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

 

CPD in osteoarthitis staging for Purton vets

Cpd

Cpd

An amazing CPD delivered to an amazing vet practice. Purton vets had part 2 of thier 2 part CPD in staging arthritis. This is all in the name of working together to deliver gold standard arthritis care.

It was greatly enjoyed by all. Thank you Purton Veterinary group!

Purton veterinary group CPD

Thank to Purton Verterinary Group for hosting us yesterday. We delivered some training in staging osteoarthritis. This meant they are fully up to date in being able to deliver gold stand arthritis care.

Arthritis is something we are passionate about treating. It can last for a significant proportion of the patients life. It does not have to mean life is compromised. Good management means life is enhanced and pain is reduced. We always wish there were as many interventions in human treatment of arthritis as readily available.

So they now are a team all well versed in how to help you manage you pets arthritis. We return soon for part two of the lecture, teaching them some hands on techniques.

Physiotherapy on the exotic patient CPD

Yesterday we delivered training titled "Rehabilitation and Physiotherapy in the exotic patient". CPD is an essential part of staying current and being good at your profession. Many prefessions are obilgated to do a set number of hours to ensure they maintain thier qualification.

So we delivered this CPD to ensure physios are able to feel confident doing physio in the more unusual pets. But this did extend to the less unusual pets. Most physio courses focus on dogs and horses. So we developed this seminar to cover cats, rabbits and other species. 

Following the CPD the delegates were able to see how to look at the body of any specie and assess it. They would know what to look into to descover potential weakness that specie may have, in advance of seeing them. They then learnt how to assess the patient type. This included animals you may not concider good candidates. We can do physio on zoo animals and animals we can't touch. Its more challanging but its not impossible. They finally learnt ways of developing and adapting excercise regimes. 

It was a small group so that we could have some hands on time and not scare our rabbits. We had excellent feedback and it was very well recieved. 

Thank you to The Rabbit Crossing Rescue for providing 3 happy bunny's for the session.

It was held at Bracknell Leisure center which was a lovely venue. Thank you.

It was wonderful to meet so many lovely physios and student physios, keen to work on other patient types.