Andy Moores was pleased with her progress. An exercise plan to increase Tilly's exercise incrementally was recommended but no off lead exercise for a further 4 weeks, with the view that Tilly could be back to normal activity after a further 4-6weeks. seven weeks post opOn my 4th session (7 weeks post op), gait assessment indicated no lameness in the left forelimb, better foot placement and flexion. She also looked more comfortable mobilising her lumbar muscles. On palpation, Tilly gave normal range of movement in all joints. She had gained 3cm of muscle in the left forelimb and only had a 1 cm deficit from the right forelimb. In the left hindlimb she had gained 5cm muscle mass and both hindlimbs were symmetrical. I introduced Tilly to the wobble cushion and discussed the importance of keeping her muscles strong and balanced due to osteoarthritis in the future. I also discussed hydrotherapy and addressed her exercise as at the moment she is doing too much for the stage of her recovery. Tilly's owner informed me she was up to 2hrs with off lead and she was back ball throwing...my heart sank slightly and I had to explain the detrimental effect of ball throwing on dogs physical and mental health as well as generally over stretching her. I think it’s difficult as owners just see the dog in-front of them and there is no denying that Tilly is making a brilliant recovery which makes it hard to hear our reasoning of not doing too much too soon. Her excessive exercise doesn't seem to be impacting her (yet), but we know as veterinary professionals, the effect of excessive exercise on joints, implants and the healing process. Lifestyle plays a role too as for her owner, long walks are an important part of her life but I needed her see the bigger picture. I will continue to see Tilly on a monthly basis until she is able to be back to normal exercise and to ensure she doesn't deteriorate or get any compensation issues again. Anna Lindley, RVN, Dip.A.Physio, IAAT

ANIMAL THERAPY MAGAZINE ISSUE 29 24PROMOTIONSFreedom of movement is vital to a happy and healthy dog, but many suffer with joint stiffness, especially in colder weather, which can affect their quality of life. Nutraquin+ [1] contains the necessary high strength ingredients that help maintain healthy joint function, whilst supporting the natural systems that control inflammation. Making it the perfect choice joint supplement for dogs, cats, and horses. Get free delivery with code ‘ATFree23’ at www.nutravet.co.uk Experience the power of the Woozelbears brand. Dive into the world of personalised, innovative, and award-winning hydrotherapy and grooming for your furry companions. Join our family and explore franchise opportunities. Start making tails wag in your local canine community today. Learn more at: www.woozelbears.com Pioneer Veterinary Products are the only supplier in the UK to offer the full Continuum of Care range of lasers and thermal imaging equipment, including both Class I and Class IV lasers. Scan the QR code to find out how you can enhance your treatment capabilities and improve patient care. pioneervet.co.uk LEARN MORE & BOOK A DEMO pioneervet.co.ukPioneer Veterinary Products Christmas PromotionsChristmas Promotions

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ANIMAL THERAPY MAGAZINE ISSUE 29 26RED LIGHT THERAPYShining a light on Photobiomodulation (PBM)Shining a light on Photobiomodulation (PBM)Despite PBM (formerly called low-level laser/light therapy LLLT) being studied for around five decades using accepted evidence-based scientific methodology, it is a shame there is still hesitancy and openness within the UK mainstream human and animal health sector to embrace its full potential. In other countries PBM is integrated more often as an integrative therapeutic modality to assist the healing process and promoting overall ‘wellness’ with a wide range of applications, especially helping all animals both in practice and at home to improve clinical outcomes. ince Photizo Vetcare’s launch in 2013, its success has been proved by a raft of animal health professionals. The clinical successes across musculoskeletal conditions, atopic issues, wound healing and in reducing pain and anxiety is not only scientifically documented, but repeatedly observed by real-life cases. Whatever arguments in the plethora of documented science or even manufacturers’ claims about the 'best protocol' or 'best wavelength' or 'best pulsed frequency' or 'best power output', the reality is there is a wide window of effective PBM dosing that will, far more often than not, result in positive biological effects via cellular messengers. PBM is simply a way of delivering energy (using photons) into the body to facilitate and often accelerate the natural healing processes...one of the key mechanisms is to fire up the production of ATP in the mitochondria where cell respiration takes place. Sadly, some of the ‘scepticism’ surrounding PBM is oftentimes heightened by the on-going debate between the efficacity of ‘laser’ over LED (Light Emitting Diode) sourced red/near-infrared light. The ideal scenario is for the integration of both for the best clinical outcomes. The conversation is not about banishing laser for LED, it’s about doing what’s best for the individual patient! However, the likes of a professional therapeutic laser (class 3b or 4) are costly and can be prohibitive for many independent practitioners and pet owners. All laser light poses risk to eyes, protective eyewear is crucial, and works intensely at one given area using a coherent pinpoint beam of light. Contrast this to the latest technology of high-power LED PBM, safe for eyes and offers ‘effective’ doses of ‘red/near-infrared’ light. LED has a spread-out beam of light with greater application potential (local & compensatory), not least for use at home in-between professional treatment sessions. Plus, apart from such devices being lightweight, portable and easy to operate, they’re more affordable both for in-practice and home use. One clear message from documented studies is PBM works accumulatively. For best results, it should really be deployed ‘little and often’. This is why the Photizo concept was born, to be the ideal solution and enable ‘top-up’s’ in-between less frequent professional laser therapy sessions. It’s common misnomer to think that 'harm' can be caused if over-dosing with LED sourced devices, when the reality is there are vital 'inhibitory effects' observed in studies, which is pain inhibition (analgesic effects). This justifies the fact that, for pain relief, the dose needs to be stronger. However, for healing effects, ‘less is more’ so, for example, it’s recommended to apply less frequent and lower doses to an open wound area. Dosing guidelines are published by WALT (World Association for Photobiomodulation Therapy). Whatever PBM device is being deployed the key is for the practitioner to understand the full potential of their device and adapt its application with practical critical thinking and even common sense in every individual case. For practitioners choosing more affordable LED PBM, what's important is to apply the device appropriately to achieve positive effects that will be clinically measurable (if not necessarily 'optimal'). Know your device, what's the dose it provides? Apply it directly or only 1cm away from the skin to ensure there is minimal loss of light into the tissue. These days, for proactive wellness & sports recovery, there are red light (LED) panels to bathe with PBM, used S

ANIMAL THERAPY MAGAZINE ISSUE 29 27RED LIGHT THERAPYalongside massage or other manual therapies, but does ‘bathing’ offer the level of dosing required for diagnosed injuries/conditions? There are wearable LED devices that attach to specific areas such as wrists, elbows, over the back and can be an advantage for busy pet owners. However, wearables are often much lower power than handheld devices (due to heat produced from LED’s), so achieving a viable dose into multiple areas of inflamed/restricted tissue will inevitably take much longer. From a naturopathic perspective, it’s important to factor in an animal’s natural healing parameters. It’s well known through other modalities such as integrating herbs, and essential oils, that valuable insight is gained from the pet’s ability to ’self-select’. Similarly with physical therapies pets should have choice to move away when they feel they’ve had enough. Ruth Milner, co-founder of Danetre Health Products, has worked in the electrophysical modality sector for over 25 years and a member of The International Light Association, she explained: “My view is, there's been an organic modern evolution of this modality over the last two decades to evidence the fact that PBM application is not to be limited to professional treatment sessions only. Modern high-output safe LED technology delivering a viable dose into the tissue and applied regularly is also to be utilised outside the professional treatment setting. This means at home, to promote recovery and on-going maintenance or could mean in a stable/yard/enclosure, vet practice or even in a field to achieve best outcomes - whatever condition is being treated on whichever animal. I am concerned that the PBM modality needs more understanding and is NOT just for application during a professional treatment session, or to encourage an owner to bring the pet back in two weeks or month for another session. If this is how it’s being 'sold' to owners, it’s not how this modality is to be correctly applied in accordance with documented evidence. The overall concept of Photizo Vetcare is the fact that LED PBM is viable and safe for home use and a key solution to the limitations of practice-based laser. I feel it’s important for practitioners to communicate this to their clients so pet owners can also be proactive and bond with their pets using PBM. Applying a device appropriately, everyday initially if needed, post trauma, during rehabilitation, managing pain, and of course in prevention and promoting wellness in the first place is the overall message from PBM experts across the world. Photizo is manufactured under Medical Device regulations to fill the gap between professionals and home users for maximum benefit to their pets.”

ANIMAL THERAPY MAGAZINE ISSUE 29 28RED LIGHT THERAPYIncreasing numbers of practitioners and pet professionals are, through experience, seeing the benefits of PBM when deployed as per the evidence for use in between professional sessions. The irony is that by empowering pet owners, it builds on-going relationships with clients and recommendations as well as happy and healthier pets! Sarah Darling, massage therapist, and founder of K9 Gait Massage concurs: "As a practitioner, every day I witness the profound impact that Photizo has on the physical and mental health of our dogs. For the owner, it has given them power in the palm of their hand to help manage and support their best friends' wellbeing and quality of life" Similarly, massage therapist, Aly Grant, founder of Dynamic Dogs Massage enthused: "I truly believe every person who has a dog (or any other animal) should have a Photizo Vetcare system in the house. It's a game changer product.” Ruth Milner sums it up: “As Photizo Vetcare has just celebrated its 10th anniversary, it’s becoming more apparent the dose guidelines we already have for superficial and deep tissue healing are likely to be the tip of the iceberg for PBM. Dynamic research is expanding on a huge number of health conditions and this modality can be positively used for animals and humans”. 1. www.gov.uk/government/publications/laser-radiation-safety-advice/laser-radiation-safety-advice 2. www.danetrehealthproducts.com/

ANIMAL THERAPY MAGAZINE ISSUE 29 29KISSING SPINEby Marc Beaussart, Dip/PG Dip EO, MIAAT, MT MIRVAP, MIAVRPT, FEI PET?Kissing Spines TOO COMMON ack pain is a common complaint, often associated with a performance limiting factor in sport horses. The most common reported pathology is impinging dorsal spinous process, more commonly known as kissing spines. Turner, one of the world's leading experts, found in a 2011 study that 39% of horses have kissing spines, however it does not cause problems in all horses. This figure is quite significant and suggests the special attention owners should give to their horses' backs. Kissing spines is obviously not a recent problem! A Polish archaeological researcher's team found that horses from the 11th and 12th centuries had kissing spines due to excessive load on the back. In research I conducted last year, in partnership with the IAAT (International Association of Animal Therapists), many horse owners believe the origin of kissing spines is due to poor riding practice and horses being put to work too young. It is true that quickly putting the horse in a frame by sometimes adding numerous gadgets is an aggravating factor, however, there are also issues concerning the ergonomics of the equipment, including the saddle. BBased in France, covers France, Belgium and UK w: www.equusphysiocare.com/en/home Instagram: @equusphysiocare

ANIMAL THERAPY MAGAZINE ISSUE 29 30KISSING SPINEAlthough the true underlying cause of kissing spines is not yet fully understood, a very recent study, conducted in 2022, discovered a genetic variant associated with the severity and development of kissing spines in horses. Certain breeds are also known to be more susceptible to developing the syndrome, such as thoroughbreds. The veterinarian is called because there is a drop in performance, a loss of impulse, a change under the saddle, defiant or even aggressive behaviour or lameness. We must not forget that the horse's back functions a bit like a suspension bridge and therefore problems affecting the back can have repercussions on different areas of the animal's body (and the opposite is also true). Often the diagnosis involves an x-ray of the horse's back confirming the spinous processes are either too close or touching. In some cases, overlapping. Bibliography in case of: Beaussart, IAAT, Kissing Spines Poster, Horses Inside Out Annual Conference, 2023 Cornille JL, Kissing Spine, Science of Motion LLC, scienceofmomotion.com/documents/279.html. Makowiecki, Pathologies of a horse skeleton from the early medieval stronghold in Gdansk (Poland), International Journal of Osteoarchaeology, Volume 32, Issue 4, 2022. Patterson, Whitaker, Allen, Genomic Loci Associated with Performance Limiting Equine Overriding Spinous Processes, Research in Veterinary Science, 2022. Turner, T.A., Overriding Spinous Processes in Horses: Diagnosis, Treatment and Outcome in 212 Cases. AAEP Proceeding, 2011.

ANIMAL THERAPY MAGAZINE ISSUE 29 31KISSING SPINEThere is one therapy that is superior to all others. This therapy is prevention! According to Turner, the most important aspect of any treatment regime is the exercise program. Exercise must achieve the goals of the horse moving freely forward in a relaxed frame. Consequently, kissing spines syndrome can be a result of poor conformation coupled with the demands of the discipline the horse works in, and inappropriate riding techniques. Saddle fit, rider technique and exercise regimes should be carefully evaluated and monitored to help prevent kissing spines syndrome. Questioning of the practice of horse riding and horse work in general must be frequent. Was the warm-up sufficient? Is the gymnastic work regular enough and appropriate for that horse? We should never generalise either, each horse is unique. Like human athletes, sufficient and appropriate preparation is necessary before participating in any sporting action to avoid risk of injury. Too short or irregular training is then a risk factor for back pain linked to kissing spines. This is even more true if you own a horse whose genetics, breed and work history make them more likely to develop kissing spines. Treatment can vary depending on the country the horse resides, but we tend to find intramuscular or intra-articular injections and mesotherapy are used. If these treatments fail, owners may be referred for possible surgical intervention such as ligament snips or resection of the dorsal spinous processes. There are also therapeutic techniques which are non-invasive and very effective including manual actions (massage, stretching and mobilisation) and using different tools such as cryotherapy, laser, TENS, PEMF, ultrasound and others.There is one therapy that is superior to all others. This therapy is prevention!Cornille (scienceofmotion.com) says ‘Competent equitation is the horse's best therapy’Photograph and x-ray of racing thoroughbred stopped because of severe kissing spines

Canine cognitive dysfunction (CCD), also known as dementia, is a common comorbidity in ageing arthritic dogs. Studies estimate that around 28% of dogs between 11 and 12 years of age suffer from varying degrees of cognitive dysfunction [1]. This figure increases with advancing age and in all likelihood this is an underestimate as many of the changes are perceived as “normal ageing” by owners. Likewise dogs suffering from osteoarthritis suffer from owners’ misconceptions that a certain amount of stiffness and loss of mobility is to be expected, meaning that clients do not always seek veterinary advice. The two conditions are often seen together and share certain features both in presentation and to some extent treatment, requiring a holistic approach for success. Disentangling and managing the effects of each is important so that we can effectively care for our older pets and ensure they receive high quality veterinary care in their senior years.CANINE COGNITIVE DYSFUNCTION and its relation to osteoarthritis Common co-morbidities in our ageing patients ANIMAL THERAPY MAGAZINE ISSUE 29 32CANINE ARTHRITIS MANAGEMENTPathophysiology The brain is very susceptible to oxidative damage due to its high metabolic rate, relative lack of endogenous antioxidant processes and high percentage of polyunsaturated fatty acids. This damage leads to structural and functional changes including a reduction in brain mass, reduction in number of neurons, neuroaxonal degeneration, beta-amyloid plaques, depletion of neurotransmitters and further decline in endogenous antioxidants. This is what is thought to lead to the clinical sign of cognitive dysfunction. There are several histopathological changes that are similar to those seen with human patients suffering from Alzheimer’s disease. Presentation & clinical signs Many pets suffering from CCD, as with arthritic patients, are initially presented to a vet or other healthcare professional for reasons not connected to these conditions. The reason for attending may be a routine healthcare appointment such as a vaccination or an unrelated complaint. This makes it vital that we are looking for these diseases in our older animals and asking the right questions. The specific signs of CCD are often know by the acronym DISHAA [2] which stands for; Disorientation getting lost in familiar surroundings, getting stuck or not recognising people Social Interactions more irritable or fearful with others and less interest in initiating interactions Sleep / wake cycles pacing and restless at night, often lethargic and sleep more in the day Loss of Housetraining problems with learning and memory, loss of learned behaviours Activity repetitive behaviours and restlessness alongside decreases in play and exploration Anxiety separation anxiety and fear of new places, increased reactivity to visual and auditory cues Other signs may include hearing loss, vision impairment and smell disorders. CCD may also present with gait and movement disorders for example proprioceptive deficits, tremors, swaying and falling. Similarly the arthritic patient may not be initially presented as such. There are several areas of overlap between the presentation of the two conditions. In addition to the gait and movement changes that can be seen with both problems, owners may report a reduction in social interactions, daytime lethargy, house soiling, restlessness and anxiety. Careful questioning as well as a thorough clinical examination will often help to start differentiating the effect of each, and in many cases, both disorders. Sarah Cooper BVetMed(Hons) MRCVS, Veterinary Surgeon

ANIMAL THERAPY MAGAZINE ISSUE 29 33CANINE ARTHRITIS MANAGEMENTParticularly when a pet is taken into a veterinary practice for “just a routine check up” these consultations can prove tricky. It is essential that they are conducted with empathy and there is clear communication from the vet or nurse about their concerns and what the implications of this may be. Owners will not necessarily be expecting the news that there is something wrong and some may become upset, angry or defensive. They may be worried they may have missed something or concerned that there is a suggestion that they have in some way let their pet down. This is where cultivation of a strong vet-client bond is so useful to help deliver the news and reassurance that everyone is working together in the best interests of their pet without criticism or judgement. CANINE COGNITIVE DYSFUNCTION

ANIMAL THERAPY MAGAZINE ISSUE 29 34CANINE ARTHRITIS MANAGEMENTClinical examination and diagnostic testing The clinical examination and history alongside tools such as the CADES questionnaire (see below) should form the basis of diagnosis for both canine cognitive dysfunction in a similar manner to which osteoarthritis is generally diagnosed. Clinical examination also allows assessment for signs of other co-morbidities or “red flags” that may point to more in depth diagnostics being necessary. Assessment for pain is vital. Other diagnostic tests that may be useful include; ● Bloods tests (haematology and biochemistry) and urine tests (Dipstick, Specific Gravity, culture and Urine Protein Creatinine Ratio- to check for other underlying diseases that may affect treatment and to look formetabolic causes ● Systemic blood pressure check ● Radiographs - to rule out other causes of pain in selected cases ● Advanced imaging (MRI) and CSF analysis - this can help rule out other neurological conditions and may show characteristic changes in the case of cognitive dysfunction It is important to consider these cases with a holistic approach and the framework described by McKenzie et al 2022 encompasses many of the changes we see in older patients as Canine Geriatric Syndrome [8]. Considering older pets under this banner, helps to emphasise the need to always consider the bigger picture.CAnine DEmentia Scale (CADES) questionnaire [3] This is a questionnaire developed and validated by Madaria et al (2015) that can be used to help diagnose CCD, differentiate it from normal age related changes and to monitor progress over time. It uses 17 questions divided into four areas, related to changes in dogs' behaviour: spatial orientation, social interactions, sleep-wake cycles and house soiling. These are each assessed on scale of 0 to 5 and then the scores are added up to obtain an overall score that reflects the degree of cognitive decline.

ANIMAL THERAPY MAGAZINE ISSUE 29 35CANINE ARTHRITIS MANAGEMENTManagement of canine cognitive dysfunction alongside osteoarthritis Early intervention is key with these patients. With both CCD and osteoarthritis, treatment should aim to slow the progression of the disease, improve mental and physical function where possible, maintain quality of life and the pet owner bond. Enrichment and home management Modification of the home environment and management of the ageing dog can often make a huge difference. Steps may include; ● Easier access to resources such as food and water ● Increased frequency of toilet trips ● Improved bedding and use of padded surfaces ● Keeping a regular routine ● Avoiding hard slippery floors ● Use of feeding puzzles and other forms of mental stimulation/behavioural enrichment especially when walks are limited by mobility ● Retraining with use of modified cues and aims to account for changes such as hearing impairment and reduced mobility ● More frequent but shorter exercise sessions outdoors and use of aids such as pushchairs when mobility is severely limited ● Thundershirts to help with anxiety ● Physical therapy and massage enhances the caregiver bond and mental stimulation as well as support for OA Nutritional interventions Feeding a good quality diet with appropriate levels of high quality protein to maintain lean body mass is essential. There is a small amount of evidence for some specific nutrient groups including ● Antioxidants - studies have shown diets high in appropriate antioxidants can slow cognitive decline and improve cognitive function [4]. ● Alpha lipoic acid and omega 3 fatty acids - enhance mitochondrial function, reduce inflammation and promote cell membrane health [2] ● Medium Chain Triglycerides - Improve energy metabolism, provides ketones as an alternative energy form for the brain and improve mitochondrial function [5] ● Phosphatidylserine - Regulate fluidity of cell membranes, neuroprotective and enhances cholinergic transmission [2] ● N-acetyl-l-carntine - helps enhance mitochondrial function and improves long term recall in ageing canines [6, 7] ● B Vitamins - needed to form methionine which is then converted to s-adenosyl-methionine (SAMe) which is important for normal brain development, function and neuronal health. They also act as co-factors in the synthesis of various neurotransmitters [2] Pharmacologocal interventions ● Pain control is essential wherever this is suspected to be contributing to clinical signs. Multimodal approaches are commonly required. Careful consideration needs to be given to any medication that could make signs of CCD worsen, for example gabapentin may cause mild sedation. Selegiline ● Anti-oxidant and neuroprotective effects as well as improving neurotransmitter function. ● May enhance learning and is indicated for use in CCD especially when signs of anxiety and/or social withdrawal are seen. [Ref rhuel et al 1997] Propentofylline ● Improves cerebral circulation, along with antioxidant and neuroprotective effects. ● Should be used with care in animals with heart disease ● Particularly useful in combination with selegiline and dietary management Clomipramine ● Improves neurotransmitter function ● Useful for management of anxiety but not specifically indicated for CCD ● Not to be used with Selegilne Collaborative care is vital to success in managing these patients. Regular check-ups with members of the care team should be scheduled to assess progress and identify any problems. Pain assessments should be carried out as well as regular weight checks. This also provides an opportunity for ongoing assessment for cognitive and mobility changes as well as reinforcing education about home management strategies, nutrition and physical therapy.What can be done to support patients and owners?

ANIMAL THERAPY MAGAZINE ISSUE 29 36OSTEOPATHYTreating two Red River Hogs Potamochoerus porcus An osteopathic case study This article will look at the difference with treating wild pigs or suids, as opposed to domestic farm pigs. The two patients in question are based at Wild Place Project which forms part of Bristol Zoo. It is currently in the process of changing its name. At the time of writing it’s called Wild Place Bristol, or is it Bristol Wild Place? The two patients are both 10-year-old siblings from the same litter. Both are male and have been kept together for their entire lives. I was first asked to become involved with the veterinary team two years ago as both patients were scoring high on the regular lameness scale. The veterinary team had performed radiography, which showed osteoarthritic changes bilaterally to their carpi joints. Both were also receiving anti-inflammatory and pain killer medication daily, and I was informed that the zoo had borrowed a class 4 laser for a couple of months, which appeared to bring the symptoms of forelimb lameness down considerably. Unfortunately, the laser company now required either the lease, purchase or return of their machine, and I was asked if there was anything I could do to help, as I was already treating their Aldabra tortoises at the old Bristol Zoo site. The veterinary team were also aware that I had my own Class 4 laser and I could tell that was where their focus of attention was. The great thing with any of the suid species is that they will usually do anything for food. Therefore, observing them moving about and the dynamic between the two brothers was easy to both observe, and assess. When I was first introduced to them, they were housed next to the giraffe enclosure and shared some of the same outdoor space with them as well as the zebra, and eland. Most of the substrate they had was either sand or grass, with a small area of concrete in the entrance area to their house. They did have separate sleeping quarters but had a single point of access for the outdoor area. This did occasionally lead to scuffles with the dominant brother always flexing his muscles and subduing his sibling. Once outside they were calm and did their own thing. For general vet care and any procedures, the staff had built a chute that held one pig at a time and had a concrete food bowl at its closed end. Once the pig in question walked in, a large door could be dropped down behind them. With food slowly added to the fixed bowl, the pigs soon learnt that this was a pretty good place to be and would even get impatient to enter it.by Tony Nevin, BSc Hons Ost, DO

ANIMAL THERAPY MAGAZINE ISSUE 29 37OSTEOPATHYThe great thing with any of the suid species is that they will usually do anything for food.Having observed them moving outdoors we then got them in one at a time to allow me to examine hands on through the bars of the chute, whilst a keeper drip fed food into the bowl. The vet team, lead by the senior nurse, had been teaching the pigs to accept touch, and the word “touch” to precede blood taking, vaccination jabbing etc… This made my job a whole lot easier. Prior to placing a hand on I would utter the word and the pig didn’t even flinch. Care and common sense dictated that I kept my hands away from the sharp end, but with care I could examine the carpi and all the other structures being affected by the altered stance and gait. All the time I would narrate what I was doing to the rest of the team (keepers and vet section) in real time. This helped reduce the chance of anything being misunderstood. By keeping firm, flat hand pressure on each patient they soon relaxed, and only the speed of the tail wagging, or the very occasional stamp of a foot would indicate if an area was uncomfortable when palpated, or during the treatment phase. The osteopathic side of this involved me using a mixture of sustained positional release, and indirect functional techniques to create positive changes to the various muscle chains and their associated fascial components.only the speed of the tail wagging, or the very occasional stamp of a foot would indicate if an area was uncomfortable

ANIMAL THERAPY MAGAZINE ISSUE 29 38OSTEOPATHYThis aspect of their treatment programme dealt with their compensatory patterns. For the actual osteoarthritis in the carpi I did fire up my trusty laser and delivered via a non contact head probe 4000j of photon energy to each joint complex, using a mix of continuous and pulse wave, as well as a decreasing frequency scale of laser light from the start to finish of each dose. By keeping the probe moving, and trying to avoid the long guard hairs on these pigs, I found that they could normally take these sessions at a delivery rate of 11W. Initially we set up the treatment programme to include my treatment combo every two weeks, with the keepers augmenting this with a handheld Photizo LED unit being used daily with both hogs. After 6 months the collection had arranged for the hogs to be moved to the old Okapi house and enclosure. The latter have a mix of substrate and vegetation. The house also allowed each hog to have its own access to the enclosure, which could also be partitioned. There is also a much larger indoor communal area, allowing far greater diversity for them both. During this move it was also noted that the subservient brother had a facial abscess. The vet team assessed this and even operated on it to open it up, clean it out, and then put the hog on a course of antibiotics. This abscess has proved very stubborn and has to this day not fully healed. However, the osteopathy/laser combo has now allowed us to reduce my visits to once a month, and the dominant brother has not had any pain management medication for more than a year, and everyone is certain the other one wouldn’t need it except for the continued treatment for his abscess. Both show no signs of lameness and are eating and pooing like normal suids. The Photizo has also been reduced to being applied every other day as well. Working within a dedicated team and seeing the changes that can be made using non invasive techniques are surely going to benefit the way we look after zoo and exotic patients. Target training has really helped in making this possible. Maybe we should do an article on that soon…….. non invasive techniques are surely going to benefit the way we look after zoo and exotic patients

Equitation science: using evidence to emp equine thapists Understanding what motivates behaviour and how horses learn offers equine therapists a horse handling ‘tool kit’ brimming with choices. Through the lens of equitation science (the only evidence-based approach to horse training) therapists have a ‘roadmap’ explaining unwanted behaviours, whilst understanding what you do, works. Over the past two decades, evidence-based knowledge has shifted equestrian beliefs from owning a ‘naughty’ horse to recognising confused, conflicted and/ or in pain horses. Veterinary professionals, pony club children, coaches and horse trainers globally have chosen to “update” their choices in an attempt to ‘do better’ for horses. When your smart phone notifies you of an update (to fix any ‘bugs’, faster efficiency) do you click ‘update’? Chances are you do. If you decide to delay the update, chances are the consequence of a slower phone response creates frustration, motivating you to ‘update’ later that evening. When we update our knowledge with the latest evidence based research we are choosing to improve aka treat horses optimally on; safety, effectiveness and ethics. The latest ‘update’ in horse-human interactions is understanding the mental capabilities of horses (cognition) the mental processes (learning) and understanding how the horses you treat, behave the way they do. The field of Equitation Science can help your horses stay calm during treatments. In the presence of an unfamiliar person or being on a busy yard are signposts for clients to observe for calm and interested behaviours as opposed to avoidant, escape (flight), and aggressive / threatening (fight) behaviours (Photo 1). Animal-based indicators of healthy bonds with their carer The behaviour of the horse you treat is a window into their emotions. Observe their behaviour with the familiar human carer versus with you, a stranger. A calm and responsive horse suggests the horse feels safe. A horse in pain, discomfort and/or conflict (training deficit) will, during human interaction, demonstrate behaviours that are fearful, avoidant or aggressive. Withdrawn, slow or zero responses may be signs of learned helplessness and warrant concern. (Note: arousal level - activation of the autonomic nervous system ranging from low to high and ANIMAL THERAPY MAGAZINE ISSUE 29 39HARTPURY UNIVERSITYPhoto 1Photo 2author Lisa Ashton, MBA PGCE BA (Hons) ESI Dip, Lecturer in Equitation Science Hartpury University www.hartpury.ac.uk Lisa@Equicoach.life

ANIMAL THERAPY MAGAZINE ISSUE 29 40HARTPURY UNIVERSITYPerformanceArousalOptimal ArousalAnxietyLowWeakStrongHighinfluenced by factors including external stimuli, emotional states, and physiological processes such as heart rate, respiratory rate and alert behaviour should be appropriate to the activities being performed. Thinking about and identifying the horse's experiences through their species-specific behaviour (also known as telos) lens helps us become effective detectives. We may not be able to ask the horse directly why they feel unsafe, but we can, as the horse’s therapist or handler, assess how a horse feels about their carer. Embracing the role of a ‘detective’ allows us to look at species specific behaviour, applying the science of ethology (animal behaviour in their natural habitat) as robust ‘clues' (detective mode) that horses are deeply social. Living in family bands and if given agency (freedom to choose) select one other horse of their choice, to have a deep relationship with. A pair-bond is effectively your horse’s BFF (friend). (Photo 4). Next is forage. Horses have evolved to eat high fibre low carbohydrate food for around 13 hours per day. The key as an ‘effective detective’ is recognising the species does not eat for calorific intake sake, but doing the behaviour of eating is valuable, and when horses are deprived of foraging behaviour, in stable environments, horses are more likely to start oral stereotypic (crib-biting, wind sucking) behaviours. Horse’s don’t just need food to physically survive they need to do foraging behaviour, if living aligned to their telos (species specific behaviour). The final F is Freedom. Freedom to move. Play is extremely important and in all species is about practicing the behaviours essential for species survival. Having a species specific lens (telos) is about always remembering the 3 F’s; Friends. Forage and Freedom, in that order. Becoming an Effective Detective Observe the behaviour of the horse when approached and haltered by the carer. Horses are brilliant at recognising markers predicting species specific behaviour (friends, forage and freedom) for example, your horse knows when you have arrived at the yard, even before they can see you. Using associative learning (classical conditioning), the sound of your car is the first predictor of consequences; food, freedom then friends - as you go about your morning routine. Similarly, a pinned ear to a horse might predict immanent aggression over a resource such as a hay pile in the field. Throughout a horse’s entire life he/she adds to his predictive list of triggers of certain behaviours through learning, known as a consequence. These consequences form what is learnt, making it more or less likely to repeat the behaviour. Every interaction a horse has with a human is a learning opportunity. If your client has a bargy horse? (Photo 1) He has simply learnt to accelerate and change direction, removing the carer. The behaviour (accelerating and swerving) was initially driven by species specific behaviour, learning how to successfully remove carer (consequence). In one trial she has learnt barging removes carer plus may result in friends/food/freedom. Double reinforcing! Barging is therefore more likely (Photo 3). When horses have deficits in their training, we tend to like a label i.e. ‘lazy’, ‘stubborn’ or ‘keen’. The problem is when we think about horses from our human perspective a label places and applies the blame for the unwanted behaviour at the hooves of the horse. Labels such as ‘naughty’ ‘rude’ and ‘bargy’ imply the horse was born that way. Whilst definitely dangerous in their behaviour, barging, biting and bolting are all behaviours of high value. The ‘naughty’ horse has simply learned unwanted behaviours that remove the carer or pain. Empowering Your Clients Helping your clients build a healthy bond with their horse by recognising training deficits can empower them to potentially provide horses with a better quality of life. A good starting point is to assess if the horse responds calmly and immediately to light halter pressure, to stop, back up and go forward, accelerate, decelerate, turn and yield (in-hand and under-saddle). Next, test for self-carriage by asking the horse immobility (stand still or ‘park’) and to maintain immobility without pressure (photo 2). a calm and responsive horse suggests the horse feels safe

ANIMAL THERAPY MAGAZINE ISSUE 29 41HARTPURY UNIVERSITYRemoval reinforcements require more skill than additional reinforcement as it is key to be accurate with the timing of pressure and immediate release to elicit the desired response. Careful shaping is the learning of complex behaviours, built from simpler ones and essential for carers to optimise clarity of communication. Shaping is the breaking down of the learning required to the smallest components. Then gradually building piece by piece towards the desired complex behaviour. Training should go as fast as your horse’s individual speed of learning and as slow as necessary. Gemma urged vets to remember pressure should never cause pain or induce fear as both are detrimental to affect / emotional state and therefore learning. Remember:For anything to be reinforcing, the horse needs to find it of value. Patting the horse is not a species-specific behaviour, whereas scratching at the base of the wither mirrors the allogrooming process (when two horses, most commonly seen between pair-bonded horses, gain value from giving and being scratched at the base of the wither). When handlers mirror allogrooming (wither scratches) with the horse directing their preference for intensity of pressure and the site, *studies report the horse’s heart rate lowers, reinforcing the behaviour just before scratching. Examples of Removal Reinforcement • If you apply pressure on the lead rope horse should walk forwards and pressure immediately released.• If the horse feels pressure from the halter when tied up and pulls back, breaking the rope releases this pressure, and so the horse is more likely to repeat this behaviour in the future. Many traditional handling and ridden practices are based on the concepts of negative reinforcement (the removal of an aversive stimulus to make a behaviour more likely) and / or punishment (the addition of an aversive stimulus to make a behaviour less likely). Vet and colleague, Dr Gemma Pearson delivered the John Hickman Plenary lecture at the 2023 BEVA Congress titled ‘Equine Behaviour: The good, the bad and the downright dangerous’. Gemma explained “lots of people get negative reinforcement confused with punishment,” urging vets to think from the mathematical sense of the word, negative means removal or subtraction of something and reinforcement means to increase the likelihood the horse will repeat the behaviour. The pressure motivates a response, on removing the pressure, (provided pressure is released as soon as desired behaviour is offered), horse offers same response the next time pressure is applied. Pressure -release training (removal/negative reinforcement) increases controllability of the environment for the horse. The change in emotional state of the horse is a secondary consequence. Removal reinforcement (negative reinforcement) belongs to the operant conditioning ‘family’. Along with additional reinforcement (positive reinforcement) when something attractive (scratches/food) is added, increasing the likelihood of the behaviour. If your horse maintains the behaviour you just signalled, until you signal otherwise, your horse has learnt to stay in the balance, speed, direction and posture, until you signal otherwise. Self-carriage lies at the very heart of ethical horse training. (Photo 3)

ANIMAL THERAPY MAGAZINE ISSUE 29 42HARTPURY UNIVERSITYWhen you hear “she walks all over her” or your client believes “he does not respect my space” the problem is not a lack of respect or the ‘wrong’ attitude. Barging is a behaviour learnt to accelerate from either the cue of the carer or the situation (sight of another horse / grass / freedom). Barging is not ‘cured’ by changing the horse’s attitude, but by retraining the basic lead responses. This concept, that leadership of the human must be respected by the horse, is at best, out-dated. More importantly it is at odds with interdisciplinary knowledge of horse ethology (repertoire of behaviours) cognition (mental capabilities ) and learning (rewards and consequences). It is important to recognise that learning processes (both horse and human) have a hard-wired framework, with gaps filled by experience. If your client believes she lacks respect, that a bargy horse is dominant or trying to dominate her, a more helpful approach is if you help her describe the barging behaviour. Key to changing behaviour and teaching better outcomes, is a change in thinking. By explaining a ‘bargy’ horse is a horse who has learnt a series of incorrect responses, may empower clients realising the logic in the behaviour (consequence) coupled to a trainable outcome you are creating the start of positive change in our horse-human relationships. “”Dominance is not a personality trait; it focuses around drive or its reduction, and varies depending on the resource to defend. Scholars have found even the most dominant horse in studies is only dominant for 70% of the time. Horses are ‘dominant' only for a specific resource; food, water, sex and play, and as with dogs, the social interactions of horses are fluid. Nature and nurture are always working together and scientists have demonstrated that learning from consequences predictably activates genes and restructuring of the brain. Consequences are why your horse behaves, they are the outcomes he behaves to achieve. Consequences are the motivations for your horse to be led, ridden, competed and therapy for humans. Through conditioned reinforcers, the variety of consequences is infinite, far beyond the horses’ primary reinforcers or drives; friends, forage, freedom. Recognising and applying evidence-based horse training in our daily work as therapists, vets, coaches and owners provides opportunities to assess how the horse is faring. Welfare, ‘well’-‘fare’ is the physical and mental state of the horse. Small practical changes in our daily practices like replace patting (as a reward) with scratches. Remove stable bars that block BFF opportunities or simply ask often, how is my horse faring? Using equitation science empowers all of us to see the negative experiences for horses, assess if we can help our horse resolve the negative experience and identify areas we can improve by adding opportunities for positive experiences. (Photo 4)

It could seem that a Shetland pony has little in common with a Shire, not much to compare on how to train a racehorse to a dressage horse. Whilst the needs of different sports may require different levels of rhythm, impulsion, contact, and collection, all horses will perform better if they are trained with as symmetrically and supple as possible. It’s just as well that horses aren’t shy in telling you exactly how straight they are (or are not!). We’ve just got to look for it, and train accordingly. When I first see a horse I make observations before we get going. The first is before the rider gets on. Most horses will naturally stand in the bend they prefer. This is often the bend they try to keep through training if left alone. I then watch to see how that changes when the rider is on board with no contact and movement, and then finally as we get moving. It’s important to remember that riders often have their own musculoskeletal issues or one-sided dominance and this may well be affecting the horse. There are really common correlations and patterns the horses' body follows. Identifying this can allow you to effectively train to achieve a straighter horse. Let’s use an example. Meet Bob. Bob is whatever horse you’re imagining right now. As you walk around and observe Bob, he will often stand with a slight left bend in his neck and often rests the opposite hind leg. This alone tells me Bob favours the left side of his forelimb and neck and is happier to weight bare on his left hind leg. So with Bob, I would focus delete 'more' on trying to train with more right flexion in the neck and exercises that would allow him to focus delete more on his right hind leg. The straighter a horse is the more power they can build and offer. This comes from delete more equal weight distribution and improved comfort, allowing a horse to look and feel happier in their work and be delete more harmonious with their rider. Win win!! Apart from Apart from rocking horses, I’ve never seen a symmetrical horse. You can typically link any lack of straightness to loss of engagement. The more engaged your horse is, the more you unlock their full potential. Along with further training principles and management you can keep them sound into older ridden age. We often talk about a ‘team’ approach to training. Involving an equine therapist and farrier who truly understands symmetry, balance and suppleness will complement the training. They are also pretty good at highlighting any issues that may need veterinary intervention. Correct riding is a form of physical therapy. With the added information from your team you can give your horse the best opportunity to develop correctly, comfortably and healthily. www.dressagewithlevihunt.com fb: Levi Hunt Dressage Insta: Dressage with Levi HuntKeep your eyes open to listen to your horseANIMAL THERAPY MAGAZINE ISSUE 29 43LEVI HUNTThere are over 400 breeds of horse in the world and we work with them for many different reasons, in many different ridden sports.

ANIMAL THERAPY MAGAZINE ISSUE 29 44IRVAPThe Institute of Registered Veterinary & Animal Physiotherapists (IRVAP) believes in promoting safe and effective practice. Its diverse membership has multiple categories and in this publication we will explore the Institute of Equine Hydrotherapists (IEH), one of its two Boards. In the last issue we highlighted the benefits of equine hydrotherapy and how it helps optimise equine performance and rehabilitation. The results of an IEH scoping exercise of the current status of equine hydrotherapy identified specific areas which require development, to ensure the industry flourishes and progresses. The IEH is building training pathways in equine hydrotherapy and IRVAP knows that long term success is founded on approved training providers with a comprehensive knowledge of the industry needs, linked to appropriate training pathways and education. Advancement is achieved by building a community of practitioners who aim to transform practice using clinical reasoning linked to clinical skills. Raising standards will include devising training opportunities, supporting a trusted community of therapists sharing clinical skill sets, plus establishing requirements to protect horses against malpractice. IRVAP already has this model in place in the Institute of Canine Hydrotherapists (ICH), the other IRVAP Board. The ICH focuses on raising standards in canine hydrotherapy and fully supports its members with exciting CPD training, an intuitive Mentoring and Support programme and a vibrant community of members. In the next few years we anticipate the animal therapy industry will be transformed by regulation. It’s likely that physiotherapy, chiropractic and osteopathy would be the first to be regulated by an independent register such as the Register of Animal Musculoskeletal Practitioners (RAMP). The ripple effect would indicate other therapies, including hydrotherapy (both canine and equine) would follow, once a working framework is in place. For those wanting to practice autonomously and offer excellent services, we know it’s imperative to have the highest level of training available. IRVAP membership requirements will include evidence of regular equine first aid training, effective water management, appropriate treatment records and Continuing Professional Development (CPD) appropriate to practice. Currently these are mandatory for ICH members and bringing the equine hydrotherapy alongside the canine model, may be considered daunting by some in the industry. However, this important step will offer confidence in the therapist from the referring vets, Multidisciplinary Team, insurance companies, owners and trainers. This professional confidence in the therapist is pivotal to success, confirming that the individual is equipped clinically and scholastically. However, this will mean that those who choose not to become qualified, may not be covered by insurers and ultimately not receive work or recognition. All practitioners will need to review their practice, follow a united code of conduct, aspire to best practice and develop a deeper understanding of the context in which they operate, which is much wider than just the yard in which they work in. &Animal Physiotherapists The Institute of Registered Veterinary irvap.org.uk

45IRVAPThis new-found transparency in equine hydrotherapy will assist practitioners to upskill beyond the technician role of using hydrotherapy equipment. “The confidence to challenge your own practice and aspire to move with the industry gives the opportunity to drive your business forward, not be dragged due to a reluctance to change.” ANIMAL THERAPY MAGAZINE ISSUE 29

ANIMAL THERAPY MAGAZINE ISSUE 29 46IRVAPWhilst regulation may take a few years to come to fruition, the Institute of Registered Veterinary and Animal Physiotherapists (IRVAP) are leading the way with their subgroup Board - Institute of Equine Hydrotherapy (IEH), which has changed their membership requirements to reflect this demand from within the industry. From March 2024, IEH members will need to evidence they are either on or have been accepted on a Level 2 course or the VetHed accredited course which is nearing release. This is devised for those wanting to use the title qualified equine hydrotherapist. All current members will need to reapply and meet the new requirements. This is as a direct result from therapists alarmed by the practice they have witnessed, where the welfare of the horse is not the focus and therapeutic handling is not at the forefront of techniques. This transformation is voiced in conversations with industry experts and practitioners; the need for a level playing field, where anyone can still work in the industry if they show a commitment to raising standards and protecting horses; the very reason most of us came to work within the industry. Research and find out what the courses offer and which one is suitable for your needs and aspirations. Commit to improvement and progression. Consider staff training, to boost skills, confidence and knowledge. Choose a pathway to advance your service and this preparation will help you stay ahead of the curve. Want to shape the future of equine hydrotherapy? Join IRVAP irvap.org.uk IEH at a very exciting time in the history of equine therapy. The Institute of Equine Hydrotherapists is a sub group of IRVAP and the only professional body for equine hydrotherapists in the UK. Their progressive outlook and drive to raise industry standards, is led by Co-Chairs Gaby Kerfoot and Grace Nattrass, and supported by industry experts.Finally what can you do to prepare?

Importance of Effective Water Management in Canine HydrotherapyANIMAL THERAPY MAGAZINE ISSUE 29 47K9HSCanine therapists qualified in hydrotherapy, deliver current and best practice by being in the body of water with the dog. This ensures effective administration and safe delivery of a range of clinical reasoned treatments. Historically, therapists used to administer treatments from outside the aquatic treadmill and hydrotherapy pool. Training and qualifications in this speciality have advanced significantly in the past few years. The Level 3 Certificate in Canine Hydrotherapy is the recognised foundation and starting point for delivering a professional service for dogs and their owners. Effective water management is crucial for maintaining a safe and hygienic environment in canine hydrotherapy facilities. This ensures that the water used in treatments is clean, sanitised and safe for the dog and the therapist. It helps prevent the growth and spread of bacteria, viruses, and other harmful microorganisms, that can cause infections or diseases. Additionally, maintaining appropriate water chemistry and temperature levels is essential for achieving the desired therapeutic benefits and best outcomes for each dog. Barbara Houlding GradDipPhys, MScVetPhys, MCSP, FIRVAP

ANIMAL THERAPY MAGAZINE ISSUE 29 48K9HSKey Aspects of Effective Water Management Water Quality Testing - Regular testing of water quality is vital to monitor various parameters such as chlorine and pH levels, total dissolved solids (TDS) and bacterial count. Testing should be done in accordance with relevant industry standards and guidelines. Disinfection + Sanitisation - Hydrotherapy facilities must have robust disinfection and sanitisation protocols in place. This involves the use of an appropriate sanitiser for the water, such as chlorine, to eliminate harmful microorganisms. Regular cleaning of equipment, surfaces, walls and floors using recommended disinfectants, plus cleaning the filtration systems is also paramount. Filtration + Water Circulation - Hydrotherapy systems require efficient filtration and water circulation systems to remove debris, sediments and contaminants. These systems help maintain water clarity and prevent the accumulation of impurities that could affect the therapeutic properties of the water. Temperature Control – Maintaining a warm water temperature following industry guidelines is crucial for hydrotherapy treatments. The temperature should be set within a safe and comfortable range, depending on the breed and specific treatment goals. Regular monitoring and adjustment of water temperature is necessary to ensure consistent canine safety and effectiveness is achieved. Water temperature under 28 degrees is not acceptable and deemed as poor practice. Risk Assessment – Biosecurity and risk assessment measures must be in place to meet professional obligations and legal requirements. Water Conservation - Hydrotherapy facilities should prioritise water conservation practices. This can include using water-efficient equipment, implementing recycling systems and promoting responsible water usage. Staff Training – Training and certification for staff members has a critical role in good hydrotherapy water management. They should be knowledgeable about water quality (testing and actions to take), hygiene practices, equipment maintenance, risk assessment, record keeping and emergency protocols, to ensure the highest standards of safety are consistently attained.

ANIMAL THERAPY MAGAZINE ISSUE 29 49K9HSK9HS Courses (k9hscourses.com) Want to update or review your canine hydrotherapy knowledge and skills? K9HS Courses offers an ideal online refresher CPD course – Award in Canine Hydrotherapy Water Management at QLS Level 3. To progress from this, K9HS Courses offers the ofqual regulated L4 Diploma in Canine Hydrotherapy Unit course – Advanced Hydrotherapy Water Management Strategies & Solutions, to achieve your advanced qualification. To explore and review canine treatment techniques (land based and water based), the perfect place for therapists is the K9 Therapy Hub. This membership community offers over 55 accredited CPD courses and empowers those who share a passion to work with the dog’s consent and deliver the optimal treatment. If you want to meet your CPD requirement, share within a vibrant canine community and have ongoing support on your canine career journey, join us now. Advance your clinical skills and optimise the canine healthcare and wellbeing services you provide. Benefits of Effective Hydrotherapy Water Management Canine Client and Therapist Safety – Good water management reduces the risk of waterborne illnesses or infections, ensuring the safety and well-being of canine clients undergoing hydrotherapy treatments, as well as the therapist delivering the service. Enhanced Therapeutic Effects - Maintaining optimal water quality and temperature levels enhances the therapeutic benefits of canine hydrotherapy. Owner Satisfaction & Retention - When owner clients witness high-quality, clean, and safe hydrotherapy treatments for their dogs, we know that they feel satisfied in the service provided. This leads to increased retention rates and positive word-of-mouth referrals. Compliance with Regulations - Adhering to water management guidelines and regulations is crucial for safe practice. Professional associations such as the Institute of Canine Hydrotherapists (ICH) – part of the Institute of Registered Veterinary & Animal Physiotherapists (irvap.org.uk) focus on raising industry standards. This commitment centres on the health and wellbeing of the animal. Compliance ensures both professional and legal responsibilities are met by the therapist, as well as avoiding potential legal issues.

ANIMAL THERAPY MAGAZINE ISSUE 29 50MCTIMONEY ANIMAL ASSOCIATION JeffTHE BEARDED DRAGON Jeff is a Bearded Dragon who belongs to the animal centre at Cirencester College. He was rehomed to the college a good few years ago now. ittle is known about Jeff’s history; however, he presents with a few abnormalities which suggest he may not have received the correct and specific care that reptiles require. Unlike dogs and horses reptiles require heat and UV lighting along with supplementation to their diet in order to support normal bone growth. If not provided, reptiles are susceptible to a condition called Metabolic Bone Disease (MBD) which reduces the bones density. In severe cases changes can be irreversible. Unfortunately, it is believed that Jeff has MBD which can be identified by the kink in his tail. Jeff’s main problem however is his mobility. When I first met Jeff his gait was rather uncoordinated with significant weakness through his hindlimbs. This caused Jeff to lose balance and topple over onto his side where he would struggle to get back up again. This was becoming quite a regular occurrence and both staff and students were having to keep a close eye. Jeff was checked by an exotic vet who believed he may have brain damage but was happy for him to be treated.L

ANIMAL THERAPY MAGAZINE ISSUE 29 51MCTIMONEY ANIMAL ASSOCIATION The staff at the animal centre have been excellent, moving Jeff into a bigger enclosure to help create more space and lessen the chance of him toppling over as he moves around. It was clear from Jeff’s gait that he was relying heavily on his forelimbs to pull himself around, rather than using his hindlimbs for propulsion. As a result of this Jeff had a lot of tension through his shoulders. He also presented with significant misalignments through his mid thoracic vertebrae where it was evident that the vertebrae had become very fixated to the left side of his body, causing quite impressive postural imbalances through his entire body. His left hind leg was also noticeably weaker with clear neurological deficits. The lightness of the McTimoney treatment was perfect for Jeff given his complex medical history. It was important not to do a full treatment but instead treat a small area and see how he responded before then treating another area during the next session. This is because his entire body was compensating for the weakness in his hindlimbs. When the body starts to compensate, the musculature will begin to be overworked. This initially allows the animal to continue moving in a way that is more comfortable however, eventually overtime the musculoskeletal system will reach a point where it cannot compensate anymore and starts to become uncomfortable. The initial treatment was focused on releasing tension through his back before then going on to working through the tension in his shoulders. Jeff has had several treatments now and there has been a significant improvement in his posture. Although Jeff’s gait is still very much uncoordinated at times, there has been much fewer episodes of him toppling over and he was even seen using his left hind leg to scratch some loose shed from his head! I feel that treating Jeff really highlights that many animals can benefit from chiropractic. The gentle McTimoney technique makes it very non-invasive and well accepted by many animals. Regardless of specie the goal is always the same, to improve comfort, health and mobility. emmaanimalchiropractor@outlook.com For more information on the McTimoney Animal Association and to find a practitioner near you go to www.mctimoneyanimal.co.uk

ANIMAL THERAPY MAGAZINE ISSUE 29 52EQUINE ARTHRITISThere are several aspects to consider such as: • Age related inflammation (Oxidative Stress) • Obesity • Glucose dysfunction such as EMS • Immune response • Mechanical degradation, a weakening of the joints Equine Arthritis: Take control with Turmeric• Assess your horse on a few different surfaces and ask you to demonstrate trot in a straight line as well as a circle. • Provide a nerve block, this helps identify exactly where the issue is in the joint to then allow a more targeted management plan. • Flexion tests, your vet will flex the joint for a few seconds and then ask you to trot the horse away. • Scans such as MRI’s, ultrasounds and X-rays may be used to provide a definitive diagnosis. What can cause Equine ArthritisArthritis is a specific term used to describe dysfunctional joint health. The two most common types of arthritis are Osteo and Rheumatoid. There have been previous claims that 60% of lameness in horses is related to Osteo-arthritis*. One of the symptoms of arthritis is an increase in inflammation which can then restrict movement in joints due to swelling and pain.Joints are complex areas where bone, capped with cartilage, connect within a fluid and so maintain low friction/low impact wear and tear, so it is important to keep this connection supported. Although horses of any age can develop equine arthritis, it is more likely to become an issue to older horses as a result of years of wear and tear. When your horse experiences inflammation within their joints this can then result in cartilage damage which can then turn into bone damage. This is because inflammation affects oxidative damage. The earlier that you can detect equine arthritis the better, as you can help support your horse and make them more comfortable. That said prevention is a better solution. It is recommended to contact your vet as soon as possible as they will help to reduce the unwanted inflammation and hopefully get it under control. To ensure an accurate diagnosis is provided, your vet may do the following:

ANIMAL THERAPY MAGAZINE ISSUE 29 53EQUINE ARTHRITISIf your horse or pony has been diagnosed with equine arthritis the main objective should be to reduce inflammation, help prevent further damage, and have a pain management plan. Here are a few management tips: • Stabling: Arthritic horses can suffer more when stabled for long periods of time, so this should be avoided as it could increase stiffness and cause more pain. If your horse has limited turnout, then you may want to consider turnout in a safe arena or larger stable if possible. • Transportation: travelling can be energy-consuming for most horses so extreme caution should be taken when travelling an arthritic horse as this can cause an increase in stiffness and pain. • Weight: Excess weight can add further unwanted strain to joints. It would be recommended to monitor your horse’s weight regularly. This can be done by using weigh tapes or weigh bridges. If you find that your horse is overweight, then you may want to reassess their diet. • Exercise: Depending on the severity of the Equine Arthritis, exercise can be very beneficial in reducing stiffness and inflammation. However, this should be closely monitored to assess how your horse is coping and how comfortable they are. Too much exercise could also have a negative effect and increase joint damage along with inflammation. You should tailor the workload to your horse's needs. If you are not able to ride your horse because of the equine arthritis, then regular turnout or walking in hand could help. • Seek veterinary advice: Your vet can help with several things such as pain relief, steroids, medicated injections, antibiotics and advise on anything to do with Equine Arthritis. • Joint supplements: There are a number of joint supplements that can help support horses and ponies suffering with arthritis. If you are wanting to provide a more natural approach to supporting your horse, then you may want to consider adding a natural joint supplement to your horse’s diet. There are several options available on the market so you may want to do some research to find the most suitable supplement. H to manage Equine Arthritis * National institutes of Healthhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC9197312/

H can Turmeric help?ANIMAL THERAPY MAGAZINE ISSUE 29 54EQUINE ARTHRITISTurmeric has been used for thousands of years, more recently in the western world. Some people deem it to be a miracle spice that has quite simply, changed lives! There are over 10,000 studies on this golden spice, with over 200 compounds that synergistically work together, showing some remarkable outcomes. Turmeric has a range of compounds from phenols (curcumin) to essential oils that have activities throughout the gut and in the body. Turmeric has a role as an antioxidant which supports the stasis of joint activity (oxidative stress) and naturally assists the body’s anti-inflammatory processes. Not only that, but Turmeric also helps maintain collagen synthesis. With these properties combined it makes it an ideal ingredient suited to support arthritis. TurmerAid from The Golden Paste Company is a complete Turmeric supplement in pellet form. Its ingredients include, a high strength Turmeric, Black pepper, Yucca, Apple cider vinegar and Linseed (a source of omega-3 fatty acids). This versatile supplement can be added to feed or simply fed by hand as it is very palatable. Overall, the “active” components of TurmerAid (Bioactives, essential oils and omega-3 fatty acids), work at several different layers to support bioavailability, moderate damaging oxidative processes and help maintain the normal inflammatory cycle away from pro-inflammatory markers. There has been several horses and ponies that have used TurmerAid for equine arthritis with amazing results. See the below story from Leanne as an example: “I have used TurmerAid pellets for both of my horses. One is 23 and arthritic and was on Bute and Devil’s Claw. I have since taken her off the Bute and replaced with TurmerAid. She usually really struggles with the farrier but since the addition of TurmerAid, my farrier has commented on how big a difference there is in suppleness and that she can hold herself much better. My other mare also loves the TurmerAid and I can feel a big difference when jumping”. If you’re thinking about giving it a go, or are already reaping the benefits of TurmerAid, get £5 off your next tub by entering code AT523 at checkout.

Danetre Health Products Limited 01327 310909  info@danetrehealthproducts.com PhotizoUk  PhotizoUk  PhotizoUkwww.danetrehealthproducts.comWhat is Photizo LED photobiomodulation?• Low cost alternative to professional laser• Awarded medical devices certification• Portable, rechargeable, simple • Evidence based pre-programmed doseFaster healing and pain relief with red light therapyBenefits for your practice• Generate additional revenue• Exclusive practitioner discount• Hire and/or sell• Delivery direct to your clients• Comprehensive support package• Photobiomodulation CPD• And lots more…• Evidence based pre-programmed doseJoin our photizo practitioner communityContact us now for more details