Follow Veterinary Practice News on Twitter at @vetpetnews. Assuring that horses receive the utmost in quality care is critical as the equine industry’s interest and capability in rehabilitation grow. “We have to give a lot of credit to those who work day in and day out to help an injured horse get better,” says Lois K. Hild, DVM. “Veterinarians working hand in hand with equine therapists and experienced professionals for the full recovery of the horse is the best combination.” Dr. Hild specializes in rehabilitation of Western performance horses at horse shows and at her Hemet, Calif., Rein Dance Farms. She provides post-injury and post-surgical care, including bandaging and wound care, hot- and hand-walking, and administering medications. Preventive treatment is emphasized foremost; Hild uses an underwater treadmill, microcurrent stimulation and cryotherapy with intermittent compression to that end. Hild commends the successful treatment provided at lay-up and rehabilitation barns for thoroughbred and quarter horse race horses. Their trainers and therapists may not necessarily hold certificates in equine rehabilitation, but their methods and techniques have helped numerous animals, she says. “You can’t say they’ve done a bad job on the horses,” Hild says, “even though they aren’t licensed veterinarians. “One problem with unlicensed professionals is that rehabilitation can be started improperly,” Hild says. “If the original diagnosis is not made by a licensed veterinarian, there is a chance that the case can go wrong. Then you’re wasting the client’s money, possibly injuring the animal and creating more problems. “Veterinarians are in on the diagnosis and the acute treatment,” she says. “Often, the two-month, three-month, six-month treatment falls to someone else. And those with experience in this area usually do a great job.” The Veterinarian These rehabilitation experts agree that they and their staffs must be respectful of veterinary medicine: Kirsten Johnson, co-owner of Kentucky Equine Sports Medicine and Rehabilitation Center in Lexington, Ky., and Ocala, Fla.: “We don’t practice veterinary medicine. We know what we do and what we don’t do.” . Brenda McDuffee of The Sanctuary in Ocala, Fla.: “We treat horses under their veterinarian’s care, under their protocols. We are not a vet clinic, though our staff includes veterinary technicians, therapists and rehabilitation specialists.” . Lois K. Hild, DVM, of Rein Dance Farms in Hemet, Calif.: “Periodic progress monitoring by the referring veterinarian is important when referring a horse to a rehabilitation facility so that adjustments in the therapeutic plan can be made.” . Jenny Rukavina of Acadia Equine Rehabilitation in Franktown, Colo.: “It is important for veterinarians to know that I am not diagnosing or treating an injury without a specific veterinary diagnosis and treatment plan from them. My job is to follow veterinary-prescribed protocols as a member of the horse’s team along with other equine professionals such as trainers and farriers.” Rehab Specialty Urged Kirsten Johnson, says rehab is the “hot button” in the veterinary world. “Millions of dollars are being spent on rehabilitation facilities. But what we really need is a rehabilitation specialty in veterinary medicine,” she suggests. “University veterinary schools need to include rotations and a research setting so that veterinarians can gain rehab experience. There is good, solid training in canine rehab (for veterinarians) but not in equine rehab.” Johnson considers herself a pioneer in the equine rehabilitation business. More than 20 years ago, she and her business partner, Hub Johnson, developed rehab programs at their first facility in Pilot Point, Texas. After 14 years there, they opened the Kentucky center outside of Lexington. When the partners started in the rehab industry, little more was used than bandage changing and hot- and hand-walking. Rehab today includes ultrasound, hyperbaric oxygen therapy, water therapies, cryotherapy, infrared and more. Johnson’s facilities in Versailles, Ky., and Ocala, Fla., treat horses of all breeds and disciplines. The Versailles center treats more high-end race horses, while the Ocala operation sees many three-day eventers. “Lexington has excellent surgeons and practitioners,” she says. “But they don’t run the rehabilitation facilities. They attend to horse athletes there, and they depend on the facilities’ professionals to implement the programs.” A successful recovery needs to be a collaborative effort with the attending veterinarian, surgeon, owner and trainer, Johnson says. “The object is to send back a high-end athlete competing above his original level,” she says. Her business also offers preventive care and conditioning for equine athletes. “We know that we can improve the level of conditioning, stimulate the immune system and help the body heal itself,” she says. Many Treatment Options “The animals’ personal veterinarians oversee their stay and consult with the owner, the trainer and with us, with the ultimate goal being to get the horse well,” general manager Brenda McDuffee says. “A vet tech assigned to each animal’s case makes an assessment every day and serves as the liaison between all involved to make sure treatment is working.” Two of The Sanctuary’s therapists have bachelor’s degrees in equine therapies, though Florida does not require equine therapists to be certified. All are veterinary technicians or equine therapists. Vets Give The Orders From changing dressings and bandages to implementing back-to-work protocols, Jenny Rukavina, owner of Acadia Equine Rehabilitation in Franktown, Colo., is adamant that a veterinarian’s instructions be followed to the letter. She is a certified equine massage therapist and instructor and brings a strong science background to her work: six years as a high school biology teacher and more than 25 years of hands-on horse experience. “My science education background helps me easily communicate with veterinarians about the horses they refer,” she says. “And that’s what veterinarians need to know: that I can easily communicate with them and carry out their instructions.” Part-time veterinary technicians assist Rukavina when her client load calls for it. “My clients have busy lives and the vets have busy schedules,” she says. “My business is here to help take the stress off owners while their horse has the consistent care it needs to get back to doing its job, no matter what that is. That’s what I do best.” Qualifications Matter Making sure that qualified people are running the rehab facilities is vital. “Most states don’t require certification, depending on what you call yourself,” Rein Dance Farms’ Hild says. “California is pretty loose in that you can call yourself just about anything and the state veterinary board is not oriented toward pursuing non-vets. For instance, you can call yourself a holistic equine therapist and there are no laws requiring certification.” The worst part of having unqualified individuals providing therapeutic care to horses, she says, is that the animal might be endangered. A growing number of certification programs are available. The University of Tennessee’s College of Veterinary Medicine offers a high-level, 140-hour certification program in equine rehabilitation. Only human physical therapists, human physical therapy assistants, veterinarians and veterinary technicians can enroll. "Human physical therapists/assistants have training in the different therapeutic modalities and veterinarians and vet techs have been trained in anatomy, physiology and locomotion,” says UT’s Steve Adair, MS, DVM, Dipl. ACVS. “We teach veterinarians the therapeutic modalities, and physical therapists/assistants equine anatomy, physiology and locomotion,” Dr. Adair says. “They each have already had more advanced training in specific disciplines, which makes their level of knowledge higher than non-medically trained individuals.” Adair, associate professor of equine surgery, says that because of their elevated medical training, the students are better able to recognize problems and notice improvements, which allow them to adjust therapies during rehabilitation. “Scientific training also helps them discern which therapies show evidence of efficacy,” he says. “They need to be able to weed through anecdotal, testimonial information and critically evaluate which therapies will benefit the animal.” Learn More Arlene D. White, PT, recommends the biannual International Symposium on Veterinary Rehabilitation and Physical Therapy as a good place to meet professionals interested in animal rehab. Lectures and labs are taught by international rehab providers. Click here for more information. Want more Veterinary Practice News? Go here. <HOME>
