Mobility issues are not just a human concern. Illness and accidents can make walking difficult for a variety of animals–even penguins. Lucas, a 4-year-old African penguin at the San Diego Zoo, is a good example. When he developed a chronic degenerative condition known as bumblefoot, his quality of life diminished to the point where he had difficulty standing upright. Over a period of three years, veterinarians tried a variety of treatments, including physical therapy and acupuncture. When Lucas started developing sores in 2022, his caretakers reached out to Thera-Paw, a company that designs mobility aids and other products for animals. The solution: custom orthopedic shoes made of neoprene and rubber. Cushioned and held in place with Velcro, the boots helped prevent the development of sores, improved Lucas’s gait, and posture, and allowed him to again enjoy life within his colony, his keepers told NPR. Orthosis vs prosthesis Lucas was not the first penguin to have its quality of life improved by custom-made boots. In 2021, Lebanon, New Jersey-based Thera-Paw came to the aid of Enrique, a geriatric southern rock hopper penguin at the Saint Louis Zoo, who had developed painful arthritis in his ankles. Within days of receiving his boots, he was back to climbing rocks with relative ease. (For more, click here.) Custom avian boots for Lucas, the penguin with bumblefoot. Lucas and Enrique are just two examples of how veterinary orthoses and prostheses can improve the quality of life for animals afflicted with mobility issues. A relatively new area of veterinary treatment, the industry has grown considerably in recent years as veterinarians and pet owners learn how orthoses and prostheses can benefit animals of all types and sizes, observers report. “There are over a dozen veterinary orthotics/prosthetics companies in the United States at this time, and the number continues to grow each year as awareness and demand expand,” says Thera-Paw founder Ilaria F. Borghese. “These companies came from the human side and have adapted their skills for use with veterinary patients.” In veterinary medicine, Borghese explains, an orthosis or orthotic device, is generally defined as a medical device used to immobilize or restrict a joint and is custom-made by an orthotics company using a mold of the patient’s limb. They are made using hard plastics, hinges, foam liners, and straps, and are usually ordered for long-term use or for larger pets. A prosthesis, or prosthetic device, is used to replace a missing body part, most commonly a limb, and is custom-made by a prosthetics company using a mold of the patient’s residual stump. The materials used are similar to those used in orthoses. Thera-Paw custom-fabricates orthoses and braces made of pliable materials such as neoprene, foam, and sheepskin, Borghese says. Innovation in animal care According to a 2021 report in the journal Frontiers in Veterinary Science, the first “artificial leg” for a canine patient was described more than 50 years ago.1 Dogs are the most common animals to be fitted with assistive devices, says Jennifer Reitz, lead fabricator with Blaine, Minnesota-based Animal Ortho Care. “We’ve also seen an increase in orders for farm animals such as goats and horses. Cats have been fitted but they can be quite tricky to fit due to their size and tolerance,” Reitz adds. Custom padded boots for a Coast Guard Search and Rescue dog with painful arthritic digits. The pair allows the dog to jump from the helicopter into the water and swim with a buoy to the person in distress. In recent years, assistive devices have been created to treat animals of all sizes and across species. Borghese says her company’s patient roster includes a pelican, llama, desert tortoise and kangaroo. Thera-Paw even designed a Dorsi-Flex Assist for a guinea pig with a spinal cord injury. “The boots we made were smaller than my pinky,” says Borghese. Assistive devices help treat a wide variety of medical issues, including CCL tears, amputations, arthritis, hyperextension, deformities, luxating patella, sprains, strains and fractures, reports Aneeta Boor Boor, general manager at Animal Ortho Care. “Angular deformities are very unique, and each device is created not quite the same,” Boor Boor adds. “We find animals that are limited by congenital abnormalities have such great desire to walk normally and be self-sufficient. When they get their assistive devices on, there may be an adjustment period, but it is amazing to see them just take off with their devices.” Among dogs, cruciate tears are the number one orthopedic issue addressed by an assistive device, says Ben Blecha, founder of Benkelman, Nebraska-based Hero Braces, which focuses on custom joint braces for dogs. “Surgery is the gold standard treatment for cruciate disease, but approximately 25 to 30 percent of patients cannot have surgery for medical or financial reasons,” Blecha says. “Those are the dogs we help.” Other common canine conditions helped by assistive devices include torn Achilles tendon, carpal hyperextension, intervertebral disc disease, and degenerative myelopathy, he says. For many patients, an assistive device can be life-changing. For example, in 2016, Mosha, an Asian elephant living at a rehab facility run by the Friends of the Asian Elephant Foundation in Lampang, Thailand, became the first elephant to receive a functioning prosthetic limb. Mosha was just 7 months old when she lost much of her front left leg to a landmine on the Burmese border, and the loss created significant orthopedic issues as she matured. The prosthetic limb alleviated those problems by improving her ability to walk normally, and is continuously redesigned as she grows. “We find that assistive devices have a compounding effect,” Boor Boor says. “While they provide support to an injured leg or a weight-bearing leg, they do so much more. As patients become more comfortable with the assistive device, they radiate with confidence and happiness because they are able to get around and be independent.” The industry’s future The field of veterinary prostheses and orthoses has seen some intriguing advances in recent years, which have helped the industry grow. “Technology has played a major role,” Borghese says. “From being able to review video and slow-mo footage of pets ambulating to gait analysis for lameness evaluation and 3-D printing for limbs with abnormal shapes. Also, being able to use Zoom to evaluate fit and function remotely has dramatically improved compliance and successful recovery,” he adds. Custom tarsal braces on a large size dog. Clients may ask about ordering prosthetics themselves but they should be discouraged from doing so. On the manufacturing end, the greatest advances have been made in the design of different braces, says Reitz. “Initially, it was a challenge to successfully fabricate a brace that would stay on an animal’s limb,” she explains. “The second issue was developing a design that would discourage irritation and sores. The materials used in veterinary devices are the same as those for human orthotics and prosthetics. As the field has grown, some companies have created specific materials for animals and specific ways of strapping.” Still, challenges remain. Foremost is a lack of awareness and education, says Borghese. “Many veterinary professionals are not yet aware of nor understand the value and capability of assistive devices,” she says. To aid veterinary professionals and pet owners, Borghese created Vital Vet, a website featuring devices, products, and resources for pets with special needs. “Vital Vet is used by pet owners to find solutions for their pet,” Borghese says. “Pet owners can then discuss these with their veterinary professional to figure out which solution is best. Alternately, Vital Vet is used by veterinary professionals to see and compare options, and discuss these with their clients to decide on the best choice for the pet. For vets, this can be a huge time-saver.” Patient education can also be a huge hurtle, adds Blecha. “It can be a challenge getting the client on board regarding the device and how to use it,” he explains. “Owners might think, I don’t want to put the device on too tightly because I don’t want to hurt my pet. But if you put it on too loosely, then it slides around, and that can cause a rub sore. It is simple things like that.” It is here, notes Borghese, that the community veterinarian plays a crucial role. “Though pet owners are now able to order veterinary orthoses and prostheses on their own, this is not advisable,” she says. “Most companies require veterinary involvement. Casting for devices and accurate measuring require intimate knowledge of animal anatomy and biomechanics. If devices are made from poor casts or measurements, then they will not fit and function properly and, worse, can cause injury to the animal.” Don Vaughan is an award-winning writer who frequently writes about veterinary-related topics. References Orthotic Device Use in Canine Patients: Owner Perception of Quality of Life for Owners and Patients by Sera Lee, Theresa M. Wendland, et al. Frontiers in Veterinary Science. Published November 2021. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8600258 https://www.npr.org/2022/09/06/1121284035/san-diego-zoo-penguin-boots (Lucas) https://abcnews.go.com/Lifestyle/meet-mosha-elephant-prosthetic-leg/story?id=40256159
