Welcome to Crispin

Crispin

Crispin

Hello and welcome to Crispin. No one is totally sure of what happened to this lovely sweet cat. But an incident rendered him with a ruptured diaphragm and hind limb paralysis.

He was sent to the referral specialist where the diaphragm was repaired and he managed to do very well.

However his paralysis remained a problem. It was further complicated by muscle spasm.

So he came for physiotherapy. He had a dedicated mum who was determind to do all she could for him. This was always going to be a real team effort to help this little one pull through.

He is now with a team of caregivers, doing thier best to help him be more comfortable.

Good luck mum and Crispin! Its a big battle that everyone is working hard to win.

Elephant CPD in Thailand With Tony Nevin

Elephant CPD in Thailand with Tony Nevin

By Donna Wills PGC A Phys, RVN Member of RAMP, BVNA and IAAT

Elephant

Just Beautiful

The Expedition

Thailand Elephant CPD

Thailand Elephant CPD

On 14th March 2019 a mixed group of animal Osteopaths and physiotherapists, set off for Thailand for a unique opportunity to both help Elephants and gain knowledge of how to work with these incredible animals. It was an incredible opportunity to work on a new specie and expand your mind by working in another way.

 

As a veterinary nurse or physiotherapist I usually work with dogs, cats and rabbits by large. But I am lucky enough to have also treated other more unusual species. I also teach my own CPD (continual professional development) on how to treat “exotic patients” and that largely is to teach how to think about treating all other species and how to know where to start on that journey. So, I was over the moon to have the opportunity to now try this, the biggest specie I have treated to date. I am very proud of how I have managed to further my nursing foundation, into specializing in rehabilitation.

We began the course with a brief which included some information on Elephants and some health and safety. You can appreciate the safety part is incredibly important. We then went to meet and palpate and treat our first elephants. The first Elephant we met was desperate to be treated and loved the whole process.

 

Me treating an elephant

Me treating an elephant

The Brief 

These elephants are in an incredible sanctuary. We were taught about the ethos of the establishment and how its method of organisation means the elephants are safe and changes of elephant ownership is discouraged, and the life of the people who own the elephant is enhanced. This made me feel so much better about how Thailand is working to move forward and be good to the elephants. Thailand is the only country in the world to have a microchipping system that is actually enforced! The mahouts (people that look after the elephants) are incredibly lovely. I never saw anything bad at the sanctuary, so I was over the moon.

elephant Play time

elephant Play time

As the work shop is an osteopathic workshop, we were taught osteopathy methods, though many of these are very similar to physiotherapy. Different Elephants had different tolerances for allowing treatments. So, we respectfully work around this. One chose to wonder off and romp through the elephant grass instead. So, we took the opportunity to watch the movement instead. Ii was great to see how high they can lift their limbs and how this could be used to encourage stifle flexion, weight shifting, balance and proprioception. Some also have different methods of treatment that they prefer. Rather like us all…we all have our favourite types of touch for ourselves. So, some Elephants wanted a stronger deep pressure and others lighter.

Veterinary care and working on the Elephants

See how much they lean into you when you hit the right spot!

See how much they lean into you when you hit the right spot!

What was truly amazing is that you think that skin will be incredibly thick and immobile. But it moves incredibly well and whilst the skin is thicker than that of a cow, it is rather similar to massaging a cow! It was so interesting to see the movement and do the gait assessment. You need to move your eyes further to see everything. But by the end of the week, you are surprisingly good at very quick gait assessment. You become tuned into the elephants and you have to stay calm around them for them to be calm with you. This is not dissimilar to everyday work, but its incredible seeing an elephant go from excited and swinging their trunk all over the place and then calmly standing with far reduced movement.

Elephant Feet - they wear out at the back just like our shoes, as the movement is so similar to our foot movement during motion

Elephant Feet - they wear out at the back just like our shoes, as the movement is so similar to our foot movement during motion

Watching gait was something I found fascinating. They stand very similarly to humans, with hyperextended stifles and their elbows hyperextend when they walk too. They only have 2 gaits, walk and faster walk. Their foot motion is the same rolling action on the floor as a human too, so instead of placing the foot straight down, it rolls from heal to toe. This means they wear out the backs just like we do on our shoes. It also means their ability to hyperextend their carpi is incredible and they can climb a hill with no issue. Seeing the sole of the elephants foot spoke volumes.

Positive reinforcement

How the vet monitors teeth. They only have a large molar that constantly grows

How the vet monitors teeth. They only have a large molar that constantly grows

Positive reinforcement was a really big thing as the whole sanctuary runs with kindness at their heart. I had a wonderful conversation with the elephant vet. She was so kind. We spent time discussing the more common elephant ailments and how they treat them. Their medications are the same as horse options, so you will be familiar with them. They do use the nutraceuticals too! I even discussed using camomile tea as I have most of my patients on this. We both laughed at the idea, but the point of my question was to see how much they think outside the box with medication and how well they do engage a multimodal approach

I liked feeling thier lower limbs. You could feel Oedema in some of them and it was fascinating

I liked feeling thier lower limbs. You could feel Oedema in some of them and it was fascinating

to treatment. I was over the moon to see they were incredibly open minded and engage lots of options. Ultimately, this is reflected by the fact that our group of MSK practitioners were there and actively encouraged to be there. They even use pain scoring to ensure they are dosing effectively, whilst also thinking about patient longevity. Elephants live a good 60 years in this environment so filling them up on Nsaids at age 20 may not be the best approach long term. Obesity was actually the biggest issue for these guys and so weight loss programs were something that they were trying to figure out a way of implementing. Its funny to think of a weight clinic for elephants, but clearly the weight problem is pandemic. They also do have body condition scoring for the elephants. Most of the ones we saw were a 5 (obese) but there was one elephant who was a 3.

 

Elephant communication

Chatting with the Vet about Ele vet care

Chatting with the Vet about Ele vet care

We did one excursion day, where we went somewhere else to see how else elephants are used here. We have to remember that here, elephants are effectively like our horses…in the uk tourists may well ride a donkey at the beach or even a horse on a hack. This is their equivalent. But I can’t deny, it did make me sad. But when we spoke to the tour leader, she explained that this work brought in money to allow the elephants to be well looked after, and pay for vet bills and vaccines etc. They finish their work day at 3pm and are turned out to the forest, same as a horse in a yard might be. So, it was not a bad situation. But elephants, whilst we don’t know how many facial muscles there are, there are 4000 muscle bundles in the trunk, so it is incredibly expressive. And when I thought about it…their trunk use for

You can see how much movement there is in the skin when you move the fascia

You can see how much movement there is in the skin when you move the fascia

communication is rather similar to how we might use our arms to gesticulate… So, they really know how to pull your heart strings and they definitely pulled mine. 

There was an amazing study being done with some of the Elephants at the Sanctury. This was to help prove sentience. Not something I feel needs proving, but if proving it helps non animal people make good changes, then its essential. They had developed a test to prove Elphants Eve's drop. Brilliant! Elephants havev amazing ways of communicating. Mostly not from thier eyes since they have very poor sight. But largly through feeling thier rumbles through thier feet and using their trucks for touch. They can also verbalise and they do heard that. But hearing thier dull rumbles is such a beautifully relaxing sound. When you hear it, you feel as you do when you hear a cat purr.

Great Experiance

It was a great experience to spend a week working with elephants in their happy home. It is bizarre to think of an elephant as a “pet”. But it was incredible to have the opportunity to observe their movements and critically assess their bodies to find areas of discomfort. The people we met at the sanctuary were all kind, welcoming and grateful. It was fabulous to see the teamwork ethic so strong here. These memories will help shape the future of my career, as all our experiences do, and let’s face it…. It’s a pretty awesome CPD location!

If you want to hear more about the expedtion visit my facebook page where I posted my daily vlog. And look out for our podcast with Dr Megan Kelly and online pet health

 

Welcome to Tico

Hello and welcome to Tico. Such a sweet little cat. Mum noticed she had started over grooming her belly. She saw a vet but nothing was found. But mum was still worried and had a physio session to explore the mobility better.

On watching her move we could see there was a slight gait abnormality in the swing phase of movement in the hind limb. This was subtle, but it was there. On futher exam there was reduced extention in that same hip.

Other than this she was a very comfy girl. But she is older, so arthritis would be a likely finding. We did her massage and set her up with a home regime to encourage her joint range. This itself is pain relieving.

We are pleased to say Tico is already seeming more comfortable at home. The licking did subside for a while and it has now come back, so we still have further to go on our rehab journey, but this is ok. We know her hip is definitly more comfy as her joint range is now normal. But every body is unique and individual and so we must work to finding Ticos own personal plan to create a discomfort free body.

Keep up the good work mum and Tico!

Welcome to Chloe

Chloe

Chloe

Hello and welcome to Chloe. Such a sweet newfoundland x collie. She is such a cheeky bean though...she demands her cuddles and really shouts when you stop! Bless her!

Poor thing has been though the ringer in her life. She has had bladder cancer and chemo. Which worked really well and she has now finished that treatment. But her issue now is her arthritis. This is mainly in her hips and knees. She is sore from this.

So have set her up with a home regime that is more managable. Her regime does include weightloss as it is such an imperitive part of the procress for pain free living. The added challange for her is that her history of being proded and poked for her bladder issues mean she is back end shy. So we are taking our time and ensuring she is happy. Dogs have incredible memory and we are more recognising how these memories shape us and our behavours. This is true of our animals too. This extends to stress which can impact thier lives and increase pain perception. So there are many factors to take into account.

Chloe is already feeling better. But as arthritis does go in flare ups, it is usual for her to have better and worse days. As treatment progresses we will see less bad and more good.

Keep up the good work chloe and dad!

Welcome to Jess

Hello and welcome to Jess. Such a sweet old lady. She was rescued in her greyer years when her previous owners were too old to care for her or themselves amymore. Rehoming makes a scar on anyone and any animal. So Jess was fearful for quite some time. Her owner had 2 dogs and one was already a regular for physio, so mum brought both of them to see us. Jess was only along for the experiance.

Over time jess really started to relax in our room. It was so sweet to see how her whole face changed. She even chose to lay on the treatment bed after the other dog was finished But she remained scared at the vets.

We have an amazing relationship with all the vets we work with and pride ourselves on this. So when Jess started to have some problems we worked together as a team to be able to treat her and not traumatise her. There was impecible communication between all the team, and as Donna is also a registered veterinary nurse, it was an easy process.

Issues were identified. Namely a sore back and right shoulder, and also she had a wart growing inside her eyelid. This was also sore.

The vets prescribed eye drops and Donna was able to give tips on how to put them in safely. Donna also treated the back and shoulder with massage. Jess was clearly incredibly grateful and tolerated it all.

She is already free of spasm and a very happy and mobile dog.

Great team work by all. Keep up the excellent work mum. It takes calm care to put these worried dogs at ease.

Slippery floor problem solved!

Any dog or with cat with a mobility problem really struggles with slippery floors. My poor boy is no acception. He insists on laying on them anyway as he likes to be near us, but he can't get up easily. So we purchased more grippy vinyl flooring from www.floorsforpaws.com and thought we'd show you the difference! Its not as amazing as carpet for traction, but no other hard floor compares to this for grip in my opinion. Thanks floors4paws! Please also know, mymoor for the sake of this video, this is his normal behaviour and free choice.

Welcome to Charlie

Charlie

Charlie

Hello and welcome to Charlie. A dear little thing. He has been through the works as he ruptured both his cruciate ligaments in the past. But both have healed seemingly well and he was back to full normal life.

But more rescently he has shown lameness. This is potentially quite a complicated case. On exam we saw he had muscle wastage which suggests the issue has been there for some time. But he was also severly licking a patch of skin. This had rendeed this very sore, weepy and uncomfortable. This was on the same limb. This rang some mild alarm bells so mum was sent back to vet to get this treated. Sometimes a secondary issue can make the pain of the first seem so much worse.

So the skin was seen and treated and this improved immensily, so we could now concentrate on the limb. We know that cruciate rupture increases the liklihood of arthritis. A study showed us that in a joint with full rupture, the signs of arthritis can be seen within just 3 days! With odds like that it is easy to see how important fast stabalisation of the joint is.

So there is a strong chance we are working with another arthritis case here. Its important we treat every case individually as no case is ever the same.

We have done treatments and set mum up with a home regime. He is making good progress.

Keep up the good work mum and Charlie!

Welcome to Coco

Coco

Coco

Hello and welcome to Coco. A very excited and very sweet Springer spaniel.

His cruciate ligament ruptured and he went for surgery very quickly and it was a massive success. However, further down the line some issues started to appear. This can happen as the cruciate ligamnet rupturing has a big impact in the body. So you think everything has all been dealt with and then lameness appears.

Common issues are the cruciate in the other knee rupturing and arthritis starting in the ruptured knee even when surgery has gone well.

So we did our assessment and set up a treatment plan. Coco is doing really well already.

Well done mum, dad and Coco. Keep up the good work!

We are off to help rehabillitate elephants!

Elephant rehabillitation

Elephant rehabillitation

We are very proud to announce that we are soon to be leaving to Thailand to help rehabilitate elephants!

Don't panic, we only go for 1 week, so we will be back in action soon! So you can still contact us, but the voicemail will direct you to email us for the week.

A team of veterinary osteopaths and physiotherapists have been put together by the lovely Tony Nevin of zoo ost. We are so proud to be able to put our skill towards such an amazing cause and to work together to do a beautiful thing for these amazing animals.

We know what you are thinking! How in earth do you do physio on an elephant!? Well, yes it won't be the usual pattern of see them, feel them, pull them into positions. But remember, we are skilled at being able to treat all animals. And there are even some domestic cats who refuse to be touched, but we can still give an effective program of treatment. We can use thier own natural movements to our advantage and encourage them to move in a way, that might encourage muscle engagment of an area they have been avoiding. In doing so, they start using that area again, and trusting that it is possible. As its used more, it gains strength and they rely on it more. This inturn results in more healthy movement and thier whole body benefits from this. End result is reduced pain. This can be done for tigers or any other animal you can think of. Donna wills, founder of animal physiotherpy ltd, has ran several CPD events, teaching physios how to do physio on more unusal species, so this will enhance that training further. If you have interest in learning more on treating other species (most commonly its rabbits and cats that you'll see as aside from the usual dog or horse) then contact us for more information.

Its so important to help these animals out. Regardless of whos fault it is that they are in the situation, its important that we take the time to help fix it.

Watch this space for more updates on how its all going! Thank you Tony for organising it!

Welcome to Molly

Hello and welcome to Molly.

Such a sweet old lady. She has serious arthiritis and she was so sore. On top of that she also got an auto immune disease that was making her skin so sore.

So her mum made a great effort to do all she could to make her more comfortable. The skin was being treated and she started physiotherapy.

We got Molly on a great home plan, and she responded so so well. We are always so proud when we see the great changes so fast. Her mum was shocked and impressed and reported that within just a few weeks, she was back to her mobility a year ago.

Well done mum and Molly. Keep up the good work!