With the rise in understanding of physiotherapy and rehabilitation for animals, and the growing body of scientific evidence supporting its use (Millis and Ciuperca, 2015), more veterinary practices are using in-house rehabilitation to generate an additional revenue stream and improve the outcomes of orthopaedic and neurological cases.
If you do not offer a rehabilitation service at your practice – or you do, but your nurses have only a basic understanding – then you could be missing an opportunity to expand and update your services.
Postoperative physiotherapy in human medicine is commonplace. For example, virtually all cases of cruciate surgery will receive a postoperative rehabilitation programme. In many cases, a prehabilitation period will even take place, which has been shown to produce beneficial effects and improve outcomes (Hewitt, 2019).
Although physiotherapy and rehabilitation is growing in veterinary practice, it is still not commonplace, with a 2016 study suggesting only 9.4% of surgeons regularly refer cases for veterinary physiotherapy (Strange and Walley, 2016).
Improved outcomes are documented for animals who receive physiotherapy over those who don’t – in-house veterinary rehabilitation should be commonplace (Monk et al, 2006; Millis and Ciuperca, 2015).
Offering a rehabilitation service at your practice
Although a myriad of “rehabilitation” equipment and modalities are available, it is not necessary to have a fully equipped centre to start offering a rehabilitation service to your clients.
The key requirement is a trained member of staff who has the knowledge and skills to implement the correct techniques and protocols for treatment.
Nurses will often possess some basic physiotherapy skills, which may have been acquired during their original nurse training – or since, through CPD and reading – but to establish the fundamental knowledge required to make clinical decisions about cases and design appropriate plans for rehabilitation, a comprehensive training programme is required.
Our Professional Diploma in Small Animal Rehabilitation for Veterinary Nurses provides a comprehensive CPD programme over a minimum of 18 months. Nurses will continue to work in practice alongside their study and progressively develop the skills required to offer a rehabilitation service.
Progressive learning and certification
The units of the diploma are all individual courses, which means that once subjects – such as exercise rehabilitation and manual therapies – are passed, nurses can begin to offer these services to your clients.
This means that, although the full diploma for the title of “veterinary nurse rehabilitation therapist” takes a minimum of 18 months to complete, the return on investment for practices can come sooner.
Business arrangement
Depending on the arrangement you make with the member of staff you will be training – and your company policy/budget for CPD – there are several ways in which your investment can vary.
Practices will often pay for the full amount of the training and adjust the nurse’s contract to ensure a return on investment (time and money) for both parties. An agreement between the nurse and the practice can also be made, whereby the course fees are shared.
Either way, a commitment can be made between the practice and the nurse through which the practice gains a rehabilitation therapist and, at the same time, provides an opportunity for a valued member of staff to progress his or her skills and knowledge in a specialist area of interest.
Case Study
Senlac Veterinary Centre, an independent small animal practice in Battle, East Sussex, has seen the benefits of offering an in-house rehabilitation service to clients after veterinary nurse Melissa Cook (pictured below) trained with Justo Development in 2016-17.
The practice now offers physiotherapy and rehabilitation as a routine postoperative service, as well as ongoing treatments for degenerative cases.
Vet Geoff Smith said: “Clients see the service as a good investment in both time and money. Physiotherapy is also valuable for our patients with degenerative conditions, where we have been able to improve quality of life for a significant amount of time.”
Practice partner Lukasz Zelaskiewicz added: “Offering physiotherapy has seen an improvement in case outcomes.”
Also, vet Peter Clark has noticed benefits of offering a rehabilitation service, such as increased goodwill, client bonding and closer monitoring of patients through better client/patient contact.
Dedicated appointments
Melissa carries out dedicated physiotherapy appointments and rehabilitation clinics alongside her regular nursing duties.
She describes an example of a typical day to include treatments such as:
- proprioceptive training for a dog recovering from spinal injury
- massage and passive range of movement for an elderly dog with OA and secondary back pain
- assisted ambulation and gait retraining for an amputee or cat following a road traffic accident
Natural career progression
Melissa decided to take the plunge and develop her skills in the specialist area of rehabilitation after 15 years of veterinary nursing.
When asked what sparked her interest, Melissa said: “Although I love nursing, I was frustrated that I could not do more to help patients through their postoperative rehabilitation period or with their musculoskeletal injury and pain.
“Surgical techniques were advancing, but I felt physiotherapy aftercare was minimal – and after having physiotherapy myself, I realised this service is absolutely essential for optimum recovery.
“The partners at my practice were very supportive through my training, and allowed me time to study and access to cases. I am now much more fulfilled in my job role, and feel rehabilitation is an obvious and natural adjunct to nursing”.
All the nurses at Senlac are involved with providing physio treatments to their patients.
Veterinary nurse Boe Samuels said: “I can definitely think of quite a few cases where having the opportunity to provide physiotherapy confidently – and with the help and advice from Melissa – has really improved an animals recovery.
“Physio and Laser appointments are often relaxing, fun and very rewarding appointments for pets and their owners.”
Find out more
Click here to find out more about the Professional Diploma in Small Animal Rehabilitation, or email Principal Katie Lawrence with any questions or for an informal chat about how this may work for your practice.
References
- Hewitt JA (2019). AB218. 12. A literature review on the effectiveness of prehabilitation on post-operative outcomes for anterior cruciate ligament deficient knees, Mesentery and Peritoneum 3(1): AB218.
- Millis DL and Ciuperca IA (2015). Evidence for canine rehabilitation and physical therapy, Veterinary Clinics of North America: Small Animal Practice 45(1): 1-27.
- Monk ML, Preston CA and McGowan CM (2006). Effects of early intensive postoperative physiotherapy on limb function after tibial plateau leveling osteotomy in dogs with deficiency of the cranial cruciate ligament, American Journal of Veterinary Research 67(3): 529-536.
- Strange M and Walley K (2016). Barriers to Innovation: the adoption of physiotherapy as a treatment in the UK veterinary sector, International Journal of Humanities and Social Science Review 2(5): 22‐31.