A veterinary assistant’s many roles include supporting the doctors as they integrate new services and treatments into the practice. Incorporating something brand new into an already busy practice comes with quite a learning curve, but as with all the therapies veterinary clinics provide, the benefits far outweigh any challenges.
Adding an underwater treadmill to our own rehabilitation arsenal took hard work, but with encouragement and constant support from our doctors, our highly motivated assistants happily put in the many hours required to learn the ins and outs of this new tool. At this point, we have successfully implemented the treadmill into our integrative practice and continue to explore the ways in which it can help our patients.
The treadmill has already proven itself to be a highly modifiable hydrotherapy option for a variety of canine conditions we see at our clinic. With its customizable features (side sidebar on page 36), it can easily be used for dogs of different sizes, ages and abilities. The challenge was for our doctors and assistants to become as familiar as possible with the treadmill in order to maximize its potential.
THE LEARNING CURVE WAS STEEP
The treadmill we use (the Oasis) is a complex device, completely customizable for each patient.
Having no previous experience with the treadmill, our assistants spent many hours researching and reading scientific publications, as well as several rehabilitation textbooks, in order to become familiar with the machine. We took extensive notes during training sessions, and while poring over the manual. Some of us spent time outside of work educating ourselves, and all of these efforts helped to build much needed confidence.
Once we completed our research, our team gathered willing subjects with whom we were able to do several “test drives” – safely working through the various speeds, incline heights, water levels, etc. Only then did we feel comfortable offering this service to other patients. Because we couldn’t see long-term progress right away, we relied on scientific studies and patient history to help us create regimens for success for each dog. Today, we continue to monitor all our patients and make adjustments as necessary in order to support their long-term rehabilitation.
One of the most interesting challenges we encountered was working with canines that weren’t quite sure of the machine. The assistants came up with some very creative ways to motivate wary patients, including tempting them with frozen peanut butter cups, goldfish crackers, floating toys, and for those with a prey drive, rocks painted to resemble cats. It’s these little details that make the experience effective and enjoyable for everyone involved.
EQUIPMENT MAINTENANCE AND MARKETING
In addition to operating the treadmill itself, our staff had to become familiar with the design and maintenance of the machine. We had to learn the proper care and cleaning procedures. We had to monitor and maintain adequate chemical levels for the water. We had to think about the most efficient layout for the treadmill and all the equipment it would require. These may seem like minor details, but in order to get the most out of this new tool, they required diligent practice and attention.
Given that the treadmill is still a relatively new product on the canine rehabilitation market, our assistants were also faced with the task of creating literature, such as educational brochures for interested clients, instructional flyers for first-time appointments, referral forms, letters to surrounding clinics informing them of our new service, etc. This publication process required many hours of brainstorming, drafting, writing and editing. With the help of our doctors, fellow assistants and technicians, we successfully distributed our literature to clients and spread the word about our new service. We received a warm reception from our previous clients, and a long list of potential treadmill patients showed interest as well, so we got the encouragement we needed to validate all the challenges we had worked through.
Our practice has several canine patients who regularly visit the treadmill every week, and we continue to add new patients. Our current patients’ conditions range from cruciate injuries to osteoarthritis and even stem cell therapy. As we are faced with new cases, our assistants work closely with the doctor to review patient history and determine the best course of treatment. We continue to spread the word about our treadmill, and have gained dozens of enthusiastic patients from around the area. Our staff has worked very hard to include the treadmill as a regular rehabilitation tool, and we remain dedicated to the rehabilitation of our patients.
Despite all the work our practice has put in so far, the doctors and staff will need to make a continuing effort to study and learn what we can about the treadmill. As with any therapeutic service, newer and better practices will continue to come to light, and we intend to remain current with those practices. There are always new textbooks to read, scientific publications to study, and manuals to peruse in order to provide the most up-to-date and effective therapy for our patients.
Incorporating new therapeutic services into an integrative practice can be difficult, but as assistants, our role is to support the practice in whatever way we can. Whether we do research and study outside of work, create literature for clients, or aid the doctor during treatment time, we can ease the process of adding a new service to a practice.
Highlights and Benefits of an Underwater Treadmill
The treadmill has been proven through various clinical studies to be a powerful hydrotherapy tool for a variety of canine cases, including rehabilitation, fitness training, and weight loss.1,2,3,5 Our clinic is dedicated to the treatment of postoperative canines, those with injuries requiring rehabilitation, patients with symptoms related to osteoarthritis, and certain neurological conditions.
The water is kept at a therapeutic 85°F to 90°F, and the water level is adjusted to each patient’s needs. For example, a dog that has recently undergone shoulder surgery would receive initial treatment with the water level above his shoulder joint in order to cushion the joint and ease him back into activity. The water level may gradually decrease as the patient becomes able to support more of his body weight. The water temperature relaxes sore joints and muscles through hydrostatic pressure, while buoyancy reduces impact and improves joint mobility.4 The additional support of the water has also been shown to correct gait patterns.6
Modifiable speed enables us to customize each patient’s metabolic demand, whether he needs a high intensity workout for strength training or weight loss, or a lower intensity for rehabilitation. The treadmill’s speed is the first element to change as the course of treatment goes on. For example, a dog that has received stem cell therapy for arthritic conditions may start off at a slow walk of 0.6mph. After a few weeks of treadmill therapy, the patient has had time to heal and is working on regaining strength, so the doctor will increase the speed with each visit.
An adjustable incline allows us to focus a patient’s weight on the affected limb. For example, a dog with a rear cruciate injury may initially be inclined one or two inches to focus the weight to that leg. This increases the demand on the rear legs, thus building strength.
Optional underwater jets provide greater resistance for a high intensity workout. We have also found the jets useful for encouraging forward movement from more hesitant patients.
The underwater treadmill with warm water, variable speed, incline and resistance jets is more strenuous than a canine pool, which in turn leads to shorter treatment times.6 The treadmill also requires the patient to bear more of his body weight, leading to increased bone strength.6 In fact, many of our clients have reported that their dogs seem more tired after a treadmill session than after spending time in the pool.
1Chauvet A, Laclair J, Elliott DA, German AJ. “Incorporation of exercise, using an underwater treadmill, and active client education into a weight management program for obese dogs”. The Canadian Veterinary Journal, 2011, 52(5), 491–496.
2Glasson S, Larkins N. “APPA provides symptom relief in clinical canine osteoarthritis”. Osteoarthritis and Cartilage, 2010, 20, S287-S287, dx.doi.org/10.1016/j.joca.2012.02.494.
3Lee, William Robert. “The Eff ects of an Underwater Treadmill Physical Therapy Program on Two Dogs with Osteoarthritis” University of Tennessee Honors Thesis Projects, 2000, trace.tennessee.edu/utk_chanhonoproj/402.
4Millis D. (n.d.). “Aquatic Therapy”. Retrieved July 8, 2015 from delawarevalleyacademyvm.org.
5”Oasis Treadmill For Dogs – H2O for Fitness”. (n.d.). Retrieved May 8, 2015, from h2oforfi tness.com/oasis_pro/oasis.html.
6Zink M. “Aquatic Therapy”. Canine sports medicine and rehabilitation , 2013, pp. 158-174. Ames, Iowa: Wiley-Blackwell.