Friday, September 16, 2016

Why are rehabilitation and physiotherapy important for treating dogs? Interview with Dr Janet Van Dyke

Dr Janet Van Dyke hiking in the Colorado Rockies.

Do you recommend rehabilitation or physiotherapy for your canine patients? SAT recently had the opportunity to quiz Dr Janet Van Dyke, a veterinarian with unique experiences in veterinary orthopaedics, sports medicine, physiotherapy and rehab.

What is your day job? 

I am the CEO of Canine Rehabilitation Institute,Inc., a company that I founded in 2002. We teach our courses around the globe though we are based in the U.S. I am involved in coordinating all international courses as well as our growing online library of continuing education programming. 

How did you become interested in canine rehabilitation and sports medicine? 

I had a surgical practice for 20+ years and had the opportunity to work with clients who were physios. They taught me what they would do for children recovering from similar surgeries to those I was performing on their pets. I was also privileged to work with many clients who competed with their dogs in canine sports and with clients who had working dogs (military, police, service dogs, etc.). These relationships lead me to pursue additional training in sports medicine and rehabilitation for people. I started to incorporate more and more of these skills into my daily practice, encouraging my residents and students to do the same.

Is canine rehabilitation and sports medicine just for athletic dogs? 

Theoretically, sports medicine would apply primarily to ‘athletic dogs’, but when you think about it, a Chihuahua who can get on the bed in a single leap is an amazing athlete, no? So all dogs can benefit from the application of techniques used in sports medicine and rehabilitation practice. We can rehabilitate aged dogs recovering from serious surgery, and we can rehabilitate elite athletes who require skilled manual therapies to return them to peak performance. Old dogs, fat dogs, immature (clumsy) puppies, injured pet dogs, covertly lame working dogs - all can benefit from these techniques.

Rehab and sports medicine are established fields when it comes to humans, why have we been slow on the uptake in the veterinary world? 

It started with equine rehabilitation/sports medicine in the 60’s when horses transitioned from beasts of burden to multi-million dollar sport horses. Canine rehabilitation did not take off until the late 90’s. So many of us were trained in veterinary school that dogs don’t need this extra care…they have 4 legs, so if one is not working, they have 3 more to protect that one…and that dogs are ‘too stupid’ to be given pain medications post operatively, as they would then play too hard and damage the surgical ‘repair’. We now recognize the fallacy of these statements, but it takes a long, long time to train an entire field of medicine to think a new way. We’re getting there…one responsible and caring veterinarian at a time!

What sort of conditions benefit from treatment with rehabilitation? 

The most commonly treated conditions would be orthopedic (anterior cruciate ligament injuries, patella lunation, hip and elbow dysplasia, etc.) and neurologic (intervertebral disc disease, degenerative myelopathy, neuronal injury), however we see many dogs for weight loss, many elderly patients to improve upon their activities of daily living, and many working and athletic dogs who have such mild (covert) lameness that no one can ‘see’ it, but their handlers notice a change in their abilities to perform.

In your view, what can veterinarians do to improve outcomes in patients presenting with lameness? 

The absolute key to improving outcomes is to be better at diagnostics. This is where physiotherapy makes all the difference in human as well as veterinary patients. So many of the impairments that our patients face are actually soft tissue (muscle, tendon, ligament, joint capsule, fascia) rather than bone and joint. These patients are lame but radiographically ‘normal’.

By applying better palpation skills along with special tests used in physiotherapy diagnostics, we can vastly improve upon the diagnoses, allowing us to tease out the specific soft tissues that are impaired, and to treat these issues specifically rather than resorting to rest and NSAID’s as is so often done. Even those patients with an obvious bone/joint issue (post op ACL for example) have soft tissue issues that left untreated prevent them from having a rapid and full recovery. 

Are there any helpful resources you could share with veterinarians? 

I highly recommend the textbook, Canine SportsMedicine and Rehabilitation, Zink and Van Dyke, ed’s, Wiley Publishing for anyone wishing to know more about this field. We invite all interested veterinary and physiotherapy professionals to attend our certification programs where they can learn the art, science and the business of canine sports medicine and rehabilitation. 

Any advice for vets and budding vets? 

Visit our website at www.caninerehabinstitute.com for more information! I would also recommend joining the American Association of Rehabilitation Veterinarians. Despite the name, it is open to vets and veterinary students globally. A great resource: www.rehabvets.org


Thank you Dr Van Dyke. Dr Van Dyke, alongside colleagues Dr Laurie Mccauley and Judy Coates, will be leading VetPrac’s Introduction to Canine Rehabilitation Workshop from October 14-18. For more information click here

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